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KMID : 1035620170050020083
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Allergy Asthma & Respiratory Disease
2017 Volume.5 No. 2 p.83 ~ p.91
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Relationship between atopy and bronchial hyperresponsiveness to indirect stimuli in asthmatic children
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Park Tae-Young
Yi Min-Ju
Choi Woo-Hyeok
Kim Su-Yeong
Yu Rita
Ban Ji-Eun
Yang Seung
Hwang Il-Tae
Baek Hye-Sung
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Abstract
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Purpose: Both atopy and bronchial hyperresponsiveness (BHR) are characteristic features of asthma. Several BHR studies comparing groups of atopic and nonatopic asthmatics have reported conflicting results. The aim of this study was to compare BHR to indirect stimuli, such as mannitol or exercise, between atopic and nonatopic asthmatics in children.
Methods: We performed a retrospective analysis of data from 110 children with asthma, aged 6?18 years using skin prick tests, and serum total and specific IgE levels. Atopy degree was measured using the sum of graded wheal size or the sum of the allergen-specific IgE. Bronchial provocation tests (BPTs) using methacholine were performed on all subjects. BPTs using indirect simuli, including exercise and mannitol, were also performed.
Results: Asthma cases were classified as atopic asthma (n=83) or nonatopic asthma (n=27) from skin prick or allergen-specific IgE test results. There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics. Atopic asthma had a significantly lower postexercise maximum decrease in % forced expiratory volume in 1 second (FEV1) (geometric mean [95% confidence interval]: 31.9 [22.9?40.9] vs. 14.0 [9.4?18.6], P=0.015) and a methacholine PC20 (provocative concentration of methacholine inducing a 20% fall in FEV1) than nonatopic asthmatics (geometric mean [95% confidence interval]: 1.24 [0.60?1.87] ng/mL vs. 4.97 [3.47?6.47]) ng/mL, P=0.001), whereas mannitol PD15 (cumulative provocative dose causing a 15% fall in FEV1) was not significantly different between the 2 groups.
Conclusion: There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics in children.
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KEYWORD
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Bronchial hyper-responsiveness, Atopy, Asthma, Child
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