Total eosinophil cationic protein levels in induced sputum as a marker of changes in eosinophilic inflammation in a patient with allergic asthma.
BACKGROUND: Counting eosinophils in induced sputum seems to be a better way to survey disease activity than indirect clinical assessments of airway inflammation, such as pulmonary function measurement. The conventional analysis of induced sputum, however, is time-consuming and requires skilled personnel, which have restricted its use. OBJECTIVE: To determine whether measuring eosinophil cationic protein (ECP) levels in the entire sputum sample could replace the method of counting eosinophils and measuring ECP levels in the supernatant only to establish a clinically more applicable method of studying the intraindividual changes in eosinophilic activity in induced sputum. METHODS: In 13 patients with mild, nonsymptomatic allergic asthma, sputum was induced before and 24 hours after allergen challenge. The entire sputum sample was diluted with 0.1% dithiothreitol, incubated, and divided into 2 parts. One part was processed according to the conventional method, and released ECP levels in the supernatant were measured. The second part was treated with a lysing reagent. Cell debris was separated, and total (intracellular and extracellular) ECP levels in the solution were measured. RESULTS: We found good correlation between total ECP levels in the entire sputum sample and released ECP levels in the supernatant before (r = 0.97) and 24 hours after (r = 0.99) allergen challenge (P < .01 for both). We also found a good correlation between the changes in total and released ECP levels (r = 0.99; P < .01). CONCLUSIONS: Total ECP concentration seems to reflect the eosinophilic inflammatory changes in asthma and might be a useful tool in clinical practice.