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Detecting asthma and bronchial hyperresponsiveness in children
1Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong.
Insights
Asthma diagnosis in children is challenging. This study highlights bronchial hyperresponsiveness and non-pharmacological tests as key to accurately identifying pediatric asthma.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
Background:
- Childhood asthma prevalence is rising globally.
- Current clinical definitions of asthma often neglect airway inflammation.
- A comprehensive definition including inflammation, reversibility, and responsiveness is needed.
Purpose of the Study:
- To review asthma features and bronchial hyperresponsiveness in children.
- To explore non-pharmacological bronchial challenge tests for diagnosis.
Main Methods:
- Overview of asthma characteristics.
- Discussion of pharmacological and non-pharmacological methods to assess bronchial hyperresponsiveness.
- Focus on non-pharmacological tests as more physiological and child-friendly.
Main Results:
- Bronchial hyperresponsiveness is a hallmark of asthma.
- Non-pharmacological bronchial challenge tests offer a viable diagnostic approach.
- These tests aid in identifying bronchial hyperresponsiveness in pediatric asthma.
Conclusions:
- A broader asthma definition incorporating airway inflammation and responsiveness is recommended.
- Non-pharmacological bronchial challenge tests are valuable tools for diagnosing asthma in children.
- Improved diagnostic criteria can enhance pediatric asthma management.
Abstract:
The prevalence of asthma in children is increasing worldwide. Although the features of asthma are well documented, defining asthma remains a problem. The clinical definition of asthma does not take into account the concept of airway inflammation. A broader definition that incorporates the inflammatory process, reversibility of airway obstruction, and airway responsiveness needs to be more widely adopted. Bronchial hyperresponsiveness is one of the key features in asthma and it can be documented by using pharmacological or non-pharmacological means. The latter appears to be a more physiological test and more acceptable to children. This article gives an overview of the features of asthma and bronchial hyperresponsiveness and shows how various non-pharmacological bronchial challenge tests can help identify bronchial hyperresponsiveness and thus help diagnose asthma in children.