title: Bronchial hyperresponsiveness to mannitol, airway inflammation and Asthma Control Test in atopic asthmatic children.
abstract: BACKGROUND
  The aim of this study was to evaluate the relationship between airway hyperresponsiveness (AHR) to mannitol and bronchial inflammation measured as exhaled nitric oxide (FeNO) and to assess whether asthma control correlates with AHR to mannitol and FeNO in atopic asthmatic children.
  
  
  METHODS
  Allergy evaluation, the mannitol challenge test, FeNO levels and the Asthma Control Test (ACT) questionnaire were assessed in 40 children with intermittent and mild persistent allergic asthma.
  
  
  RESULTS
  All the subjects showed positive AHR to mannitol. Pearson's correlation test revealed a significant inverse correlation between AHR (mannitol PD15) and FeNO (p = 0.020). There was also a significant positive correlation between ACT and PD15 (p = 0.020) and a significant negative correlation between ACT and FeNO levels (p = 0.003). The study population was divided into two groups according to FeNO levels (group A ≥ 16 ppb vs. group B < 16 ppb). In group A mannitol PD15 was significantly lower (p = 0.040) and ACT score values were significantly lower (p = 0.001) compared to group B. In group A, the ACT showed that 13.3% of subjects had well-controlled asthma, 80% had partially controlled asthma and 6.7% had uncontrolled asthma. In group B, the ACT showed that 72% of subjects had well-controlled asthma and 28% had partially controlled asthma.
  
  
  CONCLUSIONS
  Our findings indicate that the degree of AHR to mannitol correlates with the degree of airway inflammation in asthmatic atopic children; moreover, better control of asthma correlates with a lower degree of AHR to both mannitol and FeNO.
authors.affiliation: Department of Paediatrics, Allergy and Respiratory Diseases Clinic, University of Chieti, Chieti, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Attanasi
authors.affiliation: Department of Paediatrics, Allergy and Respiratory Diseases Clinic, University of Chieti, Chieti, Italy.
authors.forename: Nicola P
authors.initials: NP
authors.lastname: Consilvio
authors.affiliation: Department of Paediatrics, Allergy and Respiratory Diseases Clinic, University of Chieti, Chieti, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Rapino
authors.affiliation: Laboratory of Biostatistics, Department of Experimental and Clinical Sciences, University of Chieti, Chieti, Italy.
authors.forename: Marta Di
authors.initials: MD
authors.lastname: Nicola
authors.affiliation: Department of Paediatrics, Allergy and Respiratory Diseases Clinic, University of Chieti, Chieti, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Scaparrotta
authors.affiliation: Department of Paediatrics, Allergy and Respiratory Diseases Clinic, University of Chieti, Chieti, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Cingolani
authors.affiliation: Department of Paediatrics, Allergy and Respiratory Diseases Clinic, University of Chieti, Chieti, Italy.
authors.forename: Marianna I
authors.initials: MI
authors.lastname: Petrosino
authors.affiliation: Department of Paediatrics, Allergy and Respiratory Diseases Clinic, University of Chieti, Chieti, Italy.
authors.forename: Paola Di
authors.initials: PD
authors.lastname: Filippo
authors.affiliation: Department of Paediatrics, Allergy and Respiratory Diseases Clinic, University of Chieti, Chieti, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Di Pillo
authors.affiliation: Department of Paediatrics, University of Chieti, Chieti, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
keywords: airway hyperresponsiveness; asthma; asthma control; exhaled nitric oxide; mannitol