No abstract available.
Eosinophil Cationic Protein* ; Eosinophils* ; Rhinitis*

PURPOSE: To evaluate tear eosinophil cationic protein (ECP) as a severity marker for atopic keratoconjunctivitis (AKC) and seasonal/perennial allergic conjunctivitis (SAC/PAC). METHODS: Tear ECP levels were measured by chemiluminescent immunometric assay in 7 eyes of 7 patients with AKC, 13 eyes of 13 patients with SAC/PAC, and 10 eyes of 10 healthy control subjects. All AKC and SAC/PAC patients underwent conjunctival injection and papillary formation grading. Tear ECP levels were investigated with reference to the clinical parameters of allergic conjunctivitis (papillary formation and conjunctival injection scoring). RESULTS: Tear ECP levels in patients with AKC were significantly higher than those in patients with SAC/PAC and in control subjects (p = 0.012 and p = 0.003, respectively). The number of patients with papillary formation scores of 2-3 was significantly higher in the AKC group than in the SAC/PAC group (p = 0.016). The number of patients with conjunctival injection scores of 2-3 did not significantly differ between the AKC and SAC/PAC groups (p = 0.128). All AKC patients obtained papillary formation scores of 2-3, and tear ECP levels in patients with conjunctival injection scores of 2-3 were significantly higher than in patients with scores of 0-1 in the AKC group (p < 0.001). In the SAC/PAC group, tear ECP levels in patients with papillary formation scores of 2-3 were significantly higher than in patients with scores of 0-1 (p = 0.046). CONCLUSIONS: This study suggests that tear ECP was a useful marker to diagnose and assess the severity of disease in patients with AKC as well as SAC/PAC. It would be useful to monitor therapeutic outcome in allergic conjunctivitis.
Conjunctivitis, Allergic ; Eosinophil Cationic Protein* ; Humans ; Keratoconjunctivitis*

PURPOSE: This study was undertaken to compare blood eosinophilic inflammatory markers between the acute period and clinical remission in children with upper respiratory infection (URI) -induced wheezing, and to assess the effects of atopy and age on these changes. METHODS: In 77 children with URI-induced wheezing, blood eosinophil count and serum eosinophil cationic protein (ECP) were measured during the acute wheezing phase and clinical remission period. The data were analyzed in the subgroups divided by atopy and age, respectively. RESULTS: Blood eosinophil count was significantly lower during acute period (181.6/microliter, 67.3-490.0) than that during clinical remission period (261.8/microliter, 120.7-567.7, P=0.001), and this significant eosinopenic response was found in non-atopic children (n=36) [92.2 (41.3-206.0) /microliter vs 204.5 (106.6-392.2) /microliter, P< 0.001], but not in atopic children (n=41). A significantly higher level of serum ECP was observed during acute period (15.1 microgram/L, 7.2-31.6) than during clinical remission (13.0 microgram/L, 6.6-25.7, P=0.05), and this difference was significant only in atopic children[24.2 (15.3-38.1) microgram/L vs 16.2 (8.3-31.6) microgram/L, P< 0.001]. A significant fall in blood eosinophil count during acute period was found only in children < or=4 years (n=37), while a significant rise in serum ECP was detected only in children > 4 years (n=40). However, these differences a due to dissimilar distribution of atopy in the two age groups. CONCLUSION: Our results showed different eosinophil responses to infection in non-atopic and atopic children with URI-induced wheezing. It appears that the blunted eosinopenic response in atopic children may be associated with the predominant Th2-like response to infection.
Child* ; Eosinophil Cationic Protein ; Eosinophils* ; Humans ; Respiratory Sounds*

OBJECTIVES: To prevent progression to fatal asthma it is essential to assess the severity of asthma and treat adequetely. But there was no objective index to evaluate the severity of airway inflammation in asthmatic patients, So we evaluated that serum ECP concentration is a objective parameter of airway inflammation in patients with acute severe asthmatic attack. METHODS: We measured the parameters of asthamtic severtity(clinical parameter, FEV1, arterial blood gas, peripheral blood eosinophil counts, and serum ECP levels) before and after antiasthmatic treatment in 9patients with acute severe asthmatic attack, And we compared serum ECP concentrations of severe asthmatic patients with those of control patients with mild to moderate severity. RESULTS: 1) The serum ECP levels in patients with acute asthmatic attacks compared to patients with mild to moderate, asthmatic severity were significantly increased. 2) The serum ECP levels and pheriperal blood eosinophil counts 2hours after antiasthmatic treatment were significantly lower than the value before treatment, but the total scores of clinical parameter, FEV1, and scores of arterial blood gases were not significantly different from the basal values, CONCLUSION: It is suggested that the serum ECP level is a objective parameter as a response to antiasthmatic treatment as well as a severity of airway inflammation in patients with acute asthmatic attack.
Asthma ; Eosinophil Cationic Protein* ; Eosinophils ; Gases ; Humans ; Inflammation

OBJECTIVE: We evaluated the clinical implications of serum ECP and peripheral blood eosinophil counts as indices of airway inflammation during the follow-up of asthmatics (BA). METHODS: We repeatedly measured the serum ECP, peripheral blood eosinophil counts and peak expiratory low rate (PFR) during the follow up of 24 symptomatic BA. RESULTS: Mean serum ECP level of BA at uncontrolled status of airflow limitation was significantly higher than that of controlled state (24.5i3.7 ng/ml rs. 16.2+1.9 ng/ml, p<0.05) and the ECP levels of controlled and uncontrolled status were significantly higher than that of health control subjects (n=10, 10.1+/-2.0 ng/ml, p<0.01 respectively). Pe ripheral blood eosinophils were also significantly increased in uncontrolled status than in controlled status of BA (535.7+/-81.0/1tL vs. 300.4+33.4/micro liter, p < 0.05). In controlled status, 8 BA had higher circulating ECP levels than in uncontrolled status, but with peripheral blood eosinophil counts, only 3 BA had higher levels in controlled status than in uncontrolled status. Variations of PFR correlated with the variations of serum ECP level (r=-0.5370, p<0.01) and variations of peripheral blood eosinophil count (r=-0.6215, p<0.001). CONCLUSION: Measurement of serum ECP and peripheral blood eosinophil count would be useful tools for monitoring the disease activity of asthma, but we could not obtain any more informations from the measureinert of serum ECP levels than from the peripheral blood eosinophil counts.
Asthma* ; Eosinophil Cationic Protein* ; Eosinophils* ; Follow-Up Studies ; Humans ; Inflammation

PURPOSE: Bronchial hyperresponsiveness (BHR) is considered a hallmark of asthma. Increased levels of eosinophil cationic protein (ECP) have been identified in serum of asthma patients. Several studies have examined the relationship between serum ECP and bronchial responsiveness, expressed as methacholine PC20 in asthmatic patients, with conflicting results. The aims of this study were to examine the relationship between serum ECP and deltaFVC, another index of bronchial responsiveness, which reflects increased maximal airway response. METHODS: Six to 8-year-old children with asthma (n=109) underwent methacholine bronchoprovocation testing. The PC20 dose of methacholine and deltaFVC were calculated for each individual from the methacholine dose response curves. Serum ECP levels and blood total eosinophil counts were also measured. RESULTS: Serum ECP correlated with deltaFVC (r=0.217, P=0.023), as well as PC20 (r=-0.208, P=0.030). However, blood eosinophil counts failed to show any correlations with deltaFVC (r=0.085, P=0.378) or PC20 (r=-0.148, P=0.125). deltaFVC did not correlate with PC20 (r=-0.079, P=0.417). CONCLUSION: Blood eosinophil activation is associated with both components of BHR including increased sensitivity and increased maximal response in 6-8 year old children with asthma.
Asthma* ; Child* ; Eosinophil Cationic Protein* ; Eosinophils ; Humans ; Methacholine Chloride

PURPOSE: Eosinophil is one of the important inflammatory cell involved in the airway inflammation in childhood asthma. It has been demonstrated that markers of eosinophil activation, including eosinophil cationic protein or eosinophil protein X(EPX), are increased in childhood asthma. Furthermore, they are related to disease activity and are assumed to be helpful in monitoring the treatment effect as urinary EPX(U-EPX) can be obtained easily and in a noninvasive way in children of all ages. METHODS: Twenty-five children(22 male and three female) aged 11.87+/-3.82 years with stable asthma were challenged with methacholine and urine was collected from each child during the following periods; before methacholine challenge test(MCT); 0-3 hr after the end of MCT; 4-7 hr after the end of MCT; and 8-24 hr after the end of MCT. Bronchial reactivity was determined by using Dosimeter(Jeager, Germany) with serially diluted methacholine from 0.05 to 25.0 mg. The FEV1 less than 80% of baseline value were classified into positive MCT. U-EPX was measured with a sensitive and specific radioimmunoassay(Pharmacia & Upjohn AB, Uppsala, Sweden). Results were expressed as microgramEPX/mmol creatinine. RESULTS: An early airway response after MCT was associated with an increase of U-EPX excretion for 0-3 hr after methacholine inhalation in comparison with beseline values. Most subjects showed a small increase in U-EPX excretion during late asthmatic response for 4-7 hr, which then decreased to normal level in 8-24 hr. Also, a tendency for a higher increase of U-EPX was associated with a lower threshold of methacholine challenge and a longer duration of asthma. CONCLUSION: Measurement of EPX in urine is a noninvasive and easy method to assess the severity of airway inflammation in asthmatic children. It may be a helpful index of the events underlying the airway inflammatory responses during nonspecific bronchial challenge, and in monitoring asthma management.
Asthma* ; Child* ; Creatinine ; Eosinophil Cationic Protein ; Eosinophil-Derived Neurotoxin* ; Eosinophils* ; Humans ; Inflammation ; Inhalation ; Male ; Methacholine Chloride*

PURPOSE: Eosinophilic inflammation plays a critical role in asthma and high-resolution computed tomography (HRCT) scoring systems have been used to evaluate the extent and severity in long standing adult asthma. We investigated if there is a correlation between eosinophil degranulation markers and HRCT scores in childhood asthma. METHODS: Children with acute asthma exacerbation (n=25) underwent HRCT and were assessed for bronchial wall thickening (BWT), low lung density (LLD), and bronchial dilatation (BD) using semi-quantitative scoring techniques. Serum eosinophil-derived neurotoxin (EDN) and eosinophil cationic protein (ECP) levels indicating eosinophil degranulation were determined. Comparisons were made with normal control subjects (n=14). RESULTS: BWT (P<0.001) and LLD (P<0.001) scores were higher in the childhood asthma group than in the control group, but BD scores were not. The EDN (r=0.405, P<0.05) and ECP (r=0.565, P<0.01) levels significantly correlated with BWT scores, but not with LLD and BD in the childhood asthma group. The EDN (r=0.710, P<0.0001) and the ECP (r=0.580, P<0.0001) levels were significantly correlated with serum total eosinophil counts. CONCLUSION: The EDN and ECP levels were correlated with BWT scores on HRCT. These findings suggest that EDN and ECP may be valuable for quantifying airway thickening in children with asthma exacerbation.
Adult ; Asthma* ; Child* ; Dilatation ; Eosinophil Cationic Protein* ; Eosinophil-Derived Neurotoxin* ; Eosinophils* ; Humans ; Inflammation ; Lung

PURPOSE: Short statue or obesity has been reported in asthmatic children, but the results are inconsistent. Recently eosinophil cationic protein (ECP), eosinophil-derived neurotoxin (EDN) levels has been known as important markers of airway inflammation and reflect asthma severity as well. The aim of this study is to evaluate the growth status and to analyze the possible relation with serum EDN and ECP levels. METHODS: A total of 90 children (57 boys and 33 girls, 4 to 16 years old) who had been admitted for bronchial asthma were included. To standardize the data for age and sex, standard deviation scores (SDS) were calculated for height and weight. Values less than -2 SDS below the mean were considered to be extremely low, -1 SDS to 1 SDS as normal, values higher than 2 SDS considered very high. Serum EDN and ECP levels were measured. RESULTS: The mean height SDS was 0.33+/-0.85 and weight SDS was 0.23+/-1.20. The prevalence of short stature was 2.2%, normal stature 75.5%, and tall stature 22.2%. The prevalence of underweight was 7.8%, normal weight 71.1%, and overweight 21.1%. Height SDS was negatively correlated with serum ECP (r=-0.27, P=0.01) and EDN (r=-0.27, P=0.009) and weight SDS was negatively correlated with serum ECP (r=-0.20, P=0.05). Height SDS were significantly lower in high ECP and EDN groups compared to normal ECP and EDN groups (P<0.01 and P<0.009, respectively). Weight SDS was lower in high ECP group compared to normal ECP group (P<0.05). CONCLUSION: Growth (height and weight) was inversely correlated with serum EDN and ECP levels. These results suggest that high ECP and EDN levels might be related with growth retardation of asthmatic children.
Asthma ; Child* ; Eosinophil Cationic Protein* ; Eosinophil-Derived Neurotoxin ; Eosinophils* ; Female ; Humans ; Inflammation ; Obesity ; Overweight ; Prevalence ; Thinness

PURPOSE:To investigate whether airway eosinophilic degranulation develops in Mycoplasma pneumonia (M. pneumonia), and to elucidate the association between M. pneumonia and asthma. METHODS:Forty patients with M. pneumonia, 20 stable asthma patients (stable asthma) and 20 normal controls were recruited from October 2005 to February 2007. In the M. pneumonia, blood and induced sputum sampling were collected at admission (acute stage) and 6 to 8 weeks later (convalescent stage). Eosinophil-derived neurotoxin (EDN) and eosinophil cationic protein (ECP) levels in sputum and serum were measured in all 3 groups. RESULTS:Serum levels of EDN and ECP in the acute stage of M. pneumonia were comparable to those in the stable asthma group. However, in the convalescent stage of M. pneumonia, EDN and ECP levels were significantly lower than in the stable asthma (P<0.01 and P<0.05, respectively). Sputum levels of EDN and ECP levels in the acute stage of M. pneumonia were comparable to those in the stable asthma. Sputum EDN levels in the convalescent stage of M. pneumonia were significantly lower than those in the stable asthma (P<0.05), and sputum ECP levels were lower than those in the stable asthma, which was not statistically significant. CONCLUSION:Eosinophilic degranulation may play an important role in the pathogenesis of M. pneumonia, which suggests the association between M. pneumonia and asthma.
Asthma ; Eosinophil Cationic Protein ; Eosinophil-Derived Neurotoxin ; Eosinophils ; Humans ; Inflammation ; Mycoplasma ; Pneumonia ; Pneumonia, Mycoplasma ; Sputum