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Factors affecting bronchial hyperreactivity in asthmatic children
Koray Harmanci1, Arzu Bakirtas, Ipek Turktas
1Department of Allergy, Ministry of Health, Ankara Diskapi Children's Diseases Training and Research Hospital, Ankara, Turkey. korayharmanci@hotmail.com
Insights
Bronchial hyperresponsiveness (BHR) in children with asthma is more severe in younger patients and those with early symptom onset. Family history of asthma, passive smoking, and indoor allergen sensitization also correlate with increased BHR severity.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Asthma Research
Background:
- Bronchial hyperresponsiveness (BHR) is a hallmark of asthma, characterized by exaggerated airway narrowing.
- Understanding factors influencing BHR severity in pediatric asthma is crucial for effective management.
Purpose of the Study:
- To investigate the relationship between various clinical factors and the severity of BHR in children diagnosed with asthma.
- To identify predictors of BHR severity in a pediatric asthma cohort.
Main Methods:
- Retrospective analysis of 135 children diagnosed with asthma between January 2007 and January 2008.
- Data collected from the Gazi University Hospital Pediatric Allergy and Asthma Department asthma database.
- Evaluation of factors including age, age at onset, family history, passive smoking, atopy, and allergen sensitization.
Main Results:
- BHR severity was not significantly different between sexes.
- Younger age and earlier age at symptom onset were associated with more severe BHR.
- Asthma patients with a first-degree relative with asthma and those exposed to passive smoking exhibited more severe BHR.
- Moderate-to-severe BHR correlated with increased hospitalizations, but not chronic asthma severity.
- Indoor allergen sensitization in atopic children was linked to more severe BHR.
Conclusions:
- Age, age at symptom onset, parental asthma, passive smoking, and baseline lung function are significant factors related to BHR in pediatric asthma.
- Serum IgE levels and skin prick test positivity did not directly correlate with BHR severity.
- While no overall link was found between atopy and BHR severity, indoor allergen sensitization was a key factor in atopic children.
Abstract:
Bronchial hyperresponsiveness (BHR), the exaggerated airway narrowing in response to nonspesific stimuli, is a common characteristic of asthma. One hundred thirty-five children who were diagnosed asthma in the outpatient clinic of Gazi University Hospital, Pediatric Allergy and Asthma Department between January 2007 and January 2008 were retrospectively analysed from the asthma database of the division. BHR was not found to be different according to sex. Younger the age of the patient, more severe was BHR (p = 0.096, r = 0.164). Younger the age at onset of the symptoms, the more severe was the BHR (p < 0.001, r = 0.307). Patients who had an asthmatic first degree relative and who were exposed to passive smoking at home, had more severe BHR (p = 0.006 and p = 0.032, respectively). There were more hospitalizations among the asthmatic children with moderate-severe BHR (p = 0.027) however no correlation was found between chronic asthma severity and the degree of BHR). In this study we found that age, age at onset of symptoms, having a parent with asthma, exposure to tobacco smoke and baseline lung function are related to BHR measured at referral. Serum levels of Ig E or skin prick test positivity were not found to have any effect on BHR severity. Considering BHR severity, we could not reveal any relation between atopic and nonatopic children. However among atopic subjects, the ones with indoor allergen sensitization had more severe BHR.
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