Koller D Y, Wojnarowski C, Herkner K R, Weinländer G, Raderer M, Eichler I, Frischer T
University Children's Hospital, Division of Pulmonology and Allergy, Vienna, Austria.
J Allergy Clin Immunol. 1997 Jun;99(6 Pt 1):752-6. doi: 10.1016/s0091-6749(97)80007-3.
In association with respiratory tract infections, infants may have episodes of wheezing, which represent the onset of asthma in some of them. Activated eosinophils play a central part in asthmatic inflammation.
We investigated whether, in infants experiencing their first episode of wheezing, eosinophil activation is present and can predict the development of asthma.
In a prospective trial, eosinophil activation was measured by eosinophil cationic protein (ECP) concentrations in serum from 33 nonatopic infants with their first episode of wheezing, 15 nonatopic infants with upper respiratory tract infection without wheezing, and 18 healthy nonatopic infants. One year later, the children were re-evaluated for a diagnosis of infantile asthma.
Wheezing infants had higher median serum ECP levels (13.4 micrograms/L) than children with nonwheezy respiratory tract infection (7.6 micrograms/L, p < 0.005) or healthy subjects (7.1 micrograms/L, p < 0.005). In addition, wheezing infants (n = 13) with serum ECP concentrations greater than 20 micrograms/L were more likely to have asthma within 1 year than patients with ECP levels less than 20 micrograms/L (odds ratio = 12.4; confidence interval, 4.6-33.5).
Eosinophil activation measured by serum ECP is present in infants with their first episode of wheezing illness, especially in those infants in whom asthma subsequently develops within 1 year. These data may indicate a predictive value of serum ECP measurements in children with wheezing to identify those patients in whom infantile asthma is developing. These findings probably also indicate that serum ECP may be used to identify the children who need early antiinflammatory treatment.
与呼吸道感染相关，婴儿可能会出现喘息发作，其中一些婴儿的喘息发作代表哮喘的起病。活化的嗜酸性粒细胞在哮喘炎症中起核心作用。
我们研究了首次出现喘息发作的婴儿是否存在嗜酸性粒细胞活化，以及其是否能预测哮喘的发展。
在一项前瞻性试验中，通过测定33名首次出现喘息发作的非特应性婴儿、15名无喘息的上呼吸道感染非特应性婴儿和18名健康非特应性婴儿血清中的嗜酸性粒细胞阳离子蛋白（ECP）浓度来检测嗜酸性粒细胞活化情况。一年后，对这些儿童进行重新评估以诊断婴幼儿哮喘。
喘息婴儿的血清ECP水平中位数（13.4微克/升）高于无喘息的呼吸道感染儿童（7.6微克/升，p<0.005）或健康受试者（7.1微克/升，p<0.005）。此外，血清ECP浓度大于20微克/升的喘息婴儿（n = 13）在1年内患哮喘的可能性高于ECP水平低于20微克/升的患者（比值比=12.4；置信区间，4.6 - 33.5）。
首次出现喘息疾病的婴儿存在通过血清ECP检测到的嗜酸性粒细胞活化，尤其是那些在1年内随后发展为哮喘的婴儿。这些数据可能表明血清ECP检测对喘息儿童有预测价值，可识别出正在发展为婴幼儿哮喘的患者。这些发现可能还表明血清ECP可用于识别需要早期抗炎治疗的儿童。
