SERUM EOSINOPHILIC CATIONIC PROTEIN MAY PREDICT CLINICAL COURSE OF WHEEZING IN YOUNG-CHILDREN

Thirty eight children aged between 2 and 4 years with three or more ep isodes of wheezing were studied to evaluate the role of eosinophil inf lammation and its relation to persistence of wheezing two years later. Serum eosinophilic cationic protein, total eosinophil count, total Ig E, skin prick test, and clinical features were evaluated at visit 1. T wo years later at a second clinical evaluation the children were separ ated into two groups: group 1,those with persistent wheezing (n=20); g roup 2, those who had been asymptomatic over the past six months (tran sient wheezing) (n = 18). Mean (SEM) eosinophilic cationic protein at visit 1 was higher in group 1 than in group 2 (29.63 (5.16) v 14.42 (2 .77) mu g/l), and the probability of continuing wheezing at age 5 year s was greater in children with values greater than or equal to 20 mu g /l at visit 1 than in those with lower values (relative risk = 2.88, 9 5% confidence interval 1.42 to 5.87, p < 0.001). Eosinophil inflammati on is present from the beginning of the disease in the children who ar e going to continue with wheezing at age 5 years. The measurement of s erum eosinophilic cationic protein may help in evaluating which wheezi ng infants are going to continue with asthma in the future.