| Summary: | 碩士 === 高雄醫學大學 === 醫學研究所碩士班 === 94 === Background: Increased serum level of eotaxin is related to asthma severity in adult study. There is little data about pediatric asthma patients with regards to the effects of oral and inhaled corticosteroids on serum eotaxin, eosinophil cationic protein (ECP) concentrations and eosinophil counts.
Methods: We investigated prospectively the changes of serum level of eotaxin, eosinophil counts, and ECP after oral steroid for one week and then inhaled corticosteroids with a long–acting β2 agonist (Seretide) treatment for 2 months in the pediatric population. The data of serum eotaxin, ECP, and blood eosinophil count were collected. The peak expiratory flow (PEF) was used as outcome index and correlation study with previous inflammation markers was performed.
Results: The serum level of eotaxin persisted after one-week oral prednisolone treatment, but decreased after subsequent inhaled corticosteroids with a long–acting β2 agonist treatment (85.7±36.8 vs. 64.7±22.6 pg/ml, p<0.001). The eosinophil count and ECP declined soon after oral steroid treatment, but rebounded to the same level during inhaled treatment. The decline of ECP is positively correlated with the decline of eosinophil count while oral steroid treatment (r2 =0.28, p=0.016). There was no correlation between changes in eotaxin and PEF.
Conclusion: There is discrepancy of serum concentration of eotaxin, ECP and blood eosinophil count during the treatment of oral steroid and inhaled corticosteroids. Our data suggested that the serum eotaxin level, not eosinophil count or ECP, declined during inhaled corticosteroids with a long–acting β2 agonist treatment and might serve as a surrogate marker of Th2 residual activity in treating pediatric asthma. The concentration of eotaxin could not predict the changes of PEF.
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