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TOTAL EOSINOPHILS, EOSINOPHILIC CATIONIC PROTEIN (ECP) AND PROTEIN X (EPX) IN ASTHMATIC PATIENTS YOUNGER THAN AGE 5

We previously showed that serum ECP levels in teenagers with acute asthma correlated with severity of acute asthma (JACI 87:1991, #433). 27 asthmatics median age 2 years had eosinophils, ECP and EPX quantitated prior to therapy. Atopic patients (13 with at least 1 positive prick skin test) had higher levels of eosinophils, ECP and EPX compared to non-atopic (Eos 0.61 vs 0.34 p = 0.03; ECP 36.9 μg/l vs 15.7, p<0.001; EPX 63.2 vs 23.1, p<0.001). One patient at 1 year of age had no skin tests positive, serum IgE of 8 μg/l and ECP of 50.1. One year later, he was positive to peanut confirming atopy. 13 of these patients required treatment with continuous inhaled steroid, 9 atopic, mean ECP 39.0 and 4 non-atopic, mean ECP 11.9, p<0.001. After inhaled steroid 6 atopics were reassessed. ECP level decreased to 21.0, p = 0.03. We conclude that atopic asthma in young children is associated with higher levels of ECP and EPX than non-atopic suggesting heterogeneity in the mechanism of inflammation. In one instance the elevated ECP predicted atopy before IgE antibody. With treatment ECP fell suggesting decreased activity of eosinophils.