Respiratory symptoms, bronchial hyper-responsiveness, and eosinophilic airway inflammation in patients with moderate-to-severe atopic dermatitis
Article first published online: 20 JAN 2006
Clinical & Experimental Allergy
Volume 36, Issue 2, pages 192–197, February 2006
How to Cite
Kyllönen, H., Malmberg, P., Remitz, A., Rytilä, P., Metso, T., Helenius, I., Haahtela, T. and Reitamo, S. (2006), Respiratory symptoms, bronchial hyper-responsiveness, and eosinophilic airway inflammation in patients with moderate-to-severe atopic dermatitis. Clinical & Experimental Allergy, 36: 192–197. doi: 10.1111/j.1365-2222.2006.02419.x
- Issue published online: 20 JAN 2006
- Article first published online: 20 JAN 2006
- Submitted 24 November 2004; revised 31 July 2005; accepted 17 October 2005
- allergic rhinitis;
- atopic dermatitis;
- brochial hyper-responsiveness;
- serum immunoglobin E;
- skin prick tests;
- sputum eosinophilia
Background Patients with atopic dermatitis (AD) often have symptoms suggestive of asthma or rhinitis. The prevalence and signs of respiratory disease in AD patients have been studied to a limited extent.
Objectives To assess the prevalence and clustering of respiratory symptoms, bronchial hyper-responsiveness (BHR), and eosinophilic airway inflammation in patients with moderate-to-severe AD.
Methods Eighty-six consecutive patients with moderate-to-severe AD and 49 randomly selected control subjects without AD were studied by questionnaire, flow volume spirometry, histamine challenge to detect BHR, induced sputum test to detect eosinophilic airway inflammation, and skin prick tests (SPTs) and total serum immunoglobulin (Ig)E measurements to detect atopy.
Results The patients with AD showed increased risk of physician-diagnosed asthma (36% vs. 2%, odds ratio (OR) 10.1, confidence interval (CI) 1.3–79.7, P=0.03), physician-diagnosed allergic rhinitis (AR) (45% vs. 6%, OR 4.5, CI 1.2–16.7, P=0.02), BHR (51% vs. 10%, OR 5.5, CI 1.5–20.1, P=0.01), and sputum eosinophilia (81% vs. 11%, OR 76.1, CI 9.3-623.5, P<0.0001) compared with the control subjects. In AD patients, elevated s-IgE and positive SPTs were associated with the occurrence of physician-diagnosed asthma and AR, BHR, and the presence of sputum eosinophilia.
Conclusions BHR and eosinophilic airway inflammation are more common in patients with AD than in control subjects. The highest prevalences were seen in patients with AD who were SPT positive and had high IgE levels. Longitudinal studies are needed to assess the outcome of patients with signs of airway disease, in order to identify those who need early initiation of asthma treatment.