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and had intermittent symptoms (de Blay, Purohit et al. 1998). The combination of serum ECp
with peak expiratory flow did not translate into a useful combination to determine IHCS
adjustment and was less useful than symptomatology alone or combined with other lung
function parameters (Lowhagen, Wever et aL.2002). Also, the blood inflammatory markers
did not reflect health related quality of life scores in subjects with mild asthma (Ehrs,
Sundblad et al. 2006).
In children, serum ECP levels followed during acute exacerbation and recovery of asthma in
11 asthmatics did not show a uniform pattern of increasing then decreasing values over this
period (Niggemann, Ertel et al. 1996). In 34 children with moderate asthma, none of the
markers measured reflected asthma activity, including serum eosinophils, serum ECp, serum
EDN, urinary EDN or urinary histamine levels (Hoekstra, Grol et al. 1998). Serial
measurements of ECP and EDN in urine samples taken monthly did not provide additional
information in monitoring childhood asthma or contribute to practical management in a
prospective study that followed children over a six month period measuring diary
symptomatology and peak flow (wojnarowski, Roithner et al. 1999).
In addition, the markers when raised were not found to be specific for asthma. Considerable
overlap was seen in blood eosinophil and ECP levels in asthmatics and controls, with no
difference in the mean levels measured in adults with asthma or with allergic rhinitis or in
those who had both (Sin, Terzioglu et al. 1998). While physician diagnosed bronchitis was
more significantly associated with neutrophil count, it was also associated with eosinophil
count and, as well, chronic sputum production was also associated with both cells (Schwartz
and Weiss 1993).In children, serum ECP and EDN was higher in the 36 asthmatic than 166
healthy children but higher rates than controls were also seen in those with allergic
rhinoconjunctivitis, atopic dermatitis and/or allergic skin sensiti zation. An elevated ECp gave
an odds ratio of 2.3 for asthma, but 2.9 for atopic dermatitis. Similarly, an elevated EDN gave
an odds ration of 2.61for asthma, but 5.23 for allergic rhinoconjunctivitis (Remes, Korppi et
al. 1998). Considerable overlap existed in another study comparing serum ECp levels in 2l
children with asthma and/or atopic dermatitis (Kristjansson, Shimizu et al. lgg4). In 207
children aged 24-41 months and 76 aged 0-23 months in whom repeated samples were
obtained in a large longitudinal childhood asthma study, the serum ECp was shown to be
influenced by a number of factors including age, the presence of active eczema and the
presence of maternal smoking in a dose dependent fashion (Lodrup Carlsen, Halvorsen et al.
1998). ln 72 infants with recurrent wheezing, there was no correlation between serum ECp
and the development of asthma and similarly no correlation between serum ECp and
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