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Small Airway Dysfunction Assessed by Impulse Oscillometry in Non-Asthmatic Children with Moderate-to-Severe

Ercan Yılmaz1, Erdem Topal1

  • 1Department of Pediatric Allergy and Immunology, Faculty of Medicine, Inonu University, 44280 Malatya, Turkey.

Journal of Clinical Medicine
|July 28, 2026
PubMed

Insights

Children with allergic rhinitis show subclinical peripheral airway dysfunction. Impulse oscillometry (IOS) can detect this early airway involvement, potentially predicting future asthma development in pediatric patients.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Respiratory Medicine

Background:

  • Allergic rhinitis (AR) is increasingly viewed as a systemic airway disease.
  • Peripheral airway dysfunction can occur in AR even without asthma symptoms.
  • Impulse oscillometry (IOS) is a sensitive tool for assessing small airway function in children.

Purpose of the Study:

  • To characterize peripheral airway function in children with moderate-to-severe persistent allergic rhinitis.
  • To evaluate the utility of impulse oscillometry (IOS) in detecting subclinical airway dysfunction.
  • To compare IOS parameters between children with AR and healthy controls during immunotherapy.

Main Methods:

  • Cross-sectional case-control study of 69 children with AR and 65 healthy controls.
  • Exclusion of children with asthma symptoms, abnormal spirometry, or chronic lung disease.
  • Measurement and comparison of IOS parameters (R5, R20, R5-R20, X5, AX, Fres) between groups.

Main Results:

  • The allergic rhinitis group showed significantly higher R5, R5-R20, and AX values compared to healthy controls.
  • These findings indicate increased peripheral airway resistance and reactance in children with AR.
  • No significant differences were found in R20, X5, X20, or Fres, suggesting specific peripheral airway involvement.

Conclusions:

  • Children with moderate-to-severe persistent allergic rhinitis may have subclinical small airway dysfunction.
  • Impulse oscillometry (IOS) is effective in identifying early peripheral airway involvement in pediatric AR.
  • IOS may help identify children at higher risk for developing asthma.

Keywords:
allergen immunotherapyallergic rhinitisimpulse oscillometrysmall airway dysfunction

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