Serum Eosinophil-Derived Neurotoxin Better Reflect Asthma Control Status Than Blood Eosinophil Counts

Jin An; Ji-Hyang Lee; Ju Hee Sim; Woo-Jung Song; Hyouk-Soo Kwon; You Sook Cho; Hee-Bom Moon; Chang-Keun Kim; Tae-Bum Kim

doi:10.1016/j.jaip.2020.03.035

Serum Eosinophil-Derived Neurotoxin Better Reflect Asthma Control Status Than Blood Eosinophil Counts

J Allergy Clin Immunol Pract. 2020 Sep;8(8):2681-2688.e1. doi: 10.1016/j.jaip.2020.03.035. Epub 2020 Apr 15.

Authors

Jin An¹, Ji-Hyang Lee², Ju Hee Sim², Woo-Jung Song², Hyouk-Soo Kwon², You Sook Cho², Hee-Bom Moon², Chang-Keun Kim³, Tae-Bum Kim⁴

Affiliations

¹ Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
² Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
³ Department of Pediatrics, Asthma and Allergy Center, Inje University Sanggye Paik Hospital, Seoul, Korea.
⁴ Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: tbkim@amc.seoul.kr.

PMID: 32304842
DOI: 10.1016/j.jaip.2020.03.035

Abstract

Background: Although several biomarkers have been proposed for eosinophilic asthma, biomarkers for reflecting asthma control status remain controversial. Eosinophil-derived neurotoxin (EDN), a degranulated eosinophil protein, is an emerging biomarker in asthmatic patients.

Objective: This study analyzed serum EDN concentrations in asthmatics and compared its performance with that of blood eosinophil count as an indicator of asthma control status.

Methods: We enrolled 75 uncontrolled asthmatics, 56 controlled asthmatics, and 43 healthy controls from Asan Medical Center. Serum EDN levels (ng/mL) were measured using an enzyme-linked immunosorbent assay kit. The predictability of EDN for asthma control status was analyzed by univariate and multivariable logistic regression analyses. A receiver operating characteristic (ROC) curve analysis was conducted to compare the performances of a serum EDN level and blood eosinophil count as indicators of uncontrolled asthma status.

Results: The mean serum EDN level in the uncontrolled asthma group was higher than that in the controlled asthma and healthy groups (103.2 ± 60.2 vs 60.8 ± 49.7 vs 49.6 ± 28.3 ng/mL, P < .001). Serum EDN level was the significant parameter related to asthma control status in univariate and multivariable analysis (both P < .001). Serum EDN levels correlated with blood eosinophil counts (r = 0.510, P < .001). However, in the ROC analysis, serum EDN level showed a significantly better performance for predicting uncontrolled asthma status (area under the curve, 0.726 vs 0.628, P = .024).

Conclusions: Serum EDN levels significantly differed between patients with controlled and uncontrolled status in adult asthmatics. To our knowledge, this is the first study to identify EDN as a better indicator of asthma control status than blood eosinophil count.

Keywords: Asthma; Asthma control status; Biomarkers; Eosinophil-derived neurotoxin; Eosinophilic inflammation; Uncontrolled asthma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Asthma* / diagnosis
Eosinophil-Derived Neurotoxin
Eosinophils
Humans
Leukocyte Count
Pulmonary Eosinophilia*

Substances

Eosinophil-Derived Neurotoxin