Serum ECP levels in Asthmatic Patients: Comparison with Other Follow-up Parameters

Abstract

In recent years, eosinophil cationic protein (ECP) has been considered as a useful eosinophilic activation marker in asthmatic patients. In this study, serum ECP levels in different stages of bronchial asthma were evaluated. We studied 123 patients suffering from asthma, which was classified as mild (n = 49), moderate (n = 49), severe asthma (n = 25), and also 31 healthy controls. Serum ECP levels were 13.22 +/- 1.11 ng/mL (mean +/- s.e.m.) in controls, and 30.15 +/- 2.38 ng/mL in asthmatic patients. By subgroups, ECP levels were 24.23 +/- 3.37 ng/mL, 31.69 +/- 4.21 ng/mL and 37.61 +/- 4.52 ng/mL, in mild, moderate and severe asthmatic patients, respectively, being the differences among the three groups statistically significant (P < 0.01-P < 0.001). Peripheral blood eosinophil numbers were 157 +/- 20 eos/mm3 in controls, and 334 +/- 35 eos/mm3, 510 +/- 87 eos/mm3, and 658 +/- 72 eos/mm3, in mild, moderate, and severe asthmatic patients, respectively, with significant differences among all groups (P < 0.05-P < 0.001). The serum ECP levels as well as the eosinophil numbers were higher in symptomatic patients than in the asymptomatic ones (P < 0.01). Moderate negative correlations, although highly significant (P < or = 0.001), were found between serum ECP levels and forced vital capacity (FVC) (rs = -0.27), FEV1, MEF25-75 (rs = -031), and MEF50 (rs = -0.32). There was also a good positive correlation between ECP levels and peripheral blood eosinophil numbers (rs = 0.67, P < 0.001).

Serum eosinophil cationic protein (ECP) as a mediator of inflammation in acute asthma, during resolution and during the monitoring of stable asthmatic patients treated with inhaled steroids according to a dose reduction schedule

“…The mean level of ECP in the patients with exacerbations was low at the acute visit compared to results presented by other groups [7,9]. Nevertheless our patients showed a significant mean decrease of 36% in ECP after one week on oral steroids.…”

“…Others have studied the association between atopy, asthma and eosinophils and their mediators with somewhat contradictory results. Two publications on adult asthmatic patients reported no difference in ECP between atopic and non-atopic patients or defined as extrinsic/intrinsic asthma [9,11]. The situation might be different in small children as presented by another group [21].…”

“…Results from clinical studies show that eosinophil derived inflammatory mediators such as eosinophil cationic protein (ECP) are released during inflammation and can be measured systematically in serum [2][3] and locally in bronchoalveolar lavage (BAL) [4][5] and sputum [6]. Several studies have shown that ECP is higher in symptomatic than asymptomatic asthmatics and related to the severity of asthma [7][8][9]. It was further established that patients with the highest ECP levels in acute asthma showed the largest improvement in lung function after increased steroid treatment [7].…”

Peripheral blood eosinophilia in association with generalized pustular and erythrodermic psoriasis

“…We did not measure and compare the serum or tissue ECP levels of our patients. In several studies on allergic diseases including asthma and atopic dermatitis, ECP concentrations were significantly correlated with peripheral blood eosinophil counts 20,21 . Moreover, in a study by Nishimoto et al ., peripheral eosinophil counts were found to be more sensitive than serum ECP levels related to the improvement of atopic dermatitis 22 .…”

Effects of Supportive Treatment such as Antioxidant or Leukotriene Receptor Antagonist Drugs on Inflammatory and Respiratory Parameters in Asthma Patients

“…This requirement has increased the interest in the use of eosinophilic cationic protein (ECP) or its derivatives as they are indicators of the inflammatory activation of eosinophils. Many authors continue to suggest the use of these methods clinically 2 , 3 and many studies have shown a correlation between the serum ECP levels, the asthma symptom score, the number of inflammatory eosinophils, and the severity of asthma 12 , 13 . Therefore, the measurement of some parameters or mediators of inflammation such as ECP, leukotriene E4 (LTE 4 ), and malondialdehyde (MDA) in bronchial secretions, serum, or urine has been proposed for the evaluation of inflammation in the airways 2 , 3 , 14 , 15 …”