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Differential Excretion of Urinary Eosinophil Protein X after Methacholine Challenge Test in Children with Asthma

Journal of the Korean Pediatric Society 2003;46(5):495-499.
Published online May 15, 2003.
Differential Excretion of Urinary Eosinophil Protein X after Methacholine Challenge Test in Children with Asthma
Su-A Shin, Jae-Won Oh, Ha-Baik Lee
Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea
천식 환아에서 요중 Eosinophil Protein X의 메타콜린 기관지 유발 시험 전·후의 변화
신수아, 오재원, 이하백
한양대학교 의과대학 소아과학교실
Correspondence: 
Ha-Baik Lee, Email: hablee@hanyang.ac.kr
Abstract
Purpose
: Eosinophil is one of the important inflammatory cell involved in the airway inflammation in childhood asthma. It has been demonstrated that markers of eosinophil activation, including eosinophil cationic protein or eosinophil protein X(EPX), are increased in childhood asthma. Furthermore, they are related to disease activity and are assumed to be helpful in monitoring the treatment effect as urinary EPX(U-EPX) can be obtained easily and in a noninvasive way in children of all ages.
Methods
: Twenty-five children(22 male and three female) aged 11.87?.82 years with stable asthma were challenged with methacholine and urine was collected from each child during the following periods; before methacholine challenge test(MCT); 0-3 hr after the end of MCT; 4-7 hr after the end of MCT; and 8-24 hr after the end of MCT. Bronchial reactivity was determined by using Dosimeter(Jeager, Germany) with serially diluted methacholine from 0.05 to 25.0 mg. The FEV1 less than 80% of baseline value were classified into positive MCT. U-EPX was measured with a sensitive and specific radioimmunoassay(Pharmacia & Upjohn AB, Uppsala, Sweden). Results were expressed as gEPX/mmol creatinine.
Results
: An early airway response after MCT was associated with an increase of U-EPX excretion for 0-3 hr after methacholine inhalation in comparison with beseline values. Most subjects showed a small increase in U-EPX excretion during late asthmatic response for 4-7 hr, which then decreased to normal level in 8-24 hr. Also, a tendency for a higher increase of U-EPX was associated with a lower threshold of methacholine challenge and a longer duration of asthma.
Conclusion
: Measurement of EPX in urine is a noninvasive and easy method to assess the severity of airway inflammation in asthmatic children. It may be a helpful index of the events underlying the airway inflammatory responses during nonspecific bronchial challenge, and in monitoring asthma management.
Key Words: Urinary eosinophil protein X, Methacholine challenge, Asthma, Disease activity, Monitoring


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