ABSTRACT
OBJECTIVE: Introduction: Severe asthma phenotype is characterized by peculiarities of inflammatory process in the airways and consequently hypersensitivity and bronchial lability. The aim: The study aims at determining the diagnostic value of bronchial lability indices in identifying severe bronchial asthma phenotype compared to the moderate variant of disease in schoolchildren. PATIENTS AND METHODS: Materials and methods: We formed two clinical groups of observation, the first clinical group included 57 children with severe asthma phenotype, the second clinical group included 65 patients with moderate disease course. Bronchial lability was determined by evaluating their response to dosed physical activity (bronchospasm index) and shortacting ß2-agonist inhalation (200 mcg of salbutamol - bronchodilation index). RESULTS: Results: Despite the lack of probable differences in average bronchospasm index in children of comparison groups, patients with severe bronchial asthma tended to more pronounced bronchospasm after dosed physical activity. Pronounced bronchospasm after physical activity (bronchospasm index >20%) is characteristic for children with severe disease persistence. Significantly higher bronchodilation index and severe bronchodilation reaction (bronchodilation index >25%) was determined in children of the first clinical group. Statistical analysis showed that all bronchial lability indices at these distribution points in confirming severe bronchial asthma proved to be highly specific, but low-sensitive with insufficient likelihood ratio. CONCLUSION: Conclusions: So, the use of bronchial lability indices for screening of severe asthma phenotype is justified only in combination with other parameters reflecting the characteristic phenomena of disease because of the large proportion of false negative results and insufficient likelihood ratio.
