Pediatr Allergy Respir Dis.  2011 Mar;21(1):39-46.

Atopy as a Risk Factor for an Elevated Bronchodilator Response in Children with Asthma

• Suh DI
• Lee EJ
• Lee J
• Lee JK
• Koh YY

Abstract

PURPOSE
The bronchodilator response (BDR) is frequently measured to assess the severity of asthma and to help facilitate therapeutic decisions, as well as to confirm the diagnosis. Few reports are available on the impact of atopy, one of the most important risk factors for childhood asthma, on the BDR.
METHODS
The medical records of 207 asthmatic children (174 with atopic asthma and 33 with non-atopic asthma) were retrospectively reviewed. At the time of asthma diagnosis, the subjects underwent blood tests, bronchial provocation tests, and spirometry before and 15 minutes after inhalation of 4 puffs of salbutamol. We compared the mean BDR levels between the children with atopic and non-atopic asthma, then determined the correlations between the BDR and serum markers of eosinophilic inflammation.
RESULTS
While the mean pre-bronchodilator FEV1 was not different between children with atopic and non-atopic asthma, atopic asthmatics had a higher mean BDR than non-atopic asthmatics (9.12+/-5.69% vs. 6.93+/-3.80%, P =0.03). There were weak, but significant correlations between the BDR and the serum markers of eosinophilic inflammation (total immunoglobulin E, r =0.192, P =0.01; total eosinophil count, r =0.192, P =0.01; eosinophil cationic protein, r =0.200, P <0.01).
CONCLUSION
Asthmatic children had different mean levels of BDR based on atopic status at the time of asthma diagnosis. When the BDR was assessed to aid therapeutic decisions, the presence of atopy should be taken into consideration in children with asthma.

Keyword

Asthma; Bronchodilator response; Atopy; Non-atopy; Child

MeSH Terms

Albuterol
Asthma
Biomarkers
Bronchial Provocation Tests
Child
Eosinophil Cationic Protein
Eosinophils
Hematologic Tests
Humans
Immunoglobulin E
Immunoglobulins
Inflammation
Inhalation
Medical Records
Retrospective Studies
Risk Factors
Spirometry
Albuterol
Eosinophil Cationic Protein
Immunoglobulin E
Immunoglobulins

Figure

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  Fig. 1. Bronchodilator responses in the atopic and non-atopic groups. Horizontal bars represent mean (±SD). FEV1, forced expiratory volume in 1 second; ΔFEV1%, differences in FEV1 expressed as a percentage of initial FEV1.

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  Fig. 2. Scatter plots of the serum total immunoglobulin E and ΔFEV1% in the whole study population. FEV1, forced expiratory volume in 1 second; ΔFEV1%, differences in FEV1 expressed as a percentage of initial FEV1.

Reference

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