Helsinki University Hospital, Children and Adolescents, Lohja Hospital, Finland.
Helsinki University Hospital, Skin and Allergy Hospital, Helsinki, Finland.
Ann Allergy Asthma Immunol. 2019 May;122(5):492-497. doi: 10.1016/j.anai.2019.02.025. Epub 2019 Mar 2.
Recurrent wheezing in early life is transient in most children. The significance of airway hyperresponsiveness (AHR) in persistence of respiratory symptoms from infancy to early childhood is controversial.
We evaluated whether AHR in wheezy infants predicts doctor-diagnosed asthma (DDA) or AHR at the age of 6 years.
Sixty-one wheezy infants (age 6-24 months) were followed up to the median age of 6 years. Lung function and AHR with methacholine challenge test were assessed at infancy and 6 years. The exercise challenge test was performed at the age of 6 years. Atopy was assessed with skin prick tests.
At 6 years, 21 (34%) of the children had DDA. Children with DDA had higher logarithmic transformed dose-response slope (LOGDRS) to methacholine in infancy than children without DDA (0.047 vs 0.025; P = .033). Furthermore, AHR to methacholine in infancy and at 6 years were associated with each other (r = 0.324, P = .011). Children with exercise-induced bronchoconstriction (EIB) at 6 years were more reactive to methacholine in infancy than those without EIB (P = .019).
Increased AHR in symptomatic infants was associated with increased AHR, DDA, and EIB at median the age of 6 years, suggesting early establishment of AHR.
大多数儿童的早期反复喘息是短暂的。气道高反应性（AHR）在婴儿期到幼儿期持续呼吸道症状中的意义存在争议。
我们评估了喘息婴儿的 AHR 是否预测医生诊断的哮喘（DDA）或 6 岁时的 AHR。
61 例喘息婴儿（6-24 个月龄）随访至中位年龄 6 岁。在婴儿期和 6 岁时评估肺功能和乙酰甲胆碱激发试验的 AHR。在 6 岁时进行运动激发试验。采用皮肤点刺试验评估特应性。
6 岁时，21 名（34%）儿童患有 DDA。与无 DDA 的儿童相比，患有 DDA 的儿童在婴儿期对乙酰甲胆碱的对数转换剂量反应斜率（LOGDRS）更高（0.047 比 0.025；P =.033）。此外，婴儿期和 6 岁时的 AHR 相互关联（r = 0.324，P =.011）。6 岁时发生运动诱导的支气管收缩（EIB）的儿童比未发生 EIB 的儿童对乙酰甲胆碱的反应性更高（P =.019）。
症状性婴儿的 AHR 增加与中位年龄 6 岁时的 AHR、DDA 和 EIB 增加相关，提示 AHR 早期建立。
