title: Eosinophil protein X and childhood asthma: A systematic review and meta-analysis.
abstract: There are no reference guidelines for health care providers regarding appropriate use and interpretation of urine eosinophil protein X (u-EPX) in clinical practice. Currently, there are no clear-cut clinical or laboratory parameters to diagnose asthma in young children.
  
  
  
  In this study, we (1) systematically reviewed and qualitatively appraised the epidemiological evidence to determine diagnostic u-EPX cut points for pediatric asthma, and (2) performed a meta-analysis to provide u-EPX estimates for diagnosing pediatric asthma.
  
  
  
  Research articles in literature were identified from PubMed/Medline and Web of Science databases from 1966 to August 2015. Children <18 years of age were included. Both serum and urine EPX were included. Twenty-seven studies met the inclusion criteria for the systematic review and nine studies for the meta-analysis. Details regarding EPX analyses, treatment efficacy, and outcomes were assessed. For meta-analyses, effect estimates were abstracted using standardized means.
  
  
  
  Over 70% of studies found a significant relationship between u-EPX and childhood asthma. There was 1.94 times higher standardized means of u-EPX among acute asthmatics compared to healthy controls (confidence interval [CI]: 1.67-2.22). Similarly, the difference in standardized means between asymptomatic asthmatics and healthy controls was 1.58 times higher (CI: 1.27-1.88).
  
  
  
  Despite differences in sample sizes, EPX processing and measurement, and ages of children, a consistent trend of higher EPX levels with childhood asthma was revealed.
authors.affiliation: Department of Kinesiology and Community Health University of Illinois Urbana-Champaign Huff Hall Room 2021 A, 1206 S. Fourth St. Champaign IL 61820.
authors.forename: Hillary
authors.initials: H
authors.lastname: Klonoff-Cohen
authors.affiliation: Department of Kinesiology and Community Health University of Illinois Urbana-Champaign Huff Hall Room 2021 A, 1206 S. Fourth St. Champaign IL 61820.
authors.forename: Mounika
authors.initials: M
authors.lastname: Polavarapu
mesh_terms: D001249:Asthma / Q000175:diagnosis*; D001798:Blood Proteins; D002648:Child; D047208:Eosinophil-Derived Neurotoxin / Q000032:analysis*; D006801:Humans; D012260:Ribonucleases
chemical_list: D001798:Blood Proteins; D047208:Eosinophil-Derived Neurotoxin; D012260:Ribonucleases
keywords: Childhood asthma; cut points; inflammatory markers; meta‐analysis; review article; serum EPX; urine EPX