Monitoring of asthma inflammation by serum measurements of eosinophil cationic protein (ECP). A new clinical approach to asthma management

摘要

The recognition of asthma as an inflammatory disease has led to a change in treatment strategy of this disease, with the widespread use of anti-inflammatory inhaled corticosteroids as the first choice to control asthma. In spite of the fact that inhaled corticosteroids at ordinary doses have very few systemic side effects, the concern by the patients and by the doctors of using corticosteroids as a first line drug is understandable. This concern may partly be a consequence of the lack of appreciation of the inflammatory nature of asthma, due to the lack of clinically useful tools that clearly indicate this fact, but also to difficulties in proper dosaging of the corticosteroid treatment. Thus, how do I know when my patient is optimally treated? In most cases anamnestic information in combination with simple lung function testing will give me a clue, although no single piece of such information is a useful reflection of the inflammatory activity going on in the lungs of the asthmatic. In other cases I am for several reasons left in the dark. Therefore there is a need for the development of additional tools that objectively and accurately reflect the disease process of the asthmatic lung. One such potential tool, presented by Wever and colleagues is the blood measurement of the eosinophil cationic protein (ECP).