Kim Chang-Keun, Callaway Zak, Fletcher Rachel, Koh Young Yull
Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
J Asthma. 2010 Jun;47(5):568-73. doi: 10.3109/02770901003792833.
Eosinophil numbers and eosinophil cationic protein (ECP) levels have been proposed as markers of disease activity; however, the usefulness of eosinophil-derived neurotoxin (EDN)--another eosinophil granular protein--as a marker in pediatric asthma has not been established.
The authors compared the concentrations of blood eosinophil counts (TECs), serum ECP, and serum EDN to asthma symptom severity in young children.
Forty-three young children with asthma (Asthma group: mean age, 2.9 years; range, 1.4-5.0 years) were evaluated during both the acute and stable phases of disease. Asthma severity was measured using a symptom-scoring technique, and serum eosinophil indices (EDN and ECP levels and TECs) were determined. Nineteen age-matched controls (Control group: mean age, 2.7 years; range, 1.0-5.0 years) were used for comparison.
Levels of serum EDN, serum ECP, and TECs were significantly higher in children with acute asthma compared with Controls (p < .0001). However, in stable asthma only EDN and ECP levels differed significantly when compared to Controls (p < .0001 and p < .001, respectively). When comparing acute and stable phases, EDN and TECs differed significantly (p < .0001), whereas ECP did not. Symptom scores correlated significantly with EDN (r = 0.850, p < 0.0001), ECP (r = 0.374, p < 0.01) and TECs (r = 0.457, p < 0.01) in acute asthma patients. When symptom scores were divided into three subgroups based on severity, only EDN levels showed significant differences amongst the three groups.
These findings suggest that serum EDN is a useful marker for identifying disease activity in children with asthma. EDN levels may better reflect disease severity than ECP levels or total eosinophil counts.
嗜酸性粒细胞数量和嗜酸性粒细胞阳离子蛋白（ECP）水平已被提议作为疾病活动的标志物；然而，嗜酸性粒细胞衍生神经毒素（EDN）——另一种嗜酸性粒细胞颗粒蛋白——作为小儿哮喘标志物的效用尚未确立。
作者比较了幼儿血液嗜酸性粒细胞计数（TECs）、血清ECP和血清EDN浓度与哮喘症状严重程度的关系。
对43名患有哮喘的幼儿（哮喘组：平均年龄2.9岁；范围1.4 - 5.0岁）在疾病的急性期和稳定期进行评估。使用症状评分技术测量哮喘严重程度，并测定血清嗜酸性粒细胞指标（EDN和ECP水平以及TECs）。选取19名年龄匹配的对照儿童（对照组：平均年龄2.7岁；范围1.0 - 5.0岁）进行比较。
与对照组相比，急性哮喘患儿的血清EDN、血清ECP和TECs水平显著更高（p < .0001）。然而，在稳定期哮喘中，与对照组相比仅EDN和ECP水平有显著差异（分别为p < .0001和p < .001）。比较急性期和稳定期时，EDN和TECs有显著差异（p < .0001），而ECP没有。在急性哮喘患者中，症状评分与EDN（r = 0.850，p < 0.0001）、ECP（r = 0.374，p < 0.01）和TECs（r = 0.457，p < 0.01）显著相关。当根据严重程度将症状评分分为三个亚组时，只有EDN水平在三组之间显示出显著差异。
这些发现表明血清EDN是识别哮喘患儿疾病活动的有用标志物。EDN水平可能比ECP水平或嗜酸性粒细胞总数更能反映疾病严重程度。
