Korean J Intern Med.  2015 Mar;30(2):226-231. 10.3904/kjim.2015.30.2.226.

Association of nasal inflammation and lower airway responsiveness in schoolchildren based on an epidemiological survey

• Myung JH
• Seo HJ
• Park SJ
• Kim BY
• Shin IS
• Jang JH
• Kim YK
• Jang AS

• KMID: 2160688
• DOI: http://doi.org/10.3904/kjim.2015.30.2.226

Abstract

BACKGROUND/AIMS
We sought to increase our understanding of the rhinitis-asthma relationship and improve strategies for the treatment of patients with these diseases. The aim of this study was to identify a connection between upper airway inflammation and lower airway responsiveness.
METHODS
We counted eosinophils on nasal smears, and performed spirometry, allergic skin tests, and methacholine challenge tests in 308 schoolchildren plus a questionnaire on respiratory symptoms. The methacholine concentration causing a 20% fall in forced expiratory volume in 1 second (PC20 < 25 mg/mL) was used as the threshold of bronchial hyperresponsiveness (BHR).
RESULTS
In total, 26% of subjects had positive nasal eosinophils on a smear, and 46.2% of subjects had BHR at < 25 mg/mL methacholine PC20. Nasal symptoms were higher in subjects with than without nasal eosinophils (p = 0.012). Asthma symptoms did not differ between subjects with and without nasal eosinophils. Nasal eosinophils were higher in subjects with atopy than those without (p = 0.006), and there was no difference in PC20 methacholine according to atopy (15.5 +/- 1.07 vs. 17.5 +/- 0.62; p > 0.05). No difference in BHR was detected when comparing subjects with and without nasal eosinophils. There were significant differences in the PC20 between subjects with greater than 50% nasal eosinophils and without nasal eosinophils (11.01 +/- 2.92 mg/mL vs. 17.38 +/- 0.61 mg/mL; p < 0.001).
CONCLUSIONS
These findings demonstrated that nasal eosinophilic inflammation might contribute to lower airway responsiveness in schoolchildren, based on an epidemiological survey.

Keyword

Eosinophils; Nose; Bronchial hyperreactivity

MeSH Terms

Adolescent
Age Distribution
Age Factors
Asthma/diagnosis/*epidemiology/physiopathology
Bronchial Hyperreactivity/diagnosis/*enzymology/physiopathology
Bronchial Provocation Tests
Child
Eosinophilia/diagnosis/*epidemiology/immunology
Eosinophils/immunology
Female
Health Surveys
Humans
Intradermal Tests
Leukocyte Count
Lung/*physiopathology
Male
Nasal Mucosa/*immunology
Republic of Korea/epidemiology
Rhinitis/diagnosis/*epidemiology/immunology
Spirometry
Surveys and Questionnaires