EOSINOPHIL CATIONIC PROTEIN AND TIDAL FLOW-VOLUME LOOPS IN CHILDREN 0-2 YEARS OF AGE

Many children with recurrent wheezing in early childhood develop asthm a. Objective parameters to describe different groups of wheezers are l imited, but tidal flow volume (TFV) response to inhaled salbutamol has demonstrated differences between children with and without asthma Als o, eosinophil cationic protein (ECP) has been associated with declinin g lung function in older children, We therefore investigated whether l ung function and serum ECP (s-ECP) could differentiate between groups of wheezy young children. TFV loops were measured in 79 awake children (mean age 14 months), Minimum two wheezy episodes (mean 3.2) or minim um 4 weeks persistent wheeze were reported in 41 children (cases), whe reas the 38 controls had no history of wheeze, Airways responsiveness (change in ratio of time until peak expiratory flow to total expirator y time (tPEF/tE) after inhaled nebulized salbutamol) was measured in 2 6 cases and 24 controls, Serum ECP and serum myeloperoxidase (s-MPO) w ere measured in all children. Cases had significantly lower mean tPEF/ tE (0.21) than controls (0.33), and higher mean s-ECP (21.9 mu g . L(- 1)) than controls (14.0 mu g . L(-1)). Serum ECP (but not s-MPO) corre lated significantly with the percentage change in tPEF/tE from baselin e (r=0.7), but not with initial tPEF/tE. Serum ECP increased significa ntly with increasing immunoglobulin E (IgE), airways responsiveness an d eosinophil count, but decreased with increasing age. TFV responsiven ess to salbutamol and s-ECP levels correlate strongly, both probably r eflecting airways inflammation, and may possibly be valuable prognosti c tools in recurrent wheezy infants and toddlers.