Eosionophils in Induced Sputum and Peak Experatory Flow Rate Variability in Children with Allergic Rhinitis

Park, Kyoung Ae; Kim, Sung Eun; Do, Sung Suk; Jung, Seung Hee; Song, Do Young; Kang, Im Ju

Abstract

PURPOSE
A large number of studies have demonstrated that rhinitis and asthma commonly occur together, and that a temporary relationship between the onset of rhinitis and asthma with rhinitis frequently preceding the development of asthma. We studied to know whether there were asthmatic airway inflammations in subjects with allergic rhinitis with bronchial hyperresponsiveness to methacholine who had no asthma symptoms.
METHODS
Thirty seven children with an allergic rhinitis who visited the pediatric allergy clinic from January 1998 through June 1999 were enrolled. They were grouped into two groups according to the degree of airway responsiveness to methacholine, and 19 bronchial asthma patients with had no asthma attacks for 2 months were compared as control group.; AR-Mch (+) group (n=19) had a PC20-Methacholine lower than 10 mg/mL: AR-Mch (-) group (n=18) had a PC20-Metacholine greater than 10 mg/mL. The relationship of PEFR variability, sputum eosinophils, and nasal eosinophils with bronchial hyperresponsiveness to methacholine in each groups was compared.
RESULTS
1) The PC20-Methacholine was 5.7+/-3.5 mg/mL in the AR-Mch (+) Group, 1.9+/-2.7 mg/mL in the BA Group. 2) Sputum eosinophil was 14+/-6.9% in the AR-Mch (+) Group, 8.1+/-5.2% in the AR-Mch (-) Group, 29.6+/-16.9% in the BA Group, and sputum eosinophils of the AR-Mch (+) Group was higher than that of the AR-Mch (-) Group. 3) PEFR dinural variation was 7.0+/-2.6% in the AR-Mch (+) Group, 5.0+/-2.9% in the AR-Mch (-) Group, 14.0+/-6.0% in the BA Group, and PEFR dinural variation in AR-Mch (+) Group was higher than that of the AR-Mch (-) Group. 4) The PC20-Methacholine was not correlated with PEFR dinural variation in both the AR-Mch (+) Group and the BA Group. 5) The PC20-Methacholine was correlated with sputum eosinophils only in the BA Group. 6) Nasal eosinophils were not correlated with sputum eosinophils in the AR-Mch (+) and the BA Group.
CONCLUSIONS
This study demonstrated that patients with allergic rhinitis who had bronchial hyperresponsiveness to methacholine might have eosinophilic inflammation in the lower airway and increased dinural PEFR. Further studies are necessary to evaluate whether asthma symptoms will be developed in these allergic rhinitis children.