Asymptomatic airway hyperresponsiveness: what does it mean?

Abstract

To the Editors: I read with interest the study by van den Nieuwenhof et al. 1, which appeared in a recent issue of the European Respiratory Journal . The study’s conclusion is certainly of interest: screening for asymptomatic airway hyperresponsiveness (AHR) in adolescents does not identify subjects at risk of developing asthma, whilst the presence of allergy is a risk factor for asthma. However, the observations leading to this statement should be interpreted with caution. I agree with the authors that AHR may be variable. It can improve significantly at adolescence, the period associated with the highest incidence of asthma remission. The situation seems different in adults, however. In some subjects, AHR may reflect a previous “insult” to the airways, either of infectious, toxic or allergic origin, or it could be the consequence …