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KMID : 0390020090190040410
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Pediatric Allergy and Respiratory Disease
2009 Volume.19 No. 4 p.410 ~ p.419
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Relationships of Methacholine and Adenosine 5’-Monophosphate Responsiveness with △FVC in Children with Allergic Rhinitis
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Lee Jin-Hee
Lee Ju-Kyung
Suh Dong-In
Koh Young-Yull
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Abstract
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Purpose : Patients with allergic rhinitis without clinical evidence of asthma often have bronchial hyperresponsiveness (BHR). BHR is commonly assessed by bronchial challenges using direct or indirect stimuli. The percentage decrease in forced vital capacity (FVC) at methacholine PC20 (△FVC) has been proposed as a surrogate marker of the maximal airway response and a useful index of disease severity in asthma. The aim of this study was to compare methacholine and adenosine 5’-monophosphate (AMP) responsiveness with their △FVC in children with allergic rhinitis.
Methods : Eighty-two nonasthmatic children with allergic rhinitis underwent methacholine and AMP bronchial challenge tests. A provocative concentration causing a 20% decline in forced expiratory volume in 1 second (PC20) was calculated for each challenge, and the △FVC on concentration-response curves in methcholine challenge was analyzed retrospectively.
Results : A positive response to methacholine (methacholine PC20<16 mg/mL) was observed in 42.6% (35/82) of patients and the frequency of a positive response to AMP (PC20<200 mg/ mL) was 29.2% (24/82). Of these patients, 23 had a methacholine PC20 above 100 mg/mL and were excluded from the study. Methacholine PC20 did not correlate significantly with △FVC (r=-0.008, P=0.954). However, there was a significant and strong correlation between AMP PC20 and △FVC (r=-0.325, P=0.012).
Conclusion : The stronger correlations of △FVC for AMP PC20 than for methacholine PC20 suggest that the maximal airway response may be better reflected by BHR assessed by AMP than by methacholine in patients with allergic rhinitis.
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KEYWORD
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Allergic rhinitis, Methacholine bronchial hyperresponsiveness, AMP bronchial hyperresponsivenss
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