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Lanza FC, Wandalsen GF, Dos Santos AM, Solé D. Bronchodilator response in wheezing infants assessed by the raised volume rapid thoracic compression technique. Respir Med 2016; 119:29-34. [PMID: 27692144 DOI: 10.1016/j.rmed.2016.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/16/2016] [Accepted: 08/21/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Bronchodilator response (BDR) analyzed by the raised volume rapid thoracic compression (RVRTC) in wheezing infants is not yet well described, although bronchodilators (BD) are routine in the treatment of this population. OBJECTIVE To evaluate BDR by RVRTC technique in infants with recurrent wheezing and compare to control group. METHOD Cross sectional study, 45 infants, age 56 weeks (38-67 weeks). Two groups: wheezing group (WG: history of recurrent wheezing) and control group (CG). RVRTC was evaluated, FVC, FEV0.5, FEF50, FEF75, FEF85, FEF25-75 were measured. Salbutamol was delivered to infants and RVRTC evaluated again. BDR was determined by the increase greater than two standard deviation from the mean change in the CG. RESULTS In WG (n = 32) lung function was worse than in CG (n = 13): FEV0.5: 0.0(-0.9-0.9z score) vs 0.8(0.2-1.4z score); FEF50: 0.2(-0.3-1.1z score) vs 0.9(0.5-1.4z score); and FEF25-75: 0.2(-0.5-1.1z score) vs 1.1(0.6-1.6z score), respectively, p < 0.05. Both groups had similar increase after BD. In WG 11 patients (34%) were responder and these had worse lung function compared to nonresponder (n = 21) (p < 0.05). The increase in lung function after BD in responder was higher than in nonresponder: FEV0.5: 6.5(2.1-7.1%) vs -0.5(-2.5-0.7%), FEF50: 5.1(2.7-11.7%) vs 0.4(-1.1-2.8%), FEF75: 20.7(4.7-23.6%) vs -1.3(-6.4-3.9%), FEF25-75: 9.9(3.8-16.4%) vs 0.0(-1.5-1.0%), respectively, p < 0.05. CONCLUSION 34% WG showed BDR measured by the RVRTC. The best variables to detect BDR were FEF75, FEF25-75 and FEV0.5. Patients with worse lung function showed better response to BD.
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Affiliation(s)
- Fernanda Cordoba Lanza
- Discipline of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo - UNIFESP, Sao Paulo, SP, Otonis St 725, 04025-002, Brazil.
| | - Gustavo Falbo Wandalsen
- Discipline of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo - UNIFESP, Sao Paulo, SP, Otonis St 725, 04025-002, Brazil.
| | - Amelia Miyashiro Dos Santos
- Neonatal Division of Medicine - Department of Pediatrics - Federal University of Sao Paulo - UNIFESP, Sao Paulo, SP, Marselhesa St 630, 04020-060, Brazil.
| | - Dirceu Solé
- Discipline of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo - UNIFESP, Sao Paulo, SP, Otonis St 725, 04025-002, Brazil.
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Bousquet J, Gern JE, Martinez FD, Anto JM, Johnson CC, Holt PG, Lemanske RF, Le Souëf PN, Tepper RS, von Mutius ERM, Arshad SH, Bacharier LB, Becker A, Belanger K, Bergström A, Bernstein DI, Cabana MD, Carroll KN, Castro M, Cooper PJ, Gillman MW, Gold DR, Henderson J, Heinrich J, Hong SJ, Jackson DJ, Keil T, Kozyrskyj AL, Lødrup Carlsen KC, Miller RL, Momas I, Morgan WJ, Noel P, Ownby DR, Pinart M, Ryan PH, Schwaninger JM, Sears MR, Simpson A, Smit HA, Stern DA, Subbarao P, Valenta R, Wang X, Weiss ST, Wood R, Wright AL, Wright RJ, Togias A, Gergen PJ. Birth cohorts in asthma and allergic diseases: report of a NIAID/NHLBI/MeDALL joint workshop. J Allergy Clin Immunol 2014; 133:1535-46. [PMID: 24636091 DOI: 10.1016/j.jaci.2014.01.018] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 01/16/2014] [Accepted: 01/21/2014] [Indexed: 11/30/2022]
Abstract
Population-based birth cohorts on asthma and allergies increasingly provide new insights into the development and natural history of the diseases. More than 130 birth cohorts focusing on asthma and allergy have been initiated in the last 30 years. A National Institute of Allergy and Infectious Diseases; National Heart, Lung, and Blood Institute; Mechanisms of the Development of Allergy (MeDALL; Framework Programme 7 of the European Commission) joint workshop was held in Bethesda, Maryland, on September 11-12, 2012, with 3 objectives: (1) documenting the knowledge that asthma/allergy birth cohorts have provided, (2) identifying the knowledge gaps and inconsistencies, and (3) developing strategies for moving forward, including potential new study designs and the harmonization of existing asthma birth cohort data. The meeting was organized around the presentations of 5 distinct workgroups: (1) clinical phenotypes, (2) risk factors, (3) immune development of asthma and allergy, (4) pulmonary development, and (5) harmonization of existing birth cohorts. This article presents the workgroup reports and provides Web links (AsthmaBirthCohorts.niaid.nih.gov or www.medall-fp7.eu), where the reader will find tables describing the characteristics of the birth cohorts included in this report, the type of data collected at differing ages, and a selected bibliography provided by the participating birth cohorts.
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Affiliation(s)
- Jean Bousquet
- University Hospital, Montpellier and INSERM U1018, Villejuif, France.
| | - James E Gern
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | | | - Josep M Anto
- Centre for Research in Environmental Epidemiology (CREAL) and IMIM (Hospital del Mar Research Institute) and CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut, Barcelona, Spain
| | - Christine C Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Mich
| | - Patrick G Holt
- Telethon Institute for Child Health Research, University of Western Australia, and Queensland Children's Medical Research Institute, University of Queensland, Brisbane, Australia
| | - Robert F Lemanske
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, Princess Margaret Hospital for Children, University of Western Australia, Perth, Australia
| | - Robert S Tepper
- Indiana University School of Medicine, James Whitcomb Riley Hospital for Children, Indianapolis, Ind
| | | | - S Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, and the David Hide Asthma and Allergy Research Centre, Isle of Wight, United Kingdom
| | | | - Allan Becker
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kathleen Belanger
- Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, School of Medicine, New Haven, Conn
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - David I Bernstein
- Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Michael D Cabana
- Departments of Pediatrics, Epidemiology & Biostatistics, the University of California, San Francisco, Calif
| | - Kecia N Carroll
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Mario Castro
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, Mo
| | - Philip J Cooper
- Liverpool School of Tropical Medicine, Liverpool, and Escuela de Biologia, Pontificia Universidad Catolica del Ecuador, Quito, Ecuador
| | - Matthew W Gillman
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Mass
| | - Diane R Gold
- Channing Division of Network Medicine, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, and Harvard School of Public Health, Department of Environmental Health, Boston, Mass
| | - John Henderson
- School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Joachim Heinrich
- Helmholtz Zentrum, Muenchen, German Center for Environmental Health, Institute of Epidemiology I, Munich, Germany
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Daniel J Jackson
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitaetsmedizin Berlin, Berlin, and Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Anita L Kozyrskyj
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Rachel L Miller
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University, New York, NY
| | - Isabelle Momas
- Department of Public Health and Biostatistics, Paris Descartes University, Sorbonne, and Paris Municipal Department of Social Action, Childhood, and Health, Paris, France
| | - Wayne J Morgan
- Department of Pediatrics, University of Arizona, Tucson, Ariz
| | - Patricia Noel
- Division of Lung Diseases, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, Bethesda, Md
| | | | - Mariona Pinart
- Centre for Research in Environmental Epidemiology (CREAL) and IMIM (Hospital del Mar Research Institute) and CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Patrick H Ryan
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Julie M Schwaninger
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Malcolm R Sears
- Department of Medicine, AstraZeneca Chair in Respiratory Epidemiology, McMaster University, Hamilton, Ontario, Canada
| | - Angela Simpson
- Centre for Respiratory and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, University of Manchester and University Hospital of South Manchester, Manchester, United Kingdom
| | - Henriette A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Debra A Stern
- Arizona Respiratory Center, University of Arizona, Tucson, Ariz
| | - Padmaja Subbarao
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Xiaobin Wang
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md
| | - Scott T Weiss
- Harvard Medical School, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Robert Wood
- Department of Pediatrics, Division of Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Anne L Wright
- Arizona Respiratory Center and the Department of Pediatrics, University of Arizona College of Medicine, Tucson, Ariz
| | - Rosalind J Wright
- Department of Pediatrics and Mindich Child Health & Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alkis Togias
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Peter J Gergen
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
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