BACKGROUND Assessment of paediatric patients in the pulmonary laboratory includes several non-invasive markers of lung function and inflammation. How these markers distinguish between atopic patients and healthy children are still under investigation. AIMS To compare lung function, airway responsiveness to inhaled salbutamol, fractional concentration of exhaled nitric oxide (FENO), and acidity of the exhaled breath condensate (EBCpH) in atopic-asthmatic and healthy children. Among patients, to compare these measurements with clinical scores (asthma control test, ACT). METHODS In 80 children (60 with atopic asthma and 20 healthy) aged 10.4±2.6 yr, M/F 50/30, we assessed spirometry, FENO, EBCpH, and skin prick test. Spirometry was repeated after inhaled salbutamol and changes in FEV1 and FEF25-75 (“D” prefix) were assessed. A skin-wheal size of ≥3 mm for common allergens was used to define atopy; the sum of positive skin wheals was termed “prick index”. Acidity of EBC samples was analysed either before and after deaeration with Argon. ACT was also recorded in asthmatic children. RESULTS Baseline lung function and airway response to salbutamol (DFEV1 and DFEF25-75) correlated with prick index, FENO (e.g. FEF25-75% with prick index: -0.51, p=0.000, with FENO: -0.28, p=0.013; DFEV1 with prick index: 0.38, p=0.001). Among asthmatic patients, FEF25-75 correlated with ACT (0.26, p=0.05). Atopic-asthmatic children had lower lung function and deaerated EBCpH as well as higher bronchial responsiveness and FENO than healthy children [e.g. EBCpH: 8.12 ± 0.24 vs 8.24 ± 0.12, p=0.020; median FENO (interquartile range): 29.5 (30.0) vs 9.2 (5.6), p=0.000]. CONCLUSION Measurements of routine lung function, airway responsiveness to salbutamol and inflammometry including airway acidity well distinguish between atopic asthmatic and healthy children. Both EBCpH and small airways function help to assess airway responsiveness and asthma control.
Differences In Lung Function, Airway Responsiveness And Inflammometry Between Atopic-Asthmatic And Healthy Children / F., Ruggeri; Barreto, Mario; M., Montesano; L., Chiossi; I., Caiazzo; C., Bianchini; S., Rocchi; C., Toffoli; Villa, MARIA PIA. - In: AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE. - ISSN 1073-449X. - STAMPA. - 187:(2013), pp. A2598-A2598. (Intervento presentato al convegno American Thoracic Society International Conference tenutosi a Philadelphia, USA nel May 17 to 22, 2013).
Differences In Lung Function, Airway Responsiveness And Inflammometry Between Atopic-Asthmatic And Healthy Children.
BARRETO, Mario;VILLA, MARIA PIA
2013
Abstract
BACKGROUND Assessment of paediatric patients in the pulmonary laboratory includes several non-invasive markers of lung function and inflammation. How these markers distinguish between atopic patients and healthy children are still under investigation. AIMS To compare lung function, airway responsiveness to inhaled salbutamol, fractional concentration of exhaled nitric oxide (FENO), and acidity of the exhaled breath condensate (EBCpH) in atopic-asthmatic and healthy children. Among patients, to compare these measurements with clinical scores (asthma control test, ACT). METHODS In 80 children (60 with atopic asthma and 20 healthy) aged 10.4±2.6 yr, M/F 50/30, we assessed spirometry, FENO, EBCpH, and skin prick test. Spirometry was repeated after inhaled salbutamol and changes in FEV1 and FEF25-75 (“D” prefix) were assessed. A skin-wheal size of ≥3 mm for common allergens was used to define atopy; the sum of positive skin wheals was termed “prick index”. Acidity of EBC samples was analysed either before and after deaeration with Argon. ACT was also recorded in asthmatic children. RESULTS Baseline lung function and airway response to salbutamol (DFEV1 and DFEF25-75) correlated with prick index, FENO (e.g. FEF25-75% with prick index: -0.51, p=0.000, with FENO: -0.28, p=0.013; DFEV1 with prick index: 0.38, p=0.001). Among asthmatic patients, FEF25-75 correlated with ACT (0.26, p=0.05). Atopic-asthmatic children had lower lung function and deaerated EBCpH as well as higher bronchial responsiveness and FENO than healthy children [e.g. EBCpH: 8.12 ± 0.24 vs 8.24 ± 0.12, p=0.020; median FENO (interquartile range): 29.5 (30.0) vs 9.2 (5.6), p=0.000]. CONCLUSION Measurements of routine lung function, airway responsiveness to salbutamol and inflammometry including airway acidity well distinguish between atopic asthmatic and healthy children. Both EBCpH and small airways function help to assess airway responsiveness and asthma control.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
