哮喘患者三种细胞因子受体表达与气道高反应性研究

目的 了解Ｔ、Ｂ细胞在过生哮喘发病中的相互作用，可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）、淋巴细胞膜白细胞介素－２受体（ＩＬ－２Ｒ／ＣＤ２５）和ＩｇＥ抗体Ｆｅ段低亲合力受体ＦｃｅＲⅡ／ＣＤ２３）表达增强与气道高反应性（ＡＨＲ）的关系。方法对３１例过敏性喘患者和１２名健康人抗原吸入激发前后进行了肺功能测定，并检测了血清ｓＩＬ－２Ｒ、总ＩｇＥ（ＴＩｇＥ）、特异ＩｇＥ（ｓＩｇＥ）和ＣＤ２３、ＣＤ２５细胞     

过敏性哮喘患者二丙酸倍氯米松治疗前后血清嗜酸细胞阳离子蛋白水平的变化

分别测定发作期及缓解期过敏性哮喘共２９６例和４０例健康人血嗜酸性粒细胞（Ｅｏｓ）计数，血清嗜酸细胞阳离子蛋白（ＥＣＰ）和ＩｇＥ抗体。并观察了其中３０例患者吸入二丙酸倍氯米松（ＢＤＰ）４周前后上述指标和肺功能变化。结果：发作期过敏性哮喘患者血Ｅｏｓ计数，血清ＥＣＰ、ＴＩｇＥ、ｓＩｇＥ水平明显高于其它两组（均为Ｐ＜００１）。治疗前、后血Ｅｏｓ、ＥＣＰ和肺功能（ＦＥＶ１、ＰＥＦ、Ｒａｗ、ｓＧａｗ等）指标相比均有显著或非常显著性差异（Ｐ＜００５或Ｐ＜００１）。过敏性哮喘发作期病人Ｅｏｓ与ＥＣＰ水平变化呈高度正相关（ρ＝０７２１，Ｐ＜００１），而Ｅｏｓ、ＥＣＰ分别与ＦＥＶ１％呈高度负相关（ρ＝－０７８２，ρ＝－０６９５；Ｐ均＜００１）。结论：血清ＥＣＰ水平可作为哮喘气道炎症监测及指导治疗的客观指标     

哮喘患者IgE反应性研究

目的探讨ＩｇＥ与哮喘的关系及ＩｇＥ的遗传方式。方法用放射免疫法（ＣＡＣ－ＩＲＭＡ）测定１２１名健康人、１００例哮喘儿童的血清总ＩｇＥ，对其中２２例哮喘儿童的发作期与缓解期ＩｇＥ值作自身对照；并选择三个呈常染色体显性遗性（ＡＤ）的过敏性哮喘家系，用聚合酶链反应（ＰＣＲ）扩增，将ＩｇＥ水平与Ｄ１１Ｓ５３３作基因连锁分析，计算Ｌｏｄｓ。结果拟定ＩｇＥ＞１５０ｋＵ／Ｌ为偏高，健康人群中约有１／３者ＩｇＥ偏高；９６％哮喘儿童ＩｇＥ增高，与健康儿童相比差异有显著性（Ｐ＜０．００１）；哮喘儿童缓解期与发作期的ＩｇＥ变化，差异无显著性（Ｐ＝０．３）。三个家系４０名成员中有２３名ＩｇＥ值偏高，１５名患哮喘；家系１和３的ＩｇＥ总体水平高，家系２总体水平低，系谱分析表明，ＩｇＥ反应性符合ＡＤ遗传规律，以ＩｇＥ与Ｄ１１Ｓ５３３作二点连锁分析，二个家系２２次减数分裂中有２个重组体，θ＝０．０５时的Ｌｏｄｓ＞１．０。结论大多数哮喘儿童ＩｇＥ水平增高，其水平不受疾病严重性的影响；健康人群中约１／３者ＩｇＥ增高，为潜在的特异体质；ＩｇＥ反应性呈常染色体显性遗性，调控基因可能在１１ｑ１３．３～１３．４附近     

吸入皮质激素对哮喘患者血清嗜酸粒细胞和T－淋巴细胞功能的影响

为研究吸入皮质激素倍氯米松对哮喘患合体内嗜酸粒细胞、Ｔ－淋巴细胞功能状态的影响，对治疗前后哮喘患者血清嗜酸性阳离子蛋白（ＥＣＰ）、可溶性白细胞介素－２（ｓＩＬ－２Ｒ）浓度及患者乙酰甲胆碱气道反应性进行检测。结果表明。吸入皮质激素６周后，血清ＥＣＰ、ｓＩＬ－２Ｒ浓度降低，肺功能改善、乙酰甲胆碱－ＰＣ＿（２０）（ＦＥＶ＿１下降２０％时的乙酰甲胆碱激发浓度）值增高。提示：糖皮质激索能抑制嗜酸性粒细胞、Ｔ－淋巴细胞激活。具有抗炎和降低气道高反应性的作用。     

咳嗽变异型哮喘患者的肺功能及气道反应性特征

为探讨肺功能及气道反应性测定在诊断咳嗽变异型哮喘（ＣＶＡ）中的作用，用２２００型肺功能仪、６２００型体容积描计仪和ＡｓｔｏｇｒａｐｈＴＣＫ６１００气道反应测定仪检测了２２例典型哮喘患者、３５例ＣＶＡ患者和５１例正常健康者的肺功能及气道反应性。ＣＶＡ组的ＦＥＶ１／ＦＶＣ（％）（１秒钟用力呼气量占用力肺活量加百分比）高于哮喘组（Ｐ＜００１），但与正常组无差异（Ｐ＞００５）；Ｒａｗ（气道阻力）明显低于哮喘组（Ｐ＜００１），但高于正常组（Ｐ＜００１）；Ｒｒｓ（呼吸阻力）明显高于正常组（Ｐ＜００１），但明显低于哮喘组（Ｐ＜００５）。ＣＡＶ组和哮喘组间Ｄｍｉｎ（气道反应阈值）和ＳＧｒｓ（单位时间内诱导控制值之差）均无显著差异（Ｐ＞００５）。气道反应性测定及肺功能检查ＣＶＡ有较高临床价值     

夜间哮喘患者昼夜肺功能与血清嗜酸阳离子蛋白含量改变探讨

检测夜间哮喘患者昼夜肺细胞和气道反应性变化及血清嗜酸阳离子蛋白（ＥＣＰ）浓度改变，探讨嗜酸细胞与夜间哮喘的关系。提示：夜间嗜酸细胞释放ＥＣＰ增多可能是夜间哮喘患者肺功能周期性改变的重要因素之一。     

吸入皮质激素对哮喘患者血清嗜酸粒细胞和T—淋巴细胞功能的…

为研究吸入皮质激素倍氯米松对哮喘患者体内嗜酸粒细胞、Ｔ－淋巴细胞功能状态的影响，对治疗前后哮喘患者血清嗜酸性阳离子蛋白（ＥＣＰ）、可溶性白细胞介素－２（ｓＩＬ－２Ｒ）浓度及患者乙酰甲胆碱气道反应性进行检测。结果表明，吸入皮质激素６周后，血清ＥＣＰ、ｓＩＬ－２Ｒ浓度降低，肺功能改善，乙酰甲胆碱－ＰＣ２０（ＦＥＶ１下降２０％时的乙酰甲胆碱激发浓度）值增高。提示：糖皮质激素能抑制嗜酸性粒细胞、Ｔ－淋巴细     

白细胞介素—4和γ—干扰素对哮喘患者体外IgE合成调控的研究

目的为了探讨细胞因子在哮喘发病中的作用，寻找新的治疗途径。采用白细胞介素－４（ｒＩＬ－４）和γ－干扰素（ＩＦＮ－γ）对３０例哮喘患者及２５名空作对照，进行外周血单个核细胞（ＰＢＭＣ０体外ＩｇＥ合成调控的研究。结果 哮喘组ＰＢＭＣ体外自发合成ＩｇＥ明显高于对照组（ｔ＝４．４７１２，Ｐ〈０．００１）。经ｒＩＬ－４刺激后ＰＢＭＣ合成ＩｇＥ显著长高，ｒＩＬ－４诱导ＩｇE合成的程度哮喘组诱导低于对照组(ｔ＝４     

慢性干咳伴有气道高反应性即是咳嗽变异性哮喘吗？

目的评价气道反应性测定在咳嗽变异性哮喘（ＣＶＡ）诊断中的价值。方法１２４例慢性干咳患者经气道反应性测定后，分为咳嗽气道高反应阳性组（ＣＢＨ－Ｐ组）３５例，咳嗽气道高反应阴性组（ＣＢＨ－Ｎ组）３３例。观察常规肺功能、抗原皮肤点刺试验阳性率、血嗜酸性粒细胞计数、血ＩｇＥ水平、泼尼松试验阳性率并随访２年后发展成典型哮喘例数。结果３５例ＣＢＨ－Ｐ组一秒钟用力呼气容积占用力肺活量比值（ＦＥＶ１％）为７４±１０（Ｐ＜０．０１），３３例ＣＢＨ－Ｎ组为８３±１０（Ｐ＜０．０５）。抗原皮肤点刺试验阳性率ＣＢＨ－Ｐ组为５１％，ＣＢＨ－Ｎ组为１２％；血嗜酸性粒细胞计数ＣＢＨ－Ｐ组为０．５±０．１×１０９／Ｌ，ＣＢＨ－Ｎ组为０．３±０．１×１０９／Ｌ；泼尼松试验阳性率ＣＢＨ－Ｐ组为８３％，ＣＢＨ－Ｎ组为１５％。随访２年后发展成典型哮喘例数中ＣＢＨ－Ｐ组有１６例发展成典型哮喘。在ＣＢＨ－Ｐ组中发展成典型哮喘与未发展成典型哮喘患者在皮肤抗原点刺试验阳性率、常规肺功能、反应阈值（Ｄｍｉｎ）及致喘阈值（Ｄｃｗ／Ｄｍｉｎ）等方面差异均无显著性。结论气道反应性测定是诊断ＣＶＡ的重要依据，但不是唯一的诊断标准，还应结合其它临床资料综合判断     

以胸闷为主的哮喘患者临床,通气功能和变态反应特征

目的：阐明胸闷为主要症状的哮喘患者的临床、通气功能和变态反应特征及其相互关系。方法：测定２０例患者的临床、通气功能和变态反应参数,与典型哮喘和健康对照组比较。结果：胸闷为主要症状哮喘组超重、肥胖和变应体质者多见,晨间发作较明显,尤其在深呼吸时,可伴呼气相延长,不一定有哮鸣音,或仅偶闻散在哮鸣音;嗜酸性细胞阳离子蛋白（ＥＣＰ）８６±６０μｇ／Ｌ,ＩｇＥ８２０±５６０ｍｇ／Ｌ,２５％肺活量最大呼气流量３９％±１０％和５０％肺活量最大呼气流量４４％±１１％,与正常健康组相比有显著差别（Ｐ＜０．０５）。与典型哮喘组相比,哮鸣音和呼气相延长体征显著减少,ＥＣＰ值显著增加（Ｐ＜０．０５）。结论：在胸闷为主要症状的哮喘患者中,常年性接触室内过敏原是持续存在气道炎症的主要原因,ＥＣＰ可助长吸入非特异刺激原所致气道高反应性发病机制（而不同于ＩｇＥ依赖性）,小气道阻塞的表现是其主要的特征。     

IgE-mediated and age-related bronchial hyperresponsiveness in patients with asthma. relationship to family history of the disease

OBJECTIVE: to uncover any differences in the age-related and IgE-mediated pathophysiology of the airways in asthmatics. METHODS: we examined the relationship of both IgE-mediated bronchial hyperresponsiveness and the cell content of bronchoalveolar lavage fluid with a family history of asthma in 263 patients with asthma classified according to age at onset. RESULTS: bronchial hyperresponsiveness decreased significantly as age at onset increased in those without a family history. Responsiveness was significantly higher in patients who were > or = 60 years of age at onset who had a family history than in those who did not (P < 0.05). The proportion of lymphocytes in bronchoalveolar lavage fluid was significantly higher in patients between 50 and 59 years old at onset who had a family history than those who did not (P < 0.05). These results suggest that bronchial hyperresponsiveness and the proportion of bronchoalveolar lavage lymphocytes differ according to the presence or absence of a family history, a finding which is closely related to IgE-mediated allergy in elderly patients at onset. CONCLUSIONS: our findings suggest (i) the possibility of asthma induced by non-IgE-mediated allergy in elderly patients and (ii) that bronchial responsiveness is also influenced by IgE-mediated allergy and age at onset.     

双盲对照吸入倍氯以一年对道高反应性与哮喘的防治作用

目的 探讨长期吸入糖皮质激素对哮喘患的治疗作用和无症状的气道高反应性（ＢＨＲ）发生哮喘的预防作用。方法 以随机、双盲对照法比较５９例ＢＨＲ学生，年龄１２－１８岁，吸入倍氯米松粉剂（ＢＤＰ，６００μｇ／ｄ）安慰剂１年对气道反应性及哮喘症关诉作用。结果 试试验１年后哮喘ＢＤＰ组气道高反应性（使ＦＥＶ１较基础值下降２０％的累积吸入组胺量的对数ｌｇＰＤ２０－ＦＥＶ１）显下降（分别为０．３８５±０．４     

Serum eosinophil cationic protein (S-ECP) in a population with low prevalence of atopy

The study is a part of the European Community Respiratory Health Survey. A random sample (n = 351) of 20-44-year olds and persons of the same age with asthma-like symptoms or current asthma medication according to a postal questionnaire (n = 95) were studied. Interview was taken, methacholine challenge was done and ECP, total and specific IgE were measured from serum. The median S-ECP value was 8.0 micrograms/l in the random sample. The geometric mean of S-ECP was higher in subjects with, than without atopy (10.2 vs 8.9 micrograms/l, P < 0.01) and in subjects with bronchial hyperresponsiveness (BHR) than in subjects without BHR (9.9 vs 8.0 micrograms/l, P < 0.01). The levels correlated weakly to forced expiratory volume in one second (FEV1) (r = 0.13, P < 0.01) and were not independently correlated with respiratory symptoms, asthma or FEV1 after adjusting for BHR, IgE, sensitisation and smoking. Our results indicate that the level of eosinophil activation is low in a population with a low prevalence of atopy, even when BHR is common.     

Serum Eosinophil-Derived Neurotoxin (EDN) in Diagnosis and Evaluation of Severity and Bronchial Hyperresponsiveness in Childhood Asthma

This study sought to evaluate the use of serum eosinophil-derived neurotoxin (EDN), which has been proposed as a marker of airway inflammation in asthma in the diagnosis and evaluation of the severity and bronchial hyperresponsiveness in childhood asthma. We studied 72 children with atopic asthma, 36 children with nonatopic asthma, and 43 healthy controls. Skin prick tests, pulmonary function tests, and methacholine challenge tests were performed, in addition to total eosinophil count, serum ECP, and EDN being measured in all subjects. EDN levels were significantly higher in the atopic asthma group than those in the nonatopic asthma group or control group (p < 0.001), as were ECP levels (p < 0.001). EDN levels differed more significantly among groups divided by asthma severity (p < 0.001) than did ECP levels for these groups (p < 0.05). For the groups divided according to bronchial hyperresponsiveness, both EDN and ECP levels were significantly different (p < 0.005 and p < 0.01, respectively). Significant correlations were found between EDN and PC₂₀ (γ = −0.281; p < 0.001), between ECP and PC₂₀ (γ = −0.274; p < 0.005), and between EDN and ECP (γ = 0.443; p < 0.001). In conclusion, serum EDN, as another marker of eosinophilic inflammation together with ECP, may aid in the diagnosis of asthma, especially atopic asthma, and in the evaluation of the severity and bronchial hyperresponsiveness in childhood asthma.     

Reduction in bronchodilation following a deep inhalation is poorly related to airway inflammation in asthma.

In patients with bronchial asthma, forced expiratory flows are differently sensitive to a previous volume history. A reduced ability of a deep inhalation (DI) to dilate obstructed airways has been hypothesized to be a physiological marker for the degree of airway responsiveness and to relate to the presence and magnitude of inflammation in the lung, even in mild stable asthma. However, there are at present doubts as to whether functional changes could be used as a substitute for airway inflammation studies. In order to investigate the interrelations among airway inflammation, bronchial hyperresponsiveness and effects of volume history, 58 consecutive asthmatics with mild to moderate asthma were studied. The effects of DI were assessed as the isovolumic ratio of flows from forced expiratory manoeuvres started from maximal (M) or partial (P) lung inflation. Airway inflammation was assessed by using induced sputum. Sputum was analysed for total and differential cell counts, and levels of eosinophil cationic protein (ECP) which reflects eosinophil activation. Airway responsiveness was assessed as the provocative concentration of histamine which caused a 20% fall in forced expiratory volume in one second (FEV1) from control (PC20). The M/P ratio was significantly related to ECP (r=-0.31, p<0.03) and eosinophils (r=-0.29, p<0.03), FEV1/vital capacity (VC) (r=0.32; p<0.01), clinical score (r=-0.33; p<0.03) and age (r=-0.41; p<0.0001). In a stepwise multiple regression analysis including age, score, baseline lung function, ECP, number of eosinophils and the response to beta2-agonist, age (p<0.037) predicted a small amount of the variance in M/P ratio (r2=0.12). It is concluded that volume history response is substantially independent of both sputum outcomes (inflammatory cell number and eosinophil cationic protein) and bronchial hyperresponsiveness; rather it seems to be associated with anthropometric characteristics. Functional aspects do not provide information on eosinophilic, probably central, airway inflammation.     

Lung status in young Danish rurals: the effect of farming exposure on asthma-like symptoms and lung function.

The aim of this study was to assess the prevalence of asthma (self-reported) and relate this to lung function and factors associated with asthma in young farmers. Two hundred and ten female and 1,691 male farming students together with 407 males controls were studied. Each subject underwent a medical interview; forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were recorded using a dry wedge spirometer. Histamine bronchial reactivity was measured using the Yan method. Skin prick testing was performed using inhalant allergens. Nonsmokers had lower prevalence of asthma (5.4-10.8%) than smokers (11.3-21.0%) (p<0.05). Females reported symptoms of asthma nearly twice as often as males. Sex, smoking and a family history of asthma/allergy were significantly associated with asthma. Controls had higher standardized FEV1 and FVC residuals than male students, both nonsmokers (0.21 and 0.24) versus (-0.06 and -0.05) and smokers (0.29 and 0.33) versus (-0.11 and 0.13) (p<0.032). Bronchial hyperresponsiveness, asthma, siblings with allergy and working with cattle (controls only) were significantly associated with reduced lung function. In conclusion, the prevalence of asthma was significantly related to smoking, female sex, family history of asthma and allergy. Whilst bronchial hyperresponsiveness was associated with reduced lung function and lung function was slightly reduced in the male farming students, there was no association found between occupational farming exposure and either lung symptoms or lung function.     

Do respiratory symptoms predict chronic airflow obstruction and bronchial hyperresponsiveness in older adults?

BACKGROUND: Respiratory symptoms are common in older adults. In young populations the predictive value of such symptoms for chronic airflow obstruction and bronchial hyperresponsiveness is low. We investigated whether symptoms predict airflow obstruction and bronchial responsiveness in adults aged 45-86 years. METHODS: An age-stratified random sample of white adults aged 45 years and older was obtained from family doctor lists in Central Manchester, UK, and sent a respiratory symptoms questionnaire (exclusions: housebound, confused). Responders were invited to participate in a methacholine challenge (Newcastle dosimeter method; exclusions: ischemic heart disease, oral steroids, anticholinergic or beta-blocker medication). RESULTS: Of 783 eligible subjects, 723 responded (response rate 92.3%). Symptoms were reported by 53.8%. Methacholine challenge was completed by 208 subjects. Sixty-five (26.4%) had chronic airflow obstruction, of whom 76.6% reported respiratory symptoms. Bronchial hyperresponsiveness (PD20 < or = 100 micrograms) was present in 26.0% of subjects overall, and in 36.8% of symptomatic and 14.6% of asymptomatic subjects (p < .001). Of those with bronchial hyperresponsiveness, 26.4% were asymptomatic. Predictive values of symptoms for chronic airflow obstruction and bronchial hyperresponsiveness were low. CONCLUSIONS: Respiratory symptoms, chronic airflow obstruction, and bronchial hyperresponsiveness were all common in this adult population sample. However, the predictive value of symptoms for airflow obstruction/bronchial hyperresponsiveness was low. It was concluded that respiratory symptoms do not identify adults with airflow obstruction or bronchial hyperresponsiveness. Investigation by spirometry and peak flow monitoring is necessary to guide appropriate management.     

Methacholine challenge testing in Reserve Officer Training Corps cadets

STUDY OBJECTIVE: To determine the prevalence of positive results for methacholine challenge tests in asymptomatic Reserve Officer Training Corps (ROTC) cadets with no history of asthma. DESIGN: Prospective, blinded cohort comparison study. SETTING: Pulmonary diseases clinic in a US Army tertiary-care medical center. PATIENTS: One hundred three college students who were undergoing a physical examination before entering active duty. Group 1 subjects, 58 men and 5 women with an average age of 22.7 years, had no symptoms or personal history of asthma. Group 2 patients, 34 men and 6 women with an average age of 22.2 years, had a history or recent suggestive symptoms of asthma. INTERVENTIONS: Methacholine challenge testing using concentrations of 0.025, 0.25, 2.5, 10, and 25 mg/mL for a total dose of 188 inhalation units or until FEV(1) had declined by 20%. RESULTS: Group 2 had significantly more patients with positive results for methacholine challenge tests or reversible airflow obstruction at baseline (23 of 40 patients [57.5%]) than group 1 (8 of 63 patients [12.7%]; p < 0.05). The cadets in group 1 with positive results for methacholine challenge tests reacted with a 20% decline in FEV(1) at the following concentrations: 25 mg/mL (188 IU), 2 patients; 10 mg/mL (64 IU), 4 patients; and 2.5 mg/mL (13.8 IU), 2 patients. Using values calculated for the provocative concentration of a substance causing a 20% fall in FEV(1) and the new American Thoracic Society criteria, four patients would have borderline bronchial hyperresponsiveness (4 to 16 mg/mL) and three patients (4.8%) would have mild bronchial hyperresponsiveness (1 to 4 mg/mL). CONCLUSIONS: Asymptomatic US Army ROTC cadets with no history of asthma have possible false-positive responses to methacholine at concentrations > 0.25 mg/mL.     

Is asymptomatic bronchial hyperresponsiveness an indication of potential asthma? A two-year follow-up of young students with bronchial hyperresponsiveness.

To determine the possibility that asymptomatic bronchial hyperresponsiveness (BHR) develops into symptomatic asthma, a two-year follow-up study was conducted in 81 students (48 male, 33 female; 11 to 17 years) who were found to have BHR in a 3,067 population survey (BHR group). Eighty-eight age-matched students (48 male, 40 female) with normal bronchial responsiveness served as control subjects. Daily symptom cards were recorded. Peak expiratory flow rate was measured for 24 h when symptoms occurred. Histamine inhalation tests were performed at the beginning of the study and at the end of the first and the second year. In the BHR group, 58 students remained bronchial hyperresponsive at the end of follow-up. Nine of 31 students with initially diagnosed bronchial asthma had their symptoms relieved entirely, but ten asymptomatic students developed asthma. The incidence of newly diagnosed asthma (12.5 percent in the BHR group or 20 percent in the asymptomatic BHR group) and the total percentage of diagnosed asthma (39.5 percent) in the BHR group were significantly higher than those (2.27 percent, 2.27 percent) in the control group. FVC and FEV1 showed no significant difference between two groups. PD20 FEV1 values in newly diagnosed asthmatics were significantly lower than those in asymptomatic students both at the beginning (3.05 +/- 1.56 mumol vs 6.14 +/- 1.60 mumol, p < 0.05) or the end (3.47 +/- 1.73 mumol vs 6.55 +/- 1.51 mumol, p < 0.05). The percentage of early respiratory illness was significantly higher in those with newly diagnosed asthma (80 percent) than in asymptomatic students (22.3 percent), but atopic index and the percentage of parental asthma showed no difference between two groups. In nine asthmatics whose symptoms were relieved entirely in the two-year follow-up, PD20 FEV1 was undetectable within the cumulative dose of 7.8 mumol of histamine in three students and rose from 4.58 +/- 1.85 mumol to 7.62 +/- 1.02 mumol in the remaining six. The higher the BHR, the more likely the students developed asthma. About 45 percent of asymptomatic students with PD20 < or = 3.2 mumol developed asthma in the following two years and 80 percent of them had a history of early respiratory illness, suggesting that they may have subclinical or potential asthma.     

Serum ECP taken in the acute episode of bronchial obstruction can predict the development of bronchial asthma in young children.

For the early institution of anti-asthma treatment, reliable markers distinguishing the children with asthma from children with virus-associated wheeze are needed. Serum eosinophilic cationic protein (ECP) has been suggested as a marker correlating with the intensity of eosinophilic inflammation. We have studied 27 children (age 3 to 35 months) admitted with acute bronchial obstruction. Each child had been followed for 12 months after the first episode and then assigned to one of two groups (asthma or non-asthma) based on the clinical course. Serum ECP (s-ECP) was taken at the acute episode and again at least 6 months later, when the child was completely symptom-free. Serum ECP was analyzed using the Pharmacia CAP ECP FEIA immunofluorescence system. Mean s-ECP during the acute episode was 26.5 micrograms/L (5.5-69) in the asthma group (n = 14) and 9.7 (5.2-17 micrograms/L) in the non-asthmatics (n = 13), p < 0.01. There was no difference in the s-ECP analyzed during the symptom-free period. Elevated values of serum ECP taken during, but not outside, the acute episodes of bronchial obstruction may be helpful in predicting the development of bronchial asthma in young children with acute obstructive episodes.