Monitoring asthma in childhood: lung function, bronchial responsiveness and inflammation

Alexander Moeller, Kai-Hakon Carlsen, Peter D Sly, Eugenio Baraldi, Giorgio Piacentini, Ian Pavord, Christiane Lex, Sejal Saglani, ERS Task Force Monitoring Asthma in Children, Alexander Moeller, Kai-Hakon Carlsen, Peter D Sly, Eugenio Baraldi, Giorgio Piacentini, Ian Pavord, Christiane Lex, Sejal Saglani, Paul L P Brand, Ernest Eber, Thomas Frischer, Gunilla Hedlin, Neeta Kulkarni, Karin C Lødrup Carlsen, Mika J Mäkelä, Mariëlle W Pijnenburg, David Price, Bart L Rottier, Stanley J Szefler, Steve Turner, Alexander Moeller, Kai-Hakon Carlsen, Peter D Sly, Eugenio Baraldi, Giorgio Piacentini, Ian Pavord, Christiane Lex, Sejal Saglani, ERS Task Force Monitoring Asthma in Children, Alexander Moeller, Kai-Hakon Carlsen, Peter D Sly, Eugenio Baraldi, Giorgio Piacentini, Ian Pavord, Christiane Lex, Sejal Saglani, Paul L P Brand, Ernest Eber, Thomas Frischer, Gunilla Hedlin, Neeta Kulkarni, Karin C Lødrup Carlsen, Mika J Mäkelä, Mariëlle W Pijnenburg, David Price, Bart L Rottier, Stanley J Szefler, Steve Turner

Abstract

This review focuses on the methods available for measuring reversible airways obstruction, bronchial hyperresponsiveness (BHR) and inflammation as hallmarks of asthma, and their role in monitoring children with asthma. Persistent bronchial obstruction may occur in asymptomatic children and is considered a risk factor for severe asthma episodes and is associated with poor asthma outcome. Annual measurement of forced expiratory volume in 1 s using office based spirometry is considered useful. Other lung function measurements including the assessment of BHR may be reserved for children with possible exercise limitations, poor symptom perception and those not responding to their current treatment or with atypical asthma symptoms, and performed on a higher specialty level. To date, for most methods of measuring lung function there are no proper randomised controlled or large longitudinal studies available to establish their role in asthma management in children. Noninvasive biomarkers for monitoring inflammation in children are available, for example the measurement of exhaled nitric oxide fraction, and the assessment of induced sputum cytology or inflammatory mediators in the exhaled breath condensate. However, their role and usefulness in routine clinical practice to monitor and guide therapy remains unclear, and therefore, their use should be reserved for selected cases.

Conflict of interest statement

Conflict of interest: Disclosures can be found alongside the online version of this article at err.ersjournals.com

Copyright ©ERS 2015.

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Source: PubMed

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