Lung Function In Adolescents Research Articles

Palivizumab Following Extremely Premature Birth Does Not Affect Pulmonary Outcomes in Adolescence

Prematurity is a risk factor for impaired lung function. We sought to assess the long-term effect of palivizumab immunization and extreme prematurity (<29weeks gestation) on respiratory symptoms and pulmonary function in adolescence. What is the long-term effect of palivizumab immunization and extreme prematurity (<29 weeks) on respiratory symptoms and pulmonary function in adolescence? We examined survivors of extreme prematurity (<29weeks gestation) at 13 to 18 years of age (study group). Study group babies who were born immediately before palivizumab immunization (nonpalivizumab group [NPG]) were compared with those babies who were born just after implementation (PG) and with a control group. For study group patients, lung function in adolescence was further compared longitudinally with that at primary school age. Sixty-four adolescents aged 15.76 ± 1.52 years were included: 46 in the study group (17 PG and 29 NPG) and 18 in the control group. For the study group, wheezing episodes, inhaler use, and hospitalizations were uncommon. For the study group compared with the control group, FEV1 percent predicted was 82.60%± 13.54%vs105.83%± 13.12%(P< .001), and the lung clearance index was 7.67 ± 1.02 vs7.46 ± 0.70 (P= .48), respectively. Study group adolescents with bronchopulmonary dysplasia had a higher lung clearance index than did adolescents with no bronchopulmonary dysplasia (7.94 ± 1.11 vs7.20 ± 0.60; P= .002). PG and NPG adolescents were not significantly different. Comparing the study group in adolescence with primary school age, we found improvement in mean FEV1 percent predicted bronchodilator response (0.37%± 9.98%vs5.67%± 9.87%; P= .036) and mean provocative concentration causing 20%decline in FEV1 (12.16 ± 4.71mg/mL vs4.14 ± 4.51mg/mL, respectively; P< .001). Palivizumab did not provide any discernable long-term protective effect. Nevertheless, adolescent survivors of extreme prematurity showed good clinical and physiologic outcomes, except for mildly raised lung clearance index in patients with bronchopulmonary dysplasia. Airway hyperreactivity detected at primary school age, decreased by adolescence.

Toll-like receptor 10 rs4129009 gene polymorphism is associated with post-bronchiolitis lung function in adolescence.

The aim was to evaluate the association of polymorphisms in the Toll-like receptor (TLR) 2 subfamily encoding genes with lung function by spirometry at 10-13years of age in children who had been hospitalised for bronchiolitis at <6months of age. In a prospective cohort of 166 former bronchiolitis patients, 138 returned a structured questionnaire and 89 attended a clinical follow-up visit including spirometry before and after bronchodilation at 10-13years of age. Data on polymorphisms of the TLR1, TLR2, TLR6 and TLR10 genes were available from 81-82 children. In the TLR10 rs4129009, the wild (AA) genotype was associated with lower FEV1/FVC before (92.4 vs 97.4, P=.002) and after (95.5 vs 98.6, P=.011) bronchodilator administration, compared to those with the variant genotype. When the TLR10 rs4129009 and TLR2 rs5743708 genotypes, and the TLR10 rs4129009 and TLR1 rs5743618 genotypes, respectively, were analysed as combined, both baseline and post-bronchodilator FEV1/FVC were lowest in the subjects with the wild (AA) genotype of the TLR10 rs4129009. In this post-bronchiolitis follow-up, lung function in children with the variant TLR10 rs4129009 genotype with potentially altered TLR10 function was superior to lung function in those with the wild genotype.

Effect of regular training on lung function in adolescents

Effect of regular training on lung function in adolescents

Timing of secondhand smoke, pet, dampness or mould exposure and lung function in adolescence

BackgroundThe relevance of timing of exposure in the associations of secondhand tobacco smoke (SHS), pets, and dampness or mould exposure with lung function is unclear. We investigated the relevance of...

Nutrient intake is a predictor of lung function in obese asthmatic adolescents undergoing interdisciplinary therapy.

Asthma-obesity is a multifactorial disease with specific asthma phenotypes that aggravate due to overweight and an unbalanced diet. Furthermore, obese asthmatic patients are corticotherapy-resistant. Therefore, the aims of the present study were to evaluate the effects of an interdisciplinary intervention on food consumption, body composition, lung function and adipokines in asthmatic and non-asthmatic obese adolescents and to investigate the influence of nutrients on lung function. Obese non-asthmatic (n 42) and obese asthmatic (n 21) adolescents of both sexes were enrolled in the present study. Food intake, adipokine levels, body composition, asthma symptoms and lung function were assessed across the study. After the intervention of 1 year, there was a reduction (P ≤ 0·01) in BMI, body fat percentage, visceral and subcutaneous fat and an increase (P ≤ 0·01) in lean mass and all lung function variables in both groups, except the relation between forced expiratory volume in 1 s and forced vital capacity (FEV1:FVC) in non-asthmatic patients. Moreover, both groups decreased lipid and cholesterol consumption (P ≤ 0·01). The highest energy consumption (β = -0·021) was associated with lower values of FVC. Similarly, carbohydrate consumption (β = -0·06) and cholesterol were negative predictors (β = -0·05) in FEV1:FVC. However, the consumption of Ca (β = 0·01), fibres (β = 1·34) and vitamin A (β = 0·01) were positive predictors of FEV1:FVC. Asthma-obesity interdisciplinary treatment promoted an improvement on food consumption and lung function in adolescents and demonstrated that the consumption of nutrients influenced an increase in lung function.

Personal Exposure to Ultrafine Particles is Associated with Reduced Lung Function in Adolescents with Asthma

TPS 681: Short-term health effects of air pollutants 1, Exhibition Hall, Ground floor, August 26, 2019, 3:00 PM - 4:30 PM Background: Few studies have examined personal exposure to ultrafine particles (UFP) and respiratory health in adolescents. Our objective was to characterize personal UFP exposure and examine their association with respiratory symptoms and lung function among adolescents with and without asthma. Methods: Participants (ages 13-17 years) completed seven days of personal UFP sampling. On each day, personal UFP exposure was recorded at one second intervals for three hours using the PUFP C200, a wearable UFP monitor. Ecological momentary assessment was used to assess the frequency of respiratory symptoms and spirometry was performed by trained technicians at the completion of the seven day sampling period. The percent-predicted forced expiratory volume in 1 second (% FEV1), forced vital capacity (% FVC), ratio of FEV1/FVC, and forced expiratory flow between 25% and 75% of the FVC (% FEF25-75) were calculated for each participant based on their age, sex, race, and height. Linear and zero-inflated Poisson regression models were used to estimate the association between log-transformed weekly median UFP exposures, lung function, and frequency of respiratory symptoms adjusting for BMI. Results: A total of 98 adolescents (35% with asthma) were included in this analysis. Median weekly UFP exposures ranged from 351 – 58,300 p/cm3 (IQR = 5,478 p/cm3). Personal exposure to UFPs was associated with decreased lung function among adolescents with asthma; for a 10-fold increase in median UFP exposure the %FEV1 was decreased 10% (95% CI: -21, 0%), %FEV1/FVC decreased 11% (95%CI: -19.0, -3.5%) and the %FEF25-75 decreased 31% (95%CI: -55.5, -7.6%). No significant associations were observed between UFP exposure and lung function in children without asthma nor was UFP exposure associated with the frequency of respiratory symptoms in either asthmatic or non-asthmatic adolescents. Conclusions: Exposure to UFP is associated with reduced lung function, but not increased respiratory symptoms, in children with asthma.

Preliminary communication suggests overweight was associated with reduced lung function in adolescence after infant bronchiolitis

Preliminary communication suggests overweight was associated with reduced lung function in adolescence after infant bronchiolitis

Childhood Body Composition Trajectories and Adolescent Lung Function. Findings from the ALSPAC study.

Rationale: Body composition changes throughout life may explain the inconsistent associations reported between body mass index and lung function in children.Objectives: To assess the associations of body weight and composition trajectories from 7 to 15 years with lung function at 15 years and lung function growth between 8 and 15 years.Methods: Sex-specific body mass index, lean body mass index, and fat mass index trajectories were developed using Group-Based Trajectory Modeling on data collected at least twice between 7 and 15 years from 6,964 children (49% boys) in the UK Avon Longitudinal Study of Parents and Children birth cohort. Associations of these trajectories with post-bronchodilation lung function parameters at 15 years and with lung function growth rates from 8 to 15 years were assessed using multivariable linear regression models, stratified by sex, in a subgroup with lung function data (n = 3,575).Measurements and Main Results: For all body mass measures we identified parallel trajectories that increased with age. There was no consistent evidence of an association between the body mass index trajectories and lung function measures. Higher lean body mass index trajectories were associated with higher levels and growth rates of FVC, FEV1, and forced expiratory flow, midexpiratory phase in both sexes (e.g., boys in the highest lean body mass index trajectory had on average a 0.62 L [95% confidence interval, 0.44–0.79; P trend < 0.0001] higher FVC at 15 yr than boys in the lowest trajectory). Increasing fat mass index trajectories were associated with lower levels and growth rates of FEV1 and forced expiratory flow, midexpiratory phase only in boys and lower levels of FEV1/FVC in both sexes.Conclusions: Higher lean body mass during childhood and adolescence is consistently associated with higher lung function at 15 years in both sexes, whereas higher fat mass is associated with lower levels of only some lung function parameters.

Pollen exposure at birth and adolescent lung function, and modification by residential greenness.

Exposure to high levels of pollen in infancy is a risk factor for allergic respiratory diseases in later childhood, but effects on lung function are not fully understood. We aim to examine associations between grass pollen exposure in the first months of life and lung function at 12 and 18years, and explore potential modification. Using the Melbourne Atopy Cohort Study, a birth cohort of children with a family history of allergic diseases, we modeled the association between cumulative grass pollen exposure up to 3months after birth, on FEV1 , FVC, and FEV1 /FVC ratio at 12 and 18years. We also assessed modifying effects of residential greenness levels (derived from satellite imagery), asthma, and early life sensitization to ryegrass. Grass pollen exposure in the first 7days was associated with a reduction in FEV1 (-15.5mL; 95% CI: -27.6, -3.3 per doubling of pollen count) and FVC (-20.8mL; -35.4, -6.1) at 12years, but not at 18years. Increase in cumulative grass pollen exposure up to 3months was negatively associated with FVC at 12 and 18. Exposure to high residential greenness modified the association at 18 years. Early exposure to grass pollen was associated with decreased lung function in children and adolescents. Targeted interventions for pollen avoidance strategies that take into account local topography could be implemented alongside other clinical interventions such as immunotherapy.

ESTILO DE VIDA Y DISTRIBUCIÓN DE GRASA EN ADOLESCENTES ASMÁTICOS Y SANOS

Objectives: objective is to analyze the lifestyle, integrating exercise and diet, of a group of adolescents from the Community of Madrid, taking into account gender and pathology and its relationship with nutritional status, fat distribution and lung function in adolescents with or without asthma. Methods: This was a descriptive study including 207 subjects aged 13.20 ± 0.62 years. Lifestyle was assessed in terms of physical activity (PA) levels, Mediterranean diet, nutritional status, and respiratory health measured through FEV1 (z). Results: In the non-asthma group, boys were more active (p = 0.01) and showed a lower waist-to-height ratio (WHtR) than girls (p = 0.001). Participants without asthma were more active (p = 0.003), and had a better WHtR (p = 0.001) and FEV1 (p = 0.001) than those with asthma. Conclusions: In this Spanish population sample, non-asthmatic adolescents were more active and showed a better nutritional status, fat distribution and respiratory health than their peers with asthma.

Serum perfluoroalkyl substances and lung function in adolescents exposed to the World Trade Center disaster

The effects of childhood exposure to perfluoroalkyl substances (PFASs) on lung function remain mostly unknown. Previous research indicates that children living or going to school near the World Trade Center (WTC) disaster were exposed to high levels of PFASs, among other toxic chemicals. To explore the effects of PFAS exposure on lung function, we measured serum PFASs in a cohort of children from the WTC Health Registry and a matched control group. Perfluorooctanesulfonate had the highest median concentrations in both groups (WTCHR = 3.72 ng/mL, Comparison = 2.75 ng/mL), while the lowest median concentrations were seen for perfluoroundecanoic acid (WTCHR = 0.12 ng/mL, Comparison = 0.01 ng/mL). Lung function outcomes were measured by spirometry, plethysmography, and oscillometry. Asthma diagnosis and serum eosinophil count were also recorded. We examined the relationships of each PFAS with lung function parameters and eosinophil count using linear regressions. Odds ratios for asthma were obtained for each PFAS using logistic regression. The effect of total PFASs on these outcomes was also assessed. All regression models were adjusted for sex, race/ethnicity, age, body mass index (BMI) and tobacco smoke exposure. We found that serum PFASs were not statistically associated with the measured lung function parameters, asthma diagnosis, or eosinophil count in this cohort (p < 0.05). These findings highlight the need for more longitudinal studies to explore the long-term effects of childhood PFAS exposure on lung function past adolescence and early adulthood.

The Role of Early Life Food Sensitization in Adolescent Lung Function: Results from 2 Birth Cohort Studies

It is unclear whether early life food sensitization (as opposed to aeroallergen sensitization) is associated with subsequent poor lung function. We investigated the associations between food sensitization in the first 2 years of life and lung function at 12 to 18 years and whether these observed associations are mediated through aeroallergen sensitization or asthma. We used data from a high-risk cohort (Melbourne Atopy Cohort Study [MACS]) and a population-based "Influence of life-style-related factors on the development of the Immune System and Allergies in East and West Germany plus the influence of traffic emissions and genetics" (LISAplus) cohort. Food sensitization was assessed at 6, 12, and 24 months in MACS and 24 months in LISAplus. Lung function was evaluated by spirometry at 12 and 18 years in MACS and 15 years in LISAplus. Linear regression models were used to estimate the association with sensitization (food and/or aeroallergen) while adjusting for potential confounders. Sensitization to food without aeroallergen at 6 months was associated with reduced forced expiratory volume in 1 second (FEV1) at both 12 years (-153 mL; 95% confidence interval [CI]=-256 mL,-51 mL) and 18 years (-206 mL; 95% CI=-347 mL,-65 mL) in MACS. Similar results were observed for sensitization measured at 12 months but not at 24 months. Early-life asthma (but not aeroallergen sensitization) partially mediated these associations. Both cohorts showed that only aeroallergen sensitization at 24 months but not food sensitization was associated with lower adolescent lung function. This study showed that food sensitization at 6 and 12 months was associated with reduced FEV1 in adolescence. Our finding that this link is not completely mediated by either subsequent asthma or aeroallergen sensitization is novel and suggests that early food sensitization itself can be used to identify high-risk groups for poor lung health.

Association of Height Growth in Puberty with Lung Function. A Longitudinal Study.

Rationale: Puberty may influence lung function, but the precise role of pubertal height growth in lung development is unclear.Objectives: To examine associations of timing of puberty and peak velocity of pubertal height growth with lung function in adolescence and early adulthood.Methods: Longitudinal analyses of repeat height measurements from age 5 to 20 years for a British birth cohort with 4,772 males and 4,849 females were conducted to characterize height growth trajectories and to derive pubertal age and peak height velocity using the validated SITAR (SuperImposition by Translation and Rotation) model. Association of these estimates with prebronchodilator and post-bronchodilator spirometry measures: FEV1; FVC; FEV1/FVC; FEF25-75% at age 15 and 24 years were investigated using multivariable regression models adjusted for lung function at age 8 years, height and age at time of outcome measurements, and potential confounders.Measurements and Main Results: Later pubertal age and greater peak velocity were associated with higher FEV1 and FVC at 24 years in both sexes. A 1-year increase in pubertal age was associated with a 263-ml higher FVC (95% confidence interval [CI], 167-360 ml) for males (n = 567) and 100-ml (95% CI, 50-150 ml) higher FVC for females (n = 990). A 1-cm/yr increase in peak velocity was associated with 145-ml (95% CI, 56-234 ml) and 50-ml (95% CI, 2-99 ml) increases in FVC for males and females, respectively. No associations were found with FEV1/FVC.Conclusions: Later onset and greater peak velocity of height growth in puberty are associated with increased FEV1 and FVC in young adults but there was no evidence of dysanapsis of pubertal lung growth.

Effect of an Intervention to Promote Breastfeeding on Asthma, Lung Function, and Atopic Eczema at Age 16 Years, Follow-up of the PROBIT Randomized Trial

C Flohr, AJ Henderson, MS Kramer. JAMA Pediatr. 2018;172(1):e174064 In this study, the authors investigated whether an intervention to promote prolonged, exclusive breastfeeding could protect against asthma, atopic dermatitis, and low lung function in adolescence. There were 17 046 infant-mother pairs across 31 Belarusian hospitals enrolled in the study. Mothers had to initiate breastfeeding on admission to the postpartum ward and could not have illnesses contraindicating breastfeeding or severely compromising its success; infants had to be singletons of at least 37 completed weeks’ gestation and 2500 g …

Impact of IgE sensitization and rhinitis on inflammatory biomarkers and lung function in adolescents with and without asthma.

Both allergic and non-allergic rhinitis are associated with worse asthma control. However, it is unclear how IgE sensitization and/or rhinitis are associated with lung function. We therefore evaluated the effect of rhinitis and sensitization on lung function, including the periphery of the airway system, and inflammatory biomarkers in individuals with and without asthma. Participants in the BAMSE longitudinal birth cohort study underwent measures of spirometry, impulse oscillometry, and FeNO at age 16years. Questionnaires were used to obtain data on asthma and rhinitis. Blood samples were analyzed for eosinophils and allergen-specific IgE. Groups based on the combination of asthma, rhinitis, and sensitization were compared to a healthy reference group. Lower FEV1 /FVC levels were seen for groups with asthma only (adjusted mean difference -2.8% units (95% CI -4.7; -1.0), P<0.01), asthma with sensitization (-2.0 (-3.9; -0.2), P<0.05), and asthma with sensitization and rhinitis (-2.5 (-3.6; -1.4), P<0.001). The index of peripheral airway resistance R5-20 was higher in groups with asthma and sensitization (adjusted median difference 94.9PaL-1 s-1 (95% CI 60.4; 129.3), P<0.001), as well as asthma with sensitization and rhinitis (36.9(15.0; 58.8), P<0.01). These groups also had increased FeNO and blood eosinophil levels. We found signs of peripheral airway obstruction and increased levels of inflammatory biomarkers in the presence of allergic asthma, irrespective of rhinitis status. Despite having a reduced FEV1 /FVC, peripheral airway engagement was not seen in non-sensitized adolescents with asthma. We suggest that small airway disease is a feature related to the eosinophilic inflammation in allergic asthma in adolescence.

CC16 Levels into Adult Life Are Associated with Nitrogen Dioxide Exposure at Birth

Children&amp;#8217;s lung function and growth is adversely associated with exposure to nitrogen dioxide (NO2). Lower levels of circulating club cell secretory protein (CC16) in childhood are also associated with subsequent decreased lung function in adolescence and adulthood. Evidence from in vitro and in vivo studies suggests that NO2 exposure may induce epithelial damage in the lungs and altered club cell proliferation and morphology. Our objective was to determine if increased ambient NO2 levels at participants&amp;#8217; home addresses at birth or age 6 were associated with decreased levels of CC16 from age 6-32 years.Participants were enrolled at birth in the Tucson Children&amp;#8217;s Respiratory Study and had circulating CC16 measured at least once between age 6-32 years. Annual average estimates of NO2 were obtained for the address and year corresponding to each participant&amp;#8217;s home address at birth and at age 6. Linear mixed models were used to determine the association between exposure to NO2 at birth or age 6 with CC16 levels from age 6-32 years.NO2 exposures at birth or age 6 were available for 777 children with at least one CC16 measurement from ages 6-32. An interquartile range increase in NO2 at the children&amp;#8217;s birth address was associated with a 4.89% (95% CI -9.04, -0.75) decrease in CC16 levels from age 6-32 years. An interquartile range increase in NO2 at the children&amp;#8217;s age 6 address was not associated with a decrease in CC16 levels from age 6-32 years (-2.54%, 95% CI -7.03, 1.94). Similar results were obtained after adjusting for potential confounders including maternal smoking (NO2 at birth -4.83% [95% CI -9.00, -0.66]; NO2 at age 6 [-1.95%, 95% CI -6.47, 2.56]).Higher exposure to NO2 at birth is associated with persistently low levels of CC16 from 6-32 years. We speculate that persistently low levels of CC16 may reflect airway injury induced by exposure to NO2 during critical periods of lung growth, thus predisposing for diminished lung function later in life.

Exposure to Environmental Contaminants and Lung Function in Adolescents-Is There a Link?

Dioxins (polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDF)), polychlorinated biphenyls (PCBs), and brominated flame retardants (BDEs) are well known toxic environmental contaminants. Their possible role in the incidence of respiratory disease is not yet well understood. Previous studies showed a negative effect on lung function in relation to prenatal and lactational dioxin exposure in pre-pubertal children. Effects of BDE exposure on the lung function have not previously been evaluated. As part of a longitudinal cohort study, the effects of perinatal dioxin (PCDD/F) exposure and serum PCDD/F, dl-PCB, and BDE levels on lung function in adolescents were assessed using spirometry, a body box, and diffusion measurements. Thirty-three children (born between 1986 and 1991) consented to the current follow-up study. Prenatal, lactational, and current dioxin, PCB, and BDE concentrations were determined using GC-MS. No relationship was seen between prenatal and lactational dioxin exposure, nor with current PCB body burden, and lung function. Indications of increasing airway obstruction were seen in relation to increasing current BDE exposure. This is a novel finding and certainly warrants further research.

The effect of omalizumab on lung function in adolescents with moderate to severe allergic asthma

Purpose: In adolescents with allergic asthma, failure to adequately control disease in an early stage may reduce pulmonary function and clinical outcomes. Omalizumab, a humanized anti-Ig E, improves asthma symptoms and reduces the frequency of exacerbations [1]; however, its effect on lung function in this population is not fully understood. This analysis focuses on pooled spirometry measurements from eight clinical trials on adolescents receiving either omalizumab or placebo. The analysis retrospectively assessed the effect of omalizumab …

The effect of omalizumab on lung function in adolescents with moderate to severe allergic asthma

The effect of omalizumab on lung function in adolescents with moderate to severe allergic asthma

Abnormal lung function at preschool age asthma in adolescence?

BackgroundAsthma often begins early in childhood. However, the risk for persistence is challenging to evaluate. ObjectiveThis longitudinal study relates lung function assessed with impulse oscillometry (IOS) in preschool children to asthma in adolescence. MethodsLung function was measured with IOS in 255 children with asthma-like symptoms aged 4–7 years. Baseline measurements were followed by exercise challenge and bronchodilation tests. At age 12–16 years, 121 children participated in the follow-up visit, when lung function was assessed with spirometry, followed by a bronchodilation test. Asthma symptoms and medication were recorded by a questionnaire and atopy defined by skin prick tests. ResultsAbnormal baseline values in preschool IOS were significantly associated with low lung function, the need for asthma medication, and asthma symptoms in adolescence. Preschool abnormal R5 at baseline (z-score ≥1.645 SD) showed 9.2 odds ratio (95%CI 2.7;31.7) for abnormal FEV1/FVC, use of asthma medication in adolescence, and 9.9 odds ratio (95%CI 2.9;34.4) for asthma symptoms. Positive exercise challenge and modified asthma-predictive index at preschool age predicted asthma symptoms and the need for asthma medication, but not abnormal lung function at teenage. ConclusionAbnormal preschool IOS is associated with asthma and poor lung function in adolescence and might be utilised for identification of asthma persistence.