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Usefulness of neonatal eosinophil counts as a marker of atopy?

Eosinophil count (EC) were obtained from 312 newborns with and 172 without family history of atopy (FHA). The EC were higher in infants with than without FHA. Elevated EC were recorded in babies of parietaria sensitive mothers born in the spring, as compared to other seasons. The predictive value of EC with regard to development of atopic diseases up to 18 months of age was prospectively studied in 103 newborns with FHA. Using 5 x 10(8) cells/l as cut-off level the predictive allergy value was 41%. Elevated EC appears to be a marker of atopy in newborns.

Biomarkers↗

[Serum rheumatoid factor and peripheral blood eosinophil counts in patients with bronchial asthma].

These days some reports say that bronchial asthma, especially severe asthma, is systemic inflammatory and its severity correlates with eosinophil counts. Some patients with asthma have positive tests for rheumatoid factor (RF) which is detected in systemic hyper immunoreactive desease such as rheumatoid arthritis. So we investigated each of these factors in asthmatic patients. We randomly selected 100 asthmatics from regular outpatients of our hospital. In a positive RF level group (over 21 IU/ml), Eosinophil counts were significantly higher than those in a negative RF level group. RF levels were significantly and positively correlated with the logarithm of eosinophil count. And in severe groups (patients with severe asthma, treated with high dose inhaled steroids, and with history of systemic steroids use for the last one month), RF levels were significantly higher than those in other groups. Our result suggested that RF levels reflect eosinophilia and asthma severity.

Adolescent↗

Interleukin-10 gene promoter region polymorphism is associated with eosinophil count and circulating immunoglobulin E in adult asthma.

BACKGROUND: IL-10 has several functional effects relevant to asthma. It can modulate IgE production and induce apoptosis in eosinophils. Polymorphisms of IL-10 gene have been shown to affect IL-10 production. OBJECTIVE: To establish whether IL-10 polymorphisms are associated with asthma and phenotype-related characteristics. METHODS: The frequency of three single base exchange polymorphisms (at positions - 1082, - 819 and - 592) and corresponding haplotypes of the IL-10 gene were analysed in 245 adult asthmatic subjects and 405 controls using PCR and restriction fragment length polymorphism (RFLP). The data were assessed for correlations with the eosinophil count, serum IgE and lung function. RESULTS: The IL-10 haplotype frequencies were similar in asthmatics and controls. Eosinophil count median was 2.0- to 3.2-fold higher among asthmatics with rare ATA/ATA genotype than in asthmatics with other genotypes. No such difference was seen in the control group. When analysed by IL-10 haplotype carrier state and gender, male asthmatics with ATA haplotype had 2.8-fold higher serum IgE than those without ATA. A converse association was found in male controls with ATA haplotype, who had 1.9-fold lower serum IgE than their ATA-negative counterparts. The high IL-10-producing GCC haplotype was associated with impaired lung function in smoking male controls while in asthmatics no clear effect on lung function was found with any of the haplotypes studied. CONCLUSION: These results suggest that the eosinophil counts and serum IgE are differently regulated by IL-10 genotype in asthmatic and in normal subjects. However, IL-10 polymorphism is not related to susceptibility in asthma.

Aged↗

The relationship of serum-eosinophil cationic protein and eosinophil count to disease activity in children with bronchial asthma.

BACKGROUND: The serum-eosinophil cationic protein level (S-ECP) has been promoted as a biomarker of asthma that reflects the degree of bronchial eosinophilic inflammation. PATIENTS AND METHODS: To investigate whether S-ECP is indeed a clinically useful objective parameter, especially in mild or moderate chronic childhood asthma, we studied 100 outpatient children with chronic asthma symptoms (63 boys and 37 girls, aged three to 15 years, median of age eight) and 25 controls (12 boys and 13 girls aged three to 15 years, median of age eight). Symptom scores, lung function parameters and atopy were compared with S-ECP determined by commercially available tests and eosinophils measured by an autoanalyser. RESULTS: Asthma symptom scores in the patient group ranged between one and 13 (median of 8), S-ECP between 2.1 and 75.6 microg/l (median of 13.3 microg/ l), and eosinophils between 30/microl and 2002/microl (median of 314). Symptom scores and S-ECP were correlated significantly (P < 0.001) as were symptom scores and eosinophils (P = 0.001). S-ECPs were significantly higher in children with chronic asthma symptoms compared with non-asthmatic, non-atopic children (P = 0.005 for non-atopic chronic asthmatics and P < 0.001 for atopic asthmatics); similar results were found comparing eosinophils in these groups. There was no difference in S-ECP between atopic and non-atopic asthmatic children, but the 25 polysensitised asthmatic children especially with sensitisations to mite, pollen and pet allergens were found to have significantly higher S-ECP compared to 15 monosensitised children (P = 0.002). Similar results were found when correlating eosinophil numbers with atopy. Polysensitised (mite, pollen, pet) asthmatics had significantly higher eosinophil counts compared with monosensitised (pollen) asthmatics (P = 0.01); there was, however, a better discrimination between atopic and non-atopic asthmatics (P = 0.001). Non-asthmatic, non-atopic controls had significantly lower eosinophil counts compared with asthmatics (P < 0.001 for both non-atopic and atopic asthmatics). No correlation between S-ECP or eosinophils and any of the lung function parameters measured (FEV1, FEV1/FVC, MEF50, airway resistance and ITGV) was found. SUMMARY: Our data thus indicate that 1) S-ECP is higher than normal in children with asthma symptoms and correlates with asthma symptom score. 2) S-ECP is better correlated to symptom score than to lung function parameters especially in children with mild and moderate asthma symptoms. 3) Raised S-ECP appears to reflect the extent of allergen sensitivity and may also reflect current allergen exposure. 4) Similar correlations were seen when measuring eosinophil number by an autoanalyser instead of S-ECP. CONCLUSIONS: Although S-ECP and eosinophils are not diagnostic of asthma they are useful inflammation markers especially in the context of clinical studies. However, both methods are not yet suitable for use in daily practice because they require extensive procedures and special equipment.

Adolescent↗

Comparison of whole-blood eosinophil counts in extrinsic asthmatics with acute and chronic asthma.

Venous whole-blood eosinophil counts were performed on 50 occasions in 42 patients with varying patterns of asthma. None of the patients studied had received systemic corticosteroids during the previous year. Patients with acute severe asthma, as defined by symptomatic airways obstruction with a tachycardia of at least 120 beats/min, showed eosinopenia (21 x 10(9)/l +/- SD 57 x 10(9)/l). Patients with chronic asthma, as defined by symptomatic airways obstruction with a heart rate of less than 100 beats/min, showed appreciable eosinophilia (1048 x 10(9)/l +/- SD 708 x 10(9)/l). Finally, asymptomatic patients had a variable total eosinophil count but with values lower than those of patients with chronic asthma (345 x 10(9)/l +/- SD 431 x 10(9)/l). Eosinophilia may contain chronic asthma, thereby mediating bronchial damage, whereas absence of eosinophils in acute asthma enables vasoactive mediators to enter the systemic circulation, possibly causing circulatory disturbances.

Acute Disease↗

[Peripheral eosinophil counts relates the improvement of the skin lesions of atopic dermatitis patients more sensitive than serum eosinophil cationic protein levels].

We described the severity of skin lesions and detected peripheral eosinophil counts (Eos) and serum eosinophil cationic protein levels (s-ECP) in 81 patients with atopic dermatitis (male 33, female 48, age 20.7 +/- 8.8) at the first consultation. Eos were 583.3 +/- 560.2/mm3 and s-ECP were 18.0 +/- 21.7 micrograms/l (normal 6.88 +/- 3.46). After approximately 30 days treatment, the improvement of dermatitis were estimated and those lavatory findings were rechecked. Eos were 446.7 +/- 367.6/mm3 and s-ECP were 13.2 +/- 11.7 micrograms/l. At 5 percent level, positive correlations were observed between Eos and s-ECP (R = 0.75), Eos and the severity of dermatitis (R = 0.52) and s-ECP and the severity of dermatitis (R = 0.51) at the first consultation. We found a positive correlation between Eos and the improvement of dermatitis (R = 0.40) but no correlation between s-ECP and the improvement of dermatitis (R = 0.10). Eos related the improvement of the skin lesions of atopic dermatitis more sensitive than s-ECP.

Adolescent↗

Sputum eosinophil counts predict asthma control after discontinuation of inhaled corticosteroids.

BACKGROUND: Although inhaled corticosteroids (ICSs) are effective in preventing deterioration in asthma control, at least half of subjects with mild-to-moderate asthma will remain stable when these agents are discontinued. OBJECTIVE: We sought to determine whether noninvasive markers of inflammation predict which individuals maintain asthma control after discontinuation of ICSs. METHODS: We analyzed data obtained from 164 subjects with mild-to-moderate asthma who participated in a 16-week trial comparing the effects of continued ICS use with the effects of a switch to salmeterol or placebo. RESULTS: In comparison with continued ICS use, a switch to salmeterol or placebo was associated with increased rates of asthma deterioration over 16 weeks (9.3% vs 24.1% and 37.5%, respectively; P = .04 and P < .001, respectively). We found that neither exhaled nitric oxide nor methacholine PC 20 , when measured at randomization or 2 weeks after randomization, were significant predictors of subsequent asthma control in subjects who discontinued ICSs. However, both induced sputum eosinophil counts measured 2 weeks after a switch from ICS to placebo and changes in sputum eosinophil counts from before cessation of ICSs to after a switch to placebo predicted subsequent asthma deterioration (area under the receiver-operating characteristic curve, 0.771 [ P < .001] and 0.825 [ P < .001], respectively). CONCLUSION: On the basis of a model treatment strategy, we estimate that allocating subjects to ICS therapy on the basis of changes in sputum eosinophil counts after a trial discontinuation could allow 48% of subjects with mild-to-moderate asthma to discontinue ICS therapy without an increased risk of asthma deterioration over a period of at least 14 weeks.

Administration, Inhalation↗

Sputum eosinophil count in a large population of patients with mild to moderate steroid-naive asthma: distribution and relationship with methacholine bronchial hyperresponsiveness.

BACKGROUND: Although airway eosinophilia is seen as a cardinal feature of asthma, data eosinophilia are still lacking on the proportion of the asthma group exhibiting raised airway eosinophilia. This study aimed to assess the distribution of sputum eosinophil count and its relationship with methacholine bronchial hyperresponsiveness in mild to moderate steroid-naive asthmatic people. METHODS: Sputum was induced by inhalation of hypertonic saline (NaCl 4.5%) in 118 mild to moderate steroid-naive asthmatic people consecutively recruited from our outpatient clinic, and in 44 healthy people. The asthma group was selected on the basis of an forced expiratory volume in 1 s (FEV(1)) of > or = 70% predicted, and a provocative methacholine concentration causing a fall of 20% in FEV(1) (PC20 methacholine; PC(20)M) < or = 16 mg/ml. RESULTS: In the asthma group, the median (range) of the percentage and the absolute values of sputum eosinophils were 4.8% (0-75) and 38 10(3)/g (0-14,191), respectively, vs 0% (0-2.3) (P < 0.001) and 0 10(3)/g (0-53) (P < 0.001) in healthy participants. Based on the 95% percentile for normal values calculated from our healthy group, 69% of the asthma group had significantly raised sputum eosinophil count (that is > 2%). In the asthma group, multiple regression analysis followed by a stepwise procedure revealed that sputum eosinophil count was significantly and inversely associated with PC(20)M accounting for 16% of its total variance (P < 0.001) while neutrophil counts positively related to PC(20)M accounting for 4% of total variance (P < 0.05). By contrast, no significant relationship was found between either eosinophil or neutrophil counts and the slope of forced vital capacity (FVC) vs FEV(1) from the methacholine challenge. CONCLUSIONS: We conclude that two-thirds of people in the mild to moderate asthma group had increased sputum eosinophilia, which plays a limited role in determining the degree of methacholine airway hyperresponsiveness.

Adult↗

Total serum IgE and eosinophil count in children with and without a history of asthma, wheezing, or atopy in an urban community in Indonesia. The Respiratory Disease Working Group.

AIM: The objectives of the study were to assess total serum IgE and eosinophil count in a random sample of 20% of the children between 12 and 54 months old in a suburban community of Bandung, Indonesia, and to investigate a possible relationship between these values and atopy, asthma or wheezing and parasite infestation. METHODS: Two hundred sixty-nine children were examined at the Integrated Primary Health Care Unit, and the parents or guardians were interviewed with the use of a standardized questionnaire. RESULTS: The overall median value of IgE was 436 IU/ml (range, 18 to 9707 IU/ml); almost 94% of the children showed an IgE value of more than 100 IU/ml, and 29% showed a value of more than 1000 IU/ml. The median value for eosinophils was 580/mm3 (range, 70 to 5090/mm3); only 31% of the children had less than 400 eosinophils/mm3. IgE levels and eosinophilia were not related to age but showed a significant, although not high, correlation with each other (p < 0.05). In about 36% of the children parasites were demonstrated in a single stool sample; in those subjects eosinophilia and IgE values tended to be greater, but the difference was not significant. About 7% of the children had asthma, and in those subjects the eosinophil counts and IgE levels were much more increased (p < 0.001 and p approximately 0.01, respectively). No difference was found in IgE or eosinophil count in relation to other forms of atopy in the child (milk-induced dermatitis, urticaria, eczema, rhinitis) or in relation to a history of asthma or atopy in other family members. Yet, the occurrence of asthma in the child was significantly related to a history of asthma in other family members. CONCLUSIONS: IgE values and eosinophilia are markedly increased in these children under 5 years of age in Bandung, Indonesia, and the highest values are found in the 7% with asthma.

Asthma↗

Skin reactivity and eosinophil count in relation to the outcome of childhood asthma.

The aim of this study was to determine whether an association can be found between childhood skin reactivity and the outcome of asthma in young adulthood in a group of 406 asthmatic children, of whom 348 (86%) could be followed up in adulthood. A complete data set on skin tests and eosinophil count was available in 259 allergic subjects. They were stratified into three classes, according to initial skin test score in childhood. An increase in skin reactivity was noted from childhood to adulthood, while the differences in skin reactivity between the three classes remained significant. In childhood, a marked difference in total eosinophil count was found between the classes. Towards adulthood, a decrease in eosinophil count was noted, and the differences between the classes were no longer significant. The children with lowest skin reactivity also had the lowest symptom score in childhood. In adulthood, the prevalence of respiratory symptoms in this class was lower than in the other two classes. The prevalence of bronchial responsiveness to histamine was lowest in subjects with the lowest skin test score in childhood. Ventilatory parameters revealed no differences between the three classes. We conclude that although a low skin reactivity in childhood might be associated with a relatively favourable prognosis for asthma symptoms in adulthood, there is only limited evidence to support this hypothesis in our study.

Asthma↗

Efficacy and onset of action of fluticasone propionate aqueous nasal spray on nasal symptoms, eosinophil count, and mediator release after nasal allergen challenge in patients with seasonal allergic rhinitis.

We studied the effect and onset of action of fluticasone propionate aqueous nasal spray (FPANS) on mediator release and eosinophil accumulation in nasal secretions and on nasal symptoms of patients with seasonal allergic rhinitis after nasal allergen challenge (NAC). At the end of the pollen season, 28 patients were randomized in a double-blind and crossover design to receive 7 days' treatment with FPANS (200 microg, once daily) and matching placebo. NACs were performed before and at 6 h and 1, 2, 3, and 7 days during treatment with FPANS or placebo. Nasal secretions were collected for a quantitative determination of mediators and eosinophil count before and 5 min after each challenge. Nasal symptoms were assessed by scales grading the severity of symptoms at the same time. Results showed that for mediator concentrations there was a significant decrease of leukotriene C4 (P<0.001) at 7 days after the first administration of FPANS as compared to placebo. Two days after FPANS, both eosinophil counts and eosinophil cationic protein (ECP) concentrations were lower than those of placebo (eosinophils: P=0.032; ECP: P=0.038). The onset became even more important at day 7 (eosinophils: P=0.001; ECP: P=0.009) during the FPANS treatment period. For the subjective nasal symptoms, a significant reduction of symptom scores for nasal obstruction occurred also at day 3 (P=0.017) and for sneezing at day 7 (P=0.003). There was not yet any significant improvement of the objective nasal airway resistance after the different NACs during the study period. In conclusion, this study demonstrated that topical fluticasone propionate is effective in the treatment of mucosal inflammation induced by NAC. For optimal control of nasal symptoms induced by repeated maximal allergen challenges, a treatment period of more than 1 week is required.

Administration, Intranasal↗

Occupational asthma in aluminium potroom workers related to pre-employment eosinophil count.

Occupational asthma still occurs in aluminium potroom workers despite pre-employment medical selection. The purpose of our study was to identify workers with an increased risk of developing "potroom asthma". A nested, case-control study was carried out in two Dutch aluminium producing plants. Pre-employment data of 364 potroom workers (182 cases and 182 controls) were analyzed. Cases were workers unable to work because of work-related respiratory disease, meeting the criteria for potroom asthma. The selected controls were matched for age, year of starting employment and working conditions. Pre-employment eosinophil count was significantly related to the occurrence of potroom asthma, even though the mean number of the eosinophils in cases was within the normal range (< 275 cells.mm-3; 0.28 cells x 10(9).L-1). Hence, 39 of the 45 individuals with blood eosinophil counts in the upper range of normal (> 220 cells.mm-3; 0.22 cells x 10(9).L-1) developed potroom asthma with time. We conclude that workers without respiratory symptoms, with normal lung function and normal bronchial responsiveness before employment developed potroom asthma. Fluoride exposure, combined with an elevated eosinophil count, might induce an immunological or cytotoxic process.

Adult↗

Significant bronchospasm during sickle cell painful crises is associated with a lower peripheral eosinophil count.

BACKGROUND: Bronchial hyperresponsiveness and/or bronchospasm are recognized complications of sickle cell disease. OBJECTIVE: The aim of this study was to investigate the presence of bronchospasm during painful crises, using simple spirometry in patients with sickle cell disease. METHODS: A prospective, non-randomized study was undertaken in patients with homozygous sickle cell disease, who presented with increasing pain. A painful crisis was defined as any increase in bodily pains necessitating hospital admission. A 15% increase in FEV(1) following salbutamol nebulization was considered significant. RESULTS: Thirty-nine patients took part in the study. Significant bronchodilator responses were demonstrable in 48.7% of patients during painful crises. Patients with such a response had a significantly lower peripheral blood eosinophil count (mean count 0.17 x 10(9)/L vs. 0.445 x 10(9)/L, P = 0.02, confidence interval for difference between groups, 0.0, 0.39). Furthermore, the magnitudes of the bronchodilator responses were related to the degree of lowering of peripheral blood eosinophil counts (r(s) = -0.344, P = 0.037). CONCLUSION: Significant bronchospasm is demonstrable in a sizeable proportion of patients presenting with painful sickle cell crises. There seems to be a negative correlation between the magnitude of bronchospasm and the peripheral blood eosinophil count. We postulate a possible role for pulmonary sequestration of eosinophils in the pathophysiology of bronchospasm in sickle cell disease patients.

Adolescent↗

[The standard level of IgE RIST and eosinophil counts in 0-year old allergic children according to multiple factor analysis type II].

We specified three standard levels of IgE RIST (10, 20, 60 IU/ml) for the ninety-four (94) allergic clients of 0-year infants, who classified with three groups. Each group was furthermore divided in two groups such as a group under the standard level and a group exceeding the level respectively. Next, using the Multiple Factor Analysis Type II, we examined quantitative analysis that each of three classified groups was influenced on 12 allergic factors of sex, existence and inexistence of wheezing and atopic dermatitis, family history of allergic diseases, eosinophil counts. IgE RAST scores and antibody titers against egg white, milk and soybean, IgE RAST scores to Dermatophagoides farinae, while the we discussed how the standard levels were adequately reacted to the analysis. As a results, strong allergic factors which influenced the three groups commonly were two factors of IgE RAST scores to egg white and D.f. In particular, the factor which influenced the group of 10 IU/ml standard level was eosinophil counts and family history of allergic diseases. Furthermore, the strong factors which influenced the group classified on 60 IU/ml standard outstandingly appeared in IgE RAST scores to soybean, however, we did not find any difference between three groups. On the other hand, when we specified the standard level at 100/mm3, 200/mm3, 400/mm3 in regard to the eosinophil counts under the same method and examined results, we found strong allergic factors which influenced family history of allergic diseases. IgE RAST scores to egg white and soybean. However, the study scarcely recognize any difference between the three groups.

Eosinophils↗