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Evaluation of blood eosinophilia and the eosinophil cationic protein (ECP) in the serum of asthmatic children with varying degree of severity.

UNLABELLED
The inflammatory reaction is the main pathogenic mechanism of asthma: as the intensity of inflammation may be related with disease severity, it would be useful to have an easily obtained marker indicating the intensity of inflammation in patients. The best markers are obtained from bronchoalveolar lavage fluid (inflammatory cells and cytochemical mediators), but this technique is not often performed in children. In peripheral blood, eosinophils and eosinophilic enzymes have been related with bronchial inflammatory reactions and their levels have been shown to decline after corticoid treatment by inhalation.


OBJECTIVE
To determine if blood eosinophil count and eosinophilic cationic protein content (ECP) in serum are related with the intensity of bronchial inflammation and disease severity in asthmatic children.


MATERIAL AND METHODS
In a selection of children with bronchial asthma and Dermatophagoides pteronyssinus (D. Pt.) sensitivity, the following groups were made: group 2, 19 children with favorably evolving asthma and normal spirometric values (FEV1 and FMF25-75); group 3, 13 children with below-normal expiratory flow rates that normalized with salbutamol inhalation; group 4, 14 children with below-normal expiratory flow rates who did not recover after the bronchodilation test, suggesting more intense bronchial inflammation. The control group (group 1) contained 11 healthy subjects with negative allergy and respiratory function tests. All participants underwent bronchial challenge with D. Pt. extract. Serum eosinophil count and ECP were evaluated before challenge and 3 hours later. Respiratory function was watched for the next 24 hours.


RESULTS
There were significant differences in the eosinophil count and ECP between the control group and the three patient groups. Values differed before and after challenge in all groups. However, there were no significant differences between the three groups of asthmatic children.


CONCLUSIONS
Although the evolution of serum eosinophil count and ECP can be used to differentiate between children with and without asthma, they are not useful for judging the intensity of the bronchial mucosa inflammatory reaction.