Evaluation of serum eosinophilic cationic protein as a marker of disease activity in chronic asthma

Ferguson, Alexander C.; Vaughan, R. S.; Brown, Huguette; Curtis, Carol D.

doi:10.1016/s0091-6749(95)70148-6

Cited by 89 publications

(58 citation statements)

References 27 publications

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“…9 22 However, the relation of serum ECP levels to asthma severity is controversial. 23 Our results are in accordance with others in showing a poor relationship between serum ECP levels and symptom severity. 23 24 Indeed, we used three markers of airway inflammation but none of them related to current asthma symptoms, which was disappointing.…”

Section: Discussionsupporting

confidence: 93%

“…23 Our results are in accordance with others in showing a poor relationship between serum ECP levels and symptom severity. 23 24 Indeed, we used three markers of airway inflammation but none of them related to current asthma symptoms, which was disappointing. In studies in adults the relation between airway eosinophils and asthma severity is also unclear.…”

Section: Discussionsupporting

confidence: 93%

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Induced sputum in children: feasibility, repeatability, and relation of findings to asthma severity

Wilson

Bridge

Spanevello

et al. 2000

Thorax

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Background-The collection of induced sputum provides a non-invasive method of investigating airway inflammation. Few studies have been performed in children, so a study was undertaken to determine the feasibility of sputum induction, the repeatability of eosinophil counts and sputum eosinophil cationic protein (ECP) levels, and the relation of these to current asthma severity. For comparison, serum ECP levels were also measured. Methods-In a cross sectional study of children aged 5-15 years, 27 healthy children and 60 with asthma underwent sputum induction using inhaled nebulised hypertonic saline. The whole sputum sample was used for analysis. Ten children with stable asthma repeated the procedure within 10 days. Results-A satisfactory sample (>500 non-squamous cells) was obtained in 61% of children with asthma and in 60% of healthy controls. The limits of agreement within subjects ranged from a 0.68 to 2.8 fold diVerence for eosinophil diVerential counts and from 0.38 to 4.4 fold for sputum ECP. Despite a median of 42% squamous cells, significant diVerences were found between asthma and healthy controls for the eosinophil diVerential count (p = 0.0004), total eosinophil counts (p = 0.03), and sputum ECP level (p = 0.0001). Overall, there was no correlation between any marker of airway inflammation and asthma severity, however expressed, including lung function. Conclusions-Sputum induction is only possible in a proportion of children. The repeatability of sputum cell counts and ECP levels, measured in a small number of children, was similar to that reported in adults. Sputum analysis revealed no evidence of airway inflammation in a number of highly symptomatic children with asthma. (Thorax 2000;55:768-774)

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Induced sputum in children: feasibility, repeatability, and relation of findings to asthma severity

Wilson

Bridge

Spanevello

et al. 2000

Thorax

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“…However, the correlation between ECP in serum and BHR was weak and only close to significance (P=0.051). This fits well with previous findings of a strong correlation between ECP and bronchal reactivity (6,8,15), although other studies have not found this (6,23). Thus, the ECP level depends on both the total number of eosinophils and their state of activation.…”

Section: Ns) D) Eg2 (Mfi Units) (Ns)supporting

confidence: 93%

“…Blood and tissue eosinophilia is often found in asthma (24), and the number of eosinophils in peripheral blood correlates with the 482 severity of asthma (2,4,5). Furthermore, activated eosinophils have been demonstrated in increased numbers (5)(6)(7). The granules of the eosinophil granulocyte contain several basic proteins which are biologically active products, such as eosinophil cationic protein (ECP), which has become widely accepted as an indicator of eosinophil activity (8).…”

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confidence: 99%

Eosinophil activity markers in peripheral blood have high predictive value for bronchial hyper‐reactivity in patients with

Roquet

Halldén

Ihre

et al. 1996

Allergy

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Eosinophil activity markers in peripl blood have high predictive value for bronchial h yperr e ac t ivi t y in patients suspected mild asthma Roquet A, HalldCn G, Ihre E, Hed J, Zetterstrom 0. Eosinophil activity markers in peripheral blood have high predictive value for bronchial hyperreactivity in patients with suspected mild asthma.Allergy 1996: 51: 482488. 0 Munksgaard 1996.The present study aimed to evaluate the predictive value of eosinophils and markers of their activity for bronchial hyperreactivity (BHR) in a population of patients with recently developed clinical symptoms of asthma. The activation of eosinophils was estimated by measuring eosinophil cationic protein (ECP) in serum. In addition, flow cytometry was used to measure the expression of the EG2-epitope on intracellular ECP in eosinophils from peripheral blood. Twenty-eight consecutive patients with clinical history of asthma were studied. Of the 28 patients, 18 had a positive bronchial challenge test measured as PD,,, 5 1600 pg histamine. A signilicantly higher concentration of eosinophils and a trend to higher ECP in the peripheral blood was found in the hyperreactive group than in the nonreactive group. However, the intracellular expression of ECP did not correlate with the PD, value, and no significant difference between the groups was found. With one eosinophil activity marker, either serum ECP or EG2, BHR could be predicted in 70% of the patients. If we combined any two of the activity markers (serum ECP, EG2, or the percentage of eosinophils), the predictive value increased to 100%. We conclude that the blood eosinophil concentration, as well as, to some extent, serum ECP, has a high specificity for BHR in patients with recently developed clinical symptoms of asthma. Despite normal bronchial reactivity, some patients had signs of activated eosinophils, i.e., high serum ECP and increased EG2 expression. Thus, these markers may reflect early stages in the development of BHR. Our results also indicate that a combined evaluation of percentage of eosinophils and of eosinophil activity markers is o f clinical value to predict BHR.

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“…Activated eosinophils are able to release many cytotoxic proteins, including eosinophil cationic protein (ECP), which has a central role in bronchial epithelial damage [4,5]. The role of blood eosinophils and serum ECP in monitoring disease activity in chronic asthma has not been conclusively defined, as there is conflicting evidence concerning their relationship to clinical severity of disease [6][7][8][9][10].…”

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confidence: 99%

Do sputum eosinophils and ECP relate to the severity of asthma?

Ronchi¹,

Piragino²,

Rosi³

et al. 1997

Eur Respir J

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There is much evidence that eosinophils play an important role in bronchial epithelial damage in asthma by releasing cationic proteins. However, the extent to which eosinophil inflammation relates to indices of asthma severity in chronic stable asthma is still a matter of debate.We studied 46 clinically stable patients with mild to severe chronic asthma (forced expiratory volume in one second (FEV1) 50-126% of predicted value). The clinical severity of asthma was graded from 1 to 4 according to the Aas scoring system. Twelve normal subjects were also studied as controls. Induction of sputum was performed by hypertonic saline to determine differential cell count, and eosinophil cationic protein (ECP) by the so-called "plug technique". The concentration of ECP was measured by a fluoroimmunoassay. Bronchial hyperresponsiveness was recorded by inhaling progressive concentrations of histamine, and the concentration that caused a 20% decrease in FEV1 (PC20) was calculated.Sputum eosinophils (range 0-61%), sputum ECP (range 24-10,800 µg·L -1 ) and serum ECP (range 4-61 µg·L -1 ) were significantly greater in asthmatics than in normal subjects, and distinguished the most severe group with the highest Aas score from the others. Sputum eosinophils and sputum ECP were strongly related to each other. The relationships between sputum or serum ECP and PC20 (range 0.016-7.5 mg·mL -1 ), and between sputum ECP and FEV1 were found to be weak.In conclusion, sputum outcomes of eosinophil activation and serum eosinophilic cationic protein appear to be useful indicators of disease. They do not accurately reflect current clinical or functional indices of asthma severity in chronic stable patients, and might therefore provide complementary data disease monitoring.

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Evaluation of serum eosinophilic cationic protein as a marker of disease activity in chronic asthma

Cited by 89 publications

References 27 publications

Induced sputum in children: feasibility, repeatability, and relation of findings to asthma severity

Induced sputum in children: feasibility, repeatability, and relation of findings to asthma severity

Eosinophil activity markers in peripheral blood have high predictive value for bronchial hyper‐reactivity in patients with

Do sputum eosinophils and ECP relate to the severity of asthma?

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