Attanasi Marina, Consilvio Nicola P, Rapino Daniele, Nicola Marta Di, Scaparrotta Alessandra, Cingolani Anna, Petrosino Marianna I, Filippo Paola Di, Di Pillo Sabrina, Chiarelli Francesco
Department of Paediatrics, Allergy and Respiratory Diseases Clinic, University of Chieti, Chieti, Italy.
Laboratory of Biostatistics, Department of Experimental and Clinical Sciences, University of Chieti, Chieti, Italy.
Arch Med Sci. 2016 Feb 1;12(1):137-44. doi: 10.5114/aoms.2016.57589. Epub 2016 Feb 2.
The aim of this study was to evaluate the relationship between airway hyperresponsiveness (AHR) to mannitol and bronchial inflammation measured as exhaled nitric oxide (FeNO) and to assess whether asthma control correlates with AHR to mannitol and FeNO in atopic asthmatic children.
Allergy evaluation, the mannitol challenge test, FeNO levels and the Asthma Control Test (ACT) questionnaire were assessed in 40 children with intermittent and mild persistent allergic asthma.
All the subjects showed positive AHR to mannitol. Pearson's correlation test revealed a significant inverse correlation between AHR (mannitol PD15) and FeNO (p = 0.020). There was also a significant positive correlation between ACT and PD15 (p = 0.020) and a significant negative correlation between ACT and FeNO levels (p = 0.003). The study population was divided into two groups according to FeNO levels (group A ≥ 16 ppb vs. group B < 16 ppb). In group A mannitol PD15 was significantly lower (p = 0.040) and ACT score values were significantly lower (p = 0.001) compared to group B. In group A, the ACT showed that 13.3% of subjects had well-controlled asthma, 80% had partially controlled asthma and 6.7% had uncontrolled asthma. In group B, the ACT showed that 72% of subjects had well-controlled asthma and 28% had partially controlled asthma.
Our findings indicate that the degree of AHR to mannitol correlates with the degree of airway inflammation in asthmatic atopic children; moreover, better control of asthma correlates with a lower degree of AHR to both mannitol and FeNO.
本研究旨在评估对甘露醇的气道高反应性（AHR）与作为呼出一氧化氮（FeNO）测量的支气管炎症之间的关系，并评估特应性哮喘儿童的哮喘控制是否与对甘露醇的AHR和FeNO相关。
对40名间歇性和轻度持续性过敏性哮喘儿童进行了过敏评估、甘露醇激发试验、FeNO水平和哮喘控制测试（ACT）问卷评估。
所有受试者对甘露醇均表现出阳性AHR。Pearson相关性检验显示AHR（甘露醇PD15）与FeNO之间存在显著负相关（p = 0.020）。ACT与PD15之间也存在显著正相关（p = 0.020），ACT与FeNO水平之间存在显著负相关（p = 0.003）。根据FeNO水平将研究人群分为两组（A组≥16 ppb与B组<16 ppb）。与B组相比，A组的甘露醇PD显著更低（p = 0.040），ACT评分值显著更低（p = 0.001）。在A组中，ACT显示13.3%的受试者哮喘控制良好，80%的受试者哮喘部分控制，6.7%的受试者哮喘未控制。在B组中，ACT显示72%的受试者哮喘控制良好，28%的受试者哮喘部分控制。
我们的研究结果表明，特应性哮喘儿童对甘露醇的AHR程度与气道炎症程度相关；此外，更好的哮喘控制与对甘露醇和FeNO的较低AHR程度相关。
