Serum eosinophil cationic protein (ECP) levels increase in inflammation processes with activation of eosinophils. We studied serum ECP in (I) 32 pollinic children without symptoms, in June and October and (II) 10 children with acute asthma crisis. As control groups we included (III) 25 children sent to the hospital with suspected allergic diseases in which an IgE mediated process could be ruled out; (IV) 34 coeliac patients; (V) 15 children with cystic fibrosis and (VI) 48 normal children. The pollinic children had increased figures of ECP in June (21.2 +/- 9.2 micrograms/L) compared to normal controls (p < 0.001) and they continued to have high levels in October (13.5 +/- 9.2 micrograms/L, p < 0.05). The patients with very high ECP (> 20 micrograms/K), in spite of being asymptomatic, showed a negative correlation between ECP/peak-flow (p: 0.038). In addition, in these patients the ECP also had a negative correlation with the recovery of bronchospasm from June to October (p: 0.024). Some asthmatic children also had high ECP, but the results were too heterogeneous to draw any conclusions, possibly due to the drugs received. The ECP was independent of age and sex. It not correlated with serum IgE, nevertheless, in non-atopic patients it did correlate with blood eosinophilia (p < 0.005). In coeliac and cystic fibrosis patients, we did not find ECP to be increased. In conclusion, serum ECP increases in some allergic patients and suspected allergy, but not in all cases. It does not increase in other chronic mucosal inflammations, such as coeliac or cystic fibrosis. It correlates with bronchospasms and would have some value in predicting short-term evolution.

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