Diagnostic value study of fractional exhaled nitric oxide (FeNO) in infants with recurrent wheezing / 国际儿科学杂志

Objective To analyze the correlation between the fractional exhaled nitric oxide (FeNO) levels and blood eosinophil (EOS) count and the frequency of wheeze in infants with recurrent wheezing.Methods From February 2015 to August 2016 in the General Hospital of Northern War Zone,outpatient department of Pediatrics treatment and hospitalization of age less than or equal to 3 year old children with recurrent wheezing,101 cases were induded as the research object.On the basis of asthma predictive index (API) score were divided into API positive group (n =55) and API negative group (n =46),according to the wheeze frequency of the two groups children were divided into 3 ～ 4 times wheezing groups and more than 5 times.Select 37 cases of healthy children as control group.The concentration of FeNO and blood EOS count are detected in all the children.The correlation between the three groups of children with FeNO concentration,the correlation between FeNO and blood EOS count,the correlation between the the frequency of wheeze and FeNO in experimental groups were analyzed.Results (1) API positive group mean FeNO (19.3 ± 6.2) ppb was significantly higher than API negative group (7.7 ± 2.9) ppb,there was no difference (P ＞ 0.05).API negative group mean FeNO (7.7 ± 2.9) ppb is lower than the normal control group (9.5 ± 2.0) ppb,there was no difference (P ＞0.05).(2) API positive group mean EOS count (124.7 ± 1.6) x 106/L is higher than API negative group (86.1 ± 1.9) x 106/L,there was significant difference (P ＜ 0.01);(3) There was a correlation between FeNO level and blood EOS count in API positive group,there was no correlation between FeNO level and blood EOS count in API negative group and con~ol group.(4) No statistical differences were found in ≤4 times wheezing groups and more than 5 times of the mean FeNO.Conclusion There is no significant difference in the mean value of FeNO between different times of wheezing in children with recurrent wheezing.The combination of medical history,EOS,FeNO and API might be used to predict the wheezing episode of infants.

Relationship between serum total IgE, specific IgE, and peripheral blood eosinophil count according to specific allergic diseases

PURPOSE: Elevated IgE, and blood eosinophil count are considered the hallmarks of allergic diseases, while the levels of those parameters are shared with normal population. This study is aimed to investigate the relationship between those factor and clinical value according to specific allergic diseases. METHODS: We reviewed medical records of 946 patients with allergic diseases who had taken the allergy tests from 2001 to 2010. The effects of age, sex, specific diagnoses of diseases, such as atopic dermatitis (AD), allergic rhinitis (AR), bronchial asthma (BA), urticarial on allergy tests were assessed. RESULTS: In contrast to those of total eosinophil counts, there was the trend of increasing IgE value with the age in children with allergic diseases. The titer of total IgE and eosinophil count were higher than those of control group of patients with acute urticaria. There was the positive relation between total IgE and eosinophil count in patients with allergic diseases. The positive predictive value and negative predictive value of total IgE for specific IgE were higher than those of total eoshinophil count. CONCLUSION: There were the positive relation of total IgE and total eosinophil count in allergic diseases and the higher value of those compared with the control in this study. These values over a certain level have a positive predictive value of serum specific IgE and help us to determine whether we should test the serum specific IgE in patients with allergic diseases.

Clinical Characteristics of Allergic Rhinitis According to Allergic Rhinitis and Its Impact on Asthma Guidelines

OBJECTIVES: The Allergic rhinitis and its impact on asthma (ARIA) guidelines were suggested for use to classify allergic rhinitis (AR). However, few studies have been performed in Asians. The objective of this study is to identify the clinical characteristics of AR in Korean patients according to the ARIA guidelines. METHODS: For the study, 610 patients who had been diagnosed with allergic rhinitis at Seoul National University Bundang Hospital and 545 patients who had been diagnosed with allergic rhinitis at 3 local clinics were included. All the patients were categorized into 4 groups, such as the mild intermittent, mild persistent, moderate-severe intermittent and moderate-severe persistent groups. The patients were given a questionnaire on allergic rhinitis-related symptoms and they underwent blood tests, including the blood eosinophil count and the serum total IgE level. RESULTS: The most prevalent type was the moderate-severe persistent group (34.7%), and the moderate-severe intermittent group (17.1%) was the rarest. There were significant differences among the 4 groups for olfaction (P<0.001), self-awareness of rhinitis (P=0.013), a previous history of AR (P<0.001), self-awareness of asthma (P=0.001) and allergic conjunctivitis (P<0.001). On the allergy laboratory tests, there was a significant difference between the groups for the eosinophi count (P=0.004). The number of blood eosinophil was more in the persistent groups than in the intermittent groups. CONCLUSION: According to the ARIA guidelines, the moderate-severe persistent group was the most prevalent for Korean patients. Blood eosinophilia and olfactory dysfunction were the most severe in the moderate-severe persistent group.

Serum Eosinophil Cationic Protein Levels in Patients with Allergic Diseases / 대한임상병리학회지

BACKGROUND: Eosinophil cationic protein (ECP), one of the eosinophil granule proteins released during allergic reactions, may play a major role in the allergic inflammatory process. The measurement of ECP in serum may be a useful indicator of eosinophil activity in ongoing inflammatory processes. We investigated the clinical utility of ECP measurement in serum in patients with bronchial asthma, allergic rhinitis and atopic dermatitis, after standardizing sample processing. METHODS: We measured the serum ECP levels in patients with bronchial asthma (n=38), chronic obstructive pulmonary diseases (COPD) (n=13), respiratory symptoms (n=19), allergic rhinitis (n=26), non-allergic rhinitis (n=24), and atopic dermatitis (n=10) and in normal healthy controls (n=16) by the fluoroenzyme immunoassay using Pharmacia CAP System, and evaluated the correlation between ECP level and blood eosinophil number, or ECP and IgE levels. Blood eosinophil number was counted by the automated cell counter. RESULTS: Serum ECP levels were significantly higher in patients with bronchial asthma (15.6+/- 12.6 g/L), COPD (13.3+/-7.2 g/L), allergic rhinitis (23.8+/-13.2 g/L), and atopic dermatitis (20.6+/- 18.4 g/L) than in normal controls (7.5+/-4.2 g/L) (P <0.05). ECP levels were also significantly higher in patients with bronchial asthma and COPD than in patients with simple respiratory symptoms (6.9+/-4.7 g/L), whose ECP levels did not statistically differ from those in normal controls. ECP levels were also significantly higher in patients with allergic rhinitis than in patients with non-allergic rhinitis (9.5+/-5.1 g/L), whose ECP levels did not statistically differ from those in normal controls. Serum ECP level and eosinophil number in peripheral blood were correlated only in patients with bronchial asthma (r=0.53, P <0.01) and no correlation between ECP and IgE levels was found in all of the patients. CONCLUSIONS: ECP is the one of the secretory components released from the eosinophil granule and measurement of ECP in serum might be one of the noninvasive tool to assess the activity in relation to eosinophil involvement in various allergic diseases.

Clinical significance of eosinophil cationic protein ( ECP ) in bronchial asthma / 천식및알레르기

OBJECTIVE: The aim of this study was to investigate the usefulness of serum ECP as a marker of the severity of asthma and extent of airway inflammation. METHOD: We investigated 108 patients suffering from bronchial asthma, who were classified as mild intermittent(n=19), mild persistent(n=27), moderate persistent(n=42), and severe persistent(n=20) and 10 healthy controls. Atopy was defined as those who showed >2+ responses on skin prick test. Serum ECP, peripheral blood eosinophil, sputum eosinophil, and PEFR were measured on the same date and meth~acholine PC20 were determined within 2 weeks. RESULTS: Serum ECP levels were 10.1+- 2.0 ug/L in controls, and 29.1+- 23.6 ug/L in asthmatic patients. According to symptom severity, serum ECP levels were 22.9 +- 15.6 ug/L, 28. 6 +- 24.1 ug/L, 29.5 +- 22.2 ug/L, and 34.6 +- 31.2 ug/L in mild intermittent, mild persistent, moderate persistent and severe persistent asthmatic patients, respectively and there were no significant differences among four groups(p>0.05). Serum ECP levels correlated with peripheral blood eosinophil counts(r=0.48, p0.05). CONCLUSION: Single measurevment of ECP level at clinic could not represent the severity of asthma.