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Bronchial hyperresponsiveness: Reply

Bronchial hyperresponsiveness: Reply SIR, We have further analysed our data [1] to answer the question: 'Have asymptomatic subjects with positive skin tests to common allergens a higher degree of BHR than asymptomatic subjects with negative skin tests?', which has been raised by Professors D. Charpin and D. Vervolet, In our study sample of 2364 children, there were 1562 asymptomatic children (that is children with no reported history of wheeze, exercise wheeze or night cough) of whom 502 were atopic (that is had a positive skin-test reaction to one or more allergens) and 1060 were non-atopic. There was a significantly higher prevalence of bronchial hyperresponsiveness (BHR) (defined as a PD20 FEVi < 7-8 /imol) in the atopic group (15-7% vs 7 2%, /'<0-001). In the atopic group, 41% ofthe children with BHR had a PD20FEV1 < 3-9 /xmol and 14% had a PD20FEV1 < 0-8 /^mol. In the non-atopic group, 34% of the children with BHR had a PD2oFEVi<3-9 jumol and 7% had a PD2oFEVi<O8 ^mol. These differences between the groups were not significant. Thus, in asymptomatic children, those with atopy had significantly more BHR than those without atopy, but our data failed to show that children in the atopic group had more severe BHR. We conclude that, in the absence ofrespiratory symptoms, atopic children are more likely to have BHR.