Bronchial reactivity and initial airway status in asthmatic children

Marek Kulus

Summary
Bronchial hyper-reactivity (BHR) to various stimuli is a characteristic feature of asthma. However, it is not always possible to perform a bronchial provocation test (BPT) to assess bronchial reactivity. There is no general agreement as to whether the result of a BPT can be predicted on the basis of routine lung tests. The aim of the study was evaluation of the relationship between BPT results and baseline lung function tests, especially assessing the status of small bronchi in children suffering from asthma.
The investigated group comprised 139 children aged 7 to 17 years, with episodic, mild, or moderate asthma. Lung function was assessed on the basis of spirography, flow-volume curve, and airway resistance. Bronchial challenges were carried out with carbachol.
The results showed a good correlation between a BPT result and baseline lung function. Children with impaired initial lung tests had more pronounced bronchial hyper-reactivity. This relationship was closest in the group of children with obstruction of the small bronchi. Analysis of the correlation showed a highly significant relationship between baseline lung function tests and the degree of bronchial reactivity (PC₂₀). The highest significance was observed for MEF₅₀ and MEF₂₅ (p<0.001).
We conclude that small bronchi tests in children with asthma can predict the results of a bronchial challenge with high probability.

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