Eosinophil cationic protein (ECP) in saliva: a new marker of disease activity in bronchial asthma (original) (raw)
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Jugoslovenska medicinska biohemija, 2003
Activated eosinophilic leukocyte in asthma secretes numerous mediators, among which is ECP as well. The object of our study was to measure the serum ECP concentrations in 46 asthmatic patients with exacerabating and stable asthma, and to correlate the serum ECP concentrations with severity and exacerbation of the disease. Geometric mean of ECP in serum (Gecp) in our group of patients was 7.5 mcg/l, while it was 3.05 mcg/l in the 15 healthy subjects (controls). Highly significant correlation of serum ECP concentrations with the activity of the disease (R=0.897) and the severity of clinical picture (R=0.79) was found. The patients with stable asthma had significant correlation of ECP and the severity of disease (R=0.6). The patients with exacerbating asthma have significantly higher serum ECP concentrations than the patients with stable asthma. Serum ECP concentrations in patients with exacerbating asthma correlate with the severity of the disease.
Serum eosinophil cationic protein as a marker of eosinophilic inflammation in asthma
Clinical & Experimental Allergy, 1998
Background The serum level of eosinophil cationic protein (ECP) has been used as a clinical marker in asthma, on the assumption that it reflects ongoing eosinophilic inflammation of the airways. However, only a few studies have investigated this issue, using bronchial secretions but not tissue specimens. Objective To evaluate cross-sectionally the correlation between serum ECP level or blood eosinophil count, and the degree of eosinophilia in bronchoalveolar lavage fluid (BALF) and bronchial biopsy tissue, and disease activity, in asthmatic patients. Methods Thirty-three adults with symptomatic asthma and six healthy controls were studied. The blood eosinophil count, ECP levels in serum and BALF, percentage of eosinophils in BALF, number of eosinophils in bronchial tissue, pulmonary function, and methacholine bronchial responsiveness of these subjects were clarified. An asthma severity score and inhaled b 2-agonist requirement (puffs/day) were also assessed for the asthmatic patients. Results The asthmatic patients, compared with the controls, had more obstructive (as tested by %FEV 1 , FEV 1 /FVC, and FEF 25-75%) and more responsive airways, and showed a significant increase in the number of eosinophils in the blood, BALF, and tissue, and in the serum ECP levels. The ECP levels in BALF were below the detection limit for most of the subjects in both groups examined. In the asthmatic patients, serum ECP level demonstrated correlations with the number or percentage of eosinophils in BALF and tissue, whereas the blood eosinophil count correlated only with the percentage of eosinophils in BALF. Serum ECP level correlated with all indices of disease activity examined; %FEV 1 , FEV 1 /FVC, FEF 25-75% bronchial responsiveness, severity score and b 2-agonist usage, whereas the blood eosinophil count correlated only with %FEV 1 and bronchial responsiveness. Conclusion The data suggest that serum ECP level reflects the intensity of eosinophilic airway inflammation, as well as the disease activity, and may be useful as an inflammatory marker in asthma.
Correlation of eosinophil cationic protein with severity of asthma
Journal of Ayub Medical College, Abbottabad : JAMC, 2004
BACKGROUND Activated eosinophils play an important role in the pathogenesis of bronchial asthma. Upon activation eosinophils release their granular proteins. Eosinophil Cationic Protein (ECP) is a highly basic protein of ribonuclease-A family that is released from matrix of eosinophil granules. In the recent past a number of studies have shown increased levels of ECP in serum and induced sputum of asthmatics. We carried out this study to find out correlation of serum ECP with severity of asthma. METHODS This study was carried out on 44 asthmatics and 44 matched controls at Department of Physiology, Army Medical College, Rawalpindi from June 2002 to December 2003. Lung function tests were done using spirometer (Vitalograph-Compact) and severity of asthma was graded into four classes, mild intermittent, mild persistent, moderate persistent and severe persistent. Serum was used to assess ECP by ELISA. Statistical correlation between ECP and severity of asthma as well as lung function t...
Eosinophil cationic protein: Is it useful in asthma? A systematic review
Respiratory Medicine, 2007
Introduction: Eosinophil cationic protein (ECP) has been widely investigated as a potential biomarker of airway inflammation. Method: A systematic review was performed using Medline with key terms eosinophil cationic protein and asthma, limiting the search to titles or abstracts. Out of 688 potential papers found, abstracts were reviewed based on the following criteria: (1) ECP was used as a biological marker, (2) asthma was the index disease studied, (3) it was a controlled clinical study and (4) ECP was assessed as a diagnostic, assessment or management tool. One hundred and sixty-nine articles satisfied the selection criteria and their full-text versions were reviewed. Only 53 papers were found to provide clinically useful information. Results: ECP has been measured in serum, plasma, sputum, saliva and broncho-alveolar lavage fluids but serum and sputum are the most established. Levels of ECP in normal and asthmatic subjects in various body fluids were identified. ECP correlates well with airway inflammation but not airway hyper-responsiveness. It is raised in other atopic diseases and hence is not diagnostic for asthma. However, it has been shown to be useful in assessing asthma severity, compliance with anti-inflammatory asthma therapy and as a guide to tailing down inhaled corticosteroid therapy. Although there is some evidence that ECP levels are affected by age, smoking, circadian rhythm and seasonal variation, only smoking appears to be of clinical significance.
World Allergy Organization Journal, 2009
Background: Serum and sputum eosinophil cationic protein (ECP) levels are correlated with asthma disease severity. Objective: To establish a diagnostic accuracy of ECP and lactate dehydrogenase (LDH) in serum (indirectly) and sputum (directly) as inflammatory markers in asthma. Patients and Methods: In a cross sectional study, 76 asthmatic patients with exacerbation were enrolled in the study. ECP was determined using enzyme linked immuno-assay. Results: Asthmatic patients compared with control subjects, had a significant higher levels of ECP and LDH in sputum. Both sputum and serum ECP and LDH were reduced significantly with prednisolone treatment. FEV1 was inversely correlated with sputum ECP, serum ECP, and sputum LDH. A significant positive correlation was noted between sputum ECP and sputum LDH. Serum LDH does not demonstrate any significant correlations with other variables. The area under receiver operating characteristic curve showed that sputum ECP (0.92) was a significantly an accurate marker more than serum ECP (0.81), sputum (0.80) LDH, and serum (0.65) LDH. Furthermore, the area under curve was lower for serum ECP (0.81) than that for sputum ECP (0.92). However, serum ECP (0.81) was more accurate marker than serum LDH (0.65). Conclusion: Serum and sputum ECP as eosinophilic inflammatory markers are associated with poor asthma control. Sputum ECP and LDH were significantly an accurate markers more than serum ECP and LDH.
Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy, 1999
Background The eosinophil plays a central role in the inflammatory process in bronchial asthma. Recent studies have indicated that the assessment of eosinophil-derived proteins in various body fluids could be used for monitoring disease activity of childhood asthma. Till now, no study exists which compared the levels of eosinophil-derived proteins in various body fluids such as serum, nasal lavage fluid (NALF) and urine. Objective To investigate whether eosinophil granule proteins in different compartments were correlated and whether there is a relationship betweeen disease activity, pulmonary function and bronchial hyperreactivity. Methods Twenty-eight children with atopic bronchial asthma were recruited. Serum, NALF and urine samples were obtained and assessed for eosinophil cationic protein (ECP) and eosinophil protein X (EPX). The levels of eosinophil proteins were analysed for a relationship with lung function variables, bronchial hyperreactivity and disease activity. Eleven healthy control subjects were used as controls. Results Median ECP and EPX concentrations in serum (31.4 and 74.8 mg/L vs 15.8 and 24.3 mg/L, respectively), NALF (9.9 and 44.9 mg/L vs 0 and 2.5 mg/L, respectively) and urine (49.4 vs 16.5 mg/mmol creatinine) were significantly raised in children with bronchial asthma compared with healthy control subjects. In addition, ECP and EPX levels in serum and urine samples were significantly higher in symptomatic patients compared with asymptomatic subjects with asthma. Although no relationship between eosinophil-derived proteins in serum, NALF or urine and the level of nonspecific bronchial hyperreactivity could be detected, the concentrations of EPX in serum and urine were correlated with variables of pulmonary function. Conclusion Our findings demonstrate increased eosinophil activity in serum, NALF and urine derived from children with bronchial asthma. Due to the relationship between levels of eosinophil proteins in serum/urine samples and lung function, as well as significant concentration differences between symptomatic and asymptomatic asthmatic children, the assessment of eosinophil proteins in serum or urine samples appear to be more appropriate in monitoring disease activity than measurement of ECP or EPX in NALF. Thus, the determination of serum ECP/EPX or urinary EPX may be preferentially used in monitoring eosinophilic inflammation in childhood asthma.
Eosinophilic cationic protein: Is it useful in assessing control of childhood asthma?
Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ
This study evaluated peripheral eosinophil and serum eosinophilic cationic protein (s-ECP) levels as markers of asthma control. A total of 38 children with asthma (16 controlled and 22 partially controlled) were compared with 16 age- and sex-matched healthy children. Total asthma cases had higher eosinophil counts and s-ECP levels than healthy children and partially controlled asthmatics had significantly higher levels of both markers than controlled asthmatics. Controlled asthma cases showed non-significant changes in both parameters versus healthy children. A negative correlation was noted between degree of asthma control and both eosinophil counts and s-ECP levels (r = -0.60 and -0.75 respectively). s-ECP as well as peripheral eosinophil count may be helpful in the assessment of asthma control.
Journal of Allergy and Clinical Immunology, 1997
Airway eosinophilic inflammation is a characteristic feature of asthma. This can be assessed directly by measurement of eosinophils and eosinophilic cationic protein (ECP) in sputum or indirectly by measurement of the same markers in blood. We investigated the performance of these markers of airway eosinophilic inflammation in a population of patients with asthma compared with control subjects and the extent to which the markers differed. In a cross-sectional study, subject characteristics were documented on day 1 and induced sputum and blood samples were obtained on day 2. Nineteen patients with asthma and 20 control subjects (10 healthy subjects and 10 smokers with nonobstructive bronchitis) were consecutively enrolled in the study. Sputum (selected from saliva) and blood samples were processed by persons blind to the clinical details. Results are presented as median values (minimum-maximum); differences were measured by Mann-Whitney U test. The accuracy of the tests (sensitivity and specificity) was measured by plotting the data in receiver-operating characteristic (ROC) curves and comparing the areas under the curve for each marker. Patients with asthma in comparison with control subjects had a higher proportion of sputum eosinophils (5.2% [0.2% to 93%] vs 0.3% [0% to 1.7%], p < 0.001), higher numbers of blood eosinophils (350.0 x 10(6)/L [144.0 to 1520.0 x 10(6)/L] vs 155.0 x 10(6)/L [34.0 to 426.0 x 10(6)/L], p = 0.003), and higher levels of ECP in sputum (1040.0 micrograms/L [76.8 to 32,000.0 micrograms/L] vs 455.3 micrograms/L [54.4 to 1280.0 micrograms/L], p = 0.001) but not in serum (25.0 micrograms/L [5.6 to 52.4 micrograms/L] vs 16.5 micrograms/L [3.3 to 36.0 micrograms/L], p = 0.08). Markers of airway inflammation in induced sputum and blood samples were correlated with clinical and physiologic variables. The area under the ROC curve showed that eosinophils in sputum (0.90) are significantly more accurate markers than blood eosinophils (0.72) and serum ECP (0.67) (p = 0.02). Although the area under the ROC curve for sputum ECP was greater than those for blood eosinophils and serum ECP, the differences could have occurred by chance (p > or = 0.1). We conclude that the proportion of eosinophils in sputum is a more accurate marker of asthmatic airway inflammation than the proportions of blood eosinophils or serum ECP.