Background Allergen sensitization and airway hyperresponsiveness (AHR) are the most important characteristics of bronchial asthma and their correlation has been speculated. Objective We attempted to investigate the relationship between sensitization to allergens and AHR to methacholine in Korean high school students. Methods A questionnaire survey, methacholine bronchial provocation tests, and skin-prick tests for 16 major allergens were performed on 724 students. The mean age of participants was 15.79±0.40 years old. Serum total immunoglobulin E (IgE) and the fraction of blood eosinophils were measured. Results AHR (PC20<16mg/ml) was present in 12.3%. Log total IgE was higher in AHR-positive group than negative group (4.22±1.55, 3.70±1.33, Pa=0.001). Three hundred eighty-four students (53.0%) were sensitized to more than one allergen, and among them Dermatophagoides pteronyssinus (Der p, 295 students, 40.7%) and Dermatophagoides farinae (Der f, 301 students, 41.6%) were most common. The risk of AHR development was high in the group who had sensitization to one allergen (adjusted odds ratio [aOR]a=1.97, 95% confidence interval [CI]: 1.13-3.44, Pa=0.018) and to more than two allergens (aORa=2.94, 95% CI: 1.32-6.57, Pa=0.009). Among the specific allergens, AHR was developed in those who were sensitized to Der f (aORa=1.73, 95% CI: 1.04-2.86, Pa=0.033), dog dander (aORa=3.97, 95% CI: 1.67-9.51, Pa=0.002), and Alternaria (aORa=3.19, 95% CI: 1.24-6.41, Pa=0.016). In the groups with high IgE (>300IU/ml) and high eosinophil fraction (>4%), AHR was more developed than groups who were low in each (aORa=2.73, 95% CI: 1.15-6.51, Pa=0.023; aORa=10.82, 95% CI: 3.33-35.08, Pa=0.001). Conclusion The risk of AHR development was closely linked with allergen sensitization itself, and the number or types of sensitized allergens such as indoor and fungal allergens in Korean young adolescents.
- airway hyperresponsiveness