Niimi A, Amitani R, Suzuki K, Tanaka E, Murayama T, Kuze F
Department of Infection and Inflammation, Chest Disease Research Institute, Kyoto University, Japan.
Clin Exp Allergy. 1998 Feb;28(2):233-40. doi: 10.1046/j.1365-2222.1998.00217.x.
The serum level of eosinophil cationic protein (ECP) has been used as a clinical marker in asthma, on the assumption that it reflects ongoing eosinophilic inflammation of the airways. However, only a few studies have investigated this issue, using bronchial secretions but not tissue specimens.
To evaluate cross-sectionally the correlation between serum ECP level or blood eosinophil count, and the degree of eosinophilia in bronchoalveolar lavage fluid (BALF) and bronchial biopsy tissue, and disease activity, in asthmatic patients.
Thirty-three adults with symptomatic asthma and six healthy controls were studied. The blood eosinophil count, ECP levels in serum and BALF, percentage of eosinophils in BALF, number of eosinophils in bronchial tissue, pulmonary function, and methacholine bronchial responsiveness of these subjects were clarified. An asthma severity score and inhaled beta2-agonist requirement (puffs/day) were also assessed for the asthmatic patients.
The asthmatic patients, compared with the controls, had more obstructive (as tested by %FEV1, FEV1/FVC, and FEF25-75%) and more responsive airways, and showed a significant increase in the number of eosinophils in the blood, BALF, and tissue, and in the serum ECP levels. The ECP levels in BALF were below the detection limit for most of the subjects in both groups examined. In the asthmatic patients, serum ECP level demonstrated correlations with the number or percentage of eosinophils in BALF and tissue, whereas the blood eosinophil count correlated only with the percentage of eosinophils in BALF. Serum ECP level correlated with all indices of disease activity examined; %FEV1, FEV1/FVC, FEF25-75% bronchial responsiveness, severity score and beta2-agonist usage, whereas the blood eosinophil count correlated only with %FEV1 and bronchial responsiveness.
The data suggest that serum ECP level reflects the intensity of eosinophilic airway inflammation, as well as the disease activity, and may be useful as an inflammatory marker in asthma.
嗜酸性粒细胞阳离子蛋白（ECP）的血清水平已被用作哮喘的临床标志物，基于其反映气道持续嗜酸性粒细胞炎症的假设。然而，仅有少数研究使用支气管分泌物而非组织标本对该问题进行了调查。
横断面评估哮喘患者血清ECP水平或血嗜酸性粒细胞计数与支气管肺泡灌洗液（BALF）及支气管活检组织中嗜酸性粒细胞增多程度和疾病活动度之间的相关性。
对33例有症状的成年哮喘患者和6名健康对照者进行研究。明确了这些受试者的血嗜酸性粒细胞计数、血清和BALF中的ECP水平、BALF中嗜酸性粒细胞百分比、支气管组织中嗜酸性粒细胞数量、肺功能及乙酰甲胆碱支气管反应性。还评估了哮喘患者的哮喘严重程度评分及吸入β2受体激动剂的需求量（每日吸数）。
与对照组相比，哮喘患者气道阻塞更严重（通过FEV1%、FEV1/FVC和FEF25-75%检测）且反应性更高，血液、BALF和组织中的嗜酸性粒细胞数量及血清ECP水平显著升高。两组中大多数受试者BALF中的ECP水平低于检测限。在哮喘患者中，血清ECP水平与BALF和组织中嗜酸性粒细胞的数量或百分比相关，而血嗜酸性粒细胞计数仅与BALF中嗜酸性粒细胞百分比相关。血清ECP水平与所检测的所有疾病活动指标相关；FEV1%、FEV1/FVC、FEF25-75%、支气管反应性、严重程度评分及β2受体激动剂使用情况，而血嗜酸性粒细胞计数仅与FEV1%和支气管反应性相关。
数据表明血清ECP水平反映嗜酸性粒细胞气道炎症的强度以及疾病活动度，可能作为哮喘的炎症标志物。
