PT  - JOURNAL ARTICLE
AU  - Floortje Tupker
AU  - Fleur Blok
AU  - Samantha Irving
AU  - Andrew Bush
AU  - Louise Fleming
AU  - Sejal Saglani
TI  - Non-invasive markers of airway eosinophilic inflammation in pre-school children
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P4201
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P4201.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P4201.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Background: Finding a non-invasive test for airway eosinophilic inflammation is challenging in pre-school children. Since venepuncture and exhaled nitric oxide (FENO) are more feasible than induced sputum or broncho-alveolar lavage (BAL), we investigated whether blood eosinophilia and FENO relate to BAL eosinophils in children aged 1 - 5 years with severe recurrent respiratory symptoms.Methods: Pre-school children undergoing a clinically indicated bronchoscopy were included. Confirmed, reported and non-wheeze groups were classified using written and video questionnaires. We measured blood eosinophils and off-line FENO on the day of bronchoscopy, and compared the results with BAL eosinophils.Results: 48 children, median age (IQR) 2.7 (1.8-3.8) years, were recruited. 44 children had both BAL and blood eosinophils measured. 13/48 had successful FENO measurements. A positive relationship was found between blood and BAL eosinophils in wheezers (r2=0.460, p=0.0002), but not in non-wheezers (p=0.4). The relationship in wheezers remained even in those prescribed maintenance inhaled steroids (r2=0.271, p=0.0322). There was no relationship between FENO and BAL eosinophils (p=0.6).Conclusion: Unlike in older chilren with severe asthma (Ullmann, N. et al. Allergy 2013; 68: 402-6), blood eosinophils may be a useful non-invasive measure of BAL eosinophilia in pre-school wheezers. FENO was less promising in this small subgroup.