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Editor,—Although the recent paper by El-Radhi and colleagues presents interesting data about decreases in inflammatory markers during the resolution of acute asthma,1 some of their conclusions are not valid. Firstly, acute asthma has a tendency to resolve without corticosteroid treatment.2 As all of the children with acute asthma (quite rightly) received steroids, the observed effect may equally reflect processes associated with spontaneous resolution. Indeed, corticosteroids do not inhibit the release of eosinophil cationic protein (ECP) from eosinophils.3 Secondly, the normal controls are inadequate. Atopy per se is associated with increased serum levels of ECP,4 and it is therefore to be expected that the asymptomatic atopic asthmatics will have higher ECP levels than the mostly non-atopic controls.
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