Valutazione sierica del ruolo della proteina cationica eosinofila (s-ECP), mieloperossidasi neutrofila (s-MPO) e triptasi (s-TRI) mastocitaria nei bambini con asma allergico, infettivo e dermatite atopica

Serum level of pro-inflammatory cellular markers such as eosinophil cationic protein (s-ECP), neutrophil myeloperoxidase (s-MPO) and mast cell tryptase (s-TRI) have been analysed in a group of 80 children who were subdivided in 3 subgroups according to the underline pathology: a) allergic asthma, b) infective wheezing, c) atopic dermatitis or eczema. These children were compared with an adeguate sex-, age-mathched group of normale controls. Each patient was further assigned to symptomatica (S) or asymptomatic (As) subgroups on the basis of the presence or absence of specific acute symptoms. At entry, illness severity was accurately assessed to correlate clinical status with the markers serum levels. s-ECP has been found elevated in all the symtomatic groups unregardless of the type of disease (asthma, wheezing or atopic dermatitis) and of the etiology (allergic asthma or infective wheezing) (s-ECP: μg/L allergic asthma S = 43 ± 34; AS = 22 ± 12; C = 8 ± 3; S vs As p <0.05; S vs C p <0.0005; As vs C NS; infective wheezing S = 28 ± 13, As = 17 ± 12, C = 10 ± 3, S vs AS p <0.01, As vs C NS, atopic dermatitis S = 49 ± 13, As = 20 ± 11, C = 10 ± 3, S vs As p <0.01, S vs C p <0.002, As vs C NS). s-MPO has been found statistically significant only in acute wheezing and acute atopic dermatitis vs normal controls, whereas no statistically differences has been found in allergic asthma (s-MPO μg/l: allergic asthma S = 1180 ± 448; As = 841 ± 500; C = 596 ± 217; S vs As NS; S vs C NS; As vs C NS; infective wheezing S = 1142 ± 385; As = 1386 ± 364; C = 665 ± 384; S vs As NS; S vs C p <0.005; As vs C p <0.01; atopic dermatitis S = 1474 ± 292; As = 1011 ± 604; C = 665 ± 384; S vs As NS; S vs Cp <0.005; As vs C NS); those results on one side confirm the role of neutrophils during infections, even viral one's, but on the other side demonstrate a lesser involvement in allergic diseases, s-Tryptase was always found at lower levels of the capacity detenction of the test in all situations analysed; this surprisingly result confirm same other data present in literature. In conclusion our results confirm the usefulness, at least for s-ECP and s-MPO, as pro-inflammatory activity markers well correlated with disease activity; nevertheless, our data show, that at least for s-ECP a not specific rise according to etiology (allergy or infection). s-MPO seems more reliable as an activity marker of infective processes than allergic one's. More data are necessary to better define the role of neutrophils in allergic diseases. Data about s-TRY from our study didn't allow us to consider it as a reliable marker of allergic disease activity. Therefore more data, on larger number of patients are needed to better define the role and usefulness of these markers both in allergic and infectious diseases.