Abstract

Background and Aim: Eosinophils are a key player in allergic inflammation. ECP and IL-4 are essential mediators of allergic inflammation in the lungs and therefore can be used to help in the diagnosis and follow-up of allergic asthma. This study aimed to evaluate whether ECP and IL-4 levels in the plasma of asthmatic patients may reflect the clinical status of asthma exacerbations during sandstorms. Methods: Thirty patients had allergic asthma, and sixteen normal controls were enrolled in this study. These subjects were divided into two groups. The first group included seventeen patients who had chronic symptoms of asthma but were controlled, and the second group included thirteen patients with chronic symptoms who developed exacerbations during sandstorms. Total IgE, ECP, and IL-4 levels were measured in the plasma of asthmatic patients and normal controls by using specific ELISAs. Results: Total IgE levels were significantly higher in patients with asthma (mean≤ 467 IU/ml, P ≤ 0.0001) than in controls (113 IU/ml). IL-4 was not detected in patients with asthma or in controls. ECP levels were elevated significantly in patients with severe symptoms of asthma (mean≤ 3.28 ng/ml, P≤0.0006) in comparison to those in normal controls or patients with controlled asthma (1.9 ng/ml, P≤0.02). In addition, there was no significant increase in ECP levels in patients with controlled asthma relative to those in normal controls. Conclusions: These findings suggest that ECP but not IL-4 may be a useful marker to evaluate the severity of asthma, follow and predict a response to steroid treatment.

Keywords: Asthma · IgE · ECP · IL-4 · Eosinophils

References

  1. 1.Al-Moamary M, Alhaider S, Alangari A, Al Ghobain M, Zeitouni M, Idrees M, et al. The Saudi Initiative for Asthma - 2019 Update: Guidelines for the diagnosis and management of asthma in adults and children. Annals of Thoracic Medicine. 2019;14(1):3-48.
  2. 2.Subbarao P, Mandhane PJ, Sears MR. Asthma: epidemiology, etiology and risk factors. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne. 2009;181(9):E181-90.
  3. 3.Kanatani KT, Ito I, Al-Delaimy WK, Adachi Y, Mathews WC, Ramsdell JW. Desert Dust Exposure Is Associated with Increased Risk of Asthma Hospitalization in Children. American Journal of Respiratory and Critical Care Medicine. 2010;182(12):1475-81.
  4. 4.PLATTS-MILLS TAE. The Role of Immunoglobulin E inAllergy andAsthma. American Journal of Respiratory and Critical Care Medicine. 2001;164 (supplement_1):S1-S5.
  5. 5.McBrien CN, Menzies-Gow A. The Biology of Eosinophils and Their Role in Asthma. Frontiers in medicine. 2017;4:93-
  6. 6.Niimi A, Amitani R, Suzuki K, Tanaka E, Murayama T, Kuze F. Serum eosinophil cationic protein as a marker of eosinophilic inflammation in asthma. Clinical and experimental allergy : journal of the British Society forAllergy and Clinical Immunology. 1998;28(2):233-40.
  7. 7.Bjork A, Venge P, Peterson CG. Measurements of ECP in serum and the impact of plasma coagulation. Allergy. 2000;55(5):442-8.
  8. 8.Gour N, Wills-Karp M. IL-4 and IL-13 signaling in allergic airway disease. Cytokine. 2015;75(1):68-78.
  9. 9.Kips JC. Cytokines in asthma. European Respiratory Journal. 2001;18 (34 suppl):24s-33s.
  10. 10.Piehler D, Stenzel W, Grahnert A, Held J, Richter L, Köhler G, et al. Eosin- Majmaah Journal of Health Sciences ,Vol. 8, Issue 3, September - 2020 , Muharam - 1442 23 Assessment of plasma ECPlevels in Saudi patients with chronic asthma as a marker of asthma exacerbation during sandstorms ophils contribute to IL-4 production and shape the T-helper cytokine profile and inflammatory response in pulmonary cryptococcosis. Am J Pathol. 2011;179(2): 733-44.
  11. 11.Brusselle GG, Kips JC, Tavernier JH, van der Heyden JG, Cuvelier CA, Pauwels RA, et al. Attenuation of allergic airway inflammation in IL-4 deficient mice. Clinical and experimental allergy : journal of the British Society forAllergy and Clinical Immunology. 1994;24(1):73-80.
  12. 12.Wenzel S, Ford L, Pearlman D, Spector S, Sher L, Skobieranda F, et al. Dupilumab in persistent asthma with elevated eosinophil levels. The New England journal of medicine. 2013;368(26):2455-66.
  13. 13.Dunican EM, Fahy JV. The Role of Type 2 Inflammation in the Pathogenesis ofAsthma Exacerbations.AnnAm Thorac Soc. 2015;12 Suppl 2(Suppl 2):S144-S9.
  14. 14.Jiang X-G, Yang X-D, Lv Z, Zhuang P-H. Elevated serum levels of TNF-α, IL- 8, and ECPcan be involved in the development and progression of bronchial asthma. Journal of Asthma. 2018;55(2):111-8.
  15. 15.Venge P, Bystrom J, Carlson M, Hakansson L, Karawacjzyk M, Peterson C, et al. Eosinophil cationic protein (ECP): molecular and biological properties and the use of ECP as a marker of eosinophil activation in disease. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. 1999;29(9):1172-86.
  16. 16.Guo C-L, Sun X-M, Wang X-W, Guo Q. Serum Eosinophil Cationic Protein Is a Useful Marker for Assessing the Efficacy of Inhaled Corticosteroid Therapy in Children with Bronchial Asthma. The Tohoku Journal of Experimental Medicine. 2017;242(4):263-71.
  17. 17.Kato M, Yamada Y, Maruyama K, Hayashi Y. Serum Eosinophil Cationic Protein and 27 Cytokines/Chemokines in Acute Exacerbation of ChildhoodAsthma. International archives of allergy and immunology. 2010;152(suppl 1) (Suppl. 1):62-6.
  18. 18.Szefler SJ, Martin RJ, King TS, Boushey HA, Cherniack RM, Chinchilli VM, et al. Significant variability in response to inhaled corticosteroids for persistent asthma. The Journal of allergy and clinical immunology. 2002;109(3):410-8.
  19. 19.Koh GC, Shek LP, Goh DY, Van Bever H, Koh DS. Eosinophil cationic protein: is it useful in asthma?Asystematic review. 24 Majmaah Journal of Health Sciences ,Vol. 8, Issue 3, September - 2020 , Muharam - 1442 Assessment of plasma ECPlevels in Saudi patients with chronic asthma as a marker of asthma exacerbation during sandstorms Respiratorymedicine. 2007;101(4):696-705.
  20. 20.Vijverberg SJ, Hilvering B, Raaijmakers JA, Lammers J-WJ, Maitland-van der ZeeA-H, Koenderman L. Clinical utility of asthma biomarkers: from bench to bedside. Biologics. 2013;7:199-210.
  21. 21.HuangA-X, Lu L-W, Liu W-J, Huang M. Plasma Inflammatory Cytokine IL-4, IL-8, IL-10, and TNF-α Levels Correlate with Pulmonary Function in Patients with Asthma-Chronic Obstructive Pulmonary Disease (COPD) Overlap Syndrome. Med Sci Monit. 2016;22:2800-8.
  22. 22.Barnes PJ. Inhaled Corticosteroids. Pharmaceuticals (Basel, Switzerland). 2010;3(3):514-40.

Peer review

Peer reviewed by 2 reviewers, who chose to remain anonymous.

Majmaah Journal of Health Sciences · eISSN 1658-8223 · Majmaah University · open access