Philip M. Hanno, Jørgen Nordling, David R. Staskin, Alan J. Wein and Jean Jacques Wyndaele (eds.)Bladder Pain Syndrome – An Evolutionhttps://doi.org/10.1007/978-3-319-61449-6_24

24. What Happened to Eosinophilic Cationic Protein: A Dead End

Philip Hanno¹

(1)

Stanford University School of Medicine, Stanford, CA, USA

Philip Hanno

Email: philip.hanno@stanford.edu

Eosinophil cationic protein (ECP) is a single cationic polypeptide chain consisting of 133 amino acids. ECP is a mediator in host immune response to parasites, bacteria and viruses. Much of the literature on this protein focuses on its role in eosinophil-related disorders like asthma. ECP correlates with airway inflammation but not airway hyper-responsiveness. It is not diagnostic of asthma but is related to severity and can be used to monitor effects of asthma treatment [1, 2]. Concentrations of ECP correlate with the clinical severity of chronic allergic conjunctival disease [3]. Although present in numerous biological fluids, sample management is complex and serum has become the main avenue of determination used in the laboratory setting. The ECP molecule participates in a large number of biological reactions, which makes it an unacceptable diagnostic marker due to low diagnostic specificity [4].

24.1 What We Got Right

The search for a biomarker for the diagnosis and phenotyping of bladder pain syndrome (BPS) has been a priority for many decades. In chapter 16 of the original text, Lose and Frandsen reviewed their work from the 1980’s in which they observed an increased level of eosinophil cationic protein in the urine of patients with interstitial cystitis. Around the same time, Holm-Bentzen had demonstrated an elevated urinary excretion of metabolites of histamine in these patients. Lose and Frandsen were hopeful the urinary-ECP would provide a new tool to study patients with bladder pain syndrome and perhaps select patients with detrusor mastocytosis which at that time was considered a potential histologic confirmation of the disorder. Publications suggesting that eosinophilic infiltration of the bowel in patients with chronic bowel disease could be a marker of activity and prognosis stimulated their work.

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