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Airway inflammation and bronchial hyperreactivity in steroid naive children with intermittent and mild persistent asthma
Author(s) -
Toyran Muge,
Bakirtas Arzu,
DogrumanAl Funda,
Turktas Ipek
Publication year - 2014
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.22810
Subject(s) - medicine , asthma , exhaled nitric oxide , methacholine , spirometry , sputum , eosinophil , respiratory disease , gastroenterology , anesthesia , lung , pathology , tuberculosis
Summary Background Intermittent and mild persistent asthma are defined according to symptom frequency and spirometry and treated differently. To our knowledge, there is no study comparing airway inflammation between intermittent and mild persistent asthmatic children. Materials and methods Children aged 7–16 years, referred to our pediatric allergy clinic for recurrent respiratory complaints underwent a detailed clinical history and spirometry with reversibility. None of the subjects had been using regular anti‐inflammatory treatment. After a 2‐week run‐in period during which asthma symptoms were recorded, exhaled NO measurement, bronchial provocation test with adenosine monophosphate and methacholine and sputum induction were performed. Data of patients with intermittent and mild persistent asthma and a control group were compared. Results Thirty intermittent, 26 mild persistent asthmatic children, and 21 control subjects were studied. Sputum was obtained from 19 of intermittent asthmatics (63.3%), 18 of mild persistent asthmatics (69.2%), and 13 of control subjects (61.9%). Eosinophil count and exhaled nitric oxide were not different between asthmatic groups. Neutrophil count of children with mild persistent asthma was higher than the intermittent asthmatic group ( P = 0.003). Geometric mean of PC 20 methacoline values were not different between groups ( P = 0.058). Geometric mean of PC 20 AMP was lower among patients with mild persistent asthma ( P = 0.102). Conclusion Eosinophilic airway inflammation and direct BHR may not be significantly different in intermittent asthmatic children from their peers with mild persistent disease. Neutrophilic airway inflammation and BHR to an indirect stimuli are more pronounced in the mild persistent group. Pediatr Pulmonol. 2014; 49:140–147. © 2013 Wiley Periodicals, Inc.