The Predictive Value Of Serum Eosinophil-derived Neurotoxin And Eosinophil Cationic Protein In Early Childhood Asthmatic Disease

Wheezing is one of the most common respiratory symptoms during childhood.In recent years,the incidence of wheezing diseases is rising rapidally.Foreign data shows that about one-third children wheezed at least once before the age of 3.Most early childhood wheezing is temporary.With the lung development and maturity of immune system,most early childhood wheezing will disappear,but about 40% of children will have persistent asthma.Asthma is a common chronic respiratory disease and has a damage on children's health.Uncontrolled asthma not only damage children's mental and physical health and learning,but also delays the life and work of parents,and at the same time brings a heavy burden to our society.Survey shows that 70% of children with asthma have the first wheezing attack during infancy.However,the pathogenesis of infant asthmatic diseases are not totally clear,there is still no reliable index to predict which infants with wheezing will have persistent ashma.Therefore,to explore the pathogenesis of infantile wheezing diseases,and to understand the relationship between infant wheezing and asthma,to find a reliable index that can predict the possibility of asthma is very helpful and meaningful.Objective This clinical study attempts to detect eosinophil-derived neurotoxin(EDN)and serum cationic protein(ECP),eosinophilia(EOS)and immunoglobulin E(IgE)and compare the correlation between them to discuss the predictive value of EDN and ECP in infant wheezing disease.By exploring a non-invasive testing method of airway inflammation,namely an objective indicator predicting the occurrence of asthma,we try to identify in early stage those wheezing infants who tend to develop persistent asthmatic,thus provide clues for the early diagnosis and treantment.Methods We randomly selected infant children in pediatric inpatients of our hospital from April 2016 to March 2017.These children were 60 infants with acute exacerbation of wheezing.Detect the eosinophil count and immunoglobulin E of all subjects at admission.Peripheral venous blood samples were collected,after centrifugated,the serum specimens were forzen at-20? refrigerator.Concentration of EDN and ECP in these samples were measured by enzyme linked immunosorbent assay(ELISA).All enrolled children were followed up for a year,classified as recurrent wheezing group(32 samples)and non-recurrent wheezing group(28 samples).All experimental data were anylyzed by the SPSS 17.0 statistical software.Results1 Serum level of EDN in recurrent wheezing group was significantly higher than non-wheezing group(t=2.117,P=0.039);2 Serum level of ECP in recurrent wheezing group was significantly higher than non-wheezing group(Z=2.067,P=0.039);3 Serum level of IgE in recurrent wheezing group was significantly higher than non-wheezing group(Z=3.551,P=0.001);4 Correlation anaylsis(1)There was a positive correlation in the expression of EOS and EDN in the recurrent wheezing group(r=0.656,P=0.001);(2)There was also a positive correlation in the expression of EOS and EDN in the non-recurrent wheezing group(r=0.471,P=0.012);(3)There was a positive correlation in the expression of EDN and ECPin the non-recurrent wheezing grou(r=0.428,P=0.023);4 The area comparison of under ROC curve beteween EDN?ECP and IgE(1)The area of under ROC curve of EDN is 0.643,P=0.047;The area of under curve of ECP is 0.656,P=0.029;The area of under ROC curve of IgE is 0.767,P<0.001(2)The area comparison of under ROC curve between EDN and ECP shows that Z=0.127,P=0.8993;The area comparison of under ROC curve between ECP and IgE shows that Z=1.231,P=0.2183;The area comparison of under ROC curve between EDN and IgE shows that Z=1.363,P=0.1728;Conclusion1 Serum level of EDN and ECP in recurrent wheezing group was significantly higher than non-wheezing group,suggesting that they have an important predictive value of recurrent wheezing in infants with early wheezing.2 Serum level of IgE in recurrent wheezing group was significantly higher than non-wheezing group,indicating that allergic factors play an important role in the process of infant wheezing.3 Monitoring serum level of EDN and ECP of wheezing infants can provide early diagnosis and early intervention for asthmatic children.