Serum eosinophilic cationic protein may predict clinical course of wheezing in young children.

Thirty eight children aged between 2 and 4 years with three or more episodes of wheezing were studied to evaluate the role of eosinophil inflammation and its relation to persistence of wheezing two years later. Serum eosinophilic cationic protein, total eosinophil count, total IgE, skin prick test, and clinical features were evaluated at visit 1. Two years later at a second clinical evaluation the children were separated into two groups: group 1, those with persistent wheezing (n = 20); group 2, those who had been asymptomatic over the past six months (transient wheezing) (n = 18). Mean (SEM) eosinophilic cationic protein at visit 1 was higher in group 1 than in group 2 (29.63 (5.16) v 14.42 (2.77) micrograms/l), and the probability of continuing wheezing at age 5 years was greater in children with values > or = 20 micrograms/l at visit 1 than in those with lower values (relative risk = 2.88, 95% confidence interval 1.42 to 5.87, p < 0.001). Eosinophil inflammation is present from the beginning of the disease in the children who are going to continue with wheezing at age 5 years. The measurement of serum eosinophilic cationic protein may help in evaluating which wheezing infants are going to continue with asthma in the future.