The Association of Lung Function, Bronchial Hyperresponsiveness, and Exhaled Nitric Oxide Differs Between Atopic and Non-atopic Asthma in Children.
OBJECTIVE
Although many previous studies have attempted to identify differences between atopic asthma (AA) and non-atopic asthma (NAA), they have mainly focused on the difference of each variable of lung function and airway inflammation. The aim of this study was to evaluate relationships between lung function, bronchial hyperresponsiveness (BHR), and the exhaled nitric oxide (eNO) levels in children with AA and NAA.


METHODS
One hundred and thirty six asthmatic children aged 5-15 years and 40 normal controls were recruited. Asthma cases were classified as AA (n=100) or NAA (n=36) from skin prick test results. Lung function, BHR to methacholine and adenosine-5'-monophosphate (AMP), eNO, blood eosinophils, and serum total IgE were measured.


RESULTS
The AA and NAA cases shared common features including a reduced small airway function and increased BHR to methacholine. However, children with AA showed higher BHR to AMP and eNO levels than those with NAA. When the relationships among these variables in the AA and NAA cases were evaluated, the AA group showed significant relationships between lung function, BHR to AMP or methacholine and eNO levels. However, the children in the NAA group showed an association between small airway function and BHR to methacholine only.


CONCLUSIONS
These findings suggest that the pathogenesis of NAA may differ from that of AA during childhood in terms of the relationship between lung function, airway inflammation and BHR.
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Eunhee
E
Shim
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Eun
E
Lee
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Song I
SI
Yang
Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea.
Young Ho
YH
Jung
Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Geun Mi
GM
Park
Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea.
Hyung Young
HY
Kim
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
Ju Hee
JH
Seo
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jyu3922@gmail.com.
Jinho
J
Yu
Asthma; atopy; child; exhaled nitric oxide; lung function, bronchial hyperresponsiveness