The relationship between atopy and non-specific bronchial responsiveness


Dr D. J. Hendrick. Chest Clinic, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE, U.K.


Atopy is often regarded as a risk factor for the development of asthma, particularly childhood asthma and occupational asthma. This could reflect an association with nonspecific bronchial responsiveness (NSBR), though atopy could influence asthma independently. We have evaluated the possible relationship between atopy and NSBR (PD20FEV1 to methacholine) in the siblings of 59 probands with atopic asthma. Thirty-four (58%) were atopic (geqslant R: gt-or-equal, slanted 1 prick test with weal diameter geqslant R: gt-or-equal, slanted that of a 0.1% histamine control) and 28 (47%) showed NSBR. Atopy and NSBR occurred together more frequently than would be expected by chance (P<0.05); both variables being observed in 20 subjects, neither in 17, and only one in 22. A significant association was also noted when atopy was defined by a serum total IgE > 150IU (or >50IU), but when atopy was defined by other commonly used criteria (geqslant R: gt-or-equal, slanted 2 prick tests with weal diameter geqslant R: gt-or-equal, slanted histamine control; or weal diameter 2 mm or more > than a saline control), no significant association was demonstrated. Furthermore, linear logistic regression and multiple regression analyses showed that both the presence and the degree of NSBR were influenced much more by the baseline level of FEV1 than by atopic status. At best, atopy accounted for 10% of the variance of the PD20 measurements. We conclude that atopy is associated with NSBR but not strongly; that the relationship may be readily obscured according to the defining criteria used for atopy: and that atopy should not be used as a marker for NSBR.