Histamine challenges discriminate between symptomatic and asymptomatic children. MAS-Study Group. Multicentre Allergy Study.
The aims of this study were to investigate a threshold value for bronchial responsiveness in children aged 7 yrs, which discriminates between symptomatic and asymptomatic children, and to identify determinants of this responsiveness. Titrated bronchial histamine challenges using the reservoir method were performed in 645 children aged 7 yrs, from the birth cohort Multicentre Allergy Study (MAS). When defining a reference population of healthy children within the MAS cohort, the 95th percentile of the provocative concentration causing a 20% fall in forced expired volume in one second PC20 among these asymptomatic study subjects amounted to 0.60 mg x mL(-1). This resulted in a specificity of 93.0% and a sensitivity of 45.9%, for discriminating between "current wheezers" and "non-current wheezers". Determinants of airway responsiveness at this age were pulmonary function, sensitization to indoor allergens, total immunoglobulin E and current wheeze. The results indicate that a very low cut-off provocative concentration causing a 20% fall in forced expired volume in one second (<1.0 mg x mL(-1)) defines airway hyperresponsiveness in children aged 7 yrs using the reservoir method. Provocation protocols for histamine challenges in this age group should therefore start with concentrations markedly below 1.0 mg x mL(-1).
Niggemann
B
B
Dept of Pediatric Pneumology, University Children's Hospital Charité of Humboldt University, Berlin, Germany.
Illi
S
S
Madloch
C
C
Völkel
K
K
Lau
S
S
Bergmann
R
R
von Mutius
E
E
Wahn
U
U
D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000175:diagnosis / Q000276:immunology; D016535:Bronchial Hyperreactivity / Q000175:diagnosis* / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D002648:Child; D015331:Cohort Studies; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D005541:Forced Expiratory Volume; D006632:Histamine; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D015999:Multivariate Analysis; D011446:Prospective Studies; D011852:Radioallergosorbent Test; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014797:Vital Capacity
D000485:Allergens; D007073:Immunoglobulin E; D006632:Histamine