The haematology of the Central Australian aborigine. 11. White and differential counts; eosinophil counts and Casoni tests.
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Infants and young children with acute viral respiratory illness were studied to determine the association of peripheral blood eosinophil counts and concentrations of eosinophil cationic protein (ECP) in nasopharyngeal secretions with the development and severity of bronchiolitis. Subjects included those with upper respiratory illness (URI) alone, pneumonia or bronchiolitis. Controls consisted of healthy infants, and those hospitalized with non-respiratory illnesses. While peripheral blood eosinophil counts were suppressed in all infected infants greater than two months of age, eosinophil counts in patients with bronchiolitis were significantly greater than in those with URI alone. ECP concentrations were significantly greater among individuals with bronchiolitis than other infected infants. For bronchiolitis cases with detectable peripheral blood eosinophils, eosinophil counts correlated weakly and inversely with oxygen saturations. In contrast, ECP concentrations were strongly inversely correlated with initial oxygen saturation. ECP concentrations were also significantly correlated with peripheral blood eosinophil counts. Viral infections suppress peripheral blood eosinophil counts in infants greater than two months of age, although the effect is somewhat overcome in patients with bronchiolitis. The form and severity of bronchiolitis is much more strongly related to degranulation of eosinophils in the respiratory tract than to peripheral blood eosinophil counts.
Faecal egg counts, peripheral blood eosinophil counts and plasma pepsinogen concentrations were monitored during 2 successive, deliberate infections in 24 Scottish Blackface sheep. For all 3 techniques, the repeatability of replicate counts or of measurements made at short intervals were high which suggests that all 3 assays were reliable. Within an infection the repeatability of different samples from the same animal decreased as the interval between samples increased. The repeatability between infections was only moderate for faecal egg counts but high for peripheral eosinophil counts and plasma pepsinogen concentrations. Of the 3 variables, faecal egg count was the most strongly associated with the worm burden. Together, the three variables accounted for, in a statistical sense, one half of the variation in worm burden. The three variables, if measured concurrently, should provide a more effective identification of resistant and susceptible lambs.
Measurement of eosinophil percentages and ECP concentration in induced sputum may be useful in the diagnosis and assessment of the variability of airway inflammation in bronchial asthma (BA). To evaluate the usefulness of sputum eosinophil counts and ECP concentrations in the diagnosis of BA, we measured these parameters in 68 patients with respiratory complaints. In addition, we followed-up 14 BA patients with variable airflow limitation for 45.4 +/- 10.4 days. The BA group (n = 41) showed a higher percentage of sputum eosinophilia (24.5 +/- 7.6 vs. 2.2 +/- 2.9%, p < 0.001) and a higher level of sputum ECP (198.2 vs. 90.6 micrograms/L, p < 0.05) than those in the nonasthmatic group (NBA, n = 27). The sensitivity and specificity of sputum eosinophilia (> or = 5%) for the diagnosis of BA were 85.4% and 92.6%, respectively, which were better than the sensitivity (68.3%) and specificity (55.5%) of the increased level of sputum ECP (> or = 100 micrograms/L). Patients with moderate-to-severe persistent BA had a higher percentage of sputum eosinophil (n = 23, 34.6 +/- 10.6%) than those of mild persistent BA (n = 18, 10.7 +/- 5.2%, p < 0.01), but we could not find significant difference in ECP levels between mild persistent and moderate-to-severe persistent asthma. The percentages of sputum eosinophilia showed a moderate correlation with ECP (r = 0.4358, p < 0.01) and with the peak expiratory flow rate (PFR, r = -0.4746, p < 0.01) but sputum ECP did not correlate with PFR. In 14 BA patients who were followed, there was a relationship between changes of PFR and the percentage of sputum eosinophil (r = -0.7238, p < 0.01), but the change of PFR did not correlate with the change of sputum ECP levels. These results suggest that the sputum eosinophil count and sputum ECP level could be helpful in the diagnosis of BA, but that sputum ECP is not satisfactory for the assessment of variability of airway eosinophilic inflammation during the initial anti-inflammatory management of BA.
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UNLABELLED: Early identification of wheezing children with an increased risk of recurrent wheezing or subsequent asthma is important. The aim of the study was to determine the role of markers of eosinophil activation, along with other parameters, in the prediction of recurrent wheezing and allergic sensitization in children with early and severe wheezing. We examined 105 children without atopic dermatitis, hospitalized for wheezing during the first year of life. At a 20-mo follow-up, 101 of the children were assessed for the occurrence of recurrent wheezing (at least 3 episodes, including 1 in the previous 6 mo) and allergic sensitization (positive skin-prick test). By univariate analysis, levels of eosinophil counts at the time of hospitalization (p = 0.005, OR = 18.9), age in months (p < 0.0001, OR = 1.5), respiratory syncytial virus (RSV)-negative disease (p < 0.0001, OR = 8.8), parental atopy (p = 0.006, OR = 3.3) and male sex (0.02, OR = 2.7) were all predictive factors for recurrent wheezing at follow-up. With all parameters included in a multiple regression analysis, RSV-negative disease was not a predictive factor for recurrent wheezing. A simple model including eosinophil counts > or = 0.1 x 10(9)/L and age had a predictive accuracy of 79%, with only a 6% chance of a child being wrongly predicted as symptomatic. Urinary protein X (U-EPX) was not a predictive factor for recurrent wheezing. When included in a multiple logistic regression analysis, a level of U-EPX > or = 100 microg/mmol creatinine was the only parameter with a positive predictive value for allergic sensitization (p = 0.007, OR = 18.9), whereas age, parental allergy or parental asthma were not. CONCLUSION: Children with severe wheezing during the first year of life and subsequent recurrent wheezing are characterized by a normal or high eosinophil count in response to viral infections.
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BACKGROUND: Increased serum levels of eosinophil cationic protein (ECP) have been detected in adolescent patients with cystic fibrosis. However, ECP concentrations in adult patients with bronchiectasis unrelated to cystic fibrosis have not been studied. METHODS: Eosinophil numbers and serum concentrations of ECP were determined in 14 patients with known or newly diagnosed bronchiectasis and compared with age and sex matched patients with allergic bronchial asthma, chronic obstructive pulmonary disease (COPD), and controls in whom bronchiectasis or obstructive pulmonary disease could be excluded. RESULTS: Serum ECP levels were significantly raised both in patients with bronchiectasis (median (range) 22.5 micrograms/l (7-85)) and allergic asthma (35.0 micrograms/l (7-128)) compared with the sex and age matched subjects suffering from COPD (6.7 micrograms/l (1.5-28); p < 0.006) and non-obstructive normal controls (7.5 micrograms/l (3.5-19); p < 0.003). In contrast, significantly increased peripheral eosinophil numbers were observed in patients with bronchial asthma (305 x 10(6)/l; p < 0.01) but not in those with bronchiectasis (10(2) x 10(6)/l), COPD (117 x 10(6)/l), and healthy controls (101 x 10(6)/l). CONCLUSIONS: The discrepancy between eosinophil counts and eosinophil numbers in patients with bronchiectasis suggests that serum ECP levels may be more relevant in assessing local eosinophil involvement than blood eosinophil numbers.
Any influence of G-CSF on eosinophils is mostly negative, although reports which have studied this relationship are few with varied results. The aim of this study was to investigate the influence of G-CSF administration to healthy subjects on eosinophils in peripheral blood. Blood eosinophil counts, serum levels of eosinophil cationic protein (ECP), eosinophil peroxidase (EPO) and eosinophil protein X (EPX), as well as cell morphology were studied. 14 healthy volunteers received 7.5 microg (n = 8) or 10 microg/kg body weight (n = 6) G-CSF daily for six consecutive days. ECP and EPX were assessed by specific RIAs and EPO by a specific FEIA. Cell morphology was examined by electron microscopy. During G-CSF administration, eosinophil counts increased from 0.22 +/- 0.04 x 10(9)/l to 0.61 +/- 0.098 x 10(9)/l (P = 0.001), serum ECP from 12.39 +/- 2.45 microg/l to 61.82 +/- 7.38 microg/l (P = 0.0014), serum EPX from 28.05 +/- 4.54 microg/l to 87.86 +/- 9.84 microg/l (P = 0.002) and serum EPO from 8.89 +/- 2.2 microg/l to 19.98 +/- 5.1 microg/l (P = 0.003). All variables returned gradually to initial values after discontinuation of G-CSF. Distinct changes in the morphology of secondary granules were observed 24 h after G-CSF administration. The granules became irregular and their matrix less electron dense. We conclude that administration of G-CSF to healthy humans increases the number of circulating eosinophils and affects the mobilization of eosinophil granule proteins.
In order to determine the factors responsible for eosinophilia during the neonatal period, we counted the eosinophils of premature infants every week and compared the medical profiles of infants with eosinophil counts above the 95th percentile and those below that percentile during the course of study. Medical treatments such as mechanical ventilation, antibiotics administration and intravenous catheterization had no significant effects on the increase of eosinophils. Furthermore, the incidence of eosinophil counts above the 95th percentile was not different between breast-fed and formula-fed infants. The infants treated with erythropoietin had greater eosinophil counts than those with no treatment. It is probable that medical manipulation using foreign bodies such as intratracheal tube, intravenous catheter, antibiotics and artificial formula had no significant effects on the increase of eosinophil counts, except for exogenous erythropoietin.
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Blood eosinophils were determined in eight 7--13-month-old calves that had been reared under parasite-free conditions. Eosinophil counts were obtained by three methods, a) a direct count, b) a differential count and c) an indirect count (i.e. differential count x total leucocyte count). Methodological errors of these methods were determined. Upper limits of 1,000 eosinophils/micronl (direct count) and 9.5 per cent eosinophils (differential count) have been estimated an suitable working standards for calves of this age group. The distribution of eosinophils was skew, most direct counts being below 700 cells/micronl and most differential counts being below 7.5 per cent. A high degree of correlation was found between results obtained by either method, but an even higher correlation was found between direct and indirect counts.
Monthly eosinophil counts were taken from 40 patients while they were undergoing narcotic maintenance. The overall results indicate that there was relatively little change in the eosinophil values throughout the six-month period. This hospital found, however, that there was a positive correlation between elevated eosinophil counts and heavy illicit drug use. This seems to indicate a correlation between intravenous drug use and a high eosinophil count.
Bronchial responsiveness (histamine PC20) and peripheral blood eosinophil counts were measured in 23 asthmatic subjects, of whom 14 were atopic and nine non-atopic. In the group as a whole there was an inverse correlation between baseline eosinophil count and histamine PC20 (r = -0.71; p less than 0.001). For atopic subjects a relationship between eosinophil count and histamine PC20 was observed (r = -0.74; p less than 0.01), but there was no correlation between eosinophil count and baseline FEV1 or baseline FEV1 and histamine PC20. For the non-atopic subjects a similar relationship between eosinophil count and histamine PC20 was seen (r = -0.68; p less than 0.05) and a less significant inverse correlation between baseline eosinophil count and baseline FEV1 (r = -0.65; p less than 0.05). These results show a relationship between eosinophil count and non-specific bronchial responsiveness in both atopic and non-atopic asthma.
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BACKGROUND: Eosinophil cationic protein (ESP) is one of the granule proteins in eosinophilic granulocytes. Release of this protein may reflect the activity state of eosinophilic granulocytes in diseased subjects. The purpose of this study was to evaluate the additional value of serum ECP measurement over the eosinophil count, (specific) IgE concentration and CRP concentration in order to evaluate the effects of treatment in patients started on corticosteroids and to distinguish individual patients with asthma from healthy subjects on the basis of laboratory results. METHODS: In a longitudinal study, serial measurements of serum ECP, eosinophil count and other laboratory parameters have been evaluated and compared with spirometry and tests of bronchial hyperresponsiveness in ten asthmatic subjects. The subjects were investigated before therapy was started and 3, 6 and 9 months after the start of therapy with inhaled corticosteroids. Laboratory parameters in the patient group are compared with results obtained from a reference group of apparently healthy subjects (n=223). RESULTS: Statistically significant correlations are observed between blood eosinophil counts and serum ECP concentrations with the hyperresponsiveness tests PC20 (r=0.44 and r=0.46, respectively) and with a decrease in FEV(1) after exercise (r=0.66 and r=0.60, respectively). A significant difference was detected between serum ECP concentrations from the patients' group and from the reference group. However, a wide range of overlapping results was observed between the reference group and the asthmatic patients. CONCLUSIONS: Asthma is a disease which is now more frequently treated by general practitioners. In general practice there is not always the opportunity to evaluate asthma activity by the application of hyperreactivity tests. When hyperreactivity testing is not available, measuring serum ECP concentration or eosinophil blood count would be an alternative method to monitor the effects of corticosteroid treatment. In this study the additional value of serum ECP in addition to the eosinophil count is evaluated to determine the effects of treatment in patients who started with application of corticosteroids. However, because of the analogous correlation coefficients of laboratory parameters with tests regarding hyperresponsiveness, no additional benefit of serum ECP concentration over eosinophil blood count in monitoring the effect of corticosteroids can be detected. The additional value of serum ECP concentrations and eosinophil counts to detect an asthmatic constitution for individual cases is doubtful.
The total eosinophil count obtained by use of the standard hemacytometer is considered by several investigators to be the most reliable method for the determination of the circulating eosinophil levels in the blood because it is believed to be less subject to error than the calculated eosinophil count obtained with Wright stained blood smears from the differential count. We compared the two techniques in outpatients as well as inpatients with and without allergies (total of 514 patients). Our results demonstrate that the eosinophil count by the two methods are similar.