Background. We investigated the predictive value and the relative risk of the evaluation of serum eosinophilic cationic protein (sECP) and total IgE levels concomitantly in relation to the persistence of wheezing in young children. Methods. The study was conducted prospectively between January 2007 and December 2010. A hundred and eight children, aged between three months and four 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. Results. A statistically significant difference in terms of total IgE and sECP values was observed between the groups ( ). When measurement of IgE and sECP was assessed concomitantly, the sensitivity was found to be 92.68%, the negative predictive value was found to be 71.43%, accuracy rate was found to be 84.26%, and the relative risk was found to be 3.06 in group 1. Conclusions. In this study, we aimed to emphasize the importance of the assessment of sECP and total IgE concomitantly, as being two noninvasive and easily applicable tests, useful in predicting persistent wheezing in early childhood. 1. Introduction Wheezing is a musical sound frequently heard during expiration. It is heard in the form of a prolonged whistle and occurs mostly together with diseases that constrict the lower respiratory tract and rarely the upper respiratory tract. Wheezing is a frequent complaint among patients seeking admission to hospital. It often occurs in early childhood, although it may be observed in people of all ages. Chronic or recurrent wheezing may be caused by several etiological factors. It is a controversial topic as to whether or not children who wheeze in their early childhood will also develop asthma in the future. Asthma generally starts during the first years of life. However, young wheezing children are a heterogeneous group. About 60% of early wheezers suffer transitory disease and become asymptomatic when they reach 5-6 years of age, with only 40% continuing with asthma at this age. Identifying infants who will go on to develop persistent wheezing and determining whether inhaled anti-inflammatory drugs, or other treatments, can block the processes leading to chronic asthma are important challenges in the prevention of this common disease. Conventional modalities remain incapable of diagnosing and following up people with asthma. Respiratory function tests and prick tests, which are commonly used to establish clinical diagnoses, exhibit some difficulties when applied to young children. Therefore, assessments
References
[1]
S. Ahlstedt, Y. Enander, C. G. B. Peterson, and A. Lanner, “The clinical assessment of the inflammatory component in asthma with emphasis on the eosinophils,” Practial Allergy & Immunology, vol. 3, pp. 149–154, 1992.
[2]
E. Adelroth, L. Rosenhall, S. A. Johansson, M. Linden, and P. Venge, “Inflammatory cells and eosinophilic activity in asthmatics investigated by bronchoalveolar lavage. The effects of antiasthmatic treatment with budesonide or terbutaline,” American Review of Respiratory Disease, vol. 142, no. 1, pp. 91–99, 1990.
[3]
T. Sugai, Y. Sakiyama, and S. Matumoto, “Eosinophil cationic protein in peripheral blood of pediatric patients with allergic diseases,” Clinical and Experimental Allergy, vol. 22, no. 2, pp. 275–281, 1992.
[4]
H. Matsumoto, A. Niimi, M. Minakuchi, and T. Izumi, “Serum eosinophil cationic protein levels measured during exacerbation of asthma: characteristics of patients with low titres,” Clinical and Experimental Allergy, vol. 31, no. 4, pp. 637–643, 2001.
[5]
J. R. Villa, G. García, S. Rueda, and A. Nogales, “Serum eosinophilic cationic protein may predict clinical course of wheezing in young children,” Archives of Disease in Childhood, vol. 78, no. 5, pp. 448–452, 1998.
[6]
D. Y. Koller, C. Wojnarowski, K. R. Herkner et al., “High levels of eosinophil cationic protein in wheezing infants predict the development of asthma,” Journal of Allergy and Clinical Immunology, vol. 99, no. 6, pp. 752–756, 1997.
[7]
T. M. Reijonen, M. Korppi, L. Kuikka et al., “Serum eosinophil cationic protein as a predictor of wheezing after bronchiolitis,” Pediatric Pulmonology, vol. 23, no. 6, pp. 397–403, 1997.
[8]
V. Peona, M. D. Amici, S. Quaglini et al., “Serum eosinophilic cationic protein: is there a role in respiratory disorders,” Journal of Asthma, vol. 47, no. 2, pp. 131–134, 2010.
[9]
J. Gasiorowska, M. Czerwionka-Szaflarska, M. Gruszka, G. Swincow, and G. Odrowaz-Sypniewska, “Analysis of eosinophilic cationic protein levels in infants and children with wheezy bronchitis,” Polski Merkuriusz Lekarski, vol. 22, no. 128, pp. 134–139, 2007.
[10]
K. ？ymar and R. Bjerknes, “Is serum eosinophil cationic protein in bronchiolitis a predictor of asthma?” Pediatric Allergy and Immunology, vol. 9, no. 4, pp. 204–207, 1998.
[11]
M. Khadadah, B. O. Onadeko, C. I. Ezeamuzie, H. T. Mustafa, R. Marouf, and T. N. Sugathan, “The association of skin test reactivity, total serum IgE levels, and peripheral blood eosinophilia with asthma in Kuwait,” Journal of Asthma, vol. 37, no. 6, pp. 481–488, 2000.
[12]
S. Pedersen and L. Agertoft, “Effect of long term budosenide treatment on growth,weight and lung function in childrenwith asthma,” American Review of Respiratory Disease, vol. 147, p. A265, 1993.
