Urinary eosinophil protein X in children with atopic asthma: A useful marker of antiinflammatory treatment

Kristjánsson, Sigurður; Strannegård, Inga-Lisa; Strannegård, Örjan; Peterson, Christer; Enander, I.; Wennergren, Göran

doi:10.1016/s0091-6749(96)70182-3

Cited by 92 publications

(114 citation statements)

References 24 publications

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“…This confirms the results of previous studies, where the urinary excretion of EPX in asthmatics was not inhibited by treatment with glucocorticoids [2,17]. This may be explained by a incompletely suppressed inflammation in the bronchial mucosa in asthmatics treated with steroids [21] or by an inadequate compliance, which is known to occur frequently in anti-inflammatory treatment [22].…”

Section: Discussionsupporting

confidence: 91%

“…A correlation has been shown between analysis of LTE 4 in crude urine samples by EIA and measurements after purification on solid phase extraction followed by separation on reversed-phase high performance liquid chromatography, considered to be the most accurate method [19]. Previous studies have shown, that urinary EPX concentrations are increased in children with acute asthma compared with healthy control subjects [2,15]. However, correlation between pulmonary function variables and urinary EPX levels are not consistently found in children with symptomatic asthma [20,15].…”

Section: Discussionmentioning

confidence: 96%

“…EPX was measured by a sensitive and specific doubleantibody radioimmunoassay (Pharamacia, Sweden) [2]. All measurements were done in duplicate and the mean value was calculated.…”

Section: Subjectsmentioning

confidence: 99%

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Urinary excretion of leukotriene E4 and eosinophil protein X in children with atopic asthma

Severien¹,

Artlich²,

Jonas³

et al. 2000

Eur Respir J

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Measurement of leukotriene E 4 (LTE 4 ) in urine is a noninvasive method for assessing changes in the rate of total body cysteinyl leukotriene production. Eosinophil protein X (EPX) has been used to assess eosinophil activity and monitor inflammation in bronchial asthma. The aim of the study was to look for differences in urinary LTE 4 and EPX concentrations between children with stable atopic asthma and healthy controls and to compare asthmatic children with different disease severity. In addition the relationship was evaluated between urinary LTE 4 amd EPX levels and lung function.LTE 4 was also measured (enzyme immunoassay) together with EPX (radioimmunoassay) in urine and lung function tests were carried out in children with mild asthma (steroid-naive) (n=49), moderate to severe asthma (using inhaled steroids) (n=31) and healthy control subjects (n=28).Urinary leukotriene E 4 (LTE 4 ) was significantly higher in children with asthma than in controls (median [25±75 percentile] 238.5 (126.5±375.7) SD 191.8 versus 189 (51±253.2) SD 131.7 pg . mg -1 creatinine; p=0.021). Urinary EPX was also significantly increased in asthmatic children compared with controls (85.5 [64±131.5] SD 76.2 versus 48.5 [43.2±90] 112.1 mg . mmol -1 creatinine; p=0.006). There were no differences in urinary LTE 4 and EPX between the group of mild and the group of moderate to severe asthmatic children. There were significant associations between the urinary LTE 4 and intrathoracic gas volume (ITGV), residual volume (RV), forced expiratory volume in one second (FEV1), forced expiratory capacity (FVC) and maximum expiratory flow rate at 25% of vital capacity (MEF25).Urinary EPX was only correlated with maximum expiratory flow rate at 75% of vital capacity (MEF75). Thus measurement of urinary LTE 4 may predict the degree of airflow obstruction in asthmatic children. Urinary LTE 4 and EPX are useful markers of airway inflammation and can be helpful in guiding asthma management. There was no correlation between LTE 4 and EPX levels. Eur Respir J 2000; 16: 588±592.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 96%

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Urinary excretion of leukotriene E4 and eosinophil protein X in children with atopic asthma

Severien¹,

Artlich²,

Jonas³

et al. 2000

Eur Respir J

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“…Below I will discuss some of the advantages and disadvantages of measuring ECP in serum/plasma and sputum and also discuss the current evidence that ECP may be a useful addition to the diagnostic armamentarium for monitoring and characterization of disease activity in the allergic patient. I will also discuss the emerging evidence that seems to show that urine measurement of EPX/EDN may be an alternative to ECP measurements in blood as a reflection of eosinophil turnover and activity (43)(44)(45)(46)(47)(48)(49).…”

Section: Monitoring Eosinophil Activity and Turnovermentioning

confidence: 99%

“…In a search for noninvasive means to monitor eosinophil involving inflammation urine measurement of EPX/EDN has emerged as a promising candidate in particular in children (44,45,48,64). In order to minimize the influence of differences in water dilution of the urine the EPX/EDN levels have to be adjusted by the creatinine concentrations unless 24 h samplings are carried out.…”

Section: Epx/edn In Urinementioning

confidence: 99%

Monitoring the allergic inflammation

Venge

2003

Allergy

127

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Individual symptoms of allergy such as asthma, dermatitis, rhinitis have many different underlying mechanisms. The detailed characterization of the inflammatory mechanisms underlying symptom development in the individual patient is important in order to optimally control treatment. Measurement of eosinophil cationic protein (ECP) in sputum or blood and eosinophil protein X/eosinophil derived neurotoxin (EPX/EDN) in urine may be used to read the involvement of the eosinophil granulocyte in the process. An important information as eosinophil dominated processes seem to be particularly sensitive to corticosteroid treatment. The possibilities to measure the involvement of other inflammatory cells exist today, but are only used to a small extent. The dream would be that every patient with an inflammatory disease is characterized with respect to the profile of involving cells and mediators. Such information would provide us with a unique understanding of the underlying mechanisms of the development of disease symptoms and the possibilities of treating these.

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Third International Pediatric Consensus statement on the management of childhood asthma

1998

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Urinary eosinophil protein X in children with atopic asthma: A useful marker of antiinflammatory treatment

Cited by 92 publications

References 24 publications

Urinary excretion of leukotriene E4 and eosinophil protein X in children with atopic asthma

Urinary excretion of leukotriene E4 and eosinophil protein X in children with atopic asthma

Monitoring the allergic inflammation

Third International Pediatric Consensus statement on the management of childhood asthma

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