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Eosinophilic Cationic Protein (ECP)

40 Azn
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Eosinophilic cationic protein (ECP) is a major eosinophil mediator released from eosinophilic granules in response to the interaction of an allergen with IgE immunoglobulin. It is an RNA-degrading enzyme (ribonuclease) structurally and functionally similar to pancreatic ribonuclease.

Since eosinophils are present in the mucous membranes of almost all hollow organs (especially the respiratory and gastrointestinal tracts) and parenchymal organs, ECP secretion is associated with a wide range of clinical symptoms.

ECP plays a significant role in the development of allergic diseases, including:

  • Bronchial asthma
  • Allergic rhinitis
  • Atopic dermatitis
  • Food allergies

Clinical Importance of ECP

  • ECP concentration in blood plasma rises significantly during allergic reactions.
  • ECP is considered a biomarker for allergic disease exacerbation and is used to assess disease severity and monitor treatment effectiveness.
  • Serum ECP levels are proportional to eosinophil count, with normal levels around 7 µg/L in healthy individuals.

ECP Levels in Different Conditions

  • Mild elevation (15–20 µg/L) → Bronchial asthma
  • Moderate elevation (60–70 µg/L) → Parasitic infections (e.g., Schistosoma mansoni), exacerbation of atopic dermatitis
  • Severe elevation (up to 200 µg/L) → Hypereosinophilic syndrome (HES) (a myeloproliferative disorder)

ECP as a Diagnostic Tool

  • ECP elevation can be used for baseline diagnosis of allergic diseases.
  • In bronchial asthma, ECP levels reflect the intensity of mucosal inflammation rather than airway hyperreactivity.
  • Monitoring ECP levels helps assess treatment response, especially with inhaled corticosteroids in asthma therapy.

Biomaterial: Venous blood
Pre-test recommendations:

  • Fasting for 8 hours before the test
  • Avoid alcohol for 24 hours before the test
  • Do not smoke for 3 hours before the test

  • Diagnosis, severity assessment, and treatment monitoring of:

    • Bronchial asthma
    • Atopic dermatitis
    • Allergic rhinitis
    • Food allergies
    • Other allergic diseases

  • Symptoms indicating ECP testing:

    • Bronchial asthma symptoms: Shortness of breath, wheezing, asthma attacks triggered by allergens (e.g., animal fur, dust, pollen).
    • Atopic dermatitis symptoms: Itchy and dry skin, eczema, recurrent flare-ups over two years.
    • Allergic rhinitis symptoms: Runny nose, nasal congestion, sneezing, itching, headache, loss of smell, triggered by allergens (e.g., tobacco smoke, pollen).
    • Food allergy symptoms:Oral itching, throat swelling, skin rash, coughing, nausea, vomiting, diarrhea, hypotension, triggered by foods like shellfish, wheat, milk, nuts, and fish.

Causes of Elevated ECP Levels

  • Seasonal allergic rhinitis
  • Atopic bronchial asthma
  • Atopic dermatitis
  • Eosinophilic esophagitis, gastroenteritis, colitis
  • Food allergies
  • Parasitic infections (Ascaris lumbricoides, Taenia solium)
  • Aspirin-induced asthma
  • Acute respiratory infections
  • Nasal polyposis
  • Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis)
  • Hypereosinophilic syndrome (HES)
  • Certain medications, including:
    • Antiepileptic drugs (phenytoin, phenobarbital, carbamazepine)
    • Antibiotics (co-trimoxazole, penicillin, minocycline, doxycycline)
    • NSAIDs (nonsteroidal anti-inflammatory drugs)
    • Sulfonylureas (glibenclamide, glimepiride)

Clinical Significance of ECP Measurement

  • Higher ECP levels indicate more severe allergic inflammation.
  • Monitoring ECP levels helps adjust asthma treatment (e.g., titration of inhaled corticosteroids).
  • A decrease in ECP suggests reduced inflammation and successful therapy