Are asymptomatic airway hyperresponsiveness and allergy risk factors for asthma? A longitudinal study

Abstract

To the Editors: We read with interest the recent paper by van den Nieuwenhof et al. 1 who reported no statistically significant association of airway hyperresponsiveness (AHR) with asthma incidence over 14 yrs in 123 asymptomatic adolescents aged 10–22 yrs at baseline. They concluded that AHR is not a risk factor for the development of asthma in adulthood and that screening for AHR in adolescents to detect subjects at risk for asthma cannot be recommended. We similarly assessed the association between AHR at baseline and asthma incidence over 11.4 yrs among 172 asymptomatic children (44.2% with AHR (provocative dose causing a 20% fall in forced expiratory volume in one second <4 mg methacholine) at baseline) and 517 adults (31.7% with AHR at baseline) from the Epidemiological Study on the Genetics and Environment of Asthma (EGEA) 2, 3. Asymptomatic adults were defined as those with a null symptomatic score according to Pekkanen et al. 4 over the previous 12 months. The score is based on asthma-like symptoms (wheeze with breathlessness, woken with chest tightness, attack of shortness of breath (SOB) at rest, attack of SOB after …