{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:54:49Z","timestamp":1790272489699,"version":"4.1.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Scientific Research Projects Coordination Unit (BAP) of Giresun University","award":["SA\u011e-BAP-A-290224-31"],"award-info":[{"award-number":["SA\u011e-BAP-A-290224-31"]}]},{"DOI":"10.13039\/100017218","name":"Giresun University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017218","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>\n                      Objective biomarkers that reflect systemic inflammation in pediatric allergic rhinitis to support clinical diagnosis. We aimed to evaluate serum levels of endocan (a marker  of endothelial activation) and eosinophil-derived neurotoxin (EDN; reflecting eosinophil  degranulation) in children with AR and investigate their diagnostic performance and  associations with disease severity and conventional inflammatory markers. In this prospective  case-control study, 85 children with AR and 67 healthy controls were enrolled. Serum  endocan and EDN were measured via sandwich ELISA. Primary outcomes included group  comparisons of biomarker levels and their diagnostic accuracy determined by receiver  operating characteristic (ROC) curve analysis. Serum endocan and EDN levels were  significantly elevated in children with AR compared to controls (both\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Both  biomarkers demonstrated high diagnostic performance, with an area under the curve (AUC)\u00a0of 0.931 for endocan and 0.929 for EDN, showing greater diagnostic accuracy than absolute  eosinophil counts (AUC, 0.871). Endocan and EDN showed a strong intercorrelation  (r = 0.88,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and significant positive correlations with total IgE and eosinophil counts.  However, no significant associations were observed between these biomarkers and disease  severity, symptom control scores, or allergen sensitization patterns.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>Conclusions<\/jats:italic>\n                      : Serum endocan and EDN are significantly elevated in children with AR and demonstrate high diagnostic discrimination in this cohort. These findings suggest that endocan and EDN may serve as promising complementary biomarkers for the objective assessment of allergic inflammation in children, although further multicenter studies are needed to confirm their clinical utility.\n                      <jats:table-wrap>\n                        <jats:table>\n                          <jats:tbody>\n                            <jats:tr>\n                              <jats:td align=\"left\" colspan=\"2\">\n                                <jats:bold>What's Known:<\/jats:bold>\n                                \u2022\n                                <jats:italic>Allergic rhinitis (AR) is common in childhood and involves systemic inflammatory pathways; however, objective biomarkers to support diagnosis in pediatric practice remain limited.<\/jats:italic>\n                                \u2022\n                                <jats:italic>Endocan and eosinophil-derived neurotoxin (EDN) reflect endothelial activation and eosinophil degranulation, respectively, and have been studied in other atopic and inflammatory conditions.<\/jats:italic>\n                                <jats:bold>What is New:<\/jats:bold>\n                                \u2022\n                                <jats:italic>This study concurrently evaluates serum Endocan and EDN in children with AR in a prospective case\u2013control design.<\/jats:italic>\n                                \u2022\n                                <jats:italic>Both biomarkers demonstrated high discriminatory performance (AUC\u223c 0.93 in this cohort) and showed greater diagnostic accuracy than absolute eosinophil counts\u00a0.<\/jats:italic>\n                                \u2022\n                                <jats:italic>Endocan and EDN are largely independent of generalized systemic inflammatory indices (NLR, SII, SIRI), supporting specificity for the endothelial\u2014 eosinophilic axis in pediatric AR.<\/jats:italic>\n                              <\/jats:td>\n                            <\/jats:tr>\n                          <\/jats:tbody>\n                        <\/jats:table>\n                      <\/jats:table-wrap>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00431-026-06975-7","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T14:12:49Z","timestamp":1777558369000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Systemic endothelial activation and eosinophilic inflammation in pediatric allergic rhinitis: diagnostic value of endocan and eosinophil-derived neurotoxin"],"prefix":"10.1007","volume":"185","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9074-8466","authenticated-orcid":false,"given":"Handan Ayhan","family":"Ako\u011flu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8986-3774","authenticated-orcid":false,"given":"Hilmi Furkan","family":"Arslan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9728-8028","authenticated-orcid":false,"given":"Mahmut","family":"Do\u011fru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"6975_CR1","doi-asserted-by":"publisher","unstructured":"Bousquet J, Anto JM, Bachert C, Baiardini I, Bosnic-Anticevich S, Walter Canonica,Toppila-Salmi S (2020) Allergic rhinitis. Nat Rev Dis Primers 6:95. https:\/\/doi.org\/10.1038\/s41572-020-00227-0","DOI":"10.1038\/s41572-020-00227-0"},{"key":"6975_CR2","doi-asserted-by":"publisher","first-page":"3179","DOI":"10.2147\/COPD.S118692","volume":"11","author":"M Kechagia","year":"2016","unstructured":"Kechagia M, Papassotiriou I, Gourgoulianis KI (2016) Endocan and the respiratory system: a review. Int J Chron Obstruct Pulmon Dis 11:3179\u20133187. https:\/\/doi.org\/10.2147\/COPD.S118692","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"6975_CR3","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1002\/jcp.24485","volume":"229","author":"W Lee","year":"2014","unstructured":"Lee W, Ku S-K, Kim S-W, Bae J-S (2014) Endocan elicits severe vascular inflammatory responses in vitro and in vivo. J Cell Physiol 229:620\u2013630. https:\/\/doi.org\/10.1002\/jcp.24485","journal-title":"J Cell Physiol"},{"key":"6975_CR4","first-page":"135","volume":"25","author":"A-H Abdel-Mohsen","year":"2018","unstructured":"Abdel-Mohsen A-H, Allam E (2018) Relationship between serum level of endocan and severity of childhood asthma. Egypt J Immunol 25:135\u2013142","journal-title":"Egypt J Immunol"},{"key":"6975_CR5","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.1111\/1346-8138.13974","volume":"44","author":"H Suzuki","year":"2017","unstructured":"Suzuki H, Miyagaki T, Otobe S, Nakajima R, Oka T, Takahashi N, Kabasawa M, Suga H, Yoshizaki A, Asano Y, Sato S, Sugaya M (2017) Increased endocan expression in lesional skin and decreased endocan expression in sera in atopic dermatitis. 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Eur Respir J 50:1. https:\/\/doi.org\/10.1183\/13993003.00013-2017","journal-title":"Eur Respir J"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-026-06975-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-026-06975-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-026-06975-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T06:02:36Z","timestamp":1780120956000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-026-06975-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["6975"],"URL":"https:\/\/doi.org\/10.1007\/s00431-026-06975-7","relation":{},"ISSN":["1432-1076"],"issn-type":[{"value":"1432-1076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"assertion":[{"value":"24 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 April 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 April 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted as a non-interventional, observational study. Since there was no medical intervention, treatment modification, or experimental procedure involved, the study does not qualify as a clinical trial. Ethical approval was obtained from the Giresun Training and Research Hospital Scientific Research Ethics Committee (Desicion No: 25.12.2023\/16), and the study was conducted in accordance with the ethical principles of the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent was obtained from the parents or legal guardians of all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors affirm that all participants\u2019 parents or legal guardians provided informed consent for the publication of this research.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"327"}}