Changes in serum eotaxin and eosinophil cationic protein levels, and eosinophil count during treatment of childhood asthma
Yu-Te Chu, Wen Chiang, Tsu-Nai Wang, Chih-Hsing Hung, Yuh-Jyh Jong, Jiunn-Ren Wu
Departments of Pediatrics and Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung; Departments of Public Health and Pediatrics, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung; and Department of Pediatrics, Kaohsiung Municipal Hsiaokang Hospital, Kaohsiung, Taiwan
Received: March 7, 2006 Revised: June 20, 2006 Accepted: July 3, 2006
Background and purpose:
Increased serum levels of eotaxin are related to the severity of asthma in adults. There are limited data on the effects of oral corticosteroids and inhaled corticosteroid therapy on serum levels of eotaxin and eosinophil cationic protein (ECP) and peripheral blood eosinophil counts (ECs) in pediatric asthma patients. We investigated prospectively the changes in eotaxin and ECP serum levels and peripheral blood ECs after administering oral corticosteroids and then inhaled corticosteroids plus long-acting beta2 agonist treatment in pediatric patients.
Serum samples of 20 pediatric patients with mild-to-moderate asthma were collected before treatment, after 5-7 days of oral prednisolone treatment, and after 1-2 months of inhaled fluticasone plus salmeterol treatment. Peak expiratory flow was used as the outcome index.
eotaxin levels remained the same after oral prednisolone treatment, but decreased after subsequent inhalation treatment compared with the end of oral steroid treatment (64.7 ± 22.6 vs 85.7 ± 36.8 pg/mL, p<0.001). The EC and serum ECP levels declined soon after oral steroid treatment, rebounding to initial levels during inhalation treatment. The decrease in ECP level was positively correlated with the decrease in ECs with oral steroid treatment (r2 = 0.28, p=0.016). There was no correlation between changes in eotaxin levels and peak expiratory flow.
Our data suggest that the serum eotaxin level, not peripheral blood EC or serum ECP level, declines during inhaled fluticasone plus salmeterol treatment and might serve as a surrogate marker of T helper 2 residual activity in pediatric asthma.
Asthma; Chemokines; Child; Eosinophils; Glucocorticoids
J Microbiol Immunol Infect. 2007;40:162-167.