Scher H, Berman D, Weinberg E G, Schinkel M, Peper B, Chalton D O, Potter P C
Allergy Clinic, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Clin Exp Allergy. 1996 Oct;26(10):1131-41.
Measurement of markers of eosinophil activation in asthmatics provides information indicative of ongoing inflammatory processes in the airways.
This study was conducted to determine the correlations between serum markers of allergic inflammation with spirometry parameters in asthmatic children in different treatment groups.
Blood eosinophils, serum levels of eosinophil cationic protein (ECP), eosinophil protein X (EPX), myeloperoxidase (MPO) and tryptase were measured simultaneously with serial measurements of FEV1/FVC, FEF25-75 and FEF in 60 children with acute asthma on admission and after 2, 14, 30 and 60 days. Group A received bronchodilators only (n = 20), group B received sodium cromoglycate (SCG) (n = 20) and group C received oral and/or inhaled corticosteroids (n = 20).
Oral steroid treatment (2 mg/kg/day), given at the onset of the asthma attack, resulted in significant reduction in the ECP and EPX levels in all the children. However, these reduced ECP and EPX levels were not sustained in the children, even in those who continued on maintenance steroid treatment. Significant, but inconsistent, correlations between ECP, EPX with total eosinophil count, Percentage eosinophils and spirometry parameters were observed at the different time-points. Tryptase levels were normal in all subjects. There were no significant correlations between myeloperoxidase levels and the spirometry parameters or eosinophil parameters. Serial monitoring of ECP and EPX levels was found to be of some use in predicting clinical outcome in certain steroid-dependent asthmatics (group C) but of no value in the mild asthmatics (group A).
While elevation of ECP, EPX and MPO in the serum of childhood asthmatics suggests ongoing inflammation and may inversely correlate with spirometry parameters in some patients, the relationship between these markers and airway function is not a simple one.
测量哮喘患者嗜酸性粒细胞活化标志物可提供气道中正在进行的炎症过程的相关信息。
本研究旨在确定不同治疗组哮喘儿童中过敏性炎症血清标志物与肺功能参数之间的相关性。
对60例急性哮喘儿童入院时以及入院后2天、14天、30天和60天同时进行血液嗜酸性粒细胞、血清嗜酸性粒细胞阳离子蛋白（ECP）、嗜酸性粒细胞蛋白X（EPX）、髓过氧化物酶（MPO）和类胰蛋白酶水平的测定，以及FEV1/FVC、FEF25 - 75和FEF的系列测量。A组仅接受支气管扩张剂治疗（n = 20），B组接受色甘酸钠（SCG）治疗（n = 20），C组接受口服和/或吸入糖皮质激素治疗（n = 20）。
在哮喘发作时给予口服类固醇治疗（2mg/kg/天）可使所有儿童的ECP和EPX水平显著降低。然而，即使是继续接受维持性类固醇治疗的儿童，这些降低的ECP和EPX水平也未能持续。在不同时间点观察到ECP、EPX与嗜酸性粒细胞总数、嗜酸性粒细胞百分比和肺功能参数之间存在显著但不一致的相关性。所有受试者的类胰蛋白酶水平均正常。髓过氧化物酶水平与肺功能参数或嗜酸性粒细胞参数之间无显著相关性。发现连续监测ECP和EPX水平对预测某些类固醇依赖型哮喘患者（C组）的临床结局有一定作用，但对轻度哮喘患者（A组）无价值。
虽然儿童哮喘患者血清中ECP、EPX和MPO升高提示存在持续炎症，且在某些患者中可能与肺功能参数呈负相关，但这些标志物与气道功能之间的关系并非简单的线性关系。
