Department of Sports Medicine, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka, Japan.
Allergol Int. 2012 Mar;61(1):65-73. doi: 10.2332/allergolint.11-OA-0311. Epub 2011 Sep 25.
The present study aimed to illustrate clinical characteristics of spirometric measures and allergy sensitisation among young atopic adults who reported wheezing episodes before adulthood but were not diagnosed with asthma by physicians and have no current wheeze symptoms (self-reported past-wheezers), especially those who exhibited airway hyperresponsiveness (AHR).
Fifty self-reported past-wheezers were divided into two groups according to AHR to methacholine. Spirometric functions and blood atopic parameters were compared in these groups with those in 25 age-matched atopic adults with a history of childhood asthma diagnosed by specialists but have no current wheeze symptoms (past-asthmatics) and in 60 counterparts without a previous and current wheezing episode (never-wheezers).
Twenty-one of the 50 past-wheezers exhibited AHR (PC(20) < 8 mg/ml). Levels of spirometric function and allergic sensitization in both past-wheezer groups were intermediate between those in never-wheezers and past-asthmatics. Lower FEV(1) and FEF(25-75) values (% predicted) were observed in self-reported past-wheezers with AHR relative to those without AHR. More blood eosinophils and higher serum levels of total IgE and IgE specific to house dust mites were observed in self-reported past-wheezers with AHR relative to those without AHR.
Our findings raise the possibility that self-reported past-wheezers with AHR might form a distinct subgroup with features similar to past-asthmatics, which is one of the risk groups for adult asthma.
本研究旨在阐述成年前曾有过哮喘发作但未被医生诊断为哮喘且当前无喘息症状（自述曾有过喘息）的特应性成年人的肺功能指标和过敏敏化的临床特征，尤其是那些存在气道高反应性（AHR）的患者。
根据对乙酰甲胆碱的 AHR，将 50 名自述曾有过喘息的患者分为两组。将这些组与 25 名年龄匹配的特应性成年人进行比较，这些成年人曾有儿童哮喘病史，由专科医生诊断，但当前无喘息症状（既往哮喘者），并与 60 名无既往和当前喘息史的对照者（从不喘息者）进行比较。
50 名自述曾有过喘息的患者中，有 21 名存在 AHR（PC20 < 8mg/ml）。两组自述曾有过喘息的患者的肺功能指标和过敏敏化程度均介于从不喘息者和既往哮喘者之间。与无 AHR 的自述曾有过喘息的患者相比，存在 AHR 的自述曾有过喘息的患者的 FEV1 和 FEF（25-75）值（占预计值的百分比）较低。与无 AHR 的自述曾有过喘息的患者相比，存在 AHR 的自述曾有过喘息的患者的血液嗜酸性粒细胞计数较高，血清总 IgE 和 IgE 对屋尘螨的特异性水平较高。
我们的研究结果表明，存在 AHR 的自述曾有过喘息的患者可能形成了一个与既往哮喘者具有相似特征的亚组，这是成人哮喘的一个高危人群。
