High levels of eosinophil cationic protein in wheezing infants predict the development of asthma

Koller, D. Y.; Wojnarowski, Claudia; Herkner, Kurt; Weinländer, Georg; Raderer, Markus; Eichler, Irmgard; Frischer, Thomas

doi:10.1016/s0091-6749(97)80007-3

Cited by 106 publications

(80 citation statements)

References 26 publications

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“…The lack of blood and sputum eosinophilia does not exclude the participation of the eosinophil in the inflammatory process, as recently demonstrated, for example, in wheezing infants (19). The dissociation between eosinophil Results are presented as individual values and as meanuSD.…”

Section: Discussionmentioning

confidence: 95%

Major basic protein, but not eosinophil cationic protein or eosinophil protein X, is related to atopy in cystic fibrosis

Koller

Halmerbauer

Müller

et al. 1999

Allergy

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Increased eosinophil granule proteins have been described in serum and sputum samples of patients with cystic fibrosis (CF). It has been assumed that eosinophil degranulation is enhanced in atopic subjects – as in asthmatics. Since in CF no differences in eosinophil cationic protein (ECP), eosinophil protein X (EPX), and eosinophil peroxidase between atopic and nonatopic subjects have been detected, we investigated whether major basic protein (MBP) is increased in serum and sputum samples derived from atopic (n=14) compared with nonatopic CF subjects (n=26). In CF patients, high mean serum (sputum) levels of ECP 29.7 μg/l (2.7 mg/l), EPX 53.7 μg/l (7.9 mg/l), and MBP 984.6 μg/l but low sputum MBP levels (57.4 μg/l) were measured. In addition, in serum and in sputum samples, a significant correlation between MBP and ECP (P<0.03 and P<0.0001, respectively) or EPX (P<0.05 and P<0.0004, respectively) was detected. By subdivision of the patients into allergic and nonallergic subjects, significant differences were found for serum MBP values only (mean 1382.2 μg/l vs 770.5 μg/l; P<0.0001), but not for ECP or EPX serum levels or for eosinophil proteins in sputum. Although no differences between atopic and nonatopic CF patients in ECP and EPX were found, serum MBP levels were higher in patients sensitized to inhalant allergens than in nonsensitized subjects. These results indicate differential release of eosinophil granule proteins in peripheral blood from eosinophils, and they also indicate that MBP in serum likely is to be a better discriminator of atopy in CF.

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Section: Discussionmentioning

confidence: 95%

Major basic protein, but not eosinophil cationic protein or eosinophil protein X, is related to atopy in cystic fibrosis

Koller

Halmerbauer

Müller

et al. 1999

Allergy

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“…Although elevated eosinophilic cationic protein levels in preschool wheezers are associated with symptom persistence [57], the degree of overlap between groups renders such measurements useless for clinical purposes. Blood eosinophilia can be used as part of an asthma predictive index, but the predictive value of this index (in particular, that of a positive result) is low [39].…”

Section: Tests Of Sensitisation To Allergensmentioning

confidence: 99%

Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

Brand¹,

Baraldi²,

Bisgaard³

et al. 2008

European Respiratory Journal

735

759

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There is poor agreement on definitions of different phenotypes of preschool wheezing disorders. The present Task Force proposes to use the terms episodic (viral) wheeze to describe children who wheeze intermittently and are well between episodes, and multiple-trigger wheeze for children who wheeze both during and outside discrete episodes. Investigations are only needed when in doubt about the diagnosis.Based on the limited evidence available, inhaled short-acting b 2 -agonists by metered-dose inhaler/spacer combination are recommended for symptomatic relief. Educating parents regarding causative factors and treatment is useful. Exposure to tobacco smoke should be avoided; allergen avoidance may be considered when sensitisation has been established. Maintenance treatment with inhaled corticosteroids is recommended for multiple-trigger wheeze; benefits are often small. Montelukast is recommended for the treatment of episodic (viral) wheeze and can be started when symptoms of a viral cold develop.Given the large overlap in phenotypes, and the fact that patients can move from one phenotype to another, inhaled corticosteroids and montelukast may be considered on a trial basis in almost any preschool child with recurrent wheeze, but should be discontinued if there is no clear clinical benefit.Large well-designed randomised controlled trials with clear descriptions of patients are needed to improve the present recommendations on the treatment of these common syndromes.

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“…2 The majority of children with asthma have clinically evident atopic manifestations in later childhood, although allergies may not be apparent in infancy. 2,3 Total serum immunoglobulin E (IgE), 2 blood eosinophilia, 2 and serum eosinophil cationic protein (ECP) 4 are markers that are often used to determine subclinical atopy and susceptibility to respiratory allergy. However, these markers are nonspecific, and to point out the allergen-specific responses, skin prick tests (SPTs) or radioallergosorbent tests (RAST) thus far have had to be performed.…”

mentioning

confidence: 99%

Allergen-Specific Immunoglobulin E Antibodies in Wheezing Infants: The Risk for Asthma in Later Childhood

Kotaniemi‐Syrjänen¹,

Reijonen²,

Romppanen³

et al. 2003

PEDIATRICS

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ABSTRACT. Objective. To evaluate whether the measurement of specific immunoglobulin E (IgE) antibodies to food and/or inhalant allergens in infants who are hospitalized for wheezing can be used to predict later asthma.Methods. Eighty-two children who were hospitalized for wheezing at <2 years of age were followed prospectively until early school age. The baseline data and the characteristics of infancy had been collected at enrollment. At school age, the children were evaluated for asthma and allergic manifestations, including skin prick tests to common inhalant allergens. Frozen serum samples obtained during the index episode of wheezing were available for 80 children for determination of food and inhalant allergen-specific serum IgE antibodies by fluoroenzyme-immunometric assay, UniCAP, applying the Phadiatop Combi allergen panel.Results. Asthma was present in 32 (40%) children at school age. Food-specific IgE antibodies of >0.35 kU/L were found in 37 (46%) wheezing infants, but only specific IgE to wheat and to egg white at the level of >0.35 kU/L were significantly associated with later asthma. In regard to specific IgE to the mixture of food allergens, the cutoff level of >0.70 proved to be significant. Inhalant allergen-specific IgE of >0.35 kU/L was found only in 14 cases (18%), but when present, it was significantly predictive of asthma. Elevated levels of specific IgE antibodies to food or inhalant allergens were significantly associated with allergic rhinitis and skin-test reactivity at school age.Conclusions. When present in wheezing infants, specific IgE of >0.35 kU/L to wheat, egg white, or inhalant allergens are predictive of later childhood asthma. Consequently, detection of those specific IgE antibodies in wheezing infants may facilitate the early diagnosis of asthma, especially in cases with no clinically evident atopic manifestations. A pproximately 20% of all children experience wheezing in infancy, 1 and these children are at increased risk for asthma in later childhood. On the basis of recent prospective follow-up data, up to 40% of them experience asthma at school age. 2 The majority of children with asthma have clinically evident atopic manifestations in later childhood, although allergies may not be apparent in infancy. 2,3 Total serum immunoglobulin E (IgE), 2 blood eosinophilia, 2 and serum eosinophil cationic protein (ECP) 4 are markers that are often used to determine subclinical atopy and susceptibility to respiratory allergy. However, these markers are nonspecific, and to point out the allergen-specific responses, skin prick tests (SPTs) or radioallergosorbent tests (RAST) thus far have had to be performed. Both of these tests are qualitative, and for technical reasons, only a restricted number of allergens are applicable in SPTs in young children. These tests may also be susceptible to technical errors and variations as a result of either nonstandardized or nonautomated methods. Consequently, new approaches are needed to screen those prone to atopy or allergen-induced asthma among ...

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High levels of eosinophil cationic protein in wheezing infants predict the development of asthma

Cited by 106 publications

References 26 publications

Major basic protein, but not eosinophil cationic protein or eosinophil protein X, is related to atopy in cystic fibrosis

Major basic protein, but not eosinophil cationic protein or eosinophil protein X, is related to atopy in cystic fibrosis

Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

Allergen-Specific Immunoglobulin E Antibodies in Wheezing Infants: The Risk for Asthma in Later Childhood

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