Markers of eosinophil activation in fasting gastric juice in infants with wheezing episodes

Abstract

Rationale Children with wheezing during early childhood represent different subgroups with regard to pathophysiology and prognosis. Transient wheezing does not need early treatment whereas persistent wheezing especially with atopy has a high risk of subsequent asthma, making early recognition important, although there is no reliable predictor of asthma. In this study we examined eosinophils and eosinophil cationic protein (ECP), in order to find a reliable and practical laboratory marker for forthcoming clinical characteristics of asthma in infants with wheezy bronchitis. Methods The study group consisted of thirty infants (19 boys and 11 girls), mean age 1.3 ± 0.8 (min:0.2, max:3) years, who were coming with acute episode of wheezing attacks. They were divided into two groups; Group 1: with only one or two episodes, and Group 2: with three or more episodes. Important demographic data and history of personal and family atopy, peripheral eosinophilia, serum ECP level, ECP in fasting gastric juice, total IgE were recorded for each child and compared between the groups. Results There were no difference in serum ECP levels, peripheral and gastric juice eosinophilia between the two groups. However, mean level of gastric juice ECP was 78.24 ± 86.57 u/gl for Group 1, and 148.87 ± 83.57 u/gl for Group 2, and the difference between the groups were statistically significant (p=0.027). Conclusion Gastric juice ECP level was the only parameter significantly higher in group with three and more wheezing attacks. We conclude that high levels of gastric juice ECP may be an important marker for subsequent wheezing attacks.