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Does bronchial hyperresponsiveness in childhood predict active asthma in adolescence?
Amund Riiser1, Vegard Hovland, Kai-Håkon Carlsen
1Department of Paediatrics, Oslo University Hospital, NO-0407 Oslo, Norway. amund.riiser@gmail.com
Summary
Bronchial hyperresponsiveness (BHR) in children at age 10 predicts future asthma. Methacholine challenge is a better predictor than exercise testing for identifying children at risk of active asthma six years later.
Area of Science:
- Pediatric respiratory medicine
- Asthma epidemiology
- Pulmonary function testing
Background:
- Bronchial hyperresponsiveness (BHR) is a key characteristic of asthma but lacks specificity.
- Understanding predictors of asthma development is crucial for early intervention.
Purpose of the Study:
- To evaluate the predictive capability of BHR, assessed via methacholine challenge and exercise testing at age 10, for active asthma development 6 years later.
Main Methods:
- A Norwegian birth cohort study followed 530 children.
- Methacholine challenge (PD(20)) and exercise-induced bronchoconstriction (EIB) tests were performed at age 10.
- Active asthma at age 16 was determined by diagnosis, symptoms, or treatment.
Main Results:
- Both PD(20) and EIB at age 10 increased the risk of active asthma at age 16.
- Methacholine challenge (PD(20)) showed a higher predictive value (AUC 0.69) compared to exercise testing (AUC 0.60).
- Together, these tests explained 14% of the variation in active asthma 6 years later.
Conclusions:
- BHR at age 10 is a significant, albeit modest, predictor of active asthma in later adolescence.
- Methacholine challenge is a more effective tool than exercise testing for predicting future asthma.
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