ROLE OF SERUM EOSINOPHIL CATIONIC PROTEIN (S-ECP), NEUTROPHIL MYELOPEROXIDASE (S-MPO) AND MAST-CELL TRIPTASE (S-TRY) IN CHILDREN WITH ALLERGIC, INFECTIVE ASTHMA AND ATOPIC-DERMATITIS

Serum level of pro-inflammatory cellular markers such as eosinophil ca tionic protein (s-ECP), neutrophil myeloperoxidase (s-MPO) and mast ce ll tryptase (s-TRI) have been analysed in a group of 80 children who w ere subdivided in 3 subgroups according to the underline pathology: a) allergic asthma, b) infective wheezing, c) atopic dermatitis or eczem a. These children were compared with an adeguate sex-, age mathched gr oup of normale controls. Each patient was further assigned to symptoma tica (S) or asymptomatic (As) subgroups on the basis of the presence o r absence of specific acute symptoms. At entry, illness severity was a ccurately assessed to correlate clinical status with the markers serum levels. s-ECP has been found elevated in all the symtomatic groups un regardless of the type of disease (asthma, wheezing or atopic dermatit is) and of the etiology (allergic asthma or infective wheezing) (s-ECP : mu g/L allergic asthma S = 43 +/- 34; AS = 22 +/- 12; C = 8 +/- 3; S vs As p < 0.05; S vs C p < 0.0005; As vs C NS; infective wheezing S = 28 +/- 13, As = 17 +/- 12, C = 10 +/- 3, S vs As p < 0.01, As vs C NS , atopic dermatitis S = 49 +/- 13, As = 20 +/- 11, C = 10 +/- 3, S vs As p < 0.01, S vs C p < 0.002, As vs C NS). s-MPO has been found stati stically significant only in acute wheezing and acute atopic dermatiti s vs normal controls, whereas no statistically differences has been fo und in allergic asthma (s-MPO mu g/l: allergic asthma S = 1180 +/- 448 ; As = 841 +/- 500; C = 596 +/- 217; S vs As NS; S vs CNS; As vs CNS; infective wheezing S = 1142 +/- 385; As = 1386 +/- 364; C = 665 +/- 38 4; S vs As NS; S vs C p < 0.005; As vs C p < 0.01; atopic dermatitis S = 1474 +/- 292; As = 1011 +/- 604; C = 665 +/- 384; S vs As NS; S vs C p < 0.005; As vs C NS); those results on one side confirm the role o f neutrophils during infections even viral one's, but on the other sid e demonstrate a lesser involvement in allergic diseases. s-Tryptase wa s always found at lower levels of the capacity detenction of the test in all situations analysed; this surprisingly result confirm same othe r data present in literature. In conclusion our results confirm the us efulness, at least for s-ECP and s-MPO, as pro-inflammatory activity m arkers well correlated with disease activity; nevertheless, our data t hat at least for s-ECP a not specific rise according to etiology (alle rgy or infection). s-MPO seems more reliable as an activity marker of infective processes than allergic one's More data are necessary to bet ter define the role of neutrophils in allergic diseases. Data about s- TRY from our study didn't allow us to consider it as a reliable marker of allergic disease activity. Therefore more data on larger number of patients are needed to better define the role and usefulness of these markers both in allergic and infectious diseases.