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Thorax. 1986 April; 41(4): 283–289.
PMCID: PMC460311

Prevalence of bronchial reactivity to inhaled methacholine in New Zealand children.


The prevalence of bronchial hyperreactivity to inhaled methacholine and of a clinical history of symptoms of asthma was determined in a birth cohort of 9 year old New Zealand children. A history of current or previous recurrent wheezing was obtained in 220 of 815 children. Of 800 who had spirometric tests, 27 (3.4%) had resting airflow obstruction (FEV1/FVC less than 75%). Methacholine challenge was undertaken without problem in 766 children, the abbreviated protocol being based on five breaths and four concentrations. A fall in FEV1 of more than 20% was observed in 176 children (23% of challenges, 22% of the full cohort) after inhalation of methacholine in concentrations of up to 25 mg/ml. The prevalence of bronchial reactivity in children with symptoms was related to the frequency of wheezing episodes in the last year, and the degree of reactivity to the interval since the last episode. Sixty four children (8.0%) with no history of wheeze or recurrent dry cough were, however, also responsive to methacholine 25 mg/ml or less, while 35% of children with current or previous wheezing did not respond to any dose of methacholine. Bronchial challenge by methacholine inhalation was not sufficiently sensitive or specific to be useful as a major criterion for the diagnosis of asthma in epidemiological studies. The occurrence of airway reactivity in children without symptoms of asthma, however, raises the possibility that adult onset asthma and the development of airways obstruction in some subjects with chronic bronchitis could have origins in childhood.

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Selected References

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  • Sears MR, Jones DT, Silva PA, Simpson A, Williams SM. Asthma in seven year old children: a report from the Dunedin Multidisciplinary Child Development Study. N Z Med J. 1982 Aug 11;95(713):533–536. [PubMed]
  • Speight AN, Lee DA, Hey EN. Underdiagnosis and undertreatment of asthma in childhood. Br Med J (Clin Res Ed) 1983 Apr 16;286(6373):1253–1256. [PMC free article] [PubMed]
  • König P. Hidden asthma in childhood. Am J Dis Child. 1981 Nov;135(11):1053–1055. [PubMed]
  • Milne GA. The incidence of asthma in Lower Hutt. N Z Med J. 1969 Jul;70(446):27–29. [PubMed]
  • Anyon CP, Kiddle GB. The prevalence of wheezy children in Lower Hutt. N Z Med J. 1974 Apr 10;79(512):822–823. [PubMed]
  • McQueen F, Holdaway MD, Sears MR. A study of asthma in a Dunedin suburban area. N Z Med J. 1979 May 9;89(635):335–338. [PubMed]
  • Stanhope JM, Rees RO, Mangan AJ. Asthma and wheeze in New Zealand adolescents. N Z Med J. 1979 Oct 10;90(645):279–282. [PubMed]
  • Williams H, McNicol KN. Prevalence, natural history, and relationship of wheezy bronchitis and asthma in children. An epidemiological study. Br Med J. 1969 Nov 8;4(5679):321–325. [PMC free article] [PubMed]
  • Mcnicol KN, Macnicol KN, Williams HB. Spectrum of asthma in children. I. Clinical and physiological components. Br Med J. 1973 Oct 6;4(5883):7–11. [PMC free article] [PubMed]
  • Dodge RR, Burrows B. The prevalence and incidence of asthma and asthma-like symptoms in a general population sample. Am Rev Respir Dis. 1980 Oct;122(4):567–575. [PubMed]
  • Kiviloog J. Bronchial reactivity to exercise and metacholine in bronchial asthma. Scand J Respir Dis. 1973;54(6):347–358. [PubMed]
  • Juniper EF, Frith PA, Dunnett C, Cockcroft DW, Hargreave FE. Reproducibility and comparison of responses to inhaled histamine and methacholine. Thorax. 1978 Dec;33(6):705–710. [PMC free article] [PubMed]
  • Spector SL, Farr RS. A comparison of methacholine and histamine inhalations in asthmatics. J Allergy Clin Immunol. 1975 Oct;56(4):308–316. [PubMed]
  • Eggleston PA. A comparison of the asthmatic response to methacholine and exercise. J Allergy Clin Immunol. 1979 Feb;63(2):104–110. [PubMed]
  • Kiviloog J. Variability of bronchial reactivity to exercise and metacholine in bronchial asthma. Scand J Respir Dis. 1973;54(6):359–368. [PubMed]
  • Lee DA, Winslow NR, Speight AN, Hey EN. Prevalence and spectrum of asthma in childhood. Br Med J (Clin Res Ed) 1983 Apr 16;286(6373):1256–1258. [PMC free article] [PubMed]
  • HELLIESEN PJ, COOK CD, FRIEDLANDER L, AGATHON S. Studies of respiratory physiology in children. I. Mechanics of respiration and lung volumes in 85 normal children 5 to 17 years of age. Pediatrics. 1958 Jul;22(1 Pt 1):80–93. [PubMed]
  • Chai H, Farr RS, Froehlich LA, Mathison DA, McLean JA, Rosenthal RR, Sheffer AL, Spector SL, Townley RG. Standardization of bronchial inhalation challenge procedures. J Allergy Clin Immunol. 1975 Oct;56(4):323–327. [PubMed]
  • Hargreave FE, Ryan G, Thomson NC, O'Byrne PM, Latimer K, Juniper EF, Dolovich J. Bronchial responsiveness to histamine or methacholine in asthma: measurement and clinical significance. J Allergy Clin Immunol. 1981 Nov;68(5):347–355. [PubMed]
  • Chatham M, Bleecker ER, Norman P, Smith PL, Mason P. A screening test for airways reactivity. An abbreviated methacholine inhalation challenge. Chest. 1982 Jul;82(1):15–18. [PubMed]
  • Aquilina AT, Hall WJ, Douglas RG, Jr, Utell MJ. Airway reactivity in subjects with viral upper respiratory tract infections: the effects of exercise and cold air. Am Rev Respir Dis. 1980 Jul;122(1):3–10. [PubMed]
  • Empey DW, Laitinen LA, Jacobs L, Gold WM, Nadel JA. Mechanisms of bronchial hyperreactivity in normal subjects after upper respiratory tract infection. Am Rev Respir Dis. 1976 Feb;113(2):131–139. [PubMed]
  • Spector SL, Staudenmayer H, Kinsman RA, Fukuhara J, Westmoreland C. Methacholine and histamine inhalation challenges in asthma: relationships to age of onset, length of illness, and pulmonary functions. Allergy. 1979 Jun;34(3):167–173. [PubMed]
  • Ryan G, Latimer KM, Dolovich J, Hargreave FE. Bronchial responsiveness to histamine: relationship to diurnal variation of peak flow rate, improvement after bronchodilator, and airway calibre. Thorax. 1982 Jun;37(6):423–429. [PMC free article] [PubMed]
  • Simonsson BG. Clinical implications of bronchial hyperreactivity. Eur J Respir Dis Suppl. 1980;106:7–18. [PubMed]
  • Ramsdell JW, Nachtwey FJ, Moser KM. Bronchial hyperreactivity in chronic obstructive bronchitis. Am Rev Respir Dis. 1982 Nov;126(5):829–832. [PubMed]

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