Bersuch E, et al. - It was postulated that allergen avoidance was predominantly responsible for the observed improvements in lung function and reduction of airways inflammation in adult asthmatic patients who attended rehabilitational programs at moderate altitude (1500m to 2500m). In this study, it was demonstrated that pulmonary conditions in asthmatic children and adolescents were improved as a result of inpatient rehabilitation at moderate altitude and this was independent of patients' sensitisation status to house dust mites (HDM) or pollen. A positive effect was also observed in patients without change in medication.

Methods

• Researchers analyzed spirometries of 344 and fractional exhaled nitric oxide measurements (FeNO) of 124 asthmatic children and adolescents, staying in a rehabilitation hospital in Davos (1590m) with at least 14 days between admission and discharge, in associations with atopic sensitisation (skin-prick testing and/or specific IgE), level of asthma control, and inhalative corticosteroid (ICS) dose.

Results

• Findings demonstrated that pulmonary conditions improved significantly on average during the sojourn.
• Researchers observed that uncontrolled asthmatics derived the most benefits, with an absolute increase of predicted FEV1, MEF25 and MEF75 of 7.7, 9.9 12.7%, respectively (p<0.001).
• A decline in FeNO by 36.9ppb, 26.9ppb, 11.8ppb, was noted for uncontrolled, partly-controlled and, controlled asthmatics, respectively.
• Data reported that pulmonary improvement was comparable between patients with and without house dust mites (HDM)-sensitisation, among uncontrolled subjects.
• It was also noted that pulmonary improvements of pollen sensitised patients were not dependent on the season of the sojourn.
• Additionally, 4.9% (p<0.001) absolute increase of FEV1 occurred with a decrease in FeNO by 32.7ppb (p<0.001) in the group with constant ICS level.
• Results also revealed that when the ICS dose was elevated by one GINA-level, the absolute increase of FEV1 was slightly higher (6.6%,p<0.001), with a FeNO decrease of 31.4ppb (p<0.001).