Department of Pediatric Allergology, Gastroenterology, and Nutrition, Medical University of Lodz, Lodz, Poland.
Ann Allergy Asthma Immunol. 2010 Jul;105(1):31-8. doi: 10.1016/j.anai.2010.05.015.
Food allergy (FA) is associated with an increased risk of asthma.
To evaluate whether bronchial hyperreactivity (BHR) occurs in children with FA depending on the presence of respiratory symptoms.
Fifty-four children with FA and 62 without FA were studied for BHR, defined as a provocation concentration of methacholine that caused a decrease in forced expiratory volume in 1 second of 20% (PC20). The diagnosis of FA was established using questionnaires, clinical criteria, skin prick tests, serum specific IgE antibodies, and a double-blind placebo-controlled food challenge.
Among nonasthmatic children, BHR was diagnosed in 15 (47%) with FA and in 7 (17%) without FA (P < .005); BHR was demonstrated in 7 children (41%) with FA alone. All the patients with asthma with or without FA had BHR. The mean (SD) PC20 in children with FA alone was 2.8 [1.38] mg/mL and was significantly higher than that in children with asthma alone (0.88 [1.01] mg/mL) or with asthma and FA (0.96 [0.83] mg/mL) (P < .001). BHR was detected in 5 children (36%) with a mild anaphylactic reaction provoked by food, in 23 (74%) with a moderate reaction, and in all the children with a severe reaction.
Children with FA had increased BHR independent of respiratory symptoms. Although BHR occurs in asymptomatic children with FA, its course is milder than that in children with FA and asthma. Factors that determine BHR prevalence in children with FA are similar to those in children without FA.
食物过敏（FA）与哮喘风险增加有关。
评估 FA 患儿是否存在支气管高反应性（BHR），并根据呼吸症状的存在进行评估。
研究了 54 例 FA 患儿和 62 例无 FA 患儿的 BHR，BHR 定义为引起用力呼气量 1 秒下降 20%的乙酰甲胆碱激发浓度（PC20）。FA 的诊断采用问卷、临床标准、皮肤点刺试验、血清特异性 IgE 抗体和双盲安慰剂对照食物激发试验进行。
在非哮喘患儿中，15 例（47%）FA 患儿和 7 例（17%）无 FA 患儿诊断为 BHR（P <.005）；FA 患儿中 7 例（41%）单独存在 BHR。有或无 FA 的哮喘患儿均存在 BHR。FA 患儿中单独存在 BHR 的患儿平均（SD）PC20 为 2.8 [1.38] mg/mL，显著高于哮喘患儿（0.88 [1.01] mg/mL）或哮喘合并 FA 患儿（0.96 [0.83] mg/mL）（P <.001）。在 5 例（36%）轻度食物诱发过敏反应、23 例（74%）中度反应和所有严重反应患儿中均检测到 BHR。
FA 患儿存在独立于呼吸症状的 BHR。尽管 FA 无症状患儿存在 BHR，但与 FA 和哮喘患儿相比，其病情较轻。决定 FA 患儿 BHR 发生率的因素与无 FA 患儿相似。
