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천식 소아에서 아토피와 간접유발 기관지과민성과의 연관성
박태영 ( Tae-young Park ),이민주 ( Min-ju Yi ),최우혁 ( Woo-hyeok Choi ),김수영 ( Su-yeong Kim ),유리타미영 ( Rita Yu ),반지은 ( Ji-eun Ban ),양승 ( Seong Yang ),황일태 ( Il-tae Hwang ),백혜성 ( Hey-sung Baek ) 대한천식알레르기학회(구 대한알레르기학회) 2017 Allergy Asthma & Respiratory Disease Vol.5 No.2
Purpose: Both atopy and bronchial hyperresponsiveness (BHR) are characteristic features of asthma. Several BHR studies comparing groups of atopic and nonatopic asthmatics have reported conflicting results. The aim of this study was to compare BHR to indirect stimuli, such as mannitol or exercise, between atopic and nonatopic asthmatics in children Methods: We performed a retrospective analysis of data from 110 children with asthma, aged 6-18 years using skin prick tests, and serum total and specific IgE levels. Atopy degree was measured using the sum of graded wheal size or the sum of the allergen-spe cific IgE. Bronchial provocation tests (BPTs) using methacholine were performed on all subjects. BPTs using indirect simuli, including exercise and mannitol, were also performed. Results: Asthma cases were classified as atopic asthma (n=83) or nonatopic asthma (n=27) from skin prick or allergen-specific IgE test results. There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asth matics. Atopic asthma had a significantly lower postexercise maximum decrease in % forced expiratory volume in 1 second (FEV<sub>1</sub>) (geometric mean [95% confidence interval]: 31.9 [22.9-40.9] vs. 14.0 [9.4-18.6], P=0.015) and a methacholine PC<sub>20</sub> (provocative concentration of methacholine inducing a 20% fall in FEV<sub>1</sub>) than nonatopic asthmatics (geometric mean [95% confidence interval]: 1.24 [0.60-1.87] ng/mL vs. 4.97 [3.47-6.47]) ng/mL, P=0.001), whereas mannitol PD<sub>15</sub> (cumulative provocative dose causing a 15% fall in FEV<sub>1</sub>) was not significantly different between the 2 groups. Conclusion: There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics in children. (Allergy Asthma Respir Dis 2017:5:83-91)
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