Eosinophil cationic protein in nasopharyngeal secretions and serum of infants infected with respiratory syncytial virus

Zelaya, E A Colocho; Örvell, Claes; Strannegård, Ö.

doi:10.1111/j.1399-3038.1994.tb00225.x

Cited by 64 publications

(35 citation statements)

References 22 publications

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“…The present results conflict with these studies, since ECP concentrations were similar in the two groups. The results of the present study are consistent with those reported by others [6,7]. In the latter study, no statistical difference in ECP/albumin ratio was found between 34 RSV+ and 27 RSV-infants with respiratory tract infection.…”

Section: Discussionsupporting

confidence: 83%

“…In the latter study, no statistical difference in ECP/albumin ratio was found between 34 RSV+ and 27 RSV-infants with respiratory tract infection. However, we did not observe a difference in the ECP level of pharyngeal secretions between males and females, as described for the group of patients from El Salvador [7].…”

Section: Discussionmentioning

confidence: 69%

“…It has been observed that nasal or pharyngeal secretions recovered from infants suffering from RSV infection have increased eosinophil cationic protein (ECP) levels. A correlation between ECP levels and severity was noted in one study [5], but ECP levels were found to be similar to those of healthy infants in two other studies [6,7]. However, no study has yet examined inflammatory markers in the pharyngeal secretions of infants.…”

mentioning

confidence: 95%

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Cells and mediators from pharyngeal secretions in infants with acute wheezing episodes

Counil

Lebel²,

Segondy³

et al. 1997

Eur Respir J

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An acute wheezing episode is the most common feature of severe lower respiratory tract infection during infancy. Respiratory syncytial virus (RSV) is the major causative agent.In order to study inflammation during acute wheezing episodes in infants, we wanted to assess the feasibility and contribution of induction of pharyngeal secretions.We therefore compared inflammatory markers in the pharyngeal secretions of 27 infants suffering from acute wheezing episodes with an RSV infection (RSV+) and 18 infants suffering with acute wheezing episodes without RSV infection (RSV-). Pharyngeal secretions were recovered by physiotherapy using isotonic saline. The safety of the procedure was carefully checked. Pharyngeal secretions were homogenized with dithiothreitol. Total cells and eosinophils were counted and levels of eosinophil cationic protein (ECP) and histamine were measured.Induction of pharyngeal secretion was always well tolerated. Eosinophils were present in five RSV+ and seven RSV-patients. ECP levels were not significantly different between the groups. Histamine levels after protein adjustment were significantly increased in RSV+ patients (p<0.01) in comparison to RSV-patients.In this study, we have shown, that pharyngeal secretion can be safely recovered from infants suffering from acute wheezing episodes, and that it can be analysed for enumeration of inflammatory cells and measurement of inflammatory mediators. Eur Respir J 1997; 10: 2591-2595 An acute wheezing episode is the most common severe lower respiratory tract infection in infancy. During epidemics, over 80% of cases may be caused by a respiratory syncytial viral (RSV) infection [1]. Although symptoms may become severe, most infections are selflimited, and improvement usually occurs within several days [2,3]. Approximately 2% of infants under 2 yrs of age require hospitalization [4]. In severe acute wheezing episodes, necrosis of the respiratory epithelium, excessive production of mucus, and lymphocytic infiltration result in oedema, dense plugs of debris and subsequent bronchiolar obstruction. The role of eosinophil activation in RSV infection needs to be clarified. It has been observed that nasal or pharyngeal secretions recovered from infants suffering from RSV infection have increased eosinophil cationic protein (ECP) levels. A correlation between ECP levels and severity was noted in one study [5], but ECP levels were found to be similar to those of healthy infants in two other studies [6,7]. However, no study has yet examined inflammatory markers in the pharyngeal secretions of infants.A study was carried out during a viral infection episode in 45 infants suffering from acute wheezing episodes requiring hospitalization, and pharyngeal secretions were recovered by physiotherapy. The safety of the procedure was carefully monitored. Inflammatory cells were counted and inflammatory markers were measured in order to differentiate inflammation in infants suffering from acute wheezing episodes with RSV infection (RSV+) or without RSV infecti...

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 69%

mentioning

confidence: 95%

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Cells and mediators from pharyngeal secretions in infants with acute wheezing episodes

Counil

Lebel²,

Segondy³

et al. 1997

Eur Respir J

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“…However, one study, to support our findings of increased s-ECP levels in children with a history of wheeze, demonstrated increasing levels of s-ECP during the reconvalescent period after acute bronchiolitis in infants [25]. They also found higher s-ECP levels in infants with acute bronchiolitis than infants without a history of wheeze.…”

Section: Discussionsupporting

confidence: 62%

“…Other studies in older subjects have demonstrated increased s-ECP in asthmatic patients compared to those without asthma [12,13,23,24]. Several studies have demonstrated higher s-ECP levels in atopic compared to nonatopic subjects [13,25]. The presence or absence of atopy is not yet known in our subjects due to their young age.…”

Section: Discussionmentioning

confidence: 41%

Eosinophil cationic protein and tidal flow volume loops in children 0-2 years of age

Carlsen¹,

Halvorsen²,

Ahlstedt³

et al. 1995

Eur Respir J

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E Eo os si in no op ph hi il l c ca at ti io on ni ic c p pr ro ot te ei in n a an nd d t ti id da al l f fl lo ow w v vo ol lu um me e l lo oo op ps s i in n c ch hi il ld dr re en n 0 0--2 2 y ye ea ar rs s o of f a ag ge e TFV loops were measured in 79 awake children (mean age 14 months). Minimum two wheezy episodes (mean 3.2) or minimum 4 weeks persistent wheeze were reported in 41 children (cases), whereas the 38 controls had no history of wheeze. Airways responsiveness (change in ratio of time until peak expiratory flow to total expiratory time (tPEF/tE) after inhaled nebulized salbutamol) was measured in 26 cases and 24 controls. Serum ECP and serum myeloperoxidase (s-MPO) were measured in all children.Cases had significantly lower mean tPEF/tE (0.21) than controls (0.33), and higher mean s-ECP (21.9 µg·L -1 ) than controls (14.0 µg·L -1 ). Serum ECP (but not s-MPO) correlated significantly with the percentage change in tPEF/tE from baseline (r=0.7), but not with initial tPEF/tE. Serum ECP increased significantly with increasing immunoglobulin E (IgE), airways responsiveness and eosinophil count, but decreased with increasing age.TFV responsiveness to salbutamol and s-ECP levels correlate strongly, both probably reflecting airways inflammation, and may possibly be valuable prognostic tools in recurrent wheezy infants and toddlers.

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Serum eosinophil cationic protein as a predictor of wheezing after bronchiolitis

et al. 1997

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We have evaluated the role of eosinophil cationic protein (ECP) concentrations in serum in predicting wheezing after bronchiolitis, during infancy and early childhood. A prospective study at a university hospital serving all pediatric patients in a defined area was designed. Serum ECP concentrations were measured in 92 infants under the age of 2 years on admission for acute bronchiolitis, and 6 and 16 weeks after hospitalization. Nebulized anti‐inflammatory therapy was initiated during hospitalization: 32 patients received cromolyn sodium and 32 patients received budesonide for 16 weeks; 30 control patients received no maintenance therapy. The numbers of subsequent physician‐diagnosed wheezing episodes and hospital admissions for obstructive airway disease were recorded during 16 weeks of follow‐up. At entry, 14 of 92 (15%) children had high (≥16 μg/L) levels of ECP in their serum. During the 16‐week follow‐up period, this group of patients had significantly more physician‐diagnosed episodes of wheezing (86% vs. 43%, P < 0.01) and hospital admissions for wheezing (64% vs. 19%, P = 0.001) than those with serum levels of ECP < 16 μg/L. The number of patients with serum ECP ≥ 8 μg/L was 25 (27%); 76% of this group developed physician‐diagnosed wheezing (P < 0.01), and 48% had hospital admissions for wheezing (P < 0.01). Serum ECP levels decreased significantly with respect to time after bronchiolitis and did not differ among the three intervention groups. We conclude that a high serum ECP concentration during the acute phase of bronchiolitis is a specific but insensitive predictor of wheezing after bronchiolitis. Pediatr. Pulmonol. 1997; 23:397–403. © 1997 Wiley‐Liss, Inc.

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Eosinophil cationic protein in nasopharyngeal secretions and serum of infants infected with respiratory syncytial virus

Cited by 64 publications

References 22 publications

Cells and mediators from pharyngeal secretions in infants with acute wheezing episodes

Cells and mediators from pharyngeal secretions in infants with acute wheezing episodes

Eosinophil cationic protein and tidal flow volume loops in children 0-2 years of age

Serum eosinophil cationic protein as a predictor of wheezing after bronchiolitis

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