The importance of maximal airway response to methacholine in the prediction of asthma development in patients with allergic rhinitis

Y. Y. Koh, E. K. Kang, Y. G. Min, C. K. Kim

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Allergic rhinitis is a known predictor and correlate of asthma incidence. However, it is not clear which patients with allergic rhinitis are at greater risk of the development of asthma. Objective: The aim of this study was to investigate whether airway hypersensitivity and/or increased maximal response on the dose-response curve to methacholine would predict the development of asthma in subjects with allergic rhinitis. Methods: One hundred and forty-one children with allergic rhinitis were prospectively studied for 7 years. At the initiation of the study, bronchial provocation test with methacholine using a stepwise increasing concentration technique was performed to measure PC20 (provocative concentration causing a 20% fall in FEV1 and maximal response. Each subject was evaluated at least every 6 months and details of asthmatic symptoms or signs experienced during the intervening period were taken. Results: Twenty of 122 subjects available for the follow-up developed asthma. Nine (19.6%) of 46 hypersensitive (PC20 < 18 mg/mL) subjects developed asthma, compared with 11 (14.5%) of 76 normosensitive subjects (P = 0.462). Eight (32%) of 25 subjects without maximal response plateau developed asthma, compared with 12 (12.4%) of 97 subjects with maximal response plateau (P = 0.018). Score test for trend revealed a significant association between the level of maximal response (P = 0.007), but not the degree of methacholine PC20 (P = 0.123), and the future development of asthma. Conclusion: An increased maximal airway response to methacholine is shown to be a better predictor for the future development of asthma in patients with allergic rhinitis, than airway hypersensitivity to methacholine.

Original languageEnglish
Pages (from-to)921-927
Number of pages7
JournalClinical and Experimental Allergy
Volume32
Issue number6
DOIs
StatePublished - 2002

Keywords

  • Airway hyper-responsiveness
  • Allergic rhinitis
  • Asthma
  • Maximal airway response
  • Methacholine
  • PC

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