engleski

SERUM EOSINOPHIL CATIONIC PROTEIN (ECP), MYELOPEROXIDASE (MPO) AND EOSINOPHILS IN CHILDHOOD ASTHMA

The aim of the study was to evaluate values of dynamic monitoring of serum ECP, MPO and peripheral eosinophil counts (PEC), their specificity and sensitivity in treated asthmatic children. Methods:155 children, age 10.8 ± 3.8 years, 20 healthy (Control) and 135 children with mild and moderate asthma, 60 were treated with: inhaled steroid (IS: fluticasone propionate 100 – 200 mcg daily), 25 under specific immunotherapy (SIT) and 50 with ketotifen (KF: 2 mg daily). Duration of therapy was in IS: 1.4 ± 0.8 (mean ± SD), SIT: 3.9 ± 1.6 and in KF group: 2.2 ± 1.4 years. ECP and MPO were measured by radioimmunoassay method. ECP-1 was measured at the beginning, and ECP-3 at the end of the therapy. PEC is presented as absolute number of eosinophils in 1 mm3 of blood at the beginning (PEC-1) and at the end of therapy (PEC-2). In statistic analysis we used Kruskal-Wallis and Friedman analysis of variance, Mann-Whitney and chi-square tests. Results:Serum ECP of Control group is statistically significantly decreased in relation to the: IS, SIT and KF groups for ECP-1 (p = 0.000), ECP-2 (p = 0.003), but for ECP-3 difference is not significant. MPO shows no significant differences among the examined groups. Statistically significant decrement of ECP is shown for IS group between ECP-1 and ECP-3 (p = 0.003) and for SIT group between ECP-1 and ECP-2 (p = 0.002) and between ECP-1 and ECP-3 (p = 0.017). There is no significant difference of ECP-1, ECP-2 and ECP-3 for KF group. IS and SIT group shows no statistically significant differences for PEC. PEC-2 comparing to PEC-1 is significantly higher for KF group (p = 0.002), which suggests low efficiency of therapy. The difference between MPO-1 and MPO-2 is not significant for IS group. Conclusion: Serum concentration of ECP is higher in asthmatic than in Control group, with sensitivity 64%, and specificity 87% (with cut-off level of ECP in serum of 19.7 mcg/l). Significant decrement of ECP follows good therapeutic effect for IS and SIT group, which can not be said for KF group. PEC is not as sensitive as ECP, although their values are similar. There are no significant differences for MPO between astmathic children and Control group, and between MPO-1 and MPO-2 in IS group. Sensitivity of MPO (with cut-off level of 634 mcg/l) is low: 11%, and specificity: 94%, which essentially limits its use as a marker in treatment of childhood asthma.

ECP; MPO; Eosinophils; Asthma; Children

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