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[Reactivity of the bronchi as a function of their initial state in children with asthma]
M Kulus1, A Milanowski, A Zawadzka
1Pracowni Patofizjologii Oddychania.
Insights
Children with lower peripheral bronchial flow, measured by MEF50 and MEF25, show higher bronchial reactivity in carbachol provocation tests. These small airway flow values can predict positive bronchial provocation test results in asthma.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Physiology
Background:
- Bronchial asthma diagnosis relies on assessing airway hyperresponsiveness.
- Peripheral bronchial status may influence bronchial provocation test outcomes.
Purpose of the Study:
- To evaluate how baseline peripheral airway function affects bronchial provocation test results.
- To determine if small airway flow indices predict bronchial reactivity.
Main Methods:
- Carbachol bronchial provocation testing was performed on 65 children with asthma.
- Baseline peripheral bronchial flow was assessed using MEF50 and MEF25 values.
- Correlation analysis was used to compare bronchial provocation results with flow indices.
Main Results:
- Children with lower initial MEF50 and MEF25 values exhibited significantly higher bronchial reactivity (lower PC20 values).
- A significant linear correlation was observed between bronchial provocation results (PC) and initial MEF50 (r=0.56) and MEF25 (r=0.49) values.
- The correlation with FEV1/VC was weaker (r=0.39).
Conclusions:
- Decreased flow in peripheral small airways, indicated by MEF values, can predict a positive bronchial provocation test.
- Baseline peripheral airway function is a significant factor in bronchial provocation test outcomes for asthmatic children.
Abstract:
The aim of the study was to assess the effect of peripheral bronchial base-line status on the result of the bronchial provocation test. The study was carried out on a group of 65 children with bronchial asthma. Bronchial reactivity was assessed utilizing the carbachol provocation test. Higher reactivity was seen in children with initially lower indices of peripheral bronchial flow (MEF50, MEF25) (PC20 = 3,789 +/- 0.014 mg/ml) in comparison with children with normal indices (PC20 = 74,608 +/- 0,038 mg/ml) (p < 0.001). A linear correlation was found between the results of bronchial provocation (PC) and initial standardized small airway flow values (MEF50 - r = 0.56, p < 0.001; MEF25 - r = 0.49, p < 0.001). The correlation between bronchial provocation and initial FEV1/VC was weaker (r = 0.39 p < 0.01). The authors conclude that demonstration of decreased flow in peripheral, small airways utilizing MEF values enable to predict a positive result of bronchial provocation tests.