소아 천식 및 호산구성기관지염에서 유도객담 호산구분율과 혈청 및 혈액 알레르기 지표와 연관성
Correlations of induced sputum eosinophils with blood allergic markers in pediatric asthma and eosinophilic bronchitis
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Purpose: Induced sputum eosinophil count is useful for the evaluation and diagnosis of asthma and eosinophilic bronchitis (EB). The aim of this study was to evaluate the correlation of induced sputum eosinophil count with various allergic indicators, including the peripheral blood eosinophil count, in pediatric asthma and EB. Methods: From May 2014 to July 2018, 126 children visited Kyungpook National University Children’s Hospital, and underwent methacholine bronchial challenge test and sputum induction. Peripheral blood eosinophil counts, serum eosinophil cationic protein (ECP), serum total IgE, immunoCAP for inhalant allergens, and skin prick test were performed in the study subjects. Results: In the asthma group, the eosinophil count of induced sputum correlated with peripheral blood eosinophils (r=0.279, P=0.043). The concordance rates of sputum and peripheral blood eosinophil count in the asthma and EB groups were 64.1% and 25.7%, respectively. The number of eosinophils in the sputum also correlated with serum total IgE, ECP, and specific IgE to Dermatophagoides farinae, Dermatophagoides pteronyssinus, and Aspergillus in the asthma group. Conclusion: The number of eosinophils in the induced sputum correlated with peripheral blood in the asthma group. However, a third of subjects were discordant. Therefore, we need to keep in mind the possibility of discordance when predicting the degree of airway eosinophilic inflammation using the peripheral blood eosinophils. In EB, the number of induced sputum eosinophils did not correlate with the number of peripheral blood eosinophils, which may be attributed to the difference in mechanism. Further studies are warranted.
Abstract
Purpose: Induced sputum eosinophil count is useful for the evaluation and diagnosis of asthma and eosinophilic bronchitis (EB). The aim of this study was to evaluate the correlation of induced sputum eosinophil count with various allergic indicators, including the peripheral blood eosinophil count, in pediatric asthma and EB. Methods: From May 2014 to July 2018, 126 children visited Kyungpook National University Children’s Hospital, and underwent methacholine bronchial challenge test and sputum induction. Peripheral blood eosinophil counts, serum eosinophil cationic protein (ECP), serum total IgE, immunoCAP for inhalant allergens, and skin prick test were performed in the study subjects. Results: In the asthma group, the eosinophil count of induced sputum correlated with peripheral blood eosinophils (r=0.279, P=0.043). The concordance rates of sputum and peripheral blood eosinophil count in the asthma and EB groups were 64.1% and 25.7%, respectively. The number of eosinophils in the sputum also correlated with serum total IgE, ECP, and specific IgE to Dermatophagoides farinae, Dermatophagoides pteronyssinus, and Aspergillus in the asthma group. Conclusion: The number of eosinophils in the induced sputum correlated with peripheral blood in the asthma group. However, a third of subjects were discordant. Therefore, we need to keep in mind the possibility of discordance when predicting the degree of airway eosinophilic inflammation using the peripheral blood eosinophils. In EB, the number of induced sputum eosinophils did not correlate with the number of peripheral blood eosinophils, which may be attributed to the difference in mechanism. Further studies are warranted.
참고문헌 (27)
- 송대진, "KAAACI Evidence-Based Clinical Practice Guidelines for Chronic Cough in Adults and Children in Korea", Allergy, Asthma & Immunology Research, 10(6), pp.591~613 (2018), 대한천식알레르기학회
- Frigas E, "The eosinophil and the pathophysiology of asthma", J Allergy Clin Immunol, 77, pp.527~537 (1986)
- Wilson NM, "Asthma severity and inflammation markers in children", Pediatr Allergy Immunol, 12, pp.125~132 (2001)
- Berry MA, "Observational study of the natural history of eosinophilic bronchitis", Clin Exp Allergy, 35, pp.598~601 (2005)
- Achilleos A, "Evidence-based evaluation and management of chronic cough", Med Clin North Am, 100, pp.1033~1045 (2016)
- Jayaram L, "Induced sputum cell counts : their usefulness in clinical practice", Eur Respir J, 16, pp.150~158 (2000)
- Pizzichini E, "Indices of airway inflammation in induced sputum : reproducibility and validity of cell and fluid-phase measurements", Am J Respir Crit Care Med, 154, pp.308~317 (1996)
- Pin I, "Use of induced sputum cell counts to investigate airway inflammation in asthma", Thorax, 47, pp.25~29 (1992)
- 김민혜, "유도객담검사의 시행과 해석: 전문가 의견서", Allergy Asthma & Respiratory Disease, 5(6), pp.307~311 (2017), 대한 소아알레르기 호흡기학회[DOI]
- Ullmann N, "Blood eosinophil counts rarely reflect airway eosinophilia in children with severe asthma", Allergy, 68, pp.402~406 (2013)
- Korevaar DA, "Diagnostic accuracy of minimally invasive markers for detection of airway eosinophilia in asthma : a systematic review and meta-analysis", Lancet Respir Med, 3, pp.290~300 (2015)
- Teague W, "Blood eosinophilia may not adequately estimate lung fluid eosinophilia in childhood asthma", J Allergy Clin Immunol, 7, pp.2497~2498 (2019)
- Crapo RO, "Standardization of spirometry : 1994 update", Am J Respir Crit Care Med, 152, pp.1107~1136 (1995)
- Gonlugur U, "Eosinophilic bronchitis without asthma", Int Arch Allergy Immunol, 147, pp.1~5 (2008)
- Kuang FL, "Approach to patients with eosinophilia", Med Clin North Am, 104, pp.1~14 (2020)
- Heinzerling L, "The skin prick test-European standards", Clin Transl Allergy, 3, pp.3~ (2013)
- Crapo RO, "Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999", Am J Respir Crit Care Med, 161, pp.309~329 (2000)
- Bousquet J, "Eosinophilic inflammation in asthma", N Engl J Med, 323, pp.1033~1039 (1990)
- Pizzichini E, "Measuring airway inflammation in asthma : eosinophils and eosinophilic cationic protein in induced sputum compared with peripheral blood", J Allergy Clin Immunol, 99, pp.539~544 (1997)
- Burrows B, "Association of asthma with serum IgE levels and skin-test reactivity to allergens", N Engl J Med, 320, pp.271~277 (1989)
- De Monchy JG, "Bronchoalveolar eosinophilia during allergen-induced late asthmatic reactions", Am Rev Respir Dis, 131, pp.373~376 (1985)
- Brightling CE, "Interleukin-4 and-13 expression is co-localized to mast cells within the airway smooth muscle in asthma", Clin Exp Allergy, 33, pp.1711~1716 (2003)
- Kim KW, "Relationship between amphiregulin and airway inflammation in children with asthma and eosinophilic bronchitis", Chest, 136, pp.805~810 (2009)
- Gibson PG, "Chronic cough resembles asthma with IL-5 and granulocyte-macrophage colony-stimulating factor gene expression in bronchoalveolar cells", J Allergy Clin Immunol, 101, pp.320~326 (1998)
- Brightling CE, "Mast-cell infiltration of airway smooth muscle in asthma", N Engl J Med, 346, pp.1699~1705 (2002)
- D’Silva L, "Sputum neutrophilia can mask eosinophilic bronchitis during exacerbations", Can Respir J, 14, pp.281~284 (2007)
- Gao J, "Association between fractional exhaled nitric oxide, sputum induction and peripheral blood eosinophil in uncontrolled asthma", Allergy Asthma Clin Immunol, 14, pp.21~ (2018)