Ingram J M, Rakes G P, Hoover G E, Platts-Mills T A, Heymann P W
Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
J Pediatr. 1995 Oct;127(4):558-64. doi: 10.1016/s0022-3476(95)70112-5.
To compare eosinophil counts and concentrations of eosinophil cationic protein (ECP) in serum and nasal wash fluid from wheezing infants and children with those from age-matched children without respiratory tract symptoms.
A case-control study of 71 children treated for wheezing and 59 control subjects in the University of Virginia Pediatric Emergency Department. The patients ranged from 2 months to 16 years of age. Eosinophil numbers and ECP concentrations were assessed in serum and nasal washes. Total serum IgE was measured and the radioallergosorbent test was used to measure IgE antibody to common inhalant allergens.
Among children less than the age of 2 years, markedly elevated levels of ECP (> 200 ng/ml) were measured in nasal washes from 9 (41%) of 22 wheezing patients and 1 (6%) of 17 control subjects (p < 0.03). None of these children had a positive radioallergosorbent test result for IgE antibody to common aeroallergens or a nasal smear containing 10% eosinophils. Few of the wheezing children under 2 years of age had either increased concentrations of total IgE or ECP in their serum or an elevated total blood eosinophil count. After the age of 2 years, the percentage of patients with nasal ECP levels greater than 200 ng/ml was also significantly higher in wheezing children than in control subjects (p < 0.001), and a positive correlation was observed between ECP concentrations in their nasal washes and other eosinophil responses (total blood eosinophil counts, serum ECP levels, and nasal eosinophil counts).
Increased concentrations of ECP were detected in nasal washes from wheezing infants and children, indicating that eosinophils may contribute to the pathogenesis of airway inflammation in some children who wheeze early in life.
比较喘息婴幼儿和儿童与年龄匹配的无呼吸道症状儿童血清及鼻腔冲洗液中的嗜酸性粒细胞计数和嗜酸性粒细胞阳离子蛋白（ECP）浓度。
弗吉尼亚大学儿科急诊科对71例接受喘息治疗的儿童和59例对照受试者进行的病例对照研究。患者年龄范围为2个月至16岁。对血清和鼻腔冲洗液中的嗜酸性粒细胞数量和ECP浓度进行评估。检测总血清IgE，并采用放射变应原吸附试验检测针对常见吸入性变应原的IgE抗体。
在2岁以下儿童中，22例喘息患者中有9例（41%）鼻腔冲洗液中的ECP水平显著升高（>200 ng/ml），17例对照受试者中有1例（6%）如此（p<0.03）。这些儿童中无一例针对常见气传变应原的IgE抗体放射变应原吸附试验结果呈阳性，也无一例鼻腔涂片嗜酸性粒细胞含量达10%。2岁以下喘息儿童中很少有血清总IgE或ECP浓度升高或全血嗜酸性粒细胞计数升高的情况。2岁以后，喘息儿童鼻腔ECP水平大于200 ng/ml的患者百分比也显著高于对照受试者（p<0.001），且观察到其鼻腔冲洗液中ECP浓度与其他嗜酸性粒细胞反应（全血嗜酸性粒细胞计数、血清ECP水平和鼻腔嗜酸性粒细胞计数）之间呈正相关。
在喘息婴幼儿和儿童的鼻腔冲洗液中检测到ECP浓度升高，表明嗜酸性粒细胞可能在某些生命早期喘息儿童的气道炎症发病机制中起作用。
