METHACHOLINE AND ADENOSINE 5’-MONOPHOSPHATE CHALLENGES IN PRESCHOOL CHILDREN WITH
description
Transcript of METHACHOLINE AND ADENOSINE 5’-MONOPHOSPHATE CHALLENGES IN PRESCHOOL CHILDREN WITH
METHACHOLINE AND ADENOSINE 5’-MONOPHOSPHATE
CHALLENGES IN PRESCHOOL CHILDREN WITH
COUGH-VARIANT AND CLASSIC ASTHMA
Gazi University Faculty of MedicineDepartment of Pediatric Allergy and Asthma
ADENOSINE 5’-MONOPHOSPHATE (AMP)
Effector cell: mast cell
Indirect bronchoconstrictor
PC20Adenosine: related with airway inflammation in asthma More sensitive than methacholine in monitoring response to asthma treatment
PC20Methacholine: related with structural changes in asthma
JACI 2006;118(3): 551
BACKGROUND
In school children and adults CVA is not different fromclassic asthma concerning the methacholine responsiveness, airway inflammation and remodelling
No study has compared AMP responsiveness betweenCVA and classic asthma in any age group
Bronchial challenge with different stimuli provides
different information and may be used as an adjunct to
understand the pathophysiology of cough variant asthma
(CVA) in young children in whom the mechanism of
disease is still unresolved.
AIM
Coughvariant asthma
n=18
Classicasthma
n=31Control
n=10
Parental asthma, n (%) 5 (27.7) 8 (25.8) 0 (0)
Atopy (SPT) n (%) 7 (38.8) 16 (51.6) 0 (0)
IgE, ıu/ml 43.7 41.9 27.6
Eosinophil, /mm3 196.5 292 142
Methac. responsiveness, n (%) 18 (100) 31 (100) 1 (10)
PC15PtcO2 met (mg/ml ) 0.52 0.45 27.40
AMP responsiveness, n (%) 7 (38.9) 21 (67.7) 0 (0)
PC15PtcO2AMP (mg/ml ) 234.58 36.35 Hepsi >400
METHACHOLINEMETHACHOLINE
Calssic asthmaCoughVariant asthma
Control
PC15P
tcO
2Met
hach
olin
e (m
g/m
l)
AMPAMP
Control
PC15P
tcO
2AM
P (m
g/m
l)
CoughVariant asthma
Calssic asthma
CONCLUSION
Pre-school children with CVA were found to differ from
children with classic persistent asthma with regard to
response profiles to AMP challenge which may point to
different pathophysiologic mechanisms of CVA in the young
age group.
Ped Pulmonol 2007; 42: 973