The Predictive Value of Eosinophil Cationic Protein and Lactate Dehydrogenase in Asthma: A Comparative Study of Serum Versus Sputum

BACKGROUND : Serum and sputum eosinophil cationic protein (ECP) levels are correlated with asthma disease severity. OBJECTIVE : To establish a diagnostic accuracy of ECP and lactate dehydrogenase (LDH) in serum (indirectly) and sputum (directly) as inflammatory markers in asthma. PATIENTS AND METHODS : In a cross sectional study, 76 asthmatic patients with exacerbation were enrolled in the study. ECP was determined using enzyme linked immuno-assay. RESULTS : Asthmatic patients compared with control subjects, had a significant higher levels of ECP and LDH in sputum. Both sputum and serum ECP and LDH were reduced significantly with prednisolone treatment. FEV1 was inversely correlated with sputum ECP, serum ECP, and sputum LDH. A significant positive correlation was noted between sputum ECP and sputum LDH. Serum LDH does not demonstrate any significant correlations with other variables. The area under receiver operating characteristic curve showed that sputum ECP (0.92) was a significantly an accurate marker more than serum ECP (0.81), sputum (0.80) LDH, and serum (0.65) LDH. Furthermore, the area under curve was lower for serum ECP (0.81) than that for sputum ECP (0.92). However, serum ECP (0.81) was more accurate marker than serum LDH (0.65). CONCLUSION : Serum and sputum ECP as eosinophilic inflammatory markers are associated with poor asthma control. Sputum ECP and LDH were significantly an accurate markers more than serum ECP and LDH.