Infant's Airway Responsiveness Predicts Asthma at 6 Years of Age

Abstract

Pulmonology| July 01 2001 Infant’s Airway Responsiveness Predicts Asthma at 6 Years of Age AAP Grand Rounds (2001) 6 (1): 9–10. https://doi.org/10.1542/gr.6-1-9 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Infant’s Airway Responsiveness Predicts Asthma at 6 Years of Age. AAP Grand Rounds July 2001; 6 (1): 9–10. https://doi.org/10.1542/gr.6-1-9 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: airway device, airway structure, asthma, histamine, wheezing Source: Palmer LJ, Rye PJ, Gibson NA, et al. Airway responsiveness in early infancy predicts asthma, lung function, and respiratory symptoms by school age. Am J Respir Crit Care Med. 2001;163:37–42. The purpose of this study by investigators at the University of Western Australia and the TVW Telethon Institute for Child Health Research in Perth, Australia, was to determine the relationship between airway hyper-responsiveness in healthy neonates at 1 month of age and the subsequent development of asthma, atopy, lower respiratory tract symptoms, and lung function at 6 years of age. The subjects were randomly recruited from a metropolitan hospital prior to birth between 1987 and 1991. Initial pulmonary function and histamine challenge were performed at approximately 1 month of age, prior to any lower respiratory tract infection or clinical illness. Of the initial 253 children, 120 could be contacted and all agreed to participate in follow-up studies on about their sixth birthday. Comparing the infants available for follow-up with those lost to follow-up identified no significant differences at 1 month of age for any parameters of interest. The infant pulmonary function testing was achieved by the rapid thoracic compression technique measuring maximal flow at functional residual capacity (VmaxFRC). The histamine challenge consisted of increasing doses of nebulized histamine from .125g/L to a maximum of 8.0g/L; the provocation concentration producing a 40% decrease in VmaxFRC was estimated from the log dose-response curve. Skin reactivity was assessed for dust mites, rye grass, cow’s milk and egg white. Pulmonary function testing at 6 years of age was done by conventional spirometry according to American Thoracic Society standards. Repeated pulmonary function testing after increasing nebulized doses of histamine was used to establish the dose-response slope to histamine challenge. Skin testing at this time included the same allergens as before in addition to mixed grass, cat and dog. Careful family histories for respiratory and allergic diseases were obtained at both data intervals. Generalized linear models were constructed to investigate the relationships between the histamine responsiveness at 1 month of age and the respiratory outcome at age 6 years. Of the 120 6-year-olds, 14.2% reported wheezing apart from colds, 35.0% reported wheezing with colds, 25.8% had a usual cough and 32.5% had current or previous physician-diagnosed asthma. The histamine sensitivity at 1 month of age was significantly associated with physician-diagnosed asthma (ever) (P=.003), physician-diagnosed current asthma (P<.001), wheeze with colds (P=.003), wheeze apart from colds (P<.001), and usual cough (P=.05). The subjects with the greatest response to histamine at both 1 month and 6 years of age had the lowest forced expiratory volume at 1 second (FEV1) at 6 years of age. There was no significant association between the histamine sensitivity at 1 month and the atopy-associated factors such as eosinophil count, total serum IgE, and positive skin test reactivity assessed at 6 years of age. The authors conclude from this data that airway... You do not currently have access to this content.