5岁以下喘息儿童血清白细胞介素-10测定的临床意义

目的探讨5岁以下喘息儿童外周血IL-10和血清总IgE在不同临床表型中的表达及其临床意义。方法随机选取2010年12月-2011年4月于本院就诊的5岁以下反复喘息患儿76例,分为有特应质高危因素的喘息Ⅰ组和无特应质高危因素的喘息Ⅱ组;健康对照组为同期本院儿童保健部体检的健康儿童23例。采用ELISA法测定3组患儿外周血IL-10与总IgE水平。结果喘息Ⅰ组、喘息Ⅱ组IL-10水平均高于健康对照组(Pa<0.01),喘息Ⅰ组IL-10水平高于喘息Ⅱ组,差异有统计学意义(P<0.05)。喘息Ⅰ组总IgE水平明显高于喘息Ⅱ组和健康对照组,差异有统计学意义(Pa<0.01),喘息Ⅱ组总IgE水平和健康对照组之间差异无统计学意义(P>0.05)。喘息Ⅰ组血清IL-10水平与总IgE水平呈正相关(r=0.726,P<0.01),喘息Ⅱ组和健康对照组血清IL-10水平与总IgE水平均无相关性(r=0.043、0.048,Pa>0.05)。结论对5岁以下不能完成呼吸道激发试验和变应原测试的喘息患儿,检测血清IL-10及总IgE水平可区分不同临床表型,可为儿童哮喘的早期临床干预提供一定依据。     

5岁以下喘息儿童血清白细胞介素-17表达的意义

目的观察5岁以下喘息儿童血清IL-17水平及外周血嗜酸性粒细胞(EOS)计数,探讨IL-17水平和EOS计数对5岁以下儿童喘息评估的临床意义。方法随机选取在本院就诊的5岁以下反复喘息患儿53例。男43例,女10例。分为有特应质高危因素组(喘息Ⅰ组)(n=27),无特应质高危因素组(喘息Ⅱ组)(n=26)。从同期在本院外科诊治的斜疝、肾结石等非感染性疾病术前患儿中随机抽取同年龄患儿20例作为对照组(n=20)。男11例,女9例。3组儿童均在治疗前抽取静脉血3 mL,离心后留取血清标本置-70℃冰箱保存,双抗体夹心ELISA法测定血清IL-17水平,采用伊红染色法行外周血EOS计数。结果喘息Ⅰ组、喘息Ⅱ组IL-17水平[(1 469.315±978.300)ng.L-1、(263.340±131.800)ng.L-1]明显高于对照组[(36.478±2.000)ng.L-1](Pa<0.01),其中喘息Ⅰ组患儿IL-17水平高于喘息Ⅱ组,差异有统计学意义(P<0.05);喘息Ⅰ组外周血EOS计数[(0.546±0.100)×109L-1]明显高于喘息Ⅱ组[(0.095±0.005)×109L-1]和对照组[(0....     

毛细支气管炎患儿外周血白细胞介素-12的意义

目的探讨白细胞介素（interleukin,IL）-12在毛细支气管炎发病过程中的意义。方法选取59例2岁以下毛细支气管炎患儿,分为毛支Ⅰ组（n=28）和毛支Ⅱ组（n=31）,其中毛支Ⅰ组为具有特应质高危因素的患儿,毛支Ⅱ组为无特应质高危因素的患儿。同期住院的同年龄段支气管肺炎患儿36例和患有疝气、肾结石等非感染性疾病术前患儿31例分别作为肺炎对照组和正常对照组,分别检测4组患儿外周血IL－12的水平。结果毛支Ⅰ组患儿外周血IL-12为（34．72±7．96）pg／ml;毛支Ⅱ组患儿外周血IL-12为（55．30±6．72）pg／ml;肺炎对照组患儿及正常对照组患儿外周血IL-12分别为（56．79±10．36）pg／ml、（61．23±11．51）pg／ml,其中毛支Ⅰ组与毛支Ⅱ组相比,外周血IL-12水平降低,差异有统计学意义（P〈0．05）;毛支Ⅰ组与肺炎对照组、正常对照组相比,外周血IL-12水平显著降低,差异有统计学意义（P〈0．05）;毛支Ⅱ组与肺炎对照组、正常对照组相比,外周血IL-12水平降低,差异有统计学意义（P〈0．05）;肺炎对照组与正常对照组相比,外周血IL-12水平差异无统计学意义（P〉0．05）。结论血清IL-12降低是毛细支气管炎发病的重要因素,具有特应质高危因素的毛细支气管炎患儿IL-12降低更为明显。     

Clara细胞分泌蛋白10基因G38A多态性与5岁以下喘息患儿的相关性

目的探讨5岁以下喘息患儿Clara细胞分泌蛋白10(CC10)基因G38A位点多态性与喘息发病机制的关系。方法随机选取于本院就诊的5岁以下反复喘息患儿120例,分为有特应质高危因素的喘息Ⅰ组(n=67)(湿疹45例,父母或父母一方有哮喘病史13例,变应性鼻炎5例,变应性皮炎4例)和无特应质高危因素的喘息Ⅱ组(n=53);对照组为本院外科近期无感染疾病史、择期进行手术的术前患儿(n=55)。采用PCR-限制性片段长度多态性分析对喘息组和对照组患儿CC10 G38A位点基因型频率和等位基因频率进行检测,比较3组间CC10 G38A位点基因型频率和等位基因频率。结果喘息Ⅰ组、喘息Ⅱ组和对照组3种基因型AA、GA、GG分布频率分别为20.9%、44.8%、34.3%,9.4%、32.1%、58.5%、9.1%、31.0%、60.0%;喘息Ⅰ组和喘息Ⅱ组CC10基因G38A位点基因型频率比较差异有统计学意义(P<0.05);喘息Ⅰ组和对照组CC10基因G38A位点基因型频率比较差异亦具有统计学意义(P<0.05)。喘息Ⅰ组、喘息Ⅱ组和对照组38A和38G等位基因频率分别为43.3%、56.7%,25.5%、74.5%,24.5%、75.5%;喘息Ⅰ组和喘息Ⅱ组、喘息Ⅰ组和对照组比较差异均有统计学意义(Pa<0.05)。结论喘息患儿与哮喘存在相同的基因分布频率,发生哮喘的危险性高;对于CC10基因具有A等位基因的喘息患儿应密切关注。     

5岁以下喘息儿童鼻咽分泌物嗜酸性粒细胞和IL-17测定的临床意义

目的：探讨5岁以下喘息儿童鼻咽分泌物中嗜酸性粒细胞(EOS)计数和白介素-17（IL-17）水平在喘息评估中的临床意义。方法：53例5岁以下反复喘息患儿,分为有特应性体质的喘息Ⅰ组27例,非特应性体质的喘息Ⅱ组26例;非感染性疾病术前患儿20例作为对照组,分别收集鼻咽分泌物并处理后,显微镜下计数各组鼻咽分泌物中细胞数,用ELISA方法检测上清液中IL-17水平。结果：喘息Ⅰ组鼻咽分泌物中EOS计数明显高于喘息Ⅱ组和对照组（P＜0.05、P＜0.01);喘息喘Ⅱ组鼻咽分泌物中EOS计数和对照组比较差异无统计学意义（P＞0.05）;喘息Ⅰ组和喘息Ⅱ组患儿鼻咽分泌物中IL-17表达均高于对照组（P＜0.01）,其中喘息Ⅰ组IL-17水平高于喘息Ⅱ组,差异有统计学意义(1 474±974 pg/mL vs 788±132 pg/mL; P＜0.05);喘息Ⅰ组IL-17水平和EOS呈正相关（r=0.62,P＜0.05)。结论：检测鼻咽分泌物中EOS和IL-17可以作为识别5岁以下有发展为哮喘倾向的喘息儿童的指标,并给予早期临床干预和治疗。［中国当代儿科杂志,2010,12（2）：113-116］     

血清Clara 细胞分泌蛋白、总IgE与嗜酸性粒细胞阳离子蛋白在儿童哮喘检测中的临床意义

目的探讨血清Clara细胞分泌蛋白（CC16）、总IgE和嗜酸性粒细胞阳离子蛋白（ECP）检测在哮喘儿童中的意义。方法采用酶联免疫吸附法（ELISA）测定59例哮喘患儿急性发作期血清CC16水平,同时应用UniCAP100变态反应检测仪检测血清总IgE、ECP;另设30例健康儿童作为健康对照组。结果与健康对照组比较,哮喘组血清CC16水平显著降低、血清总IgE、ECP水平显著增高（t=2.93,2.72,4.52Pa〈0.01）;中重度哮喘发作患儿血清CC16水平显著低于轻度发作患儿（t=5.26P〈0.05）,中重度哮喘发作患儿血清总IgE显著高于轻度发作患儿（t=3.89P〈0.05）,血清ECP水平在哮喘轻度发作组与中重度发作组比较无统计学差异（t=1.57P〉0.05）;哮喘组血清CC16与总IgE呈显著负相关（r=-0.602P〈0.05）,血清CC16与ECP（r=0.153P〉0.05）及总IgE与ECP（r=0.290P〉0.05）无相关。结论血清CC16降低与总IgE、ECP水平增高在儿童哮喘发病过程中发挥重要作用;血清总IgE、CC16可反映哮喘发作严重程度;血清ECP水平高低并不能反映呼吸道炎症严重程度。     

血清生长激素和胰岛素样生长因子-Ⅰ在危重症中的变化及临床意义

目的 探讨血清生长激素（growth hormone,GH）和胰岛素样生长因子-Ⅰ （insulin like growth factor-Ⅰ,IGF-Ⅰ）在危重症患儿中的变化及其临床意义.方法 选择2009年1月至2012年1月同期入住PICU的脓毒症患儿42例为脓毒症组,先天性心脏病择期在体外循环下行开胸手术治疗后的患儿20例为术后组,检测入院次日及手术后次日晨血清GH和IGF-Ⅰ水平,选择健康体检儿童60例为对照组,比较组间GH、IGF-Ⅰ水平的变化.结果 脓毒症组GH水平为（6.71±6.62） ng/ml,术后组GH水平为（8.86±8.06） ng/ml,,两者均显著高于对照组（3.87±3.31） ng/ml,差异有统计学意义（P＜0.05）,而脓毒症组与术后组之间差异无统计学意义;脓毒症组IGF-Ⅰ水平为（63.72±54.17） ng/ml,与术后组（119.06±102.12） ng/ml和健康对照组（154.22±107.10） ng/ml比较,显著降低,差异有统计学意义（P＜0.05）,术后组与对照组比较差异无统计学意义;脓毒症组内存活者与死亡者比较GH无统计学意义差异,IGF-Ⅰ水平显著降低（P＜0.05）.结论 危重症时GH水平升高对机体应激具有积极作用;脓毒症时IGF-Ⅰ水平显著降低,可作为反映重症感染存在的较灵敏指标,并有助于判断预后.     

喘息婴幼儿外周血气道炎症相关介质水平的研究

目的 通过检测喘息婴幼儿外周血相关炎症介质水平,从辅助性T细胞（Th）1/Th2失衡及气道炎症两个方面探讨婴幼儿喘息发生的可能机制。方法 选取急性喘息发作婴幼儿50例为喘息组,25例健康婴幼儿为健康对照组。喘息组患儿依据喘息发生次数分为首次喘息组（首发组）25例和反复喘息组（反复组,发作次数≥ 2次）25例;根据是否存在哮喘发生的高危因素分为有高危因素组22例和无高危因素组28例;根据病原学检测结果分为病原学阳性组23例和病原学阴性组27例。检测各组外周血Th1细胞因子白介素（IL）-2,Th2细胞因子IL-4、IL-5、IL-13、转化生长因子-β1（TGF-β1）,以及总IgE （TIgE）水平。喘息组患儿同时送检外周血嗜酸性粒细胞（EOS）计数,并采集标本进行呼吸道病原学检测。结果 喘息组外周血IL-4、IL-5、IL-13、TGF-β1及TIgE水平较健康对照组均明显升高（P < 0.05）;外周血IL-2、IL-4、IL-5、IL-13、TGF-β1及TIgE水平在首发组与反复组,有哮喘高危因素组与无哮喘高危因素组,以及病原学阳性组与病原学阴性组之间比较,差异均无统计学意义（P > 0.05）。相关性分析表明喘息组外周血EOS计数与IL-4水平呈正相关（P < 0.01）;IL-4水平与IL-5、IL-13水平呈正相关（P < 0.01）;IL-5水平与IL-13水平呈正相关（P < 0.01）;IL-2水平与TGF-β1水平呈正相关（P < 0.05）。结论 喘息婴幼儿存在Th1/Th2失衡,表现为Th2优势表达;IL-4、IL-5、IL-13、TGF-β1及IgE共同参与了婴幼儿喘息性疾病的发病过程。喘息婴幼儿存在气道炎症,与喘息发作次数、是否存在哮喘高危因素及病原学检测是否阳性无关。     

支气管哮喘儿童血清25-（OH）D3和总免疫球蛋白E的变化

目的：研究支气管哮喘儿童血清25-羟维生素D3［25-（OH）D3］和总免疫球蛋白E（TIgE）的变化及临床意义。方法采用放射免疫分析法,检测30例支气管哮喘、40例喘息性支气管炎患儿及40例正常对照儿童血清25-（OH）D3及TIgE含量,比较3组间其血清含量的差异。结果支气管哮喘组血清25-（OH）D3含量（18±3 ng/mL）明显低于喘息性支气管炎组（43±3 ng/mL）和正常对照组（43±3 ng/mL）,且TIgE含量（192±16 IU/mL）明显高于喘息性支气管炎组（123±14 IU/mL）和正常对照组（118±15 IU/mL）,差异均有统计学意义（P＜0.01）。支气管哮喘组血清25-（OH）D3与TIgE呈负相关（r=-0.783,P＜0.01＝,喘息性支气管炎组、正常对照组血清25-（OH）D3与TIgE均无相关性。结论血清25-（OH）D3缺乏可能是导致儿童支气管哮喘发作的原因。血清25-（OH）D3水平增高可以抑制IgE的过度表达,这可能成为预防和治疗支气管哮喘等过敏性疾病的一种新的有效途径。     

生长因子β1对儿童哮喘的作用及孟鲁司特钠对其影响

目的 探讨生长因子β1在儿童哮喘中的作用及观察孟鲁司特钠对其的影响。方法 筛选2009年9月-2010年9月我院哮喘专病门诊轻度持续哮喘患儿60例及来院健康体检儿童30例,将哮喘患儿随机分成孟鲁司特钠组和安慰剂对照组;采用双抗夹心酶联免疫吸附试验( ELISA)、RT-PCR技术分别检测治疗前后患儿血浆中TGF-β1水平和外周血单个核细胞(PBMC)中TGF-β1mRNA表达;采用流式细胞技术,检测表达叉状头/翅膀状螺旋转录因子3的CD4T调节细胞(Foxp3+ CD4+ Treg)及各亚型的比例。结果 (1)血浆中TGF-β1水平：治疗前哮喘组[(11.51±1.12) ng/L]明显低于健康对照组[(47.92±1.52) ng/L](q=20.01,P＜0.01);治疗后,孟鲁司特钠组[ (20.03±1.14)ng/L]高于安慰剂组[(12.10±3.91) ng/L]（q=14.62,P＜0.05）,但均值仍低于健康对照组;(2)外周血单个核细胞中TGF-β1 mRNA表达：治疗前哮喘组(0.31 +0.07)明显低于健康对照组(0.61±0.2) (q =8.97,P＜0.05);治疗后,孟鲁司特钠组(0.46±0.13)表达高于安慰剂组(0.32±0.04)（q=8.25,P＜0.05）,但仍低于健康对照组;(3)流式细胞检测结果各组间比较差异有统计学意义(P＜0.05)：哮喘患儿与健康对照组相比,Foxp3+ CD4+ Treg细胞比例增加[(8.30±1.30)％,(6.05±1.80)％];其中CD45 RA+ Foxp3lo比例增高[(4.60±1.04)％,(3.27±1.03)％];CD45 RA - Foxp3h1比例降低[(0.75±0.13)％,(0.93±0.26)％];CD45 RA-Foxp3lo比例两组差异无统计学意义。治疗后,孟鲁司特钠组较安慰剂组,aTreg细胞占Foxp3+ CD4+ Treg比例增加[(1.16±0.24)％,(0.89±0.22)％],差异有统计学意义。结论哮喘儿童体内存在血浆及外周血单个核细胞中TGF-β1表达的降低,可能是导致哮喘发病的重要原因;孟鲁司特钠能有效改善TGF-β1的表达并通过调节Foxp3的表达来发挥治疗作用。     

CD14基因多态性与儿童特应性疾病的相关性

目的研究脂多糖受体基因（CD14）多态性在温州地区汉族儿童中的分布特征及其与特应性疾病的关联。方法特应征组113例,病例入选符合下列标准：（1）年龄2～12岁的汉族儿童;（2）临床诊断为哮喘、过敏性鼻炎或特应性皮炎;（3）血清总IgE升高;（4）血清特异性IgE阳性。选取2～12岁正常体检儿童79例为对照组。应用免疫荧光法测定血清总IsE,UniCAP系统测定sIgE。应用测序法测定两组儿童CD14基因序列,寻找多态位点,调查多态位点的分布特征,比较两组儿童多态位点的基因型频率和等位基因频率,比较不同基因型的血浆IgE水平。结果（1）特应征组和对照组儿童均发现CD141—159多态性,以TT基因型为主,未发现其他多态位点。其中对照组儿童TT、TC、CC3种基因型频率分别为57．0％、28．0％和15．0％,特应征组儿童TT、TC、CC3种基因型频率分别为46.9％、35．4％和17．7％,按Hardy-Weinberg平衡吻合度检验,差异无统计学意义（x^2=3．462,P〉0．05）。两组的基因型频率和等位基因频率分布差异无统计学意义（x^2=1．918,P〉0．05）。（2）不同性别间基因型频率差异无统计学意义（x^2=3．458,P〉0．05）。（3）经对数转换,CD14/—159CC基因型、TC基因型和TT基因型的血清IgE分别为（2500±460）IU／L、（2400±460）IU／L、（2520±460）IU／L,方差分析差异无统计学意义（F=0．807,P〉0．05）。结论（1）温州地区汉族儿童存在CD141—159多态性,未发现CD14基因其他多态位点。温州地区汉族儿童CD141—159基因型以TT为主。（2）未发现CD141—159基因型和特应征发病及IgE水平之间的关联。     

The Natural History of IgE Sensitisation and Atopic Disease in Early Childhood

ABSTRACT. We have prospectively followed 57 children of atopic parents up to 5 years of age, documenting clinical atopic disease and allergen skin test reactions. The cumulative prevalences of the clinical features of atopic disease over the 5 years were: atopic dermatitis (58%), wheeze (49%), recurrent wheeze (33%), rhinitis (68%) and immediate food reactions (18%). Atopic dermatitis and immediate food reactions predominated in infancy (birth to 20 months) while wheezing was more prominent in later childhood (20 months to 5 years). Rhinitis was common in both infancy and childhood. IgE sensitisation to ingested allergens was prominent in early infancy and was usually transient. Inhaled allergen sensitisation occurred later in infancy and was generally permanent with wheal sizes tending to increase with age. There was a significant association between IgE sensitisation to ingested but not inhaled allergens and all atopic manifestations in infancy, with the exception of rhinitis. In contrast IgE sensitisation to inhaled allergens was associated with rhinitis and wheeze in later childhood. We found two clinical groups. One group, with only ingested allergen sensitisation had a high incidence of atopic dermatitis but low incidence of respiratory symptoms at 5 years of age. The other group, who developed evidence of IgE sensitisation to inhaled allergens, had a high incidence of rhinitis and wheeze but low incidence of atopic dermatitis at 5 years of age.     

The natural history of IgE sensitisation and atopic disease in early childhood

We have prospectively followed 57 children of atopic parents up to 5 years of age, documenting clinical atopic disease and allergen skin test reactions. The cumulative prevalences of the clinical features of atopic disease over the 5 years were: atopic dermatitis (58%), wheeze (49%), recurrent wheeze (33%), rhinitis (68%) and immediate food reactions (18%). Atopic dermatitis and immediate food reactions predominated in infancy (birth to 20 months) while wheezing was more prominent in later childhood (20 months to 5 years). Rhinitis was common in both infancy and childhood. IgE sensitisation to ingested allergens was prominent in early infancy and was usually transient. Inhaled allergen sensitisation occurred later in infancy and was generally permanent with wheal sizes tending to increase with age. There was a significant association between IgE sensitisation to ingested but not inhaled allergens and all atopic manifestations in infancy, with the exception of rhinitis. In contrast IgE sensitisation to inhaled allergens was associated with rhinitis and wheeze in later childhood. We found two clinical groups. One group, with only ingested allergen sensitisation had a high incidence of atopic dermatitis but low incidence of respiratory symptoms at 5 years of age. The other group, who developed evidence of IgE sensitisation to inhaled allergens, had a high incidence of rhinitis and wheeze but low incidence of atopic dermatitis at 5 years of age.     

Total serum IgE and outcome in infants with recurrent wheezing.

OBJECTIVE: To investigate the relation between total serum IgE at 0.5-3 and 3-6 years, and the risk of allergic sensitisation and persistent wheezing up to 8 years of age. METHODS: Prospective follow up study of 45 infants with highly recurrent wheezing, no allergic symptoms, and negative skin tests. RESULTS: In the last follow up year, 15 children still suffered from wheezing. Five wheeze-free and four episodically wheezing children had become sensitised. No association was found between early (0.5-3 years) IgE z scores and the recurrence of wheezing during follow up, or atopic sensitisation. IgE z scores at 3-6 years were significantly higher in children with positive skin tests (p = 0.013), but were still not associated with recurrence of wheezing. CONCLUSIONS: In subjects with frequent early wheezing and no signs of atopy, early total serum IgE measurements are not predictive of outcome.     

Serum eosinophilic cationic protein may predict clinical course of wheezing in young children

Thirty eight children aged between 2 and 4 years with three or more episodes of wheezing were studied to evaluate the role of eosinophil inflammation and its relation to persistence of wheezing two years later. Serum eosinophilic cationic protein, total eosinophil count, total IgE, skin prick test, and clinical features were evaluated at visit 1. Two years later at a second clinical evaluation the children were separated into two groups: group 1, those with persistent wheezing (n = 20); group 2, those who had been asymptomatic over the past six months (transient wheezing) (n = 18). Mean (SEM) eosinophilic cationic protein at visit 1 was higher in group 1 than in group 2 (29.63 (5.16) v 14.42 (2.77) micrograms/l), and the probability of continuing wheezing at age 5 years was greater in children with values > or = 20 micrograms/l at visit 1 than in those with lower values (relative risk = 2.88, 95% confidence interval 1.42 to 5.87, p < 0.001). Eosinophil inflammation is present from the beginning of the disease in the children who are going to continue with wheezing at age 5 years. The measurement of serum eosinophilic cationic protein may help in evaluating which wheezing infants are going to continue with asthma in the future.     

具有喘息症状或过敏性疾病的年幼儿皮肤点刺试验结果分析

目的：通过分析0~5岁儿童变应原皮肤点刺试验结果,了解具有喘息症状的可疑哮喘及过敏性疾病症状的患儿对吸入变应原过敏反应的特点,为儿童哮喘及过敏性疾病的早期诊断提供依据。方法：选择2010年9月1日至12月31日长沙市某社区0~5岁具有喘息症状或过敏性疾病症状的患儿共102例为变应原筛查组;对照组选择同年龄组无喘息及过敏性疾病史的儿童94例。两组均进行变应原皮肤点刺试验。结果：变应原筛查组皮肤点刺试验阳性率61.8%（63/102）明显高于对照组的9.6%（9/94）,差异有统计学意义（P<0.05）;反复喘息合并过敏性鼻炎者的皮肤点刺试验阳性率明显高于单纯喘息组（P<0.05）;喘息次数与皮肤点刺试验阳性率呈正相关（r=0.91,P<0.05）;对螨虫的皮肤点刺试验阳性率（24.2%）明显高于其他过敏原（3.5%）,差异有统计学意义（P<0.05）;粉尘螨的皮肤点刺阳性率（50.0%）明显高于屋尘螨（14.7%）,差异有统计学意义（P<0.05）。结论：早期儿童喘息可能是发生过敏性哮喘的重要因素;变应原皮肤点刺试验是诊断过敏性疾病的重要依据,并有助于评估喘息患儿对吸入性变应原的过敏反应特点。     

Molecular mimicry in autoimmune disease

Thirty eight children aged between 2 and 4 years with three or more episodes of wheezing were studied to evaluate the role of eosinophil inflammation and its relation to persistence of wheezing two years later. Serum eosinophilic cationic protein, total eosinophil count, total IgE, skin prick test, and clinical features were evaluated at visit 1. Two years later at a second clinical evaluation the children were separated into two groups: group 1, those with persistent wheezing (n = 20); group 2, those who had been asymptomatic over the past six months (transient wheezing) (n = 18). Mean (SEM) eosinophilic cationic protein at visit 1 was higher in group 1 than in group 2 (29.63 (5.16) v 14.42 (2.77) µg/l), and the probability of continuing wheezing at age 5 years was greater in children with values ⩾ 20 µg/l at visit 1 than in those with lower values (relative risk = 2.88, 95% confidence interval 1.42 to 5.87, p < 0.001). Eosinophil inflammation is present from the beginning of the disease in the children who are going to continue with wheezing at age 5 years. The measurement of serum eosinophilic cationic protein may help in evaluating which wheezing infants are going to continue with asthma in the future.