Comparison of Non-Invasive Methods for Detecting Exercise-Induced Bronchoconstriction in Asthmatic Children
Monday, March 7, 2016
South Exhibit Hall H (Convention Center)
Heysung Baek, MD PhD, Kenji Izuhara, MD PhD, Man-Yong Han, MD, Sun-Hee Choi, MD, PhD, Youn Ho Shin, MD, Jung Won Yoon
Rationale: Non-invasive methods used to assess asthma include the measurement of fractional exhaled nitric oxide (FeNO), serum periostin levels, and the mannitol provocation test. Exercise-induced bronchoconstriction (EIB) is a distinct form of bronchial hyperresponsiveness (BHR), and is a cardinal feature of asthma. This study examined the utility of non-invasive methods in detecting EIB in asthmatic children.

Methods: The study enrolled 41 asthmatic children between 6 and 15 years old. We measured FeNO and serum periostin levels and performed pulmonary function tests at baseline and mannitol inhalation. An exercise bronchoprovocation test was used for EIB diagnosis, the results of which were considered positive with a 15% or greater decrease in forced expiratory volume in 1 second (FEV1) after exercise. 

Results: Twenty six (63.4%) subjects with asthma showed positive exercise challenge tests. The maximum decrease in %FEV1 after exercise was positively correlated with FeNO (r = 0.468, p = 0.008), the response–dose ratio (RDR) to mannitol (r = 361, p = 0.046), and serum periostin level (r = 0.373, p = 0.039) in asthmatics with EIB. To discriminate between asthmatics with and without EIB based on non-invasive methods, receiver operating characteristic curve analyses were performed. No significant difference was observed among the area under the curve values for FeNO, RDR to mannitol, or serum periostin levels.

Conclusions: FeNO levels, BHR to mannitol, and serum periostin levels were significantly correlated with maximum decreases in %FEV1 after exercise. No significant difference was observed regarding the diagnostic properties of these methods for detecting EIB in asthmatic children.