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Thomas Frischer - One of the best experts on this subject based on the ideXlab platform.
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urinary leukotriene e4 Eosinophil Protein X and nasal Eosinophil cationic Protein are not associated with respiratory symptoms in 1 year old children
Allergy, 2001Co-Authors: Claudia Wojnarowski, G Halmerbauer, Thomas Frischer, C Gartner, Johannes Forster, E Mayatepek, Joachim KuehrAbstract:Background: Eosinophilic airways inflammation forms the pathophysiologic basis for a proportion of children at risk of developing recurrent wheezing. Early preventive measures and/or anti-inflammatory treatment may be guided by the identification of such children. We aimed to study the relationship between respiratory symptoms and indirect markers of airway inflammation. Methods: We measured Eosinophil Protein X (EPX) and leukotriene E4 (LTE4) in urine, as well as Eosinophil cationic Protein (ECP) in nasal lavages, in a random sample of 1-year-old children with a family history of atopy who participated in an international multicenter study on the prevention of allergy in Europe. For urine analyses, 10 children with upper respiratory illness and 19 healthy children without a family history of atopy were also enrolled. Endogenous urinary LTE4 was separated by HPLC and determined by enzyme immunoassay with a specific antibody. The concentrations of nasal ECP and urinary EPX were determined by RIA analysis. Results: One hundred and ten children (mean age: 1.05±0.1 years) were enrolled. Prolonged coughing during the first year of life was reported in 29 children, wheezy breathing in 17 children, and dry skin in 33 children. A doctor's diagnosis of wheezy bronchitis was given to 17 children. Sensitization to dust mites (specific IgE ≥1.43 ML/units) was detected in two children. Children with a doctor's diagnosis of atopic dermatitis within the first 12 months of life (n=6) had significantly higher urinary EPX than children without this (66.7 vs 30.1 µg/mmol creatinine, P=0.01). Urinary eXcretion of EPX and LTE4 showed a weak correlation (r=0.22, P=0.02). There were no significant differences in urinary eXcretion of EPX and LTE4 or nasal ECP between children with and without respiratory symptoms (P>0.1). Conclusions: At the age of 1 year, urinary EPX is increased in children with atopic dermatitis. With regard to respiratory symptoms, urinary and nasal inflammatory parameters are not helpful in characterizing the phenotype of a single patient.
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Eosinophil cationic Protein and Eosinophil Protein X in the nasal lavage of children during the first 4 weeks of life
Allergy, 2000Co-Authors: G Halmerbauer, D Y Koller, C Gartner, M Schierl, J Kuhr, Johannes Forster, R Urbanek, Thomas FrischerAbstract:Eosinophil cationic Protein (ECP) and Eosinophil Protein X (EPX) are well established as markers of Eosinophil activation. We analyzed ECP and EPX concentrations in nasal lavage fluids (NALF) of 378 neonates during their first 4 weeks of life. Inclusion criteria were a positive history of parental allergy and a positive skin prick test or specific IgE (RAST class ≥2) against at least one out of a panel of common aeroallergens in one or both parents. Twenty-four infants with no history of parental allergy were used as controls. A volume of 2 ml of 0.9% saline was instilled into each nostril and immediately recovered by a suction device. ECP and EPX were analyzed by radioimmunoassay. In 65 samples of three consecutive lavages, EPX was detected in nine samples (13.8%) in the control group, whereas it was detected in 197/360 samples (54.7%) in the study population. The corresponding figures for ECP were 17/65 (26.2%) in the control group and 173/365 (47.4%) in the study group. Both Proteins showed a skewed distribution (median/5–95th percentiles for ECP: 0 µg/l [0–69.4] and EPX: 6.6 µg/l [0–73.2]). The differences between the control group and the study group were statistically significant, regardless of the allergic disease of the parents. In children of allergic parents, activation Proteins of the Eosinophil granulocyte are released on the nasal mucosal surface in about 50% of the studied population at the age of 4 weeks. This early onset of Eosinophil activation in the nasal respiratory epithelium may reflect a genetic predisposition to allergy or early eXposure to allergens.
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Eosinophil derived Proteins in nasal lavage fluid of neonates of allergic parents and the development of respiratory symptoms during the first 6 months of life
Allergy, 2000Co-Authors: Thomas Frischer, G Halmerbauer, D Y Koller, E Tauber, C Gartner, M Schierl, Johannes Forster, R Urbanek, R Rath, J KuhrAbstract:BACKGROUND Eosinophilic airways inflammation forms the pathophysiologic basis for a proportion of children at risk of developing recurrent wheezing. Early preventive measures and/or anti-inflammatory treatment may be guided by the identification of such children. METHODS We studied upper-airways inflammation by nasal lavage in a cohort of 397 infants within the first 4 weeks of life. They participated in an international multicenter study on the prevention of allergy in Europe (SPACE-Biomed II Program). A volume of 2 ml of prewarmed 0.9% saline was instilled into each nasal cavity and immediately re-collected by a suction device. The average recovery was 502 microl (SD: 311 microl). The concentrations of Eosinophil cationic Protein (ECP) and Eosinophil Protein X (EPX) were determined by RIA analysis. RESULTS ECP was detectable (>2 microg/l) in 47% of samples (173/365) and EPX (>3 microg/l) in 54.7% (197/360). Children with a doctor's diagnosis of a wheezy bronchitis within the first 6 months of life (n = 40) had significantly higher ECP and EPX concentrations in the nasal lavage at 4 weeks of age (median ECP: 14 microg/l; 5-95th percentile: 0-122.4 microg/l) than children without such diagnosis (median ECP: 0 microg/l; 5-95th percentile: 0-86.6 microg/l; P<0.05). Corresponding figures for EPX were 12.14 microg/l (0-148.98 microg/l) vs 7.5 microg/l (0-81.46 microg/l; P<0.05). No associations between nasal ECP/EPX and the development of food allergy or eczema were observed. CONCLUSIONS Increased nasal ECP and EPX in the first 4 weeks of life are associated with wheezing in 6-month-old infants at increased risk of atopic disease. We suggest that this might be related to a general tendency for a Th2 cytokine pattern in these young infants and subsequent trafficking of Eosinophils into the nasal mucosa, or it might be a consequence of intrauterine allergen eXposure.
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urinary Eosinophil Protein X in children the relationship to asthma and atopy and normal values
Allergy, 2000Co-Authors: E Tauber, G Halmerbauer, Thomas Frischer, D Y Koller, C Gartner, F Horak, A Veiter, M StudnickaAbstract:Background: In epidemiologic studies, it may be difficult to identify children with bronchial asthma. Since this is the most common chronic respiratory disease in childhood, and its prevalence is still increasing, reliable methods for identification of asthmatic children are required. This study evaluates the use of urinary Eosinophil Protein X (U-EPX) in epidemiologic studies in identifying atopic and asthmatic children. Methods: U-EPX was measured in 877 Austrian schoolchildren. The skin prick test (SPT) was performed with eight common aeroallergens, and established questionnaires were used to assess respiratory symptoms. Results: Of our cohort, 2.8% reported physician-diagnosed asthma, 5.1% reported wheezing within the last 12 months, and 24.1% were found to be atopic. In children with physician-diagnosed asthma, as well as in atopic children (positive SPT), median U-EPX levels were significantly higher than in healthy subjects (142.8 and 89.6 vs 63.9 µg/mmol creatinine, P<0.0001 and P<0.0001, respectively). In addition, perennial sensitization to inhalant allergens resulted in higher U-EPX levels than did seasonal sensitization. The odds ratio for U-EPX levels over the 90th percentile was significantly elevated for asthma, for wheezing, for nocturnal cough, and for breathlessness at eXercise, as well as for seasonal and perennial sensitization. Pulmonary function was negatively relatedto U-EPX levels. Conclusions: Measurement of U-EPX, which can be obtained easily, may be helpful in diagnosing both asthma and atopy in children. However, there is a great overlap between controls and symptomatics, a fact which reduces the sensitivity of U-EPX in determination of the prevalence of asthma in epidemiologic studies.
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major basic Protein but not Eosinophil cationic Protein or Eosinophil Protein X is related to atopy in cystic fibrosis
Allergy, 1999Co-Authors: D Y Koller, G Halmerbauer, Thomas Frischer, Judit Muller, M SchierlAbstract:Increased Eosinophil granule Proteins have been described in serum and sputum samples of patients with cystic fibrosis (CF). It has been assumed that Eosinophil degranulation is enhanced in atopic subjects - as in asthmatics. Since in CF no differences in Eosinophil cationic Protein (ECP), Eosinophil Protein X (EPX), and Eosinophil peroXidase between atopic and nonatopic subjects have been detected, we investigated whether major basic Protein (MBP) is increased in serum and sputum samples derived from atopic (n = 14) compared with nonatopic CF subjects (n = 26). In CF patients, high mean serum (sputum) levels of ECP 29.7 microg/l (2.7 mg/l), EPX 53.7 microg/l (7.9 mg/l), and MBP 984.6 microg/l but low sputum MBP levels (57.4 microg/l) were measured. In addition, in serum and in sputum samples, a significant correlation between MBP and ECP (P<0.03 and P<0.0001, respectively) or EPX (P<0.05 and P<0.0004, respectively) was detected. By subdivision of the patients into allergic and nonallergic subjects, significant differences were found for serum MBP values only(mean 1382.2 microg/l vs. 770.5 microg/l; P<0.0001), but not for ECP or EPX serum levels or for Eosinophil Proteins in sputum. Although no differences between atopic and nonatopic CF patients in ECP and EPX were found, serum MBP levels were higher in patients sensitized to inhalant allergens than in nonsensitized subjects. These results indicate differential release of Eosinophil granule Proteins in peripheral blood from Eosinophils, and they also indicate that MBP in serum likely is to be a better discriminator of atopy in CF.
G Halmerbauer - One of the best experts on this subject based on the ideXlab platform.
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urinary leukotriene e4 Eosinophil Protein X and nasal Eosinophil cationic Protein are not associated with respiratory symptoms in 1 year old children
Allergy, 2001Co-Authors: Claudia Wojnarowski, G Halmerbauer, Thomas Frischer, C Gartner, Johannes Forster, E Mayatepek, Joachim KuehrAbstract:Background: Eosinophilic airways inflammation forms the pathophysiologic basis for a proportion of children at risk of developing recurrent wheezing. Early preventive measures and/or anti-inflammatory treatment may be guided by the identification of such children. We aimed to study the relationship between respiratory symptoms and indirect markers of airway inflammation. Methods: We measured Eosinophil Protein X (EPX) and leukotriene E4 (LTE4) in urine, as well as Eosinophil cationic Protein (ECP) in nasal lavages, in a random sample of 1-year-old children with a family history of atopy who participated in an international multicenter study on the prevention of allergy in Europe. For urine analyses, 10 children with upper respiratory illness and 19 healthy children without a family history of atopy were also enrolled. Endogenous urinary LTE4 was separated by HPLC and determined by enzyme immunoassay with a specific antibody. The concentrations of nasal ECP and urinary EPX were determined by RIA analysis. Results: One hundred and ten children (mean age: 1.05±0.1 years) were enrolled. Prolonged coughing during the first year of life was reported in 29 children, wheezy breathing in 17 children, and dry skin in 33 children. A doctor's diagnosis of wheezy bronchitis was given to 17 children. Sensitization to dust mites (specific IgE ≥1.43 ML/units) was detected in two children. Children with a doctor's diagnosis of atopic dermatitis within the first 12 months of life (n=6) had significantly higher urinary EPX than children without this (66.7 vs 30.1 µg/mmol creatinine, P=0.01). Urinary eXcretion of EPX and LTE4 showed a weak correlation (r=0.22, P=0.02). There were no significant differences in urinary eXcretion of EPX and LTE4 or nasal ECP between children with and without respiratory symptoms (P>0.1). Conclusions: At the age of 1 year, urinary EPX is increased in children with atopic dermatitis. With regard to respiratory symptoms, urinary and nasal inflammatory parameters are not helpful in characterizing the phenotype of a single patient.
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Eosinophil cationic Protein and Eosinophil Protein X in the nasal lavage of children during the first 4 weeks of life
Allergy, 2000Co-Authors: G Halmerbauer, D Y Koller, C Gartner, M Schierl, J Kuhr, Johannes Forster, R Urbanek, Thomas FrischerAbstract:Eosinophil cationic Protein (ECP) and Eosinophil Protein X (EPX) are well established as markers of Eosinophil activation. We analyzed ECP and EPX concentrations in nasal lavage fluids (NALF) of 378 neonates during their first 4 weeks of life. Inclusion criteria were a positive history of parental allergy and a positive skin prick test or specific IgE (RAST class ≥2) against at least one out of a panel of common aeroallergens in one or both parents. Twenty-four infants with no history of parental allergy were used as controls. A volume of 2 ml of 0.9% saline was instilled into each nostril and immediately recovered by a suction device. ECP and EPX were analyzed by radioimmunoassay. In 65 samples of three consecutive lavages, EPX was detected in nine samples (13.8%) in the control group, whereas it was detected in 197/360 samples (54.7%) in the study population. The corresponding figures for ECP were 17/65 (26.2%) in the control group and 173/365 (47.4%) in the study group. Both Proteins showed a skewed distribution (median/5–95th percentiles for ECP: 0 µg/l [0–69.4] and EPX: 6.6 µg/l [0–73.2]). The differences between the control group and the study group were statistically significant, regardless of the allergic disease of the parents. In children of allergic parents, activation Proteins of the Eosinophil granulocyte are released on the nasal mucosal surface in about 50% of the studied population at the age of 4 weeks. This early onset of Eosinophil activation in the nasal respiratory epithelium may reflect a genetic predisposition to allergy or early eXposure to allergens.
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Eosinophil derived Proteins in nasal lavage fluid of neonates of allergic parents and the development of respiratory symptoms during the first 6 months of life
Allergy, 2000Co-Authors: Thomas Frischer, G Halmerbauer, D Y Koller, E Tauber, C Gartner, M Schierl, Johannes Forster, R Urbanek, R Rath, J KuhrAbstract:BACKGROUND Eosinophilic airways inflammation forms the pathophysiologic basis for a proportion of children at risk of developing recurrent wheezing. Early preventive measures and/or anti-inflammatory treatment may be guided by the identification of such children. METHODS We studied upper-airways inflammation by nasal lavage in a cohort of 397 infants within the first 4 weeks of life. They participated in an international multicenter study on the prevention of allergy in Europe (SPACE-Biomed II Program). A volume of 2 ml of prewarmed 0.9% saline was instilled into each nasal cavity and immediately re-collected by a suction device. The average recovery was 502 microl (SD: 311 microl). The concentrations of Eosinophil cationic Protein (ECP) and Eosinophil Protein X (EPX) were determined by RIA analysis. RESULTS ECP was detectable (>2 microg/l) in 47% of samples (173/365) and EPX (>3 microg/l) in 54.7% (197/360). Children with a doctor's diagnosis of a wheezy bronchitis within the first 6 months of life (n = 40) had significantly higher ECP and EPX concentrations in the nasal lavage at 4 weeks of age (median ECP: 14 microg/l; 5-95th percentile: 0-122.4 microg/l) than children without such diagnosis (median ECP: 0 microg/l; 5-95th percentile: 0-86.6 microg/l; P<0.05). Corresponding figures for EPX were 12.14 microg/l (0-148.98 microg/l) vs 7.5 microg/l (0-81.46 microg/l; P<0.05). No associations between nasal ECP/EPX and the development of food allergy or eczema were observed. CONCLUSIONS Increased nasal ECP and EPX in the first 4 weeks of life are associated with wheezing in 6-month-old infants at increased risk of atopic disease. We suggest that this might be related to a general tendency for a Th2 cytokine pattern in these young infants and subsequent trafficking of Eosinophils into the nasal mucosa, or it might be a consequence of intrauterine allergen eXposure.
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urinary Eosinophil Protein X in children the relationship to asthma and atopy and normal values
Allergy, 2000Co-Authors: E Tauber, G Halmerbauer, Thomas Frischer, D Y Koller, C Gartner, F Horak, A Veiter, M StudnickaAbstract:Background: In epidemiologic studies, it may be difficult to identify children with bronchial asthma. Since this is the most common chronic respiratory disease in childhood, and its prevalence is still increasing, reliable methods for identification of asthmatic children are required. This study evaluates the use of urinary Eosinophil Protein X (U-EPX) in epidemiologic studies in identifying atopic and asthmatic children. Methods: U-EPX was measured in 877 Austrian schoolchildren. The skin prick test (SPT) was performed with eight common aeroallergens, and established questionnaires were used to assess respiratory symptoms. Results: Of our cohort, 2.8% reported physician-diagnosed asthma, 5.1% reported wheezing within the last 12 months, and 24.1% were found to be atopic. In children with physician-diagnosed asthma, as well as in atopic children (positive SPT), median U-EPX levels were significantly higher than in healthy subjects (142.8 and 89.6 vs 63.9 µg/mmol creatinine, P<0.0001 and P<0.0001, respectively). In addition, perennial sensitization to inhalant allergens resulted in higher U-EPX levels than did seasonal sensitization. The odds ratio for U-EPX levels over the 90th percentile was significantly elevated for asthma, for wheezing, for nocturnal cough, and for breathlessness at eXercise, as well as for seasonal and perennial sensitization. Pulmonary function was negatively relatedto U-EPX levels. Conclusions: Measurement of U-EPX, which can be obtained easily, may be helpful in diagnosing both asthma and atopy in children. However, there is a great overlap between controls and symptomatics, a fact which reduces the sensitivity of U-EPX in determination of the prevalence of asthma in epidemiologic studies.
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major basic Protein but not Eosinophil cationic Protein or Eosinophil Protein X is related to atopy in cystic fibrosis
Allergy, 1999Co-Authors: D Y Koller, G Halmerbauer, Thomas Frischer, Judit Muller, M SchierlAbstract:Increased Eosinophil granule Proteins have been described in serum and sputum samples of patients with cystic fibrosis (CF). It has been assumed that Eosinophil degranulation is enhanced in atopic subjects - as in asthmatics. Since in CF no differences in Eosinophil cationic Protein (ECP), Eosinophil Protein X (EPX), and Eosinophil peroXidase between atopic and nonatopic subjects have been detected, we investigated whether major basic Protein (MBP) is increased in serum and sputum samples derived from atopic (n = 14) compared with nonatopic CF subjects (n = 26). In CF patients, high mean serum (sputum) levels of ECP 29.7 microg/l (2.7 mg/l), EPX 53.7 microg/l (7.9 mg/l), and MBP 984.6 microg/l but low sputum MBP levels (57.4 microg/l) were measured. In addition, in serum and in sputum samples, a significant correlation between MBP and ECP (P<0.03 and P<0.0001, respectively) or EPX (P<0.05 and P<0.0004, respectively) was detected. By subdivision of the patients into allergic and nonallergic subjects, significant differences were found for serum MBP values only(mean 1382.2 microg/l vs. 770.5 microg/l; P<0.0001), but not for ECP or EPX serum levels or for Eosinophil Proteins in sputum. Although no differences between atopic and nonatopic CF patients in ECP and EPX were found, serum MBP levels were higher in patients sensitized to inhalant allergens than in nonsensitized subjects. These results indicate differential release of Eosinophil granule Proteins in peripheral blood from Eosinophils, and they also indicate that MBP in serum likely is to be a better discriminator of atopy in CF.
C Gartner - One of the best experts on this subject based on the ideXlab platform.
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urinary leukotriene e4 Eosinophil Protein X and nasal Eosinophil cationic Protein are not associated with respiratory symptoms in 1 year old children
Allergy, 2001Co-Authors: Claudia Wojnarowski, G Halmerbauer, Thomas Frischer, C Gartner, Johannes Forster, E Mayatepek, Joachim KuehrAbstract:Background: Eosinophilic airways inflammation forms the pathophysiologic basis for a proportion of children at risk of developing recurrent wheezing. Early preventive measures and/or anti-inflammatory treatment may be guided by the identification of such children. We aimed to study the relationship between respiratory symptoms and indirect markers of airway inflammation. Methods: We measured Eosinophil Protein X (EPX) and leukotriene E4 (LTE4) in urine, as well as Eosinophil cationic Protein (ECP) in nasal lavages, in a random sample of 1-year-old children with a family history of atopy who participated in an international multicenter study on the prevention of allergy in Europe. For urine analyses, 10 children with upper respiratory illness and 19 healthy children without a family history of atopy were also enrolled. Endogenous urinary LTE4 was separated by HPLC and determined by enzyme immunoassay with a specific antibody. The concentrations of nasal ECP and urinary EPX were determined by RIA analysis. Results: One hundred and ten children (mean age: 1.05±0.1 years) were enrolled. Prolonged coughing during the first year of life was reported in 29 children, wheezy breathing in 17 children, and dry skin in 33 children. A doctor's diagnosis of wheezy bronchitis was given to 17 children. Sensitization to dust mites (specific IgE ≥1.43 ML/units) was detected in two children. Children with a doctor's diagnosis of atopic dermatitis within the first 12 months of life (n=6) had significantly higher urinary EPX than children without this (66.7 vs 30.1 µg/mmol creatinine, P=0.01). Urinary eXcretion of EPX and LTE4 showed a weak correlation (r=0.22, P=0.02). There were no significant differences in urinary eXcretion of EPX and LTE4 or nasal ECP between children with and without respiratory symptoms (P>0.1). Conclusions: At the age of 1 year, urinary EPX is increased in children with atopic dermatitis. With regard to respiratory symptoms, urinary and nasal inflammatory parameters are not helpful in characterizing the phenotype of a single patient.
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Eosinophil cationic Protein and Eosinophil Protein X in the nasal lavage of children during the first 4 weeks of life
Allergy, 2000Co-Authors: G Halmerbauer, D Y Koller, C Gartner, M Schierl, J Kuhr, Johannes Forster, R Urbanek, Thomas FrischerAbstract:Eosinophil cationic Protein (ECP) and Eosinophil Protein X (EPX) are well established as markers of Eosinophil activation. We analyzed ECP and EPX concentrations in nasal lavage fluids (NALF) of 378 neonates during their first 4 weeks of life. Inclusion criteria were a positive history of parental allergy and a positive skin prick test or specific IgE (RAST class ≥2) against at least one out of a panel of common aeroallergens in one or both parents. Twenty-four infants with no history of parental allergy were used as controls. A volume of 2 ml of 0.9% saline was instilled into each nostril and immediately recovered by a suction device. ECP and EPX were analyzed by radioimmunoassay. In 65 samples of three consecutive lavages, EPX was detected in nine samples (13.8%) in the control group, whereas it was detected in 197/360 samples (54.7%) in the study population. The corresponding figures for ECP were 17/65 (26.2%) in the control group and 173/365 (47.4%) in the study group. Both Proteins showed a skewed distribution (median/5–95th percentiles for ECP: 0 µg/l [0–69.4] and EPX: 6.6 µg/l [0–73.2]). The differences between the control group and the study group were statistically significant, regardless of the allergic disease of the parents. In children of allergic parents, activation Proteins of the Eosinophil granulocyte are released on the nasal mucosal surface in about 50% of the studied population at the age of 4 weeks. This early onset of Eosinophil activation in the nasal respiratory epithelium may reflect a genetic predisposition to allergy or early eXposure to allergens.
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Eosinophil derived Proteins in nasal lavage fluid of neonates of allergic parents and the development of respiratory symptoms during the first 6 months of life
Allergy, 2000Co-Authors: Thomas Frischer, G Halmerbauer, D Y Koller, E Tauber, C Gartner, M Schierl, Johannes Forster, R Urbanek, R Rath, J KuhrAbstract:BACKGROUND Eosinophilic airways inflammation forms the pathophysiologic basis for a proportion of children at risk of developing recurrent wheezing. Early preventive measures and/or anti-inflammatory treatment may be guided by the identification of such children. METHODS We studied upper-airways inflammation by nasal lavage in a cohort of 397 infants within the first 4 weeks of life. They participated in an international multicenter study on the prevention of allergy in Europe (SPACE-Biomed II Program). A volume of 2 ml of prewarmed 0.9% saline was instilled into each nasal cavity and immediately re-collected by a suction device. The average recovery was 502 microl (SD: 311 microl). The concentrations of Eosinophil cationic Protein (ECP) and Eosinophil Protein X (EPX) were determined by RIA analysis. RESULTS ECP was detectable (>2 microg/l) in 47% of samples (173/365) and EPX (>3 microg/l) in 54.7% (197/360). Children with a doctor's diagnosis of a wheezy bronchitis within the first 6 months of life (n = 40) had significantly higher ECP and EPX concentrations in the nasal lavage at 4 weeks of age (median ECP: 14 microg/l; 5-95th percentile: 0-122.4 microg/l) than children without such diagnosis (median ECP: 0 microg/l; 5-95th percentile: 0-86.6 microg/l; P<0.05). Corresponding figures for EPX were 12.14 microg/l (0-148.98 microg/l) vs 7.5 microg/l (0-81.46 microg/l; P<0.05). No associations between nasal ECP/EPX and the development of food allergy or eczema were observed. CONCLUSIONS Increased nasal ECP and EPX in the first 4 weeks of life are associated with wheezing in 6-month-old infants at increased risk of atopic disease. We suggest that this might be related to a general tendency for a Th2 cytokine pattern in these young infants and subsequent trafficking of Eosinophils into the nasal mucosa, or it might be a consequence of intrauterine allergen eXposure.
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urinary Eosinophil Protein X in children the relationship to asthma and atopy and normal values
Allergy, 2000Co-Authors: E Tauber, G Halmerbauer, Thomas Frischer, D Y Koller, C Gartner, F Horak, A Veiter, M StudnickaAbstract:Background: In epidemiologic studies, it may be difficult to identify children with bronchial asthma. Since this is the most common chronic respiratory disease in childhood, and its prevalence is still increasing, reliable methods for identification of asthmatic children are required. This study evaluates the use of urinary Eosinophil Protein X (U-EPX) in epidemiologic studies in identifying atopic and asthmatic children. Methods: U-EPX was measured in 877 Austrian schoolchildren. The skin prick test (SPT) was performed with eight common aeroallergens, and established questionnaires were used to assess respiratory symptoms. Results: Of our cohort, 2.8% reported physician-diagnosed asthma, 5.1% reported wheezing within the last 12 months, and 24.1% were found to be atopic. In children with physician-diagnosed asthma, as well as in atopic children (positive SPT), median U-EPX levels were significantly higher than in healthy subjects (142.8 and 89.6 vs 63.9 µg/mmol creatinine, P<0.0001 and P<0.0001, respectively). In addition, perennial sensitization to inhalant allergens resulted in higher U-EPX levels than did seasonal sensitization. The odds ratio for U-EPX levels over the 90th percentile was significantly elevated for asthma, for wheezing, for nocturnal cough, and for breathlessness at eXercise, as well as for seasonal and perennial sensitization. Pulmonary function was negatively relatedto U-EPX levels. Conclusions: Measurement of U-EPX, which can be obtained easily, may be helpful in diagnosing both asthma and atopy in children. However, there is a great overlap between controls and symptomatics, a fact which reduces the sensitivity of U-EPX in determination of the prevalence of asthma in epidemiologic studies.
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lack of relationship between Eosinophil cationic Protein and Eosinophil Protein X in nasal lavage and urine and the severity of childhood asthma in a 6 month follow up study
Clinical & Experimental Allergy, 1999Co-Authors: C Wojnarowski, G Halmerbauer, D Y Koller, E Tauber, C Gartner, B Roithner, Thomas FrischerAbstract:Background Recent studies suggest that Eosinophil cationic Protein (ECP) and Eosinophil Protein X (EPX) may be valuable markers of airway inflammation in various body fluids of asthmatic children. Most of these studies have relied on a single measure of inflammatory markers. Objective We measured ECP and EPX in nasal lavage fluids (NALF) and urine samples in children with asthma over a 6-month period to study the relationship between inflammatory markers and clinical severity. Methods Fourteen children with mild persisting asthma (mean age 11.7 years, sd 2.2) were recruited. All patients were on therapy including inhaled steroids. For a 6-month period asthma severity was monitored by at least monthly physical eXamination and pulmonary function tests. Daily morning and evening PEF, asthma symptoms and medication were recorded in diaries for the whole study period. Telephone interviews were performed between visits and additional visits were done in case of an increase in asthmatic symptoms or drop of PEF values under 80% of best value. An eXacerbation was defined by a fall of FEV1 > 10% and an increase in asthma symptoms and additional need of β2-agonist. NALF and urine samples were obtained at each visit and analysed for ECP (NALF only) and EPX. Results Mean observation time was 186.4 days ( sd 19.8). Thirteen patients completed the study. During the study period 11 eXacerbations were observed in siX patients. No significant associations between PEF, PEF variability (amplitude % of mean), daily symptoms, additional β2-agonist, FEV1 and MEF50 and nasal ECP, nasal EPX and urinary EPX were found. However, at eXacerbations an average increase of nasal ECP (9.3 vs 50.3 μg/L) and EPX (nasal EPX 36.4 vs 141.7 μg/L, urinary EPX 46.4 vs 74.1 μg/mmol creatinine) was observed. Conclusion Serial measurements of ECP and EPX in NALF and urine samples do not provide additional information for the practical management in monitoring childhood asthma.
D Y Koller - One of the best experts on this subject based on the ideXlab platform.
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Eosinophil cationic Protein and Eosinophil Protein X in the nasal lavage of children during the first 4 weeks of life
Allergy, 2000Co-Authors: G Halmerbauer, D Y Koller, C Gartner, M Schierl, J Kuhr, Johannes Forster, R Urbanek, Thomas FrischerAbstract:Eosinophil cationic Protein (ECP) and Eosinophil Protein X (EPX) are well established as markers of Eosinophil activation. We analyzed ECP and EPX concentrations in nasal lavage fluids (NALF) of 378 neonates during their first 4 weeks of life. Inclusion criteria were a positive history of parental allergy and a positive skin prick test or specific IgE (RAST class ≥2) against at least one out of a panel of common aeroallergens in one or both parents. Twenty-four infants with no history of parental allergy were used as controls. A volume of 2 ml of 0.9% saline was instilled into each nostril and immediately recovered by a suction device. ECP and EPX were analyzed by radioimmunoassay. In 65 samples of three consecutive lavages, EPX was detected in nine samples (13.8%) in the control group, whereas it was detected in 197/360 samples (54.7%) in the study population. The corresponding figures for ECP were 17/65 (26.2%) in the control group and 173/365 (47.4%) in the study group. Both Proteins showed a skewed distribution (median/5–95th percentiles for ECP: 0 µg/l [0–69.4] and EPX: 6.6 µg/l [0–73.2]). The differences between the control group and the study group were statistically significant, regardless of the allergic disease of the parents. In children of allergic parents, activation Proteins of the Eosinophil granulocyte are released on the nasal mucosal surface in about 50% of the studied population at the age of 4 weeks. This early onset of Eosinophil activation in the nasal respiratory epithelium may reflect a genetic predisposition to allergy or early eXposure to allergens.
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Eosinophil derived Proteins in nasal lavage fluid of neonates of allergic parents and the development of respiratory symptoms during the first 6 months of life
Allergy, 2000Co-Authors: Thomas Frischer, G Halmerbauer, D Y Koller, E Tauber, C Gartner, M Schierl, Johannes Forster, R Urbanek, R Rath, J KuhrAbstract:BACKGROUND Eosinophilic airways inflammation forms the pathophysiologic basis for a proportion of children at risk of developing recurrent wheezing. Early preventive measures and/or anti-inflammatory treatment may be guided by the identification of such children. METHODS We studied upper-airways inflammation by nasal lavage in a cohort of 397 infants within the first 4 weeks of life. They participated in an international multicenter study on the prevention of allergy in Europe (SPACE-Biomed II Program). A volume of 2 ml of prewarmed 0.9% saline was instilled into each nasal cavity and immediately re-collected by a suction device. The average recovery was 502 microl (SD: 311 microl). The concentrations of Eosinophil cationic Protein (ECP) and Eosinophil Protein X (EPX) were determined by RIA analysis. RESULTS ECP was detectable (>2 microg/l) in 47% of samples (173/365) and EPX (>3 microg/l) in 54.7% (197/360). Children with a doctor's diagnosis of a wheezy bronchitis within the first 6 months of life (n = 40) had significantly higher ECP and EPX concentrations in the nasal lavage at 4 weeks of age (median ECP: 14 microg/l; 5-95th percentile: 0-122.4 microg/l) than children without such diagnosis (median ECP: 0 microg/l; 5-95th percentile: 0-86.6 microg/l; P<0.05). Corresponding figures for EPX were 12.14 microg/l (0-148.98 microg/l) vs 7.5 microg/l (0-81.46 microg/l; P<0.05). No associations between nasal ECP/EPX and the development of food allergy or eczema were observed. CONCLUSIONS Increased nasal ECP and EPX in the first 4 weeks of life are associated with wheezing in 6-month-old infants at increased risk of atopic disease. We suggest that this might be related to a general tendency for a Th2 cytokine pattern in these young infants and subsequent trafficking of Eosinophils into the nasal mucosa, or it might be a consequence of intrauterine allergen eXposure.
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urinary Eosinophil Protein X in children the relationship to asthma and atopy and normal values
Allergy, 2000Co-Authors: E Tauber, G Halmerbauer, Thomas Frischer, D Y Koller, C Gartner, F Horak, A Veiter, M StudnickaAbstract:Background: In epidemiologic studies, it may be difficult to identify children with bronchial asthma. Since this is the most common chronic respiratory disease in childhood, and its prevalence is still increasing, reliable methods for identification of asthmatic children are required. This study evaluates the use of urinary Eosinophil Protein X (U-EPX) in epidemiologic studies in identifying atopic and asthmatic children. Methods: U-EPX was measured in 877 Austrian schoolchildren. The skin prick test (SPT) was performed with eight common aeroallergens, and established questionnaires were used to assess respiratory symptoms. Results: Of our cohort, 2.8% reported physician-diagnosed asthma, 5.1% reported wheezing within the last 12 months, and 24.1% were found to be atopic. In children with physician-diagnosed asthma, as well as in atopic children (positive SPT), median U-EPX levels were significantly higher than in healthy subjects (142.8 and 89.6 vs 63.9 µg/mmol creatinine, P<0.0001 and P<0.0001, respectively). In addition, perennial sensitization to inhalant allergens resulted in higher U-EPX levels than did seasonal sensitization. The odds ratio for U-EPX levels over the 90th percentile was significantly elevated for asthma, for wheezing, for nocturnal cough, and for breathlessness at eXercise, as well as for seasonal and perennial sensitization. Pulmonary function was negatively relatedto U-EPX levels. Conclusions: Measurement of U-EPX, which can be obtained easily, may be helpful in diagnosing both asthma and atopy in children. However, there is a great overlap between controls and symptomatics, a fact which reduces the sensitivity of U-EPX in determination of the prevalence of asthma in epidemiologic studies.
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major basic Protein but not Eosinophil cationic Protein or Eosinophil Protein X is related to atopy in cystic fibrosis
Allergy, 1999Co-Authors: D Y Koller, G Halmerbauer, Thomas Frischer, Judit Muller, M SchierlAbstract:Increased Eosinophil granule Proteins have been described in serum and sputum samples of patients with cystic fibrosis (CF). It has been assumed that Eosinophil degranulation is enhanced in atopic subjects - as in asthmatics. Since in CF no differences in Eosinophil cationic Protein (ECP), Eosinophil Protein X (EPX), and Eosinophil peroXidase between atopic and nonatopic subjects have been detected, we investigated whether major basic Protein (MBP) is increased in serum and sputum samples derived from atopic (n = 14) compared with nonatopic CF subjects (n = 26). In CF patients, high mean serum (sputum) levels of ECP 29.7 microg/l (2.7 mg/l), EPX 53.7 microg/l (7.9 mg/l), and MBP 984.6 microg/l but low sputum MBP levels (57.4 microg/l) were measured. In addition, in serum and in sputum samples, a significant correlation between MBP and ECP (P<0.03 and P<0.0001, respectively) or EPX (P<0.05 and P<0.0004, respectively) was detected. By subdivision of the patients into allergic and nonallergic subjects, significant differences were found for serum MBP values only(mean 1382.2 microg/l vs. 770.5 microg/l; P<0.0001), but not for ECP or EPX serum levels or for Eosinophil Proteins in sputum. Although no differences between atopic and nonatopic CF patients in ECP and EPX were found, serum MBP levels were higher in patients sensitized to inhalant allergens than in nonsensitized subjects. These results indicate differential release of Eosinophil granule Proteins in peripheral blood from Eosinophils, and they also indicate that MBP in serum likely is to be a better discriminator of atopy in CF.
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lack of relationship between Eosinophil cationic Protein and Eosinophil Protein X in nasal lavage and urine and the severity of childhood asthma in a 6 month follow up study
Clinical & Experimental Allergy, 1999Co-Authors: C Wojnarowski, G Halmerbauer, D Y Koller, E Tauber, C Gartner, B Roithner, Thomas FrischerAbstract:Background Recent studies suggest that Eosinophil cationic Protein (ECP) and Eosinophil Protein X (EPX) may be valuable markers of airway inflammation in various body fluids of asthmatic children. Most of these studies have relied on a single measure of inflammatory markers. Objective We measured ECP and EPX in nasal lavage fluids (NALF) and urine samples in children with asthma over a 6-month period to study the relationship between inflammatory markers and clinical severity. Methods Fourteen children with mild persisting asthma (mean age 11.7 years, sd 2.2) were recruited. All patients were on therapy including inhaled steroids. For a 6-month period asthma severity was monitored by at least monthly physical eXamination and pulmonary function tests. Daily morning and evening PEF, asthma symptoms and medication were recorded in diaries for the whole study period. Telephone interviews were performed between visits and additional visits were done in case of an increase in asthmatic symptoms or drop of PEF values under 80% of best value. An eXacerbation was defined by a fall of FEV1 > 10% and an increase in asthma symptoms and additional need of β2-agonist. NALF and urine samples were obtained at each visit and analysed for ECP (NALF only) and EPX. Results Mean observation time was 186.4 days ( sd 19.8). Thirteen patients completed the study. During the study period 11 eXacerbations were observed in siX patients. No significant associations between PEF, PEF variability (amplitude % of mean), daily symptoms, additional β2-agonist, FEV1 and MEF50 and nasal ECP, nasal EPX and urinary EPX were found. However, at eXacerbations an average increase of nasal ECP (9.3 vs 50.3 μg/L) and EPX (nasal EPX 36.4 vs 141.7 μg/L, urinary EPX 46.4 vs 74.1 μg/mmol creatinine) was observed. Conclusion Serial measurements of ECP and EPX in NALF and urine samples do not provide additional information for the practical management in monitoring childhood asthma.
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an eXtragranular compartment of blood Eosinophils contains Eosinophil Protein X Eosinophil derived neurotoXin epX edn
Inflammation, 2013Co-Authors: Malgorzata Karawajczyk, Per Venge, Christer Peterson, Rodolfo C GarciaAbstract:Serum and plasma profiles of Eosinophil Protein X (EPX/EDN) and those of other Eosinophil Proteins differ in various conditions, suggesting a different mobilisation from storage granules. This work studied the subcellular localisation of EPX/EDN in non-primed and in vivo primed blood Eosinophils from healthy and allergic subjects, during and out of the pollen season. Primed Eosinophils contain easily mobilisable secretory Proteins. By fractionation on sucrose density gradients, EPX/EDN localised in the specific granules as well as in a cytoplasmic eXtra-granular compartment of low equilibrium density that partially overlapped with vesicular structures, cytosolic Proteins and plasma membranes. This compartment was clearly separate from the low density peak of ECP that increases during the pollen season. There were no significant differences in the amounts of EPX/EDN present in the low density peak of healthy and allergic subjects. Immuno-gold labelling electron microscopy showed EPX/EDN in specific granules, cytoplasm and associated to plasma membranes. In conclusion, substantial amounts of EPX/EDN localise in an eXtra-granular, low equilibrium density compartment of human Eosinophils.
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fecal Eosinophil cationic Protein as a marker of active disease and treatment outcome in collagenous colitis a pilot study
Scandinavian Journal of Gastroenterology, 2011Co-Authors: Michael Wagner, Christer Peterson, Ingrid Stolt, Per Sangfelt, Margret Agnarsdottir, Maria Lampinen, Marie CarlsonAbstract:Abstract Background and aims. Fecal calprotectin (FC) is used as a marker for intestinal inflammation in inflammatory bowel disease (IBD) but there is no reliable marker for collagenous colitis (CC). We have previously demonstrated that the mucosal inflammation in CC is characterized by Eosinophil activation, which is restored during budesonide treatment, but there is no enhanced neutrophil activity. The aim of this study was to evaluate the use of fecal Eosinophil cationic Protein (F-ECP) and Eosinophil Protein X (F-EPX) compared with the neutrophil-derived myeloperoXidase (F-MPO) and FC in patients treated for active CC. Methods. Patients with active CC (n = 12) were studied before and after 3, 7, 28 and 56 days of budesonide treatment. Clinical symptoms and stool frequency were recorded, fecal samples were collected, and F-ECP, F-EPX, F-MPO and FC were measured at each occasion. Results. All but one patient achieved remission. On inclusion 92%, 67%, 67% and 75% of the patients had elevated F-ECP, F-EPX...
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detection of inflammatory markers in stools from patients with irritable bowel syndrome and collagenous colitis
Scandinavian Journal of Gastroenterology, 2006Co-Authors: Helene Lettesjo, Christer Peterson, Tony Hansson, Gisela Ringstrom, Hasse Abrahamsson, Magnus SimrenAbstract:Objective. Irritable bowel syndrome (IBS) and collagenous colitis (CC) share chronically recurring symptoms of altered bowel habits associated with abdominal pain or discomfort. The aims of the present study were to investigate whether inflammatory markers could be detected in faeces from patients with IBS and CC, and to elucidate whether such analyses could be used as non-invasive tools to distinguish between these disorders. Material and methods. Stool samples were obtained from 18 patients with CC, 46 patients with IBS and 20 healthy controls (HC). Eosinophil Protein X (EPX), myeloperoXidase (MPO), tryptase, interleukin-1 beta (IL-1β) and tumour necrosis factor alpha (TNFα) were measured in supernatants from processed faeces using immunoassays. Results. EPX levels were enhanced in faeces from CC patients (median 3.8 µg/g (0.47–16.2)) compared to patients with IBS (0.44 µg/g (0.25–1.8)), p<0.001, and HC (0.46 µg/g (0.21–1.3)), p<0.001. In addition, MPO was increased in CC patients (11.7 µg/g (2.0–124)) ...
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urinary Eosinophil Protein X in children with atopic asthma a useful marker of antiinflammatory treatment
The Journal of Allergy and Clinical Immunology, 1996Co-Authors: Sigurdur Kristjansson, Christer Peterson, I. Enander, Ingalisa Strannegard, Orjan Strannegard, Goran WennergrenAbstract:Abstract BACKGROUND: Bronchial asthma is associated with elevated serum levels of Eosinophil products, such as Eosinophil Protein X (EPX), but the occurrence in urine of this substance in patients with asthma has not previously been studied. OBJECTIVE: This study was performed to clarify whether increased amounts of Eosinophil granulocyte Proteins in urine and serum reflect ongoing asthmatic inflammation and whether decreasing values reflect successful treatment. METHODS: Twelve children with a median age of 12.5 years who had mild or moderate atopic asthma were studied for 3 months. At the time of inclusion in the study, treatment with inhaled budesonide was initiated. Nine children of the same age without atopic disease served as control subjects. Levels of EPX, Eosinophil cationic Protein (ECP), and myeloperoXidase in serum and in urine (urinary EPX) were determined at inclusion and then after 3 months of treatment. Spirometry was performed on the same occasions. RESULTS: At the time of inclusion, urinary EPX and serum ECP were significantly higher in children with atopic asthma than in the control subjects (mean, 116.4 vs 43.0 μg/mmol creatinine [ p = 0.004] and 37.0 vs 14.8 μg/L [ p = 0.004]). In the asthma group urinary EPX, as well as serum ECP, decreased significantly after 3 months of treatment with budesonide (116.4 to 68.4 μg/mmol creatinine [ p = 0.005] and 37.0 to 24.0 μg/L [ p = 0.04]). At the same time, peak eXpiratory flow values increased significantly in the children with asthma (76.0% to 87.8% of predicted value [ p = 0.005]) but not in the control subjects (87.0% to 90.1%). In the asthma group the levels of myeloperoXidase were similar to those in the control group, both at inclusion and after 3 months. CONCLUSION: Increased urinary EPX and serum ECP levels seem to reflect active atopic asthma, whereas decreased levels after antiinflammatory treatment probably reflect normalization of airway inflammation, and indirectly, improved lung function. (J Allergy Clin Immunol 1996;97:1179-87.)
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High concentrations of Eosinophil cationic Protein and Eosinophil Protein X in Eosinophilic pleural effusions.
Chest, 1993Co-Authors: Tom Pettersson, Henrik Riska, Seppo Sutinen, Matti Klockars, Christer PetersonAbstract:To analyze the association of the Eosinophil granulocyte with pleural effusions, we measured the concentrations of two Eosinophil Proteins, Eosinophil cationic Protein (ECP) and Eosinophil Protein X (EPX), in pleural fluid and serum of 92 patients with pleural effusions of various causes. We observed significantly higher ECP and EPX concentrations in Eosinophilic than in nonEosinophilic pleural effusions (p