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Asthma Control

Asthma control test reflects not only lung function but also airway inflammation in children with stable asthma

Woo Yeon LeeDepartment of Pediatrics, School of Medicine, The Catholic University of Korea, Bucheon St. Mary’s Hospital, Bucheon, Korea;

, MD,

Dong In SuhDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, Korea;

, MD, PhD,

Dae Jin SongDepartment of Pediatrics, Korea University College of Medicine, Seoul, Korea;

, MD, PhD,

Hey-Sung BaekDepartment of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea;

, MD, PhD,

Meeyong ShinDepartment of Pediatrics, Soonchunhyang University School of Medicine, Bucheon, Korea;

, MD, PhD,

Young YooDepartment of Pediatrics, Korea University Anam Hospital, Seoul, Korea;

, MD, PhD,

Ji-Won KwonDepartment of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea;

, MD, PhD,

Gwang Cheon JangDepartment of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, Korea;

, MD, PhD,

Hyeon-Jong YangDepartment of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea;

, MD, PhD,

Eun LeeDepartment of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea;

, MD, PhD,

Ju-Hee SeoDepartment of Pediatrics, Dankook University Hospital, Cheonan, Korea;

, MD, PhD,

Sung-Il WooDepartment of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea;

, MD, PhD,

Hyung Young KimDepartment of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea;

, MD, PhD,

Youn Ho ShinDepartment of Pediatrics, Gangnam CHA Medical Center CHA University School of Medicine, Seoul, Korea;

, MD, PhD,

Ju Suk LeeDepartment of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea;

, MD, PhD,

Jisun YoonDepartment of Pediatrics, Mediplex Sejong Hospital, Incheon, Korea;

, MD,

Sungsu JungDepartment of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;

, MD,

Minkyu HanDepartment of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea;

, PhD,

Eunjin EomDepartment of Statistics, Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea;

, MSc,

Jinho YuDepartment of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;

, MD, PhD,

Woo Kyung KimDepartment of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea;

, MD, PhD,

Dae Hyun LimDepartment of Pediatrics, School of Medicine, Inha University, Incheon, Korea;

, MD, PhD,

Jin Tack KimDepartment of Pediatrics, School of Medicine, The Catholic University of Korea, Uijeongbu St. Mary’s hospital, Uijeongbu, Korea;

, MD, PhD,

Woo-Sung ChangDivision of Allergy and Chronic Respiratory Diseases, Center for Biomedical Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Osong, Korea

, PhD,

Jeom-Kyu LeeDivision of Allergy and Chronic Respiratory Diseases, Center for Biomedical Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Osong, Korea

, PhD &

Hwan Soo KimDepartment of Pediatrics, School of Medicine, The Catholic University of Korea, Bucheon St. Mary’s Hospital, Bucheon, Korea; Correspondence[email protected]

http://orcid.org/0000-0002-5952-7849

, MD, PhD

show all

Abstract

Objective: Various numerical asthma control tools have been developed to distinguish different levels of symptom control. We aimed to examine whether the asthma control test (ACT) is reflective of objective findings such as lung function, fractional exhaled nitric oxide (FeNO) and laboratory data in patients with stable asthma.

Methods: We included patients who were enrolled in the Korean Childhood Asthma Study. ACT, spirometry, blood tests and FeNO were performed in patients after stabilization of their asthma. We examined differences among spirometry parameters, blood tests and FeNO according to control status as determined by ACT and investigated for any significant correlations.

Results: The study population consisted of 441 subjects. Spirometry showed that forced expiratory volume in one second (FEV₁), forced expiratory flow between 25% and 75% of forced vital capacity and FEV₁/forced vital capacity were all significantly higher in the controlled asthma group. Likewise, FeNO and percent-change in FEV₁ were both significantly lower in the controlled asthma group. In blood tests, the eosinophil fraction was significantly lower in the controlled asthma group while white blood cell count was significantly higher in the controlled asthma group. Lastly, among the various factors analyzed, only provocative concentration of methacholine causing a 20% fall in FEV₁ significantly correlated with ACT score.

Conclusion: ACT is useful as part of the routine evaluation of asthmatic children and should be used as a complement to existing tools such as spirometry and FeNO measurement.

Keywords:

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

This study was supported by a fund (2016-ER6703-00, 2019-ER6701-00) from the Research of Korea Centers for Disease Control and Prevention, Republic of Korea.

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Asthma control test reflects not only lung function but also airway inflammation in children with stable asthma

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Asthma control test reflects not only lung function but also airway inflammation in children with stable asthma

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