Nonspecific bronchial hyperreactivity in schoolchildren with atopic and nonatopic phenotypes of bronchial asthma

АСТМА ТА АЛЕРГІЯ, No 1 • 2015 Bronchial asthma (BA) and recurrent bronchitis occupy the leading place among chronic and recurrent respiratory diseases in children age. Special importance of problem of these diseases gets in view of the provisions that recurrent respiratory diseases in children is the debut of chronic bronchopulmonary pathology of adult period of life [1, 16]. One of the important aspects of inadequate asthma control is determined by its phenotypic heterogeneity [15, 18]. The question of differentiation asthma phenotypes of childhood-determining the particular aspects of the disease and individual approaches to treatment is a major controversial problems in allergology [5]. Clinical phenotypes of asthma are heterogeneous; their formation depends on the genetic and environmental influences and is determined mostly by the interaction of cellular elements of the respiratory tract and immune system [19]. Currently phenotyping of disease occurs in the two areas: clinical, pathophysiological, molecular markers [12] and variants of response to therapy [21]. Since the asthma classification provides for atopic and nonatopic forms [7, 10, 14], it was expedient considered to analyze the indices, that reflect characteristic phenomenon of disease as bronchial hyperreactivity in these phenotypes, due to evidence-based medicine. The aim of the study was to evaluate the indicies of bronchial hyperresponsiveness and lability in school-age children with atopic and nonatopic asthma phenotypes. Materials and methods In pulmonary department of Regional Pediatric Clinical Hospital (Chernivtsi) under the principles of bioethics were examined 64 children, suffering from bronchial asthma. To identify the degree of atopy anamnestic atopic status and skin allergic tests were used. According to a survey 38 children with atopic asthma phenotype formed first clinical group (I), and the remaining 26 patients with nonatopic asthma joined the second (II) clinical group. For the main clinical features comparison group did not differ significantly. So, boys in I clinical group accounted for 28 (73,7 %), in the comparison group were 14 persons (53,9 %, pφ > 0,05), the rural population accounted for 60,5 % among children with atopic asthma phenotype and in the second clinical group were 73,1 % (19 patients, pφ > 0,05). The average age of representatives in I clinical group was (11,6 ± 0,55), in the comparison group of children was (12,0 ± 0,68) years (p > 0,05). Bronchial lability was determined according to recommendations [6, 8, 20] by assessing their response to dosed physical load (DFL) and short-acting β2-agonists inhalation (salbutamol 200 mcg) followed by calculating the index of bronchial lability as the sum of the components, such as index of bronchospasm (IBS) and bronchodilation (IBD). A positive bronchodilation answer was considered with indicators IDB more than 12 % [6]. Nonspecific bronchial hyperreactivity in schoolchildren with atopic and nonatopic phenotypes of bronchial asthma