Inflammation markers and symptom activity in children with bronchial asthma. Influence of atopy and eczema

Background. Eosinophil cationic protein (ECP) has been reported to reflect the eosinophil inflammatory activity in asthma. However, the relative impact of asthma symptoms and atopic eczema upon serum (s)-ECP in asthmatic children has not not been established. Objectives. To examine s-ECP levels and s-myeloperoxidase (MPO) in relation to asthma symptoms and atopic eczema in asthmatic children. Methods. S-ECP and s-MPO were assessed in relation to symptom activity, lung function, exercise-induced bronchoconstriction and bronchial responsiveness in 101 children; median age 9 years, range 1-16 years; with moderate to severe asthma, admitted to Voksentoppen Center. Results. S-ECP was significantly higher in children with persistent compared to episodic or no asthma symptoms in the past four weeks. S-ECP was also higher in children with atopic compared to non-atopic asthma, as well as in those with active compared to past history or no history of atopic eczema. S-MPO was higher in children with persistent asthma symptoms, but did not differ in relation to atopy or eczema state. Persistent asthma symptoms had the greatest impact upon s-ECP levels, followed by atopy and active eczema. Conclusion. S-ECP may be used in assessing symptom activity in asthmatic children, but with the realisation that active eczema and the presence of atopy may also influence levels.