Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Relationship between △FVC(% fall in FVC at the PC20 Dose of Methacholine) and Serum Eosinophil Cationic Protein(ECP) in 6-8 Year Old Children with Asthma

6-8세 천식 환아에서 △FVC(메타콜린 PC20에서의 강제폐활량의 감소율)와 혈청 호산구 양이온 단백의 관계

  • Suh, Dong In (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Yu, Jinho (Department of Pediatrics, College of Medicine, Dongguk University) ;
  • Yoo Young (Department of Pediatrics, College of Medicine, Korea University) ;
  • Kim, Do Kyun (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Kang, Hee (Department of Pediatrics, College of Medicine, Korea University) ;
  • Koh, Young Yull (Department of Pediatrics, College of Medicine, Seoul National University)
  • 서동인 (서울대학교 의과대학 소아과학교실) ;
  • 유진호 (동국대학교 의과대학 소아과학교실) ;
  • 유영 (고려대학교 의과대학 소아과학교실) ;
  • 김도균 (서울대학교 의과대학 소아과학교실) ;
  • 강희 (고려대학교 의과대학 소아과학교실) ;
  • 고영률 (서울대학교 의과대학 소아과학교실)
  • Received : 2005.05.20
  • Accepted : 2005.08.05
  • Published : 2005.10.15
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Abstract

Purpose : Bronchial hyperresponsiveness(BHR) is considered a hallmark of asthma. Increased levels of eosinophil cationic protein(ECP) have been identified in serum of asthma patients. Several studies have examined the relationship between serum ECP and bronchial responsiveness, expressed as methacholine $PC_{20}$ in asthmatic patients, with conflicting results. The aims of this study were to examine the relationship between serum ECP and ${\Delta}FVC$, another index of bronchial responsiveness, which reflects increased maximal airway response. Methods : Six to 8-year-old children with asthma(n=109) underwent methacholine bronchoprovocation testing. The $PC_{20}$ dose of methacholine and ${\Delta}FVC$ were calculated for each individual from the methacholine dose response curves. Serum ECP levels and blood total eosinophil counts were also measured. Results : Serum ECP correlated with ${\Delta}FVC$(r=0.217, P=0.023), as well as $PC_{20}$(r=-0.208, P=0.030). However, blood eosinophil counts failed to show any correlations with ${\Delta}FVC$(r=0.085, P=0.378) or $PC_{20}$(r=-0.148, P=0.125). ${\Delta}FVC$ did not correlate with $PC_{20}$(r=-0.079, P=0.417). Conclusion : Blood eosinophil activation is associated with both components of BHR including increased sensitivity and increased maximal response in 6-8 year old children with asthma.

목 적 : 기관지 과반응성은 천식의 주된 특징이다. 또한 천식 환자에서 혈청 호산구 양이온 단백의 농도가 증가되어 있음이 잘 알려져 있다. 혈청 호산구 양이온 단백의 농도와, 기관지 과반응성의 대표적 지표인 메타콜린 $PC_{20}$과의 관계에 대해서 결과가 다소 상반되는 여러 보고가 있어왔다. 본 연구의 목적은 혈청 호산구 양이온 단백의 농도와 기관지 과반응성의 또다른 지표로서 최대 기도 반응을 반영하는 ${\Delta}FVC$와의 상관관계를 살펴보는 것이다. 방 법 : 6-8세 천식 환아 109명을 대상으로 폐기능 검사 및 메타콜린 기관지 흡입 유발 시험을 시행하였다. 개개의 환자로부터 메타콜린 용량 반응 곡선에서 ${\Delta}FVC$ 및 $PC_{20}$을 계산하였다. 이들의 혈액 내 총 호산구 수 및 혈청 ECP 농도를 측정하여 ${\Delta}FVC$ 및 $PC_{20}$과 상관관계를 분석하였다. 결 과 : 혈청 ECP는 ${\Delta}FVC$(r=0.217, P=0.023) 및 $PC_{20}$(r=-0.208, P=0.030)과 상관관계를 나타내었다. 반면 혈액 내 총 호산구 수는 ${\Delta}FVC$(r=0.085, P=0.378) 및 $PC_{20}$(r=-0.148, P=0.125)과 상관관계를 보이지 않았다. ${\Delta}FVC$는 $PC_{20}$과도 상관관계를 보이지 않았다(r=-0.079, P=0.417). 결 론 : 6-8세 천식 환아에서 기관지 과반응성이, 민감성 증가뿐만 아니라 최대반응의 증가라는 측면에서도 호산구성 염증의 활성화와 관련이 있다.

Keywords

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