Risk factors influencing bronchial hyperresponsiveness to methacholine in school age and adolescence of atopic dermatitis

Myong Soon Sung; Jin Wook Choi; Young Jin Hwang; Sung Won Kim

doi:10.4168/aard.2014.2.3.179

Journal List > Allergy Asthma Respir Dis > v.2(3) > 1059023

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Sung, Choi, Hwang, and Kim: Risk factors influencing bronchial hyperresponsiveness to methacholine in school age and adolescence of atopic dermatitis

Original Article

Allergy, Asthma & Respiratory Disease 2014; 2(3): 179-186.

Published online: 31 July 2014

DOI: https://doi.org/10.4168/aard.2014.2.3.179

Risk factors influencing bronchial hyperresponsiveness to methacholine in school age and adolescence of atopic dermatitis

Myong Soon Sung, Jin Wook Choi, Young Jin Hwang, Sung Won Kim

Department of Pediatrics, Busan St. Mary's Hospital, Busan, Korea.

Correspondence to: Sung Won Kim. Department of Pediatrics, Busan St. Mary's Hospital, 25-14 Yongho-ro 232beon-gil, Nam-gu, Busan 608-838, Korea. Tel: +82-51-933-7981, Fax: +82-51-936-7531, sbdph1@daum.net

Received 8 October 2013 Revised 29 December 2013 Accepted 7 February 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Purpose

Many studies have shown the importance for bronchial hyperresponsiveness (BHR) in children with bronchial asthma and allergic rhinitis. However, studies have not been done in BHR in school age and adolescence with atopic dermatitis (AD).

Methods

The patients with history of bronchial asthma were excluded and methacholine challenge test (MCT) was performed in 103 children with atopic dermatitis. The positive of MCT result is defined as provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 second (PC₂₀)≤8 mg/mL. According of the level of PC₂₀, the patients were divided into two groups.

Results

The group 1 (BHR+) was observed in 43 of all patients (41.7%). Of two groups, significant differences were observed in age, body mass index. No significant differences were observed in the number of male, SCORing Atopic Dermatitis (SCORAD) index, admission history, smoking exposure history, other allergic disease, parental allergic disease. The group 1 (BHR+) have higher levels of total eosinophil count compared with the group 2 (BHR-) (629.8±360.5/µL vs. 470.2±253.9/µL, P=0.01). But no significant association was found between severity of BHR and SCORAD score, total immunoglobulin E, total eosin ophil count and eosinophil cationic protein (r=0.008, P=0.961; r=-0.217, P=0.162; r=0.225, P=0.147; r=-0.032, P=0.841). The list of allergen is that the house dust mite, tree, weed, food, animal hair, and fungus. The house dust mite has correlation with bronchial hypersensitivity statistically and the any of allergen groups, either.

Conclusion

No significant relationship was observed between degree of BHR and allergy laboratory finding, severity of AD.

Keywords: Bronchial hyperreactivity, Methacholine challenge test, Atopic dermatitis

Figures and Tables

Fig. 1

Correlation of PC₂₀ levels with total immunoglobulin E (IgE) (A), eosinophil cationic protein (ECP) (B), total eosinophil count (C), SCORing Atopic Dermatitis (SCORAD) index (D). P<0.05 is statistically significant. PC₂₀, provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 second.

Table 1

The clinical characteristics of the two groups classified according to the presence of BHR to methacholine

Values are presented as number (%) or mean±standard deviation.

BHR, bronchial hyperresponsiveness; SCORAD, SCORing Atopic Dermatitis; Hx, history; NA, not applicable.

Table 2

The result of pulmonary fuction test and laboratory findings of the two groups classified according to the presence of BHR to methacholine

Values are presented as mean±standard deviation or number (%).

BHR, bronchial hyperresponsiveness; PC₂₀, provocative concentration of methacholine causing a 20% fall in FEV₁; FEV₁, forced expiratory volume in 1 second; IgE, immunoglobulin E; ECP, eosinophic cationic protein; S. aureus, Staphylococcus aureus; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-sensitive Staphylococcus aureus; NA, not applicable.

Table 3

The positive allergen results of the two groups classified according to the presence of BHR to methacholine

Values are presented as number (%).

BHR, bronchial hyperresponsiveness.

Table 4

Odds ratio and 95% confidence interval for BHR with total IgE and allergen test in BHR (+)

BHR, bronchial hyperresponsiveness; OR, odds ratio; CI, confidence interval; IgE, immunoglobulin E.

^*Adjusted for sex, age, forced expiratory volume in 1 second (FEV₁)/functional vital capacity (FVC), total IgE, and sensitization to other allergen groups. ^†Adjusted for sex, age, FEV₁/FVC, and total IgE.

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