CORRELATION OF EOSINOPHIL CATIONIC PROTEIN WITH SEVERITY OF ASTHMA

Authors

  • Ahmed Badar
  • Waseem Saeed
  • M Mazhar Hussain
  • Muhammad Aslam

Abstract

Background: Activated eosinophils play an important role in the pathogenesis of bronchial asthma. Upon activation eosinophils release their granular proteins. Eosinophil Cationic Protein (ECP) is a highly basic protein of ribonuclease-A family that is released from matrix of eosinophil granules. In the recent past a number of studies have shown increased levels of ECP in serum and induced sputum of asthmatics. We carried out this study to find out correlation of serum ECP with severity of asthma. Methods: This study was carried out on 44 asthmatics and 44 matched controls at Department of Physiology, Army Medical College, Rawalpindi from June 2002 to December 2003. Lung function tests were done using spirometer (Vitalograph-Compact) and severity of asthma was graded into four classes, mild intermittent, mild persistent, moderate persistent and severe persistent. Serum was used to assess ECP by ELISA. Statistical correlation between ECP and severity of asthma as well as lung function tests was calculated. Results: The asthmatics as compared with the controls had significantly more serum ECP. Serum ECP increased significantly with increase in severity of asthma (from mild intermittent to severe persistent). Serum ECP was negatively correlated with FEV1 and FEV1/FVC(r=-.823 and r=-.772, p<.001 respectively). There was a significant positive correlation between serum ECP and severity of asthma (r=0.947 p<0.001) Conclusions: We conclude from this study that serum ECP can be used as a useful laboratory investigation for severity of asthma.Keywords: Asthma, Eosinophil, Eosinophil Cationic Protein, ECP 

References

Gibbs DD. Medical History:Sir John Floyer, MD (1649-1734). BMJ 1969;I:242-5

Huber HL, Koessler KK. The pathology of bronchial asthma. Arch Intern Med 1922; 30: 689-760

Mitra SN, Slungaard A, Hazen SL. Role of eosinophil peroxidase in the origins of protein oxidation in asthma. Redox Rep 2000;5(4):215-24

Fujimoto K, Kubo K, Matsuzawa Y, Sekiguchi M. Eosinophil cationic protein levels in induced sputum correlate with the severity of bronchial asthma. Chest 1997;112(5):1241-7.

Gleich GJ. The eosinophil and bronchial asthma: current understanding. J Allergy Clin Immunol 1990;85: 422-36.

Onadeko BO, Khadadah ME, Mustafa HT, Ezeamuzie CI, Marouf R, Khamis A, et al. Serum eosinophil cationic protein as a predictor of disease activity in acute and chronic asthma. East Afr Med J 1999;76(9):524-9

Bessis M, Thiery H. Electron microscopy of human white bl-ood cells and their stem cells.Int Rev Cytol 1961;12:199-241.

Miller FE, de harven E, Palde GE. The structure of eosinophil leukocyte granules in rodents and man. J Cell Biol 1996;31:349-62.

Wardlaw AJ. Eosinophil trafficking in asthma. Clin Med 2001;1(3):214-8.

Spry C. Eosinophils. A comprehensive review and guide to the scientific and medical literature. Oxford, 1988, Oxford University Press, p.484.

Huber HL, Koessler KK. The pathology of bronchial asthma. Arch Intern Med 1922;30: 689-760

Kay AB. Asthma and inflammation. J Allergy Clin Immunol 1991;87:893-910.

Bentley AM, Menz G, Sortz CHR. Identification of T lymphocytes, macrophages and activated eosinophils in the bronchial mucosa in intrinsic asthma: Relationship to symptoms and bronchial responsiveness. Am Rev Respir Dis 1992;146:500-6.

Venge P. Soluble markers of allergic infl ammation. Allergy 1993:34:15-9

Boix E, Leonidas DD, Nikolovski Z, Nogues MV, Cuchillo CM, Acharya KR. Crystal structure of eosinophil cationic protein at 2.4 A resolution. Biochemistry. 1999;38(51):16794-801.

Venge P, Zetterstrom O, Dahl R, Roxin LE, Olsson I. Low levels of eosinophil cationic proteins in patients with asthma. Lancet 1977;2(8034):373-5

Dahl R, Venge P, Olsson I.The content of eosinophil cationic protein in eosinophil leucocytes. Study on normal controls and patients with bronchial asthma.Allergy 1978;33(3):152-4

Dahl R, Venge P. Blood eosinophil leucocyte and eosinophil cationic protein. In vivo study of the influence of beta-2-adrenergic drugs and steroid medication. Scand J Respir Dis 1978;59(6):319-22.

Carreras E, Boix E, Rosenberg HF, Cuchillo CM, Nogues MV. Both aromatic and cationic residues contribute to the membrane-lytic and bactericidal activity of eosinophil cationic protein. Biochemistry. 2003;42(22):6636-44.

Simon HU, Yousefi S, Schranz C, Schapowal A, Bachert C, Blaser K. Direct demonstration of delayed eosinophil apoptosis as a mechanism causing tissue eosinophilia. J Immunol 1997; 158:3902–8.

Maeda T, Kitazoe M, Tada H, de Llorens R, Salomon DS, Ueda M et al.Growth inhibition of mammalian cells by eosin-ophil cationic protein. Eur J Biochem 2002;269(1):307-16.

Mallorqui-Fernandez G, Pous J, Peracaula R, Aymami J, Maeda T, Tada H et al. Three-dimensional crystal structure of human eosinophil cationic protein (RNase 3) at 1.75 A resolution. J Mol Biol 2000;300(5):1297-307.

Sorkness C, McGill K, Busse WW. Evaluation of serum eosinophil cationic protein as a predictive marker for asthma exacerbation in patients with persistent disease. Clin Exp Allergy 2002;32(9):1355-9

American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. Am Rev Respir Dis 1987;136: 225-44.

Parra A, Sanz ML, Vila L, Prieto I, Dieguez I, Oehling AK. Eosinophil soluble protein levels, eosinophil peroxidase and eosinophil cationic protein in asthmatic patients. J Investig Allergol Clin Immunol 1999;9(1):27-34

Dal Negro R, Micheletto C, Tognella S, Mauroner L, Burti E, Turco P et al. Effect of inhaled beclomethasone dipropionate and budesonide dry powder on pulmonary function and serum eosinophil cationic protein in adult asthmatics. J Investig Allergol Clin Immunol. 1999;9(4):241-7.

Di Lorenzo G, Drago A, Pellitteri ME, Candore G, Colombo A, Potestio M, Di Salvo A, Mansueto S, Caruso C. Serum levels of soluble CD23 in patients with asthma or rhinitis monosensitive to Parietaria. Its relation to total serum IgE levels and eosinophil cationic protein during and out of the pollen season. Allergy Asthma Proc 1999;20(2):119-25.

Numao T, Fukuda T, Hirata A, Sagara H, Majima K, Nakajima H et al. Eosinophil cationic protein in patients with bronchial asthma. Arerugi 1991;40(2):93-9

Zubovic I, Rozmanic V, Ahel V, Banac S. Manifold significance of serum eosinophil cationic protein in asthmatic children. Acta Med Croatica 2002;56(2):53-6.

Krug N, Napp U, Enander I, Eklund E, Rieger CH, Schauer U. Intracellular expression and serum levels of eosinophil peroxidase (EPO) and eosinophil cationic protein in asthmatic children. Clin Exp Allergy 1999;29(11):1507-15.

Kunkel G, Ryden AC. Serum eosinophil cationic protein (ECP) as a mediator of inflammation in acute asthma, during resolution and during the monitoring of stable asthmatic patients treated with inhaled steroids according to a dose reduction schedule. Inflamm Res 1999;48(2):94-100.

Badr-el-Din OM, el-Sawy IH, el-Azzouni OE, Badr-el-Din MM, Salem AM. Eosinophil cationic protein as a serological marker of disease activity in childhood bronchial asthma. East Mediterr Health J 1999;5(4):664-75

Schmekel B, Ahlner J, Malmstrom M, Venge P. Eosinophil cationic protein (ECP) in saliva: a new marker of disease activity in bronchial asthma. Respir Med 2001;95(8):670-5

Azevedo I, de Blic J, Scheinmann P, Vargaftig BB, Bachelet M. Eosinophil cationic protein in bronchoalveolar lavage from wheezy infants. J Investig Allergol Clin Immunol 1997;7(5):346-7.

Robinson DS. Eosinophil cationic protein (ECP) and eosinophil protein X (EPX) concentrations in serum and bronchial lavage fluid in asthma. Effect of prednisolone treatment. Clin Experimental allergy 1995;25(11):1118-27.

Villa-Asensi JR, Garcia-Hernandez G, Boya-Cristia MJ, Rueda-Esteban S, Marin-Ferrer M, Nogales-Espert A. Eosinophil cationic protein in the asthmatic infant: correlation with the clinic and pulmonary function. An Esp Pediatr 1996;45(5):479-82.

Dal Negro R, Tognella S, Micheletto C, Pomari C, Burti E, Mauroner L, Turco P. Serum eosinophil cationic protein and bronchial hyperresponsiveness to hypoosmolar challenge in naive atopic asthmatics. J Investig Allergol Clin Immunol 1998;8(5):294-9.

Wever AM, Wever-Hess J, Hensgens HE, Hermans J. Serum eosinophil cationic protein (ECP) in chronic asthma. Relationship to spirometry, flow-volume curves, PC20, and exacerbations. Respir Med 1994;88(8):613-21.

Motojima S, Tateishi K, Koseki T, Makino S, Fukuda T. Serum levels of eosinophil cationic protein and IL-5 in patients with asthma without systemic corticosteroids. Int Arch Allergy Immunol 1997;114 Suppl 1:55-9.

Koller DY, Nilsson M, Enander I, Venge P, Eichler I. Serum eosinophil cationic protein, eosinophil protein X and Eosinophil peroxidase in relation to pulmonary function in cystic fibrosis. Clin Exp Allergy 1998;28(2):241-8.

Jang AS, Choi IS, Koh YI, Jeong TK, Lee KY, Kim YS et al. Effects of prednisolone on eosinophils, IL-5, eosinophil cationic protein, EG2+ eosinophils, and nitric oxide metabolites in the sputum of patients with exacerbated asthma. J Korean Med Sci 2000;15(5):521-8

Niggemann B, Ertel M, Lanner A, Wahn U. Relevance of serum ECP measurements for monitoring acute asthma in children. J Asthma 1996;33(5):327-30

Vatrella A, Ponticiello A, Parrella R, Romano L, Zofra S, DiLeva A, et al. Serum eosinophil cationic protein (ECP) as a marker of disease activity and treatment efficacy in seasonal asthma. Allergy 1996;51(8):547-55

Marks GB, Kjellerby J, Luczynska CM, Burney PG. Serum eosinophil cationic protein: distribution and reproducibility in a randomly selected sample of men living in rural Norfolk, UK. Clin Exp Allergy 1998;28(11):1345-50.

Prehn A, Seger RA, Faber J, Torresani T, Molinari L, Gerber A, Sennhauser FH. The relationship of serum-eosinophil cationic protein and eosinophil count to disease activity in children with bronchial asthma. Pediatr Allergy Immunol 1998;9(4):197-203.

Juntunen-Backman K, Jarvinen P, Sorva R. Serum eosinophil cationic protein during treatment of asthma in children. J Allergy Clin Immunol 1993;92(1 Pt 1):34-8.

Wilson NM, James A, Uasuf C, Payne DN, Hablas H, Agrofioti C et al. Asthma severity and inflammation markers in children. Pediatr Allergy Immunol. 2001;12(3): 125-32.

Hasegawa M, Fujisawa T, Komada M, Uchida Y, Haibara C. Measurement of serum eosinophil cationic protein levels in bronchial asthma. Arerugi 1991;40(3 Pt 1):173-80.

Miyoshi M, Sakurai T, Kodama S. Measurement of serum eosinophil cationic protein levels in patients with bronchial asthma--analysis according to various clinical backgrounds. Arerugi 1991;40(11):1391-8.

Jang AS, Choi IS. Eosinophil activation markers in induced sputum in asthmatics. Korean J Intern Med. 2000;15(1): 1-7.

Vanto T, Koskinen P. Serum eosinophil cationic protein in the evaluation of asthma severity in children. Allergy 1998;53(4):415-9.

Ishigaki N, Masuhara C, Sakamaki K, Ishikawa Y, Ohta K, Koike R et al. Relation between serum eosinophil cationic protein (ECP) level and asthma attack in children. Arerugi 2000;49(11):1093-103

Niimi A, Amitani R, Suzuki K, Tanaka E, Murayama T, Kuze F. Serum eosinophil cationic protein as a marker of eosinophilic inflammation in asthma. Clin Exp Allergy. 1998;28(2):233-40.

Yoshizawa A, Kamimura M, Sugiyama H, Kudo K, Kabe J. Eosinophil cationic protein in serum from adults with asthma and with chronic obstructive pulmonary disease. Nihon Kyobu Shikkan Gakkai Zasshi 1996;34(1):24-9.

Nakazawa T, Kagami M, Matumura R, Kawashima T, Matuzuwa Y, Takada M. Sensitivity of sputum eosinophil cationic protein level for monitoring asthmatic patients with normal peak expiratory flow. Arerugi 1999;48(10):1153-60

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