Source: Annual Congress 2002 - Regulation of responsiveness and inflammation in airway disease
Disease area: Airway diseases, Paediatric lung diseases

Abstract

The management of asthmatic children relies on monitoring symptoms and lung function. However, airway inflammation can be present in asthmatics who have normal lung function measurements. In order to control airway inflammation it would be important to have reliable measures of airway inflammation. Recently, the analysis of breath condensates was suggested as a possible new substrat for the monitoring of inflammatory markers in asthmatics. From earlier publication we know that allergen avoidance may improve allergic inflammation of the respiratory mucosa.
Forty-eight asthmatic children on regular anti-asthma treatment with a normal FEV₁ and positive skin prick test for house dust mites were recruited from an alpine clinic. They all used daily inhaled corticosteroids. Subjects were assessed on their arrival and departure. Spirometry, bronchial provocation tests and measurements of nitrites in breath condensates were performed.
Mean levels of nitrites were significantly higher before than after high altitude climate therapy (1.9 and 1.3μM; p=0.0081). In addition, bronchial hyperresponsiveness and MEF₅₀ significantly improved (p<0.001 and p=0.02). However, there was no difference between FEV₁ before and after therapy (p=0.2). There was a significant correlation between nitrites in breath condensates and bronchial hyperresponsiveness, MEF₅₀ as well as symptoms (r=0.41, p=0.004; r=-0.63, p<0.001 and r=0.47, p=0.0007).
We found a reduction in airways inflammation. In addition the measurement of nitrites may be a feasible method to objectively measure airway inflammation in asthmatic children in order to detect ongoing inflammation in children with normal FEV₁ but persistent symptoms.

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D. A. Straub, R. Ehmann, U. Frey, G. L. Hall, J. Hamacher, F. H. Sennhauser, J. H. Wildhaber (Zuerich and Bern, Switzerland). Correlation of breath condensates and lung function measurements in asthmatic children before and after high altitude climate therapy. Eur Respir J 2002; 20: Suppl. 38, 3159

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