Chapter 4 Objective evaluation of asthma

Abstract

Following the Japanese Pediatric Guideline for the Treatment and Management of Asthma: JPGL 2020, Chapter 4 in JPGL2023 described the objective tests required for the diagnosis and treatment of pediatric bronchial asthma. The evaluation of the Th2-type response, which is the basic immune abnormality in asthma, is discussed, including serum total IgE level, peripheral blood eosinophil count, allergen-specific IgE antibodies and skin prick test. Practically, evaluation of respiratory function [including spirometry, oscillometry and bronchial hyperresponsiveness test] and fractional exhaled nitric oxide (FeNO) measurement, which are important for diagnosis of asthma, evaluation of severity and therapeutic effect, are described in detail. Since spirometry is the most important test, the principle of measurement, the interpretation of results and the points to be noted in the pediatric patients are explained. Other techniques for evaluation of airway condition and airway inflammation are also introduced.