Comparison of bronchial responsiveness to histamine in asthma, allergic rhinitis and allergic sensitization at the age of 7 years.
BACKGROUND
Bronchial responsiveness (BR) to histamine or methacholin is a common finding in adult non-asthmatic patients with allergic rhinitis.


OBJECTIVE
We tested whether BR is also present in children with a comparatively short history of allergic rhinitis in a paediatric cohort.


METHODS
We performed pulmonary function tests and histamine challenges in a total of 654 children (age 7 years, participants of the German Multicenter Allergy Study) and compared PC20 FEV1 values in children with asthma, allergic rhinitis, asymptomatic allergic sensitization and non-atopic controls.


RESULTS
Most pronounced BR to histamine was observed in allergic asthmatics (n = 28), irrespective of the presence or absence of allergic rhinitis. Furthermore, PC(20)FEV(1) values in non-asthmatic children with allergic rhinitis (n = 24) were not significantly different from those seen in asymptomatic atopic (n = 54) or non-atopic controls (n = 92).


CONCLUSIONS
In contrast to adult study populations, 7-year-old non-asthmatic children with allergic rhinitis do not show a higher degree of BR than asymptomatic atopic or non-atopic controls. Therefore, secondary preventive measures in non-asthmatic children with allergic rhinitis (such as regular local anti-inflammatory therapy or specific immunotherapy) should be studied and applied more intensely to prevent bronchial hyper-responsiveness (BHR) and asthma in this high-risk group.
Nickel
R
R
Department of Pediatric Pneumology and Immunology, Charité--Humboldt University, Berlin, Germany. renate.nickel@charite.de
Lau
S
S
Niggemann
B
B
Sommerfeld
C
C
Wahn
U
U
D001249:Asthma / Q000503:physiopathology*; D016535:Bronchial Hyperreactivity; D001985:Bronchial Provocation Tests; D016085:Bronchoconstrictor Agents; D016022:Case-Control Studies; D002648:Child; D005541:Forced Expiratory Volume; D006632:Histamine; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000503:physiopathology; D008168:Lung / Q000503:physiopathology; D012221:Rhinitis, Allergic, Perennial / Q000503:physiopathology*
D016085:Bronchoconstrictor Agents; D006632:Histamine