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Korean Journal of Pediatrics 2006;49(11):1216-1222.
Published online November 15, 2006.
Methacholine and adenosine 5'-monophosphate challenge tests in children with atopic asthma and with nonatopic asthma, and their relationships to blood eosinophil markers
Sun Hee Lee, Do Kyun Kim, Sun Hee Choi, Young Yull Koh
Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
아토피성 천식 환아와 비아토피성 천식 환아에서 메타콜린과 아데노신 기관지 유발 검사의 비교 및 혈중 호산구 염증 지표와의 관련성
이선희, 김도균, 최선희, 고영률
서울대학교 의과대학 소아과학교실
Correspondence:  Young Yull Koh,
Email: kohyy@plaza.sun.ac.kr
Abstract
Purpose
: Though atopic and nonatopic asthma have different clinical manifestations, bronchial hyperresponsiveness (BHR) and airway inflammations are common characteristics of them. We investigated BHR to both methacholine and adenosine 5'-monophosphate (AMP), and their relationships with blood eosinophil markers in nonatopic asthma as well as atopic asthma.
Methods
: We studied 116 children (82 atopics; 34 nonatopics) with mild to moderate asthma. Methacholine and AMP challenge tests were performed and bronchial responsiveness was expressed as PC20 (provocative concentration causing a 20 percent fall in FEV1); blood eosinopil counts (ETCs) and serum eosinophil cationic protein (ECP) levels were gauged.
Results
: In atopics, 95.1 percent and 90.2 percent showed hyperreactivity to methacholine (PC20<16 mg/mL) and AMP (PC20<200 mg/mL), respectively. Meanwhile, in nonatopics, 94.1 percent and 52.9 percent displayed hyperreactivity to methacholine and AMP, respectively. The geometric mean of AMP PC20 was lower in atopics (31.6 mg/mL) than in nonatopics (125.9 mg/mL); that of methacholine PC20 was similar in the two groups. AMP PC20 correlated with blood ETCs in both atopics(r=-0.30, P<0.01) and nonatopics (r=-0.57, P<0.01), and correlated with serum ECP levels (r=-0.23, P<0.01) in atopics, but not in nonatopics. Apart from AMP, methacholine PC20 was not associated with blood eosinophil markers in either group.
Conclusion
: Atopics more frequently displayed BHR to AMP than nonatopics. Furthermore, BHR to AMP was associated with not only blood ETCs, but serum ECP levels in atopics but was correlated with only blood ETCs in nonatopics. Those results suggest that BHR to AMP reflects airway inflammation in asthma and is more related to atopy.
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