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Airway hyperresponsiveness to mannitol and methacholine and exhaled nitric oxide in children with asthma

 Young A. Park  ;  Hyun Bin Park  ;  Yoon Hee Kim  ;  In Sook Sul  ;  Seo Hee Yoon  ;  Hye Ran Kim  ;  Kyung Won Kim  ;  Kyu-Earn Kim  ;  Myung Hyun Sohn 
 JOURNAL OF ASTHMA, Vol.54(6) : 644-651, 2017 
Journal Title
Issue Date
Administration, Inhalation ; Adolescent ; Adrenal Cortex Hormones/therapeutic use ; Asthma/drug therapy ; Asthma/physiopathology* ; Australia ; Breath Tests/methods* ; Bronchial Hyperreactivity/physiopathology* ; Bronchial Provocation Tests/methods* ; Child ; Child, Preschool ; Eosinophils/metabolism ; Female ; Humans ; Immunoglobulin E/blood ; Male ; Mannitol/administration & dosage ; Methacholine Chloride/administration & dosage ; Nitric Oxide/analysis* ; Spirometry
Airway hyperresponsiveness ; childhood asthma exhaled nitric oxide ; mannitol dry powder ; methacholine
OBJECTIVE: Asthma is characterized by airway hyperresponsiveness (AHR), inflammation, and obstruction. AHR to stimuli that indirectly cause bronchial smooth muscle (BSM) contractions via release of endogenous mediators is thought to better reflect airway inflammation than AHR to stimuli that act directly on BSM. Fractional exhaled nitric oxide (FeNO) is a useful parameter for noninvasive clinical airway inflammation assessments. Accordingly, this study aimed to examine the relationships of mannitol and methacholine challenge test outcomes with FeNO and the influence of inhaled corticosteroid treatment in children with asthma. METHODS: One hundred thirty-four asthmatic children (89 males; ages: 5-17 years, median: 9 years) underwent spirometry, FeNO measurement, serum total/specific IgE testing, and blood eosinophil count. All subjects were challenged with mannitol dry powder (MDP; AridolH, Pharmaxis, Australia) and methacholine at 7-day intervals. Data of steroid-treated and steroid-naïve children were compared. RESULTS: Positive responses to MDP and methacholine challenge tests were observed in 74.6% and 67.2% of total subject group, respectively, and 72 children had positive response to both challenge tests. The median FeNO level, response-dose ratio (RDR) of PC20 methacholine, and RDR of PD15 MDP were significantly higher in the steroid-treated group than in the steroid-naïve group (p < 0.001, 0.226, and 0.004, respectively). FeNO levels associated significantly with PD15 MDP and RDR PD15 MDP in total subject populations (p = 0.016 and 0.003, respectively); however, a significant correlation between FeNO and RDR PD15 MDP was observed only in the steroid-naïve group. CONCLUSIONS: Compared with AHR to methacholine, AHR to MDP more closely reflected the level of FeNO in steroid-naïve asthmatic children.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Kyu Earn(김규언)
Kim, Yoon Hee(김윤희) ORCID logo https://orcid.org/0000-0002-2149-8501
Kim, Hye Ran(김혜란)
Sol, In Suk(설인숙) ORCID logo https://orcid.org/0000-0003-2470-9682
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
Yoon, Seo Hee(윤서희) ORCID logo https://orcid.org/0000-0002-8361-9815
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