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首页> 外文期刊>The Internet Journal of Asthma, Allergy and Immunology >The relationship between FEF25-75 and skin test sensitization, nasal inflammation, and bronchial hyperreactivity in young subjects without asthma
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The relationship between FEF25-75 and skin test sensitization, nasal inflammation, and bronchial hyperreactivity in young subjects without asthma

机译：FEF25-75与年轻哮喘患者的皮肤测试敏感性，鼻炎症和支气管高反应性之间的关系

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Background: A close link exists between allergic rhinitis and asthma. Small airway disease (SAD), defined by a reduction in FEF25-75 and normal spirometry (normal FEV1, FVC, and FEV1/FVC ratio), may be a marker for early allergic or inflammatory involvement of the small airways in subjects with allergic diseases and no asthma. Objectives: The aim of the present study was to determine if there is a relationship with SAD, the outcome variable, and several allergic predictors in patients without asthma but with allergic disease. Study Design: Cross-sectional.Methods: Two-hundred eleven midshipmen attending the third and fifth course of Navy Academy of Livorno were screened. Fifty-eight showed slight spirometric anomalies. Thus, they were referred to Navy Hospital of La Spezia for standardized tests: skin prick test, nasal cytology, spirometry, and methacholine bronchial challenge. A reduced FEF25-75 was defined as less than 80% of predicted.Results: All 58 subjects had a normal FEV1, FVC, and FEV1/FVC ratio. Twenty subjects had a reduced FEF25-75 consistent with the definition of SAD. A mean value of FEF25-75 of 70.3 (SD 8.5) was measured in patients with a reduced FEF, while it was 108.0 (SD 14.3) in those with preserved FEF25-75. All the candidate allergic predictors appeared to be strongly associated with a reduced FEF25-75. The proportion of subjects with reduced FEF25-75 appeared to increase with increasing severity of the allergic predictors, and correspondingly the mean value of FEF25-75 appeared to decrease.Conclusions: The FEF25-75 value may be envisioned as a possible marker of SAD in atopic subjects. Moreover, this study supports the link between upper and lower airways in sensitized subjects. Introduction Despite the fact that asthma prevalence is increasing worldwide (1), asthma is still underdiagnosed, especially in children and young adults (2,3). A close association between allergic rhinitis and asthma has been reported (4). Moreover, allergic rhinitis has been demonstrated to be a strong risk factor for the onset of asthma in adults (5). Asthma is characterized by a reversible airflow obstruction and small airways are involved in the pathogenesis of asthma (6). The forced expiratory flow at the 25 and 75% of the pulmonary volume (FEF25-75) might be considered as a measure of the caliber concerning distal airways, particularly in subjects with normal FEV1 (7). Thus, FEF25-75 may be envisioned as a possible marker of early bronchial impairment, as recently described by ourselves in patients with allergic rhinitis alone (8,9,10). Therefore, small airways disease (SAD) as defined by a reduction in FEF25-75 and normal spirometry (normal FEV1 and FVC) may be a marker for early allergic or inflammatory involvement of the small airways in subjects with allergic disease and no asthma. On the other hand, bronchial hyperreactivity (BHR) is a paramount feature of asthma and may be observed in a high proportion of rhinitics, sensitized to perennial allergens (9), pollens (10), or both (8). In addition, Th2-dependent cytokines and eosinophilic inflammation are related to nasal and bronchial airflow impairment in rhinitics (11,12).The aim of the present study was determine if there was a relationship between SAD, the outcome variable, and allergic predictors in healthy as Naval conscripts without asthma but with allergic disease. Materials and Methods Study design: The study included all the midshipmen attending the third and fifth course of Navy Academy of Livorno. All of them were, of course, healthy subjects, continuously trained and checked. All of them had to carry out specialistic examinations, including spirometry, to obtain the fitness for attending specific courses (e.g. for pilot, frogman, diver, submariner, etc.). The Review Board approved the study and an informed consent was obtained from each subject. Subjects: Fifty eight midshipmen (out of 211) with slight spirometric abnormalities were referred to the Navy Hosp
机译：背景：过敏性鼻炎和哮喘之间存在密切联系。小气道疾病（SAD）（定义为FEF25-75降低和肺活量正常（正常FEV1，FVC和FEV1 / FVC比值）定义）可能是小气道在过敏性疾病患者中早期过敏或发炎的标志而且没有哮喘。目的：本研究的目的是确定在没有哮喘但有过敏性疾病的患者中，是否与SAD，结果变量和几种过敏预测因子有关。研究设计：横断面方法：筛选参加里窝那海军学院第三和第五课程的211名中尉。 58例显示轻微的肺活量异常。因此，他们被转至拉斯佩齐亚海军医院接受标准化测试：皮肤点刺测试，鼻细胞学，肺活量测定法和乙酰甲胆碱支气管激发试验。 FEF25-75的降低被定义为低于预期的80％。结果：所有58名受试者的FEV1，FVC和FEV1 / FVC比率均正常。 20名受试者的SAF定义降低了FEF25-75。 FEF降低的患者的FEF25-75平均值为70.3（SD 8.5），而FEF25-75保留的患者为10​​8.0（SD 14.3）。所有候选变态反应预测因子似乎都与FEF25-75降低密切相关。 FEF25-75降低的受试者比例似乎随着变态反应预测因子的严重程度的增加而增加，相应地，FEF25-75的平均值也随之降低。结论：FEF25-75值可作为可能的SAD标志。特应性科目。此外，这项研究支持了敏感人群上呼吸道和下呼吸道之间的联系。引言尽管全世界范围内的哮喘患病率都在增加（1），但仍未充分诊断出哮喘，特别是在儿童和年轻人中（2,3）。过敏性鼻炎和哮喘之间有密切的联系（4）。此外，已证明变应性鼻炎是成人哮喘发作的重要危险因素（5）。哮喘的特征是可逆性气流阻塞，哮喘的发病机制涉及小气道（6）。在肺部容积的25％和75％（FEF25-75）处的强制呼气流量可能被认为是有关远端气道的口径的量度，特别是在FEV1正常的受试者中（7）。因此，正如我们自己最近在单独的过敏性鼻炎患者中所描述的那样，FEF25-75可能被认为是早期支气管损伤的可能标志物（8,9,10）。因此，FEF25-75降低和肺活量测定正常（FEV1和FVC正常）所定义的小气道疾病（SAD）可能是过敏性疾病且无哮喘患者小气道早期过敏或发炎的标志。另一方面，支气管高反应性（BHR）是哮喘的重要特征，可能在对常年性变应原（9），花粉（10）或二者兼有（8）敏感的大量鼻炎患者中观察到。此外，鼻炎患者Th2依赖的细胞因子和嗜酸性粒细胞炎症与鼻和支气管气流障碍有关（11,12）。本研究的目的是确定SAD，结局变量和过敏预测因素之间是否存在相关性。海军应征者一样健康，没有哮喘，但患有过敏性疾病。材料和方法研究设计：研究包括参加里窝那海军学院第三和第五课程的所有中士。当然，所有这些人都是健康的受试者，需要接受持续的培训和检查。为了获得参加特定课程（例如飞行员，蛙人，潜水员，潜水员等）的适应性，他们所有人都必须进行包括肺活量测定在内的专门检查。审查委员会批准了该研究，并获得了每个受试者的知情同意。受试者：轻微肺活量异常的58名中尉（211名中尉）被转诊至海军医院

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