Serum eosinophil cationic protein as a predictor of disease activity in acute and chronic asthma

Background: Eosinophils may contribute to airway hyper responsiveness in as thma through the effects of eosinophil derived granular proteins in the bro nchial epithelium. Increased concentration of eosinophil cationic protein ( ECP) has been reported in patients with acute and chronic asthma, Objective: To examine if ECP can serve as a marker of disease activity in a cute and chronic asthma patients. Design: Prospective case control study. Patients: Sixteen non smoking asthmatics in exacerbation (group 1); twenty two in relatively stable state (group 2); and sixteen normal control subjec ts (group 3) were recruited into the study. Setting: Casuality and outpatients departments, Mubarak hospital, Kuwait be tween August 1997 and July 1998. Main outcome measures: The mean serum ECP, blood eosinophil count and peak expiratory flow rate (PEFR), Results: There was a statistically significant difference between the group s in blood eosinophil count (p < 0.01) and in PEFR (p < 0.0001). At week fo ur, the mean ECP and blood eosinophil count fell as a result of therapy in group 1. The difference in PEFR values between week 0 and 4 in group 1 reac hed statistical significance (p < 0.05). Ire group 2 patients, the mean ser um ECP, blood eosinophil count and PFER values between week 0 and 4 did not show any significant difference. A correlation was observed between ECP an d PEFR in group 1 (p < 0.05) and between ECP and eosinophil count in group 2 (p < 0.01), Conclusion: Serum ECP has the potential to serve as a marker for predicting and monitoring the clinical course of asthma. Further studies are required to verify these baseline findings in our environment.