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PubMed2002

Correlation between blood glucose concentration and glucose concentration in subcutaneous adipose tissue evaluated with microdialysis during intensive care.

BACKGROUND: Hyper- as well as hypoglycemia may be detrimental for brain energy metabolism and even a moderate increase in blood glucose concentration can affect outcome adversely. During physiological conditions, glucose concentration obtained from microdialysis of subcutaneous adipose tissue adequately reflects plasma glucose concentration. This study examines whether this correlation is also obtained during intensive care in patients with severe injuries. METHODS: The study included 62 patients with severe traumatic brain injuries. All patients received one 30 mm microdialysis catheter (CMA 60, CMA Microdialysis) inserted into periumbilical subcutaneous adipose tissue. The probe was perfused (0.3 microl/min) with a Ringer solution from a microinfusion pump and analyzed for glucose, lactate, and glycerol. The study included 2.434 simultaneous analyses of glucose concentration in arterial blood and subcutaneous adipose tissue. RESULTS: The correlation coefficient for glucose concentration in blood and interstitial fluid was 0.743 for the whole material. The correlation was relatively poor for 1-6 h after insertion of the probes. During this period, a continuous increase in the subcutaneous level of glucose and decreases in lactate and glycerol were noted. CONCLUSIONS: The correlation between blood glucose concentration and glucose concentration in subcutaneous adipose tissue was not as good during intensive care as in normal humans. The poor correlation during the first 6 h probably reflects a stress reaction (and possibly local vasoconstriction). Microdialysis of subcutaneous adipose tissue permits frequent bedside analyses of the biochemical composition of the extracellular fluid and may be of value during routine intensive care provided the methodological limitations are recognized.

Adipose Tissue↗

PubMed2001

Relationship between blood selenium concentration or glutathione peroxidase activity, and milk selenium concentrations in New Zealand dairy cows.

AIM: To determine the relationships between blood selenium (Se) concentrations or glutathione peroxidase activity (GSH-Px), and milk Se concentrations in dairy cows. METHODS: Seventy-two Friesian dairy cows were either untreated or injected with 0.5, 1.0 or 2.0 mg Se/kg liveweight as barium selenate (BaSeO4) formulations, resulting in 6 groups of animals with mean blood Se concentrations that varied from 212 to 2272 nmol/l. Milk samples were collected on Days 104 and 188, and blood samples were collected prior to treatment and on Days 41, 76, 104, 188, 244, and 292 after Se injection. RESULTS: Significant quadratic relationships between blood Se and milk Se concentrations, as well as blood GSH-Px activity and milk Se concentrations, were evident at Days 104 and 188. Using combined data, these were represented by the equations: milk Se = 27.3 + 0.073 blood Se -0.00001 (blood Se)2; R2=0.79, p<0.005, and; milk Se = 34.8 + 4.99 GSH-Px -0.068 (GSHPx)2; R2=0.79, p<0.005. CONCLUSIONS: The Se status of dairy cows can be assessed from milk Se concentrations. CLINICAL SIGNIFICANCE: Bulk-tank milk Se concentrations could be evaluated as a method to assess the Se status of dairy herds.

Journal Article↗

PubMed1998

Unexpected suppression of total digoxin concentrations by cross-reactants in the microparticle enzyme immunoassay: elimination of interference by monitoring free digoxin concentration.

The microparticle enzyme immunoassay (MEIA for digoxin (Abbott Laboratories, Abbott Park, Ill) requires no sample pretreatment and is widely used in clinical toxicology laboratories for monitoring serum digoxin concentrations. One advantage of the new MEIA is the lower cross-reactivities with such cross-reactants as digitoxin, oleandrin, and bufalin compared with the fluorescence polarization immunoassay (FPIA)for digoxin. Digitoxin, oleandrin, and bufalin showed positive cross-reactivity with MEIA and FPIAs for digoxin in the absence of the primary analyte, digoxin. A surprising finding was that digoxin concentrations were falsely decreased by these cross-reactants when serum pools containing digoxin were supplemented with various concentrations of these cross-reactants and when digoxin concentrations were measured by the MEIA. In contrast, digoxin concentrations were falsely elevated when measured by the FPIA. For example, when a serum pool containing 2.15 nmol/L of digoxin was supplemented with 129.5 nmol/L of bufalin, the apparent digoxin concentrations were 1.45 nmol/L with the MEIA and 3.00 nmol/L with the FPIA. Taking the advantage of only 25% protein binding of digoxin and more than 95% protein binding of digitoxin and bufalin, we demonstrated that monitoring free digoxin instead of total digoxin eliminated negative interference of digoxin by these cross-reactants in the MEIA and positive interference in the FPIA. Although oleandrin is also strongly bound to serum protein, high concentrations of oleandrin still modestly affect the free digoxin assay for both MEIA and FPIAs.

Bufanolides↗

PubMed2001

Dietary plant sterols alter the serum plant sterol concentration but not the cholesterol precursor sterol concentrations in young children (the STRIP Study). Special Turku Coronary Risk Factor Intervention Project.

Plant sterol supplementation reduces serum cholesterol concentration but may increase serum plant sterol concentrations, especially in children. We determined whether natural dietary plant sterols derived mainly from vegetable oil or margarine in early childhood affect serum concentrations of plant sterols (campesterol and sitosterol) and cholesterol precursor sterols (Delta-8 cholestenol, desmosterol, and lathosterol), reflecting endogenous cholesterol synthesis. We measured the serum sterol concentrations using gas liquid chromatography in 20 healthy 13-mo-old intervention children in a randomized, prospective study designed to decrease exposure of the children to known environmental atherosclerosis risk factors and in 20 control children. The diet of the intervention children was rich in plant sterols due to replacement of milk fat with vegetable fat, whereas the diet of the control children contained only small amounts of plant sterols. The intervention children consumed twice as much plant sterols as the control children (P < 0.001). Their serum concentrations of campesterol and sitosterol were 75% and 44% higher, respectively, than those in the control children (P < 0.001 for both), but serum cholesterol precursor sterol concentrations did not differ between the two groups. We conclude that doubling dietary plant sterol intake almost doubles serum plant sterol concentrations in 13-mo-old children, but has no effect on endogenous cholesterol synthesis. Relative intestinal absorption of natural plant sterols from the diet in early childhood is similar to that in adults.

Arteriosclerosis↗

PubMed1997

Interdependence of pH, malate concentration, and calcium and magnesium concentrations in the xylem sap of beech roots.

The presence and concentration of mineral nutrients and organic acids were analyzed in root xylem sap of mature beech trees (Fagus sylvatica L.). An interdependence between malate concentration, pH, and calcium and magnesium concentrations was observed. Significant correlations were found between low pH values and high calcium and magnesium concentrations, low pH values and high malate concentration, and high malate concentration and high total calcium and magnesium concentrations. The observed correlations suggest that malic acid determines the chemical milieu of the xylem sap and tends to form complexes with hydrated or exchangeable adsorbed cations, thereby influencing the mobilization and translocation of calcium and magnesium in beech sapwood.

Journal Article↗

PubMed1998

The effect of adenosine triphosphate on sevoflurane requirements for minimum alveolar anesthetic concentration and minimum alveolar anesthetic concentration-awake.

UNLABELLED: We evaluated the effects of i.v. adenosine triphosphate (ATP) on sevoflurane minimum alveolar anesthetic concentration (MAC) and MAC-Awake. The study group included healthy patients 20-60 yr of age. The study groups for MAC-Awake determination included 49 patients who were scheduled for elective surgery. The study groups for MAC determination included 53 patients scheduled for elective surgery involving a skin incision. These patients were randomly assigned to two groups, an ATP group and a control group. The ATP group received 100 micrograms.kg-1.min-1 ATP i.v., and the control group received no medication. The ATP group and the control group were compared with regard to MAC-Awake (anesthetic concentration achieving 50% probability of eye opening in response to a verbal command) and MAC (anesthetic concentration achieving 50% probability of no movement in response to skin incision). The MAC-Awake was 0.7% +/- 0.1% in the control group (mean +/- SD) and 0.7% +/- 0.1% in the ATP group. MAC was 1.9% +/- 0.1% in the control group and 2.1% +/- 0.2% in the ATP group. The differences in MAC and MAC-Awake between the two groups were not statistically significant. We conclude that ATP infusion (100 micrograms.kg-1.min-1) has no effect on sevoflurane MAC and MAC-Awake. IMPLICATIONS: We found that an i.v. adenosine triphosphate infusion (100 micrograms.kg-1.min-1) has no effect on sevoflurane minimum alveolar anesthetic concentration (anesthetic concentration achieving 50% probability of no movement in response to skin incision) and minimum alveolar anesthetic concentration-Awake (anesthetic concentration achieving 50% probability of eye opening in response to a verbal command) in humans.

Adenosine Triphosphate↗

PubMed2001

Age, minimum alveolar anesthetic concentration, and minimum alveolar anesthetic concentration-awake.

UNLABELLED: Two defining effects of inhaled anesthetics (immobility in the face of noxious stimulation, and absence of memory) correlate with the end-tidal concentrations of the anesthetics. Such defining effects are characterized as MAC (the concentration producing immobility in 50% of patients subjected to a noxious stimulus) and MAC-Awake (the concentration suppressing appropriate response to command in 50% of patients; memory is usually lost at MAC-Awake). If the concentrations are monitored and corrected for the effects of age and temperature, the concentrations may be displayed as multiples of MAC for a standard age, usually 40 yr. This article provides an algorithm that might be used to produce such a display, including provision of an estimate of the effect of nitrous oxide. IMPLICATIONS: Two defining effects of inhaled anesthetics (immobility in the face of noxious stimulation, and absence of memory) correlate with the end-tidal concentrations of the anesthetics. Thus, these defining effects may be monitored and the results displayed if the concentrations are known and corrected for the effects of age and temperature.

Aging↗

PubMed2003

Minimum alveolar anesthetic concentration of isoflurane with different xenon concentrations in Swine.

UNLABELLED: For patients requiring a fraction of inspired oxygen more than 0.3, the use of xenon (Xe) as the sole anesthetic is limited because of its large minimum alveolar anesthetic concentration (MAC) of 71%. This warrants investigating the combination of Xe with other inhaled anesthetics. We therefore investigated the influence of Xe on the MAC of isoflurane. The study was performed in 10 swine (weight, 28-35 kg) ventilated with Xe 0%, 15%, 30%, 40%, 50%, and 65% in oxygen. For each Xe concentration, various concentrations of isoflurane were administered in a step-wise design. For each combination, a supramaximal pain stimulus (claw-clamp) was applied, and the appearance of a withdrawal reaction was recorded. The isoflurane MAC was defined as the end-tidal concentration required to produce a 50% response rate. At each Xe concentration, the responses to the pain stimulus were categorized, and a logistic regression model was fitted to the results to determine isoflurane MAC. Isoflurane MAC was decreased by inhalation of Xe in a nonlinear manner from 1.92% (95% confidence interval, 1.70%-2.15%) with 0% Xe to 1.17% (95% confidence interval, 0.75%-1.59%) with 65% Xe. Although this indicates partial antagonism of the two anesthetics, a combination of Xe with isoflurane may prove valuable for patients requiring a fraction of inspired oxygen more than 0.3. IMPLICATIONS: We investigated the influence of the anesthetic gas xenon on the minimum alveolar anesthetic concentration (MAC) for isoflurane (another anesthetic gas). The study was performed in 10 swine ventilated with fixed xenon and various concentrations of isoflurane. The isoflurane MAC is decreased by inhalation of xenon in a nonlinear relationship.

Anesthetics, Inhalation↗

PubMed1994

Influence of sex, age, weight, and carbamazepine dose on serum concentrations, concentration ratios, and level/dose ratios of carbamazepine and its metabolites.

We have conducted a comprehensive study in a group of epileptic children (25 boys and 30 girls) receiving carbamazepine (CBZ) monotherapy. The influence of sex, age, weight, and CBZ daily dose on serum CBZ, carbamazepine-10,11-epoxide (CBZ-E), and trans-10,11-dihydroxy-10,11-dihydro-carbamazepine (CBZ-H) concentrations, concentration ratios, and level/dose ratios were investigated. Compared with girls, boys required significantly larger CBZ dose and showed higher CBZ apparent clearances and lower level/dose ratios of CBZ and its metabolites. There were no significant differences between boys and girls in serum concentrations, concentration ratios, and free fractions of CBZ and its metabolites, although there were trends that boys had slightly higher concentration ratios. The relationship analysis suggested that there was a dose-dependent autoinduction of CBZ metabolism, and CBZ metabolism was decreased as patients mature, as measured by weight and age. Age showed a significant positive relationship with the free fractions of CBZ and its metabolites, indicating decreased protein binding of CBZ and its metabolites with the increase of age. Serum CBZ concentration is not a reliable index of CBZ dose, as there is only a weak correlation between them. Serum CBZ-H concentration showed strong positive correlations with CBZ dose and might be a valuable index in assessing patient compliance. The influence of sex, body weight, age, and CBZ dose on CBZ and its metabolites should be taken into consideration in further clinical studies.

Aging↗

PubMed1999

Sensitive methods for determination of free digitoxin concentration using digitoxin immunoassays: demonstration of elevated free digitoxin concentration caused by digitoxin-phenytoin interaction by applying these new techniques.

Digitoxin is very strongly bound to serum albumin. Although free digitoxin is pharmacologically active, it is not monitored because of the lack of a sufficiently sensitive technique. The concentration of free digitoxin in the protein-free ultrafiltrate is usually below the detection limit of digitoxin immunoassays. A modified technique is described by which free digitoxin can be routinely monitored using commercially available immunoassays. The fluorescence polarization immunoassay for determining total digitoxin concentration requires that 100 microL of serum be treated with 300 microL of methanol to precipitate proteins. It is demonstrated that free digitoxin can easily be measured by adding 100 microL of methanol to 300 microL of ultrafiltrate, thus improving the sensitivity of the assay three-fold. The free digitoxin concentration can easily be calculated by dividing the observed value by 3. An attempt to use only ultrafiltrate (no methanol added) caused significant bias in the result, probably as a result of a matrix problem. The chemiluminescent assay for digitoxin does not require any specimen pretreatment and requires only 10 microL of serum. The program was modified and used 50 microL of ultrafiltrate to improve the sensitivity of the free digitoxin assay. If the chemiluminescent assay is used to measure free digitoxin, the true free digitoxin concentration can be calculated by dividing the observed value by 4.3. The free digitoxin concentrations were comparable in eight patients receiving digitoxin as measured by both methods. To show an application of this technique, two serum pools were prepared from patients receiving digitoxin and supplemented with various concentrations of phenytoin. A significant increase in free digitoxin concentration was observed because of the displacement of digitoxin from protein binding sites by phenytoin.

Binding, Competitive↗

PubMed1994

A cross-over pharmacokinetic and thrombogenicity study of a prothrombin complex concentrate and a purified factor IX concentrate.

A prospective cross-over study was carried out on 19 patients with haemophilia B. comparing the pharmacokinetics of a purified factor IX concentrate prepared by metal chelate affinity chromatography (9MC) with a conventional three-factor prothrombin complex concentrate (9A). The highly purified factor IX concentrate was shown to have a half-life comparable to the PCC; the in vivo recovery of the purified concentrate was significantly greater than that of the complex (P < 0.01). The 20% change in the value of the International Standard for Factor IX Concentrate, introduced in 1988, might have been expected to lower the recovery values. However, the in vivo recovery for both concentrates was somewhat higher than reported previously, particularly in the older literature. In nine patients, serial assays for fibrinopeptide A, prothrombin fragment F1+2 and thrombin-antithrombin complexes (TAT) were performed to assess the potential thrombogenicity of the two concentrates. Evidence was obtained that there was significantly less activation of coagulation following administration of purified factor IX (9MC), as compared to the activation that occurred after the PCC.

Blood Coagulation↗

PubMed1995

Interactions of phenobarbital and phenytoin with carbamazepine and its metabolites' concentrations, concentration ratios, and level/dose ratios in epileptic children.

The effects of phenytoin (PHT) or phenobarbital (PB) comedication on the concentrations, concentration ratios, and level/dose ratios of carbamazepine (CBZ) and its metabolites were investigated. The hetero-induction effects of CBZ metabolism by PHT or PB were clearly demonstrated. Serum CBZ level/dose ratios in patients with CBZ polytherapy were decreased while CBZ-10,11-epoxide (CBZ-E) and trans-10,11-dihydroxy-10,11-dihydro-CBZ (CBZ-H) concentrations were increased as compared with those of patients receiving CBZ alone. The concentration ratios of CBZ-H/CBZ and CBZ-E/CBZ were also greater in patients receiving CBZ+PHT or CBZ+PB than in patients receiving CBZ alone. In addition, positive correlations between serum PHT concentration and CBZ-H/CBZ or CBZ-E/CBZ concentration ratios were observed. There were no significant differences in CBZ-H/CBZ-E concentration ratios, the free fractions of CBZ and its metabolites, and CBZ-E or CBZ-H level/dose ratios among the three groups of patients. Because this approach investigates the in vivo relation between the substrates and products of the enzymes involved in CBZ biotransformation, more detailed information about the drug interactions was obtained. The results suggest that the PHT has a potent induction effect on CBZ epoxidase, whereas PB is a moderate inducer.

Biotransformation↗

PubMedDate not supplied

Inference of blood glucose concentrations from subcutaneous glucose concentrations: applications to glucose biosensors.

An approach for inference of blood glucose concentrations in real time is considered. First, a model that predicts the subcutaneous glucose concentration from the blood glucose concentration is presented. The model includes diffusive transport from the blood to the subcutaneous tissue and reactive-like cellular uptake of glucose. Next, the Phillips-Tikhonov regularization method is considered to solve the real-time input estimation problem that determines the blood glucose concentration given the subcutaneous glucose concentration. The inverse problem is regularized by imposing a smoothing condition to obtain a stable solution. Three different penalization functionals were considered in evaluating the regularization method using a synthetic function that approximates the subcutaneous glucose response to an oral glucose tolerance test in a human subject. Various levels of either white noise or time-correlated noise were superimposed onto the synthetic response to evaluate the sensitivity of the inverse to measurement error. For inversion assuming only diffusive transport, the optimal time interval of integration of previous subcutaneous measurements was found to be about 1.5/alpha, where alpha(-1) is the dominant time constant for the exchange of glucose between the blood and subcutaneous tissue. The optimal sampling rate was found to be 54alpha. Linear regularizations based on minimization of first or second derivatives of the blood glucose concentration were found to be satisfactory, each yielding a minimum error that was about 50% greater than the measurement error. Including nonlinear, reactive-like uptake of glucose was found to decrease the error magnification factor slightly. Both the model and the inverse method relating blood and subcutaneous glucose concentrations are successfully applied to experimental measurements using glucose biosensors reported by Schmidtke et al. (Proc. Natl. Acad. Sci. USA 95:294-299, 1998).

Algorithms↗

PubMed1984

Relationship of unbound bilirubin concentration to reserve albumin-binding concentration for bilirubin in human neonatal plasma.

We examined the relationship of plasma unbound bilirubin concentration and reserve albumin-binding concentration for bilirubin in a sample of 545 neonates. Plasma unbound bilirubin concentration and total bilirubin-binding concentration were determined with the peroxidase assay. Contrary to published reports, we found that plasma unbound bilirubin concentration and plasma reserve albumin for bilirubin-binding concentration are highly correlated (r = -0.706; p less than 0.001) and that the relationship between these two parameters is dependent upon the total bilirubin-binding concentration. That these measured parameters correlate in the same manner as predicted for free bilirubin and free albumin by the law of mass action, suggests that these measurements may be meaningful.

Bilirubin↗

PubMed2006

Limited sampling models for oral midazolam: midazolam plasma concentrations, not the ratio of 1-hydroxymidazolam to midazolam plasma concentrations, accurately predicts AUC as a biomarker of CYP3A activity.

Oral midazolam is used as a phenotyping probe for cytochrome P450 (CYP) 3A activity and requires multiple plasma samples to measure drug exposure. Limited sampling is a useful strategy for optimizing sampling and reducing costs and labor. We studied limited sampling models using multiple linear regressions to predict the area under the concentration versus time curve (AUC) of midazolam using either midazolam plasma concentrations or the ratio of 1-hydroxymidazolam (1-OH MDZ) to midazolam plasma concentrations. CYP3A baseline activity data for oral midazolam from previous studies were used (45 healthy adults for models using midazolam plasma concentrations and 41 healthy adults for models using the ratios of 1-OH MDZ to midazolam plasma concentrations). Limited sampling models were derived, validated, and evaluated for precision and bias. Two equations using the time points at 0.5 and 6 hours and 0.5, 2, and 6 hours were acceptable and predictive of midazolam AUC using midazolam plasma concentrations. No 1-OH MDZ to midazolam plasma concentration ratios accurately predicted midazolam AUC.

Adult↗

PubMed1994

Determination of end-tidal sevoflurane concentration for tracheal intubation and minimum alveolar anesthetic concentration in adults.

The purpose of this study was to determine both the concentration of sevoflurane required for tracheal intubation (MACEI) and its minimum alveolar anesthetic concentration (MAC) in adults. The study group consisted of 86 elective surgical patients, ASA physical status I or II, aged 16-59 yr. There was no premedication administered. For MACEI determination, after establishing and maintaining the predetermined end-tidal concentration for 20 min, tracheal intubation was attempted using a cuffed tracheal tube without muscle relaxant or other adjuvants. Each concentration at which tracheal intubation was attempted was predetermined as follows: 2.5%, 3.0%, 3.5%, 4.0%, 4.5%, 5.0%, 5.5%, 6.0%, 6.5%, and 7.0%. For MAC determination, the patients examined were basically the same as those for MACEI determination, except for those who received muscle relaxant or other adjuvants because they were "not intubated smoothly." After establishing and maintaining the predetermined end-tidal concentration for 20 min, skin incision was attempted. Each concentration at which skin incision was attempted was predetermined as follows: 0.5%, 1.0%, 1.5%, 2.0%, 2.5%, and 3.0%. The MACEI of sevoflurane was 4.52% (95% confidence limits, 3.91%-5.21%), and the ED95 for tracheal intubation was 8.07%. The MAC of sevoflurane was 1.58% (95% confidence limits, 1.14%-1.98%), and the AD95 (anesthetic ED95) was 2.96%. The MACEI/MAC ratio was 2.86 (95% confidence limits, 2.63-3.43). Anesthesia induction followed by tracheal intubation can be accomplished in adults when sevoflurane is administered as a sole anesthetic, but in excess of 8% end-tidal concentration.

Adolescent↗

PubMed2003

Minimum anesthetic concentration of sevoflurane with different xenon concentrations in swine.

UNLABELLED: In a previous study, we described a partial antagonism of xenon (Xe) in combination with isoflurane. One hypothetical explanation suggested that Xe and isoflurane probably induced anesthesia via different pathways at the neuronal level. This warranted investigating the combination of Xe with other inhaled anesthetics to examine the relationship between Xe and volatile anesthetics in general. We therefore investigated the influence of Xe on the minimum alveolar concentration (MAC) of sevoflurane. The study was performed in 10 swine (weight 30.8 kg +/- 2.6, mean +/- SD) ventilated with xenon 0%, 15%, 30%, 40%, 50%, and 65% in oxygen. At each Xe concentration, various concentrations of sevoflurane were administered in a stepwise design. For each a supramaximal pain stimulus (claw clamp) was applied. The appearance of a withdrawal reaction was recorded. The sevoflurane MAC was defined as the end-tidal concentration required to produce a 50% response rate. At each Xe concentration, the animals' responses to the pain stimulus were categorized and a logistic regression model was fitted to the results to determine sevoflurane MAC. Sevoflurane MAC was decreased by inhalation of Xe in a linear manner from 2.53 with 0% Xe to 1.54 with 65% Xe. In contrast to Xe and isoflurane, the anesthetic effects of Xe and sevoflurane appear to be simply linear. IMPLICATIONS: We investigated the influence of the anesthetic gas, xenon, on the minimum alveolar concentration (MAC) for the volatile anesthetic sevoflurane. The study was performed in 10 swine ventilated with fixed xenon and various concentrations of isoflurane. The sevoflurane MAC is decreased by inhalation of xenon in a linear relationship.

Algorithms↗

PubMed1997

Eosinophil protein X concentration is dependent on eosinophil concentration.

The relationship between the eosinophil concentration and the serum eosinophil protein X concentration was investigated in 80 subjects. Higher eosinophil counts resulted in obviously increased serum eosinophil protein X concentrations. However, the amount of eosinophil protein X released per eosinophil granulocyte is significantly higher in subjects with lower eosinophil counts. Atopic subjects (N = 19) show a significantly higher eosinophil concentration (p = 0.002) and eosinophil protein X concentration (p = 0.004) and a significantly lower eosinophil protein X/eosinophil ratio (p = 0.02), compared with non-atopic subjects (N = 61). However, there appears to be no difference between the concentration of eosinophil protein X in atopic and non-atopic subjects if the eosinophil concentration is taken into account. When using eosinophil protein X as an indicator of eosinophil activation, for instance in asthmatic subjects, the eosinophil count should also be considered for correct clinical interpretation of results.

Adolescent↗