Abstract：
Eosinophil-derived neurotoxin (EDN) is related to childhood asthma, while normal values are lacking. We aimed to document serum EDN levels at 1 and 3 years in general and in non-atopic children, and explore if EDN levels differed by sex or were associated with preschool asthma at 3 years.
From the PreventADALL birth cohort, we included 1233 children with EDN analysed using ImmunoCAP at 1 and/or 3 years. Non-atopic children had no history of wheeze, asthma, allergic sensitization or atopic dermatitis. Preschool asthma was defined as having ≥3 episodes of bronchial obstruction between 2 and 3 years, plus doctor diagnosed asthma and/or asthma medication use by 3 years. The upper limit of normal (ULN) of EDN was defined as the 95th percentile. With Youden Index we calculated EDN cut-off levels for risk of preschool asthma.
The overall median (ULN) EDN levels were 27.4 (121) μg/L at 1 year (n = 787), and 20.1 (87.8) μg/L at 3 years (n = 857). Non-atopic children had EDN levels of 24.0 (107) μg/L at 1 year (n = 147), and 17.3 (84.6) μg/L at 3 years (n = 173). EDN levels were higher in boys compared to girls; 32.0 (133) versus 24.5 (97.0) μg/L at 1 year, and 20.9 (96.3) versus 19.0 (72.4) μg/L at 3 years. Preschool asthma was observed in 109/892 (12.2%) children. Higher EDN levels at 1 (>26.7 μg/L) and 3 (≥20.5 μg/L) years were associated with preschool asthma; adjusted OR (95% CI) 2.20 (1.09, 4.41) and 4.68 (2.29, 9.55), respectively.
We report EDN values in early childhood, demonstrating higher levels at 1 compared to 3 years and in boys compared to girls at both ages. Higher EDN levels at both ages were associated with preschool asthma. However, EDN cut-off levels for preschool asthma were overall lower than the ULN of non-atopic children, limiting translation into clinical practice.
From the PreventADALL birth cohort, we included 1233 children with EDN analysed using ImmunoCAP at 1 and/or 3 years. Non-atopic children had no history of wheeze, asthma, allergic sensitization or atopic dermatitis. Preschool asthma was defined as having ≥3 episodes of bronchial obstruction between 2 and 3 years, plus doctor diagnosed asthma and/or asthma medication use by 3 years. The upper limit of normal (ULN) of EDN was defined as the 95th percentile. With Youden Index we calculated EDN cut-off levels for risk of preschool asthma.
The overall median (ULN) EDN levels were 27.4 (121) μg/L at 1 year (n = 787), and 20.1 (87.8) μg/L at 3 years (n = 857). Non-atopic children had EDN levels of 24.0 (107) μg/L at 1 year (n = 147), and 17.3 (84.6) μg/L at 3 years (n = 173). EDN levels were higher in boys compared to girls; 32.0 (133) versus 24.5 (97.0) μg/L at 1 year, and 20.9 (96.3) versus 19.0 (72.4) μg/L at 3 years. Preschool asthma was observed in 109/892 (12.2%) children. Higher EDN levels at 1 (>26.7 μg/L) and 3 (≥20.5 μg/L) years were associated with preschool asthma; adjusted OR (95% CI) 2.20 (1.09, 4.41) and 4.68 (2.29, 9.55), respectively.
We report EDN values in early childhood, demonstrating higher levels at 1 compared to 3 years and in boys compared to girls at both ages. Higher EDN levels at both ages were associated with preschool asthma. However, EDN cut-off levels for preschool asthma were overall lower than the ULN of non-atopic children, limiting translation into clinical practice.
摘要：
背景：嗜酸性粒细胞衍生的神经毒素（EDN）与儿童哮喘有关，而正常值是缺乏的。我们旨在记录一般和非特应性儿童在1年和3年的血清EDN水平，并探讨EDN水平是否因性别而异或与3年的学龄前哮喘相关。
方法：从PreventADALL出生队列中，我们纳入了1233名在1年和/或3年时使用ImmunoCAP分析的EDN患儿.非特应性儿童没有喘息史，哮喘,过敏性致敏或特应性皮炎。学龄前哮喘被定义为在2至3年之间有≥3次支气管阻塞发作，加上医生诊断为哮喘和/或哮喘药物使用3年。EDN的正常上限(ULN)定义为第95百分位数。通过YoudenIndex，我们计算了学龄前哮喘风险的EDN临界值。
结果：1年时（n=787）的总中位数（ULN）EDN水平为27.4（121）μg/L，3年为20.1(87.8)μg/L(n=857)。非特应性儿童在1年时EDN水平为24.0（107）μg/L（n=147），和17.3（84.6）μg/L在3年（n=173）。与女孩相比，男孩的EDN水平更高；1年时32.0（133）对24.5（97.0）μg/L，3年时分别为20.9（96.3）和19.0（72.4）μg/L。在109/892（12.2％）儿童中观察到学龄前哮喘。1年（>26.7μg/L）和3年（≥20.5μg/L）较高的EDN水平与学龄前哮喘相关；校正OR（95％CI）2.20（1.09，4.41）和4.68（2.29，9.55），分别。
结论：我们报告了儿童早期的EDN值，与3岁相比，1岁和男孩在两个年龄段都比女孩表现出更高的水平。两个年龄段的较高EDN水平与学龄前哮喘有关。然而,学龄前哮喘的EDN截止水平总体低于非特应性儿童的ULN，限制转化为临床实践。
方法：从PreventADALL出生队列中，我们纳入了1233名在1年和/或3年时使用ImmunoCAP分析的EDN患儿.非特应性儿童没有喘息史，哮喘,过敏性致敏或特应性皮炎。学龄前哮喘被定义为在2至3年之间有≥3次支气管阻塞发作，加上医生诊断为哮喘和/或哮喘药物使用3年。EDN的正常上限(ULN)定义为第95百分位数。通过YoudenIndex，我们计算了学龄前哮喘风险的EDN临界值。
结果：1年时（n=787）的总中位数（ULN）EDN水平为27.4（121）μg/L，3年为20.1(87.8)μg/L(n=857)。非特应性儿童在1年时EDN水平为24.0（107）μg/L（n=147），和17.3（84.6）μg/L在3年（n=173）。与女孩相比，男孩的EDN水平更高；1年时32.0（133）对24.5（97.0）μg/L，3年时分别为20.9（96.3）和19.0（72.4）μg/L。在109/892（12.2％）儿童中观察到学龄前哮喘。1年（>26.7μg/L）和3年（≥20.5μg/L）较高的EDN水平与学龄前哮喘相关；校正OR（95％CI）2.20（1.09，4.41）和4.68（2.29，9.55），分别。
结论：我们报告了儿童早期的EDN值，与3岁相比，1岁和男孩在两个年龄段都比女孩表现出更高的水平。两个年龄段的较高EDN水平与学龄前哮喘有关。然而,学龄前哮喘的EDN截止水平总体低于非特应性儿童的ULN，限制转化为临床实践。
