Determination of serum eosinophil cationic protein, eosinophil count, and total lgE in children with different severities of atopic diseases

Eosinophil cationic protein (ECP) levels may be of value in assessing tissue inflammation in atopic diseases. However, conflicting results have been reported regarding levels of serum ECP (s-ECP) and symptom activity in asthma, atopic dermatitis, or allergic rhinitis. To examine s-ECP levels, eosinophil counts and total immunoglobulin E (IgE) in relation to atopic disease activity in a random population of children admitted to hospital for atopic and nonatopic conditions. s-ECP, eosinophil counts, and total IgE were evaluated in all the children admitted, to a pediatric ward, excluding patients treated with systemic steroids. A total of 216 children were studied. Shin prick tests (SPT) and a validated questionnaire for asthma, atopic: dermatitis, and allergic rhinitis were obtained. s-ECP was significantly higher in children with symptomatic atopic disease (19.88 mu g/L) compared with nonatopic control patients (8.58 mu g/L). The levels of s-ECP were also elevated in patients with a positive response to the ISAAC Questionnaire for symptoms of asthma, atopic dermatitis, or rhinitis in the previous 12 months (9.12 mu g/L) or a positive SPT to relevant allergens (8.58 mu g/L), but no symptoms of atopy at the time of examination. Intermediate values of s-ECP were found in children with combined positive SPT and positive response to the ISAAC Questionnaire (13.7 mu g/L), but no symptoms of atopic disease at the time of examination. s-ECP is more elevated in symptomatic atopic subjects than in nonallergic patients. Subjects with latent (nonsymptomatic) allergy conditions show intermediate values probably reflecting allergen exposure and minimal persistent tissue inflammation.