Introduction. Bronchial hyperresponsiveness (BHR) is a factor in predicting
bronchial asthma independently of inflammation markers. Objective. The aims
were to determine the frequency and important predictive facts of BHR and the
effect of prophylaxis by Global Initiative for Asthma (GINA) and National
Asthma Education and Prevention Program (NAEPP) on BHR in asthmatic children.
Methods. BHR in 106 children was evaluated by the bronchoprovocation test
with methacholine. Results. The prevalence rate of symptomatic BHR is 18% for
crucial point of PC20=4.1?3.03 mg/ml and PD20=3.22?2.59 ?mol methacholine. On
average asthmatic children express moderate BHR, which persists even two
years after administering prophylaxis. After two years bronchial reactivity
is significantly smaller, the change of FEV1 is significantly smaller, the
velocity of change of slope dose response curve (sDRC) is faster and the
provocative concentration of methacholine that causes wheezing is 2-3 times
lower. A mild sDRC shows milder bronchoconstriction after two years. The fast
change of bronchial reactivity in 41% of asthmatic children is contributed to
aero-pollution with sulfur dioxide and/ or, possible insufficient and/or
inadequate treatment during two years of administering prophylaxis. A
simultaneous effect of allergens from home environment and grass and tree
pollens and of excessive aero-pollution on children?s airways is important in
the onset of symptomatic BHR. After two years of treatment by GINA and NAEPP
children do not show asthma symptoms or show mild asthma symptoms, however
bronchial sensitivity remains unchanged. Conclusion. Optimal duration of
anti-inflammatory treatment in asthmatic children who show moderate bronchial
hyperresponsiveness should be longer than two years.
Objective test for food sensitivity in asthmatic children: increased bronchial reactivity after cola drinks.
