RATIONALE: The aim of the study was to investigate if and how the quality of life (QoL) is influenced by asthma severity and bronchial inflammation measured with objective markers in school children.METHODS: We studied 45 patients with severe asthma having recurrent symptoms, treated with ≥800 microgram inhaled Budesonide or equivalent and 20 matched children having mild/moderate asthma with symptom control by 100-400 microgram Budesonide or equivalent. The age rang was 6 to 18 years (mean = 13,7yy. female = 22), all skin prick tested (SPT) and 40 showed sensitization to aeroallergens by one or more allergens ≥3 mm positive SPT. Paediatric Asthma Quality of Life Questionnaire (PAQLQ(S)) and Asthma Control Test (ACT) were used to evaluate self reported QoL and asthma control. Exhaled nitric oxide (FENO); total number of blood Eosinophils; forced expiratory volume in one second (FEV1); and bronchial hyper-responsiveness (BHR) using methacholine challenge were measured. Non parametric tests were applied to evaluate differences between groups and correlations (SPSS 16.0 software).RESULTS: Children with severe asthma had poorer self reported quality of life and asthma control than mild/moderate asthmatics (p = <0,001). There were significant correlations between PAQLQ(S) and ACT (r = 0,701∗∗p = 0,01), FENO (r = -0,260∗p = 0,05) and FEV1 (r = 0,265∗p = 0,05). PAQLQ(S) also correlated with blood eosinophils (r = -0,396∗p = 0,05) but only in allergic sensitised children. BHR showed no correlation to PAQLQ(S).CONCLUSIONS: In asthmatic children, there seems to be a relationship between self-reported QoL and the severity of bronchial inflammation and asthma. This supports the usefulness of combining subjective and objective measures in paediatric asthma management. RATIONALE: The aim of the study was to investigate if and how the quality of life (QoL) is influenced by asthma severity and bronchial inflammation measured with objective markers in school children. METHODS: We studied 45 patients with severe asthma having recurrent symptoms, treated with ≥800 microgram inhaled Budesonide or equivalent and 20 matched children having mild/moderate asthma with symptom control by 100-400 microgram Budesonide or equivalent. The age rang was 6 to 18 years (mean = 13,7yy. female = 22), all skin prick tested (SPT) and 40 showed sensitization to aeroallergens by one or more allergens ≥3 mm positive SPT. Paediatric Asthma Quality of Life Questionnaire (PAQLQ(S)) and Asthma Control Test (ACT) were used to evaluate self reported QoL and asthma control. Exhaled nitric oxide (FENO); total number of blood Eosinophils; forced expiratory volume in one second (FEV1); and bronchial hyper-responsiveness (BHR) using methacholine challenge were measured. Non parametric tests were applied to evaluate differences between groups and correlations (SPSS 16.0 software). RESULTS: Children with severe asthma had poorer self reported quality of life and asthma control than mild/moderate asthmatics (p = <0,001). There were significant correlations between PAQLQ(S) and ACT (r = 0,701∗∗p = 0,01), FENO (r = -0,260∗p = 0,05) and FEV1 (r = 0,265∗p = 0,05). PAQLQ(S) also correlated with blood eosinophils (r = -0,396∗p = 0,05) but only in allergic sensitised children. BHR showed no correlation to PAQLQ(S). CONCLUSIONS: In asthmatic children, there seems to be a relationship between self-reported QoL and the severity of bronchial inflammation and asthma. This supports the usefulness of combining subjective and objective measures in paediatric asthma management.