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Aberrant small airways function relates to asthma severity in young children
Satu Kalliola1, L Pekka Malmberg1, Anna S Pelkonen1
1Department of Allergology, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland.
Respiratory Medicine
|January 7, 2016
Summary
Frequency dependence of resistance (R5-20) measured during methacholine challenge indicates severe exercise-induced bronchoconstriction (EIB) in young children. This finding, along with increased beta-agonist use, highlights potential markers for severe EIB.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Asthma Research
Background:
- Frequency dependence of resistance (R5-20) measured by impulse oscillometry (IOS) is a proposed indicator of small airway function.
- Small airway involvement in induced bronchoconstriction correlates with asthma severity in adults.
Purpose of the Study:
- To investigate the association between methacholine (Mch)-induced changes in R5-20 and the severity of exercise-induced bronchoconstriction (EIB) in young children.
- To assess small airway function during Mch challenge in children aged 3-8 years.
Main Methods:
- 109 children (3-8 years) underwent Mch challenge with IOS measurements of R5-20 and other parameters.
- Children were categorized by EIB severity based on the percentage increase in resistance at 5 Hz (ΔR5) post-exercise: no EIB (<40%), moderate EIB (40-80%), and severe EIB (>80%).
Main Results:
- Baseline R5-20 did not correlate with EIB severity.
- During Mch challenge, the change in R5-20 was significantly higher in children with severe EIB (2.61-fold increase) compared to moderate (1.48) or no EIB (1.74).
- Children with severe EIB reported more frequent short-acting beta-agonist use in the preceding two months.
Conclusions:
- IOS-measured R5-20 during Mch-induced bronchoconstriction is associated with severe EIB in young children.
- Increased beta-agonist use is also linked to severe EIB in this pediatric population.
- These findings suggest R5-20 during Mch challenge and beta-agonist usage as potential indicators of severe EIB.
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