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Peripheral Blood Eosinophil Counts and Serum ECP in Adolescents with Long-term Asthma Remission and Persistent Bronchial Hyperresponsiveness : Comparison with Adolescents with Symptomatic Asthma

Journal of the Korean Pediatric Society 2003;46(10):1013-1018.
Published online October 15, 2003.
Peripheral Blood Eosinophil Counts and Serum ECP in Adolescents with Long-term Asthma Remission and Persistent Bronchial Hyperresponsiveness : Comparison with Adolescents with Symptomatic Asthma
Hee Kang, Young Yoo, Jinho Yu, Yang Park, Young Yull Koh
Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
기관지 과민성을 가진 장기간 천식 관해 상태의 청소년에서혈액 내 호산구와 혈청 호산구 양이온 단백에 대한 연구
강희, 유영, 유진호, 박양, 고영률
서울대학교 의과대학 소아과학교실
Abstract
Purpose
: Bronchial hyperresponsiveness(BHR) in asthma is thought to be a consequence of underlying airway inflammation. But the mechanism responsible for persistent BHR in adolescents with long-term asthma remission is poorly understood. The aim of this study was to examine whether BHR in adolescents with asthma remission is associated with peripheral blood eosinophilia and/or increased serum levels of eosinophil cationic protein(ECP).
Methods
: We studied 35 adolescents with long-term asthma remission(neither symptoms nor medication during the previous two years) who have persistent BHR(remission group) and 35 adolescents with symptomatic asthma(symptomatic group) who were matched for methacholine provocative concentration producing a 20% fall in FEV1(PC20) with subjects in the remission group. The peripheral blood eosinophil counts and serum ECP concentrations were compared between these two groups. Correlations between PC20 and peripheral blood eosinophil counts or serum ECP concentrations were assessed in these two groups.
Results
: Peripheral blood eosinophil counts and serum ECP concentrations were significantly lower in the remission group than in the symptomatic group(273?08 vs. 365?78/ L; 16.3?.4 vs. 26.5?5.1 g/L, both, P<0.05). PC20 was correlated with peripheral blood eosinophil counts and serum ECP concentrations in the symptomatic group(r=-0.385, P=0.022; r=-0.439, P=0.008), but not in the remission group(r=-0.292, P=0.089; r=-0.243, P=0.159).
Conclusion
: BHR in adolescents with long-term asthma remission is not associated with peripheral blood eosinophilia or an increase in serum ECP concentration, which suggests that BHR in this clinical setting may not be attributed to airway eosinophilic inflammation. Further studies including direct assessment of airway inflammation are needed to confirm this conclusion.
Key Words: Adolescents, Asthma, Long-term remission, Bronchial hyperresponsiveness, Eosinophil, Eosinophil cationic protein


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