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Collaro AJ, McElrea MS, Marchant JM, Chatfield MD, Sondergeld P, Perret JL, Vicendese D, Anuntaseree W, Dharmage SC, Chang AB. The effect of early childhood respiratory infections and pneumonia on lifelong lung function: a systematic review. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:429-440. [PMID: 37037210 DOI: 10.1016/s2352-4642(23)00030-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 04/12/2023]
Abstract
Early childhood respiratory infections, including pneumonia, are an important global public health issue, with more than 40 million annual cases resulting in approximately 650 000 deaths. A growing number of published studies have examined the effects of early childhood lower respiratory tract infections (LRTIs) or pneumonia on lung function, particularly as part of large early-life exposure studies. To our knowledge, there is no published systematic review of these data. We searched PubMed, Embase, and Web of Science for studies published between database inception and May 12, 2022. Case-control, cohort, and cross-sectional studies were included if they reported forced expiratory volume in 1 s (FEV1) or forced vital capacity (FVC) values of participants older than 5 years. Article titles and abstracts were screened in Rayyan before retrieval, assessment, and data extraction of the full text. Primary outcome measures were differences in mean FEV1 or FVC values between exposed groups (ie, children aged ≤5 years with LRTIs) and non-exposed groups. This study is registered with PROSPERO, CRD42021265295. Database searches yielded 3070 articles, and 14 studies were included in this systematic review, providing a total of 23 276 participants, including 9969 children and 13 307 adults. Eight of 14 articles reported significant reductions in FEV1 values, and six of 12 studies reported reductions in FVC values in children and adults with a history of early childhood LRTIs or pneumonia, compared with unexposed controls (p<0·05). Most studies reporting reductions in lung function described deficits consistent with a restrictive spirometry pattern. Only two of 14 studies reported data from low-income and middle-income countries or disadvantaged populations in middle-income and high-income countries, and there were scarce data available on the effect of LRTI severity and recurrence on lung function. LRTIs in early childhood could be associated with a restrictive spirometry pattern in later childhood and adulthood. Data are needed from low-income and middle-income nations, and from disadvantaged populations in middle-income and high-income countries in which early childhood respiratory infection burden is disproportionately high. Data are also needed on the effect of LRTI severity and recurrence on future lung function.
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Affiliation(s)
- Andrew J Collaro
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia.
| | - Margaret S McElrea
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Julie M Marchant
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Mark D Chatfield
- Child Health Division, Menzies School of Health Research, Darwin, NT, Australia; Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Peter Sondergeld
- Library, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jennifer L Perret
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Institute for Breathing and Sleep, Melbourne, VIC, Australia
| | - Don Vicendese
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; School of Engineering and Mathematical Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Wanaporn Anuntaseree
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Shyamali C Dharmage
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Anne B Chang
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia; Child Health Division, Menzies School of Health Research, Darwin, NT, Australia
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Rusconi F, Lombardi E, Spada E, Brescianini S, Culasso M, Di Toro F, Frassanito A, Richiardi L, Ronfani L, Stella I, Gagliardi L. Lung function at school age in infants with lower respiratory tract infections with and without wheezing: A birth cohort study. Pediatr Pulmonol 2022; 57:857-861. [PMID: 35048563 DOI: 10.1002/ppul.25835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/04/2022] [Accepted: 01/17/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the relationship between lower respiratory tract infections (LRTI), in the first 2 years of life and lung function at school age in the Piccolipiù birth cohort (Italy). METHODS Data on LRTI (doctor diagnosis of bronchitis, bronchiolitis, pneumonia) and wheezing (≥3 episodes or a diagnosis of asthmatic bronchitis) in the first 2 years of life were obtained from parental questionnaires. Lung function was assessed at 7 years by spirometry and forced volume vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, forced expiratory flow between 25% and 75%, and at 75% of FVC (FEF25-75 and FEF75 ) were reported as Z-scores. The associations between LRTI and spirometric variables were estimated with linear regression models. RESULTS Among 877 children studied, 22.1% had LRTI only, 5.4% wheezing only, 13.2% had both, and 59.3% had neither LRTI nor wheezing. Children with LRTI had lower FVC and FEV1 than children without (Z-score differences: -0.18 [95% confidence intervals: -0.31; -0.06] and -0.15 [-0.27; -0.03]). When children were stratified by history of both LRTI and wheezing, there was no association between LRTI only and spirometric values. Conversely, having had both LRTI and wheezing was inversely associated with all lung function measures: Z-score differences of -0.24 (-0.42; -0.07); -0.42 (-0.59; -0.24); -0.25 (-0.41; -0.08); -0.37 (-0.54; -0.21); -0.30 (-0.46; -0.14) for FVC, FEV1, FEV1 /FVC, FEF25-75 and FEF75, respectively. CONCLUSION Infants with wheezing and LRTI, but not those with LRTI only, had reduced lung function at school-age.
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Affiliation(s)
- Franca Rusconi
- Division of Epidemiology, Meyer Children's University Hospital, Florence, Italy.,Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, Pisa, Italy
| | - Enrico Lombardi
- Division of Pediatric Pulmonology, Meyer Children's University Hospital, Florence, Italy
| | - Elena Spada
- Division of Epidemiology, Meyer Children's University Hospital, Florence, Italy
| | - Sonia Brescianini
- Department of Behavioural Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Martina Culasso
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Francesca Di Toro
- Division of Clinical Epidemiology and Public Health Research, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Antonella Frassanito
- Department of Maternal Infantile and Urological Sciences, Sapienza University, Rome, Italy
| | - Lorenzo Richiardi
- Department of Medical Sciences, University of Turin, CPO Piemonte, Turin, Italy
| | - Luca Ronfani
- Division of Clinical Epidemiology and Public Health Research, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Ileana Stella
- Division of Pediatrics, Maria Vittoria Hospital, Turin, Italy.,Division of Pediatrics, Department of Health Sciences, Eastern Piedmont University, Novara, Italy
| | - Luigi Gagliardi
- Division of Neonatology and Pediatrics, Ospedale Versilia, Viareggio, AUSL Toscana Nord Ovest, Pisa, Italy
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Chang JC, Chiou JY, Ko JL, Huang JY, Lue KH. Early Bronchiolitis Contributes to Preschool Asthma. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8121176. [PMID: 34943372 PMCID: PMC8700733 DOI: 10.3390/children8121176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/06/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
This study aims to analyze whether bronchiolitis in children younger than one-year-old contributes to subsequent asthma. Medical data were retrieved from the National Health Insurance Research Database of Taiwan. Participants were divided into study (N = 65,559) and control (N = 49,656) groups, depending on whether they had early bronchiolitis. Incidences of asthma, potential comorbidities, and associated medical conditions were compared. The incidence of childhood asthma was significantly higher in the study group (aHR = 1.127, 95% CI: 1.063-1.195). Children with bronchiolitis hospitalization displayed higher asthma risk in the period between two and four years of age. The risk diminished as the children grew up. No relevant synergistic effects were found between bronchiolitis and atopic dermatitis. In conclusion, bronchiolitis before one year of age exhibits predictive value for development of preschool asthma, especially in children with bronchiolitis hospitalizations.
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Affiliation(s)
- Jih-Chin Chang
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan;
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (J.-L.K.); (J.-Y.H.)
| | - Jeng-Yuan Chiou
- School of Health Policy and Management, Chung Shan Medical University, Taichung 402, Taiwan;
| | - Jiunn-Liang Ko
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (J.-L.K.); (J.-Y.H.)
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (J.-L.K.); (J.-Y.H.)
| | - Ko-Huang Lue
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (J.-L.K.); (J.-Y.H.)
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
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Yang W, Li F, Li C, Meng J, Wang Y. Focus on Early COPD: Definition and Early Lung Development. Int J Chron Obstruct Pulmon Dis 2021; 16:3217-3228. [PMID: 34858022 PMCID: PMC8629909 DOI: 10.2147/copd.s338359] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/03/2021] [Indexed: 12/24/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a disease with high incidence rate and mortality rates worldwide. It is the third leading cause of death in the world. Nevertheless, little progress has been made in treating and preventing the disease. Under these circumstances, the concept of “early COPD” was proposed. Although this concept is not new, most health-care workers do not fully understand early COPD and tend to confuse it with mild COPD. In this review, we mainly discuss the definition of early COPD and the developmental trajectory of lung function. Although patients with early COPD have no symptoms, their lung function is already lower than that of normal people. A relatively complete definition is needed to identify this group of people. Reduced lung function is the diagnostic criterion for COPD, but lung development is a long-term dynamic process. In addition to smoking and air pollution, we should pay more attention to prenatal and childhood risk factors, for example, parents smoking, birth weight, preterm birth, mode of delivery, childhood respiratory infections and childhood asthma. Health-care workers need to be fully aware of early COPD, to reduce the morbidity of COPD and take effective measures to prevent these risk factors.
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Affiliation(s)
- Weichang Yang
- Department of Respiratory and Critical Care Medicine, Nanchang First Hospital, Nanchang University, Nanchang, 330000, Jiangxi, People's Republic of China
| | - Fengyuan Li
- Department of Respiratory and Critical Care Medicine, Nanchang First Hospital, Nanchang University, Nanchang, 330000, Jiangxi, People's Republic of China
| | - Can Li
- Department of Respiratory and Critical Care Medicine, Nanchang First Hospital, Nanchang University, Nanchang, 330000, Jiangxi, People's Republic of China
| | - Jiaqi Meng
- Department of Respiratory and Critical Care Medicine, Nanchang First Hospital, Nanchang University, Nanchang, 330000, Jiangxi, People's Republic of China
| | - Ying Wang
- Department of Respiratory and Critical Care Medicine, Nanchang First Hospital, Nanchang University, Nanchang, 330000, Jiangxi, People's Republic of China
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5
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Martinez FD. Bending the Twig Does the Tree Incline: Lung Function after Lower Respiratory Tract Illness in Infancy. Am J Respir Crit Care Med 2017; 195:154-155. [PMID: 28084817 DOI: 10.1164/rccm.201611-2325ed] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Fernando D Martinez
- 1 Asthma and Airway Disease Research Center University of Arizona Tucson, Arizona
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6
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van Meel ER, Jaddoe VWV, Bønnelykke K, de Jongste JC, Duijts L. The role of respiratory tract infections and the microbiome in the development of asthma: A narrative review. Pediatr Pulmonol 2017; 52:1363-1370. [PMID: 28869358 PMCID: PMC7168085 DOI: 10.1002/ppul.23795] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/02/2017] [Indexed: 12/31/2022]
Abstract
Asthma is a common disease in childhood, and might predispose for chronic obstructive respiratory morbidity in adolescence and adulthood. Various early-life risk factors might influence the risk of wheezing, asthma, and lower lung function in childhood. Cohort studies demonstrated that lower respiratory tract infections in the first years of life are associated with an increased risk of wheezing and asthma, while the association with lung function is less clear. Additionally, the gut and airway microbiome might influence the risk of wheezing and asthma. The interaction between respiratory tract infections and the microbiome complicates studies of their associations with wheezing, asthma, and lung function. Furthermore, the causality behind these observations is still unclear, and several other factors such as genetic susceptibility and the immune system might be of importance. This review is focused on the association of early-life respiratory tract infections and the microbiome with wheezing, asthma, and lung function, it is possible influencing factors and perspectives for future studies.
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Affiliation(s)
- Evelien R van Meel
- The Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Klaus Bønnelykke
- COPSAC (Copenhagen Prospective Studies on Asthma in Childhood), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Danish Pediatric Asthma Center, Gentofte Hospital, The Capital Region, Copenhagen, Denmark
| | - Johan C de Jongste
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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7
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Gray DM, Turkovic L, Willemse L, Visagie A, Vanker A, Stein DJ, Sly PD, Hall GL, Zar HJ. Lung Function in African Infants in the Drakenstein Child Health Study. Impact of Lower Respiratory Tract Illness. Am J Respir Crit Care Med 2017; 195:212-220. [PMID: 27509359 PMCID: PMC5394784 DOI: 10.1164/rccm.201601-0188oc] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 08/09/2016] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Lower respiratory tract illness is a major cause of childhood morbidity and mortality. It is unknown whether infants are predisposed to illness because of impaired lung function or whether respiratory illness reduces lung function. OBJECTIVES To investigate the impact of early life exposures, including lower respiratory tract illness, on lung function during infancy. METHODS Infants enrolled in the Drakenstein child health study had lung function at 6 weeks and 1 year. Testing during quiet natural sleep included tidal breathing, exhaled nitric oxide, and multiple breath washout measures. Risk factors for impaired lung health were collected longitudinally. Lower respiratory tract illness surveillance was performed and any episode investigated. MEASUREMENTS AND MAIN RESULTS Lung function was tested in 648 children at 1 year. One hundred and fifty (29%) infants had a lower respiratory tract illness during the first year of life. Lower respiratory tract illness was independently associated with increased respiratory rate (4%; 95% confidence interval [CI], 1.01-1.08; P = 0.02). Repeat episodes further increased respiratory rate (3%; 95% CI, 1.01-1.05; P = 0.004), decreased tidal volume (-1.7 ml; 95% CI, -3.3 to -0.2; P = 0.03), and increased the lung clearance index (0.13 turnovers; 95% CI, 0.04-0.22; P = 0.006) compared with infants without illness. Tobacco smoke exposure, lung function at 6 weeks, infant growth, and prematurity were other independent predictors of lung function at 1 year. CONCLUSIONS Early life lower respiratory tract illness impairs lung function at 1 year, independent of baseline lung function. Preventing early life lower respiratory tract illness is important to optimize lung function and promote respiratory health in childhood.
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Affiliation(s)
- Diane M. Gray
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and MRC Unit on Child and Adolescent Health, and
| | - Lidija Turkovic
- Telethon Kids Institute and Centre for Child Health, University of Western Australia, Perth, Australia
| | - Lauren Willemse
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and MRC Unit on Child and Adolescent Health, and
| | - Ane Visagie
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and MRC Unit on Child and Adolescent Health, and
| | - Aneesa Vanker
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and MRC Unit on Child and Adolescent Health, and
| | - Dan J. Stein
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Peter D. Sly
- Children’s Lung, Environment and Asthma Research, Child Health Research Centre, University of Queensland and Queensland Children's Medical Research Institute, Brisbane, Australia; and
| | - Graham L. Hall
- Telethon Kids Institute and Centre for Child Health, University of Western Australia, Perth, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and MRC Unit on Child and Adolescent Health, and
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Kouzouna A, Gilchrist FJ, Ball V, Kyriacou T, Henderson J, Pandyan AD, Lenney W. A systematic review of early life factors which adversely affect subsequent lung function. Paediatr Respir Rev 2016; 20:67-75. [PMID: 27197758 DOI: 10.1016/j.prrv.2016.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 03/08/2016] [Indexed: 01/15/2023]
Abstract
It has been known for many years that multiple early life factors can adversely affect lung function and future respiratory health. This is the first systematic review to attempt to analyse all these factors simultaneously. We adhered to strict a priori criteria for inclusion and exclusion of studies. The initial search yielded 29,351 citations of which 208 articles were reviewed in full and 25 were included in the review. This included 6 birth cohorts and 19 longitudinal population studies. The 25 studies reported the effect of 74 childhood factors (on their own or in combinations with other factors) on subsequent lung function reported as percent predicted forced expiration in one second (FEV1). The childhood factors that were associated with a significant reduction in future FEV1 could be grouped as: early infection, bronchial hyper-reactivity (BHR) / airway lability, a diagnosis of asthma, wheeze, family history of atopy or asthma, respiratory symptoms and prematurity / low birth weight. A complete mathematical model will only be possible if the raw data from all previous studies is made available. This highlights the need for increased cooperation between researchers and the need for international consensus about the outcome measures for future longitudinal studies.
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Affiliation(s)
- A Kouzouna
- Institute of Science and Technology in Medicine, Keele University, Staffordshire, ST5 5BG, UK; School of Health Rehabilitation, Keele University, Staffordshire, ST5 5BG, UK
| | - F J Gilchrist
- Institute of Science and Technology in Medicine, Keele University, Staffordshire, ST5 5BG, UK; Royal Stoke University Hospital, Stoke on Trent, Newcastle Road, ST4 6QG
| | - V Ball
- School of Health Rehabilitation, Keele University, Staffordshire, ST5 5BG, UK
| | - T Kyriacou
- School of Computing, Keele University, Staffordshire, ST5 5BG, UK
| | - J Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, BS8 2BN, UK
| | - A D Pandyan
- Institute of Science and Technology in Medicine, Keele University, Staffordshire, ST5 5BG, UK; School of Health Rehabilitation, Keele University, Staffordshire, ST5 5BG, UK
| | - W Lenney
- Institute of Science and Technology in Medicine, Keele University, Staffordshire, ST5 5BG, UK; Royal Stoke University Hospital, Stoke on Trent, Newcastle Road, ST4 6QG.
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A longitudinal study on early hospitalized airway infections and subsequent childhood asthma. PLoS One 2015; 10:e0121906. [PMID: 25919024 PMCID: PMC4412821 DOI: 10.1371/journal.pone.0121906] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 02/04/2015] [Indexed: 12/26/2022] Open
Abstract
Background Acute airway infections, including bronchiolitis, are common causes of early childhood hospitalization. The development of later asthma may be related to early airway infections in young children. This study is to investigate the relationship between hospitalized airway infections (HAI) in young children (< 3 years old) and later childhood asthma. Methods Hospitalized children (< 3 years old) with bronchiolitis or other acute airway infections (other HAI group) from 1997-2000 were retrieved from the National Health Insurance Research Database of Taiwan, and compared to age- and gender-matched subjects with regards to asthma until 10 years of age; and potential comorbidities and medical care conditions. Results In total, 3,264 children (1,981 with bronchiolitis; 1,283 with other HAIs) were compared to 18,527 controls. The incidence of childhood asthma was higher in the study (16.2%) than the control (11.7%) group, and most cases were diagnosed between 3-5 years old. The hazard ratios were 1.583 (95% CI: 1.414-1.772) and 1.226 (95% CI: 1.053-1.428) for the bronchiolitis and other HAI subgroups, respectively, compared to the control group, and 1.228 (95% CI: 1.075-1.542) in the bronchiolitis subgroup compared to the other HAIs subgroup. A significantly higher odds ratio (1.973, 95% CI: 1.193-3.263) for the children with congenital heart disease (CHD) in the bronchiolitis subgroup was found at an age of 3-5 years compared to the control group. Conclusions and Clinical Relevance Young children (< 3 years old) hospitalized due to acute HAIs are at a higher risk of developing childhood asthma at age 3 to 10 years. The parents of children with HAIs at age 0 to 2 years should be informed for the higher risk of developing childhood asthma, especially in children with CHD and bronchiolitis.
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10
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Mikalsen IB, Halvorsen T, Øymar K. Blood eosinophil counts during bronchiolitis are related to bronchial hyper-responsiveness and lung function in early adolescence. Acta Paediatr 2014; 103:86-92. [PMID: 24117779 DOI: 10.1111/apa.12432] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 08/06/2013] [Accepted: 09/24/2013] [Indexed: 11/28/2022]
Abstract
AIM To assess whether inflammatory markers measured in urine and blood during acute bronchiolitis in infancy were associated with asthma, lung function, bronchial hyper-responsiveness (BHR) and atopy at 11 years of age. METHODS We included 105 children hospitalised for bronchiolitis during their first year of life. At hospitalisation, urinary (U-) eosinophil protein X, U-leukotriene E4 , U-prostaglandin 9α, 11β-PGF2 and blood eosinophil counts were measured. Ninety-five children (90%) were available for follow-up at 11 years of age. RESULTS At follow-up, higher blood eosinophil counts obtained during bronchiolitis were observed in the group with asthma than in the group without asthma (median 0.27 versus 0.09 × 10(9) /L, respectively, p = 0.048). By regression analyses, blood eosinophil counts during the acute bronchiolitis were positively associated with BHR (p = 0.006) and negatively associated with forced expiratory volume in first second (p = 0.025) at 11 years of age. None of the other inflammatory markers were associated with asthma, lung function, BHR or atopy at 11 years of age. CONCLUSION Eosinophil inflammation during bronchiolitis may have a long-term impact on lung function and airway responsiveness. The associations could be related to virus-host interactions during bronchiolitis or to predisposed children.
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Affiliation(s)
| | - Thomas Halvorsen
- Department of Clinical Science; University of Bergen; Bergen Norway
- Department of Paediatrics; Haukeland University Hospital; Bergen Norway
| | - Knut Øymar
- Department of Paediatrics; Stavanger University Hospital; Stavanger Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
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11
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Abstract
Respiratory syncytial virus (RSV) is amongst the most important pathogenic infections of childhood and is associated with significant morbidity and mortality. Although there have been extensive studies of epidemiology, clinical manifestations, diagnostic techniques, animal models and the immunobiology of infection, there is not yet a convincing and safe vaccine available. The major histopathologic characteristics of RSV infection are acute bronchiolitis, mucosal and submucosal edema, and luminal occlusion by cellular debris of sloughed epithelial cells mixed with macrophages, strands of fibrin, and some mucin. There is a single RSV serotype with two major antigenic subgroups, A and B. Strains of both subtypes often co-circulate, but usually one subtype predominates. In temperate climates, RSV infections reflect a distinct seasonality with onset in late fall or early winter. It is believed that most children will experience at least one RSV infection by the age of 2 years. There are several key animal models of RSV. These include a model in mice and, more importantly, a bovine model; the latter reflects distinct similarity to the human disease. Importantly, the prevalence of asthma is significantly higher amongst children who are hospitalized with RSV in infancy or early childhood. However, there have been only limited investigations of candidate genes that have the potential to explain this increase in susceptibility. An atopic predisposition appears to predispose to subsequent development of asthma and it is likely that subsequent development of asthma is secondary to the pathogenic inflammatory response involving cytokines, chemokines and their cognate receptors. Numerous approaches to the development of RSV vaccines are being evaluated, as are the use of newer antiviral agents to mitigate disease. There is also significant attention being placed on the potential impact of co-infection and defining the natural history of RSV. Clearly, more research is required to define the relationships between RSV bronchiolitis, other viral induced inflammatory responses, and asthma.
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Affiliation(s)
- Andrea T. Borchers
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6501, Davis, CA 95616 USA
| | - Christopher Chang
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6501, Davis, CA 95616 USA
| | - M. Eric Gershwin
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6501, Davis, CA 95616 USA
| | - Laurel J. Gershwin
- Department of Pathology, Microbiology and Immunology, University of California, Davis, School of Veterinary Medicine, Davis, CA USA
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Torjussen TM, Munthe-Kaas MC, Mowinckel P, Carlsen KH, Undlien DE, Lødrup Carlsen KC. Childhood lung function and the association with β2-adrenergic receptor haplotypes. Acta Paediatr 2013; 102:727-31. [PMID: 23463918 DOI: 10.1111/apa.12221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 02/14/2013] [Accepted: 02/26/2013] [Indexed: 11/27/2022]
Abstract
AIM To determine associations between ADRB2 polymorphisms and lung function through childhood, and possible modification by gender, pet keeping or tobacco smoke. METHODS Four ADRB2 single nucleotide polymorphisms (rs1042711, rs1042713, rs1042714 and rs1800888) were genotyped in 953 children from the prospective birth cohort 'Environment and Childhood Asthma' study and analysed for association with flow-volume parameters at birth (tidal breathing) and at 10 years of age (maximally forced), stratified by environmental exposures. RESULTS The risk of reduced lung function was reduced in 10-year-old children carrying the most common ADRB2 haplotype (CGGC) (OR 0.45 (95% CI 0.25, 0.82)), whereas there was no association between lung function at birth and ADRB2 haplotypes. Tobacco smoke exposure, gender and pet keeping did not significantly interact with the haplotypes in influencing lung function. CONCLUSION This study demonstrates a possible protective effect by the ADRB2 haplotype I (CGGC) on reduced FEV1 in 10-year-old children, whereas no ADRB2 geno-/haplotypes were significantly associated with neonatal lung function. The ADRB2 gene thus appears to contribute to lung function development in childhood, independently of smoking, pets and gender.
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Affiliation(s)
- Tale M Torjussen
- Department of Paediatrics; Women and Children's Division; Oslo University Hospital; Oslo; Norway
| | | | - Petter Mowinckel
- Department of Paediatrics; Women and Children's Division; Oslo University Hospital; Oslo; Norway
| | | | - Dag E Undlien
- Department of Medical Genetics; Oslo University Hospital and University of Oslo; Oslo; Norway
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Savenije OE, Kerkhof M, Koppelman GH, Postma DS. Predicting who will have asthma at school age among preschool children. J Allergy Clin Immunol 2012; 130:325-31. [DOI: 10.1016/j.jaci.2012.05.007] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 05/07/2012] [Accepted: 05/07/2012] [Indexed: 10/28/2022]
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Mikalsen IB, Halvorsen T, Øymar K. The outcome after severe bronchiolitis is related to gender and virus. Pediatr Allergy Immunol 2012; 23:391-8. [PMID: 22435682 DOI: 10.1111/j.1399-3038.2012.01283.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The association between bronchiolitis in the first year of life and subsequent asthma, atopy, airway obstruction and bronchial hyper-responsiveness (BHR) is unsettled. Genetic predispositions, pre-morbid lung function, environmental interactions and altered immunological responses are risk factors that have been studied. The aim of this study was to assess lung function, BHR and the occurrence of asthma and atopy 11 yr after hospitalization for bronchiolitis in the first year of life, particularly focusing on the role of gender and virus involved. The study included 121 of 131 (92%) children hospitalized for bronchiolitis, 90 (74%) respiratory syncytial virus (RSV)-positive children and 141 children in an age-matched and unselected control group. At follow-up, current asthma was more common after RSV-negative bronchiolitis compared to controls (35.5% vs. 9.2%; p < 0.001), but not after RSV bronchiolitis (15.6%; p = 0.144). Higher BHR and an obstructive lung function pattern were observed after bronchiolitis, the latter most prominent after RSV-negative bronchiolitis. Higher BHR was confined to boys, but present in both the RSV-positive and RSV-negative groups (p = 0.007 and 0.003, respectively). Asthma after bronchiolitis was not associated with atopy. Atopy was similarly distributed between the RSV-positive and RSV-negative bronchiolitis groups and the control group. This study has shown that gender and type of virus are important factors to consider when addressing later development of asthma, BHR and lung function after hospitalization for bronchiolitis in early life.
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Affiliation(s)
- Ingvild B Mikalsen
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway.
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Decreased lung function after preschool wheezing rhinovirus illnesses in children at risk to develop asthma. J Allergy Clin Immunol 2011; 128:532-8.e1-10. [PMID: 21878241 PMCID: PMC3233203 DOI: 10.1016/j.jaci.2011.06.037] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 06/24/2011] [Accepted: 06/28/2011] [Indexed: 12/02/2022]
Abstract
Background Preschool rhinovirus (RV) wheezing illnesses predict an increased risk of childhood asthma; however, it is not clear how specific viral illnesses in early life relate to lung function later on in childhood. Objective To determine the relationship of virus-specific wheezing illnesses and lung function in a longitudinal cohort of children at risk for asthma. Methods Two hundred thirty-eight children were followed prospectively from birth to 8 years of age. Early life viral wheezing respiratory illnesses were assessed by using standard techniques, and lung function was assessed annually by using spirometry and impulse oscillometry. The relationships of these virus-specific wheezing illnesses and lung function were assessed by using mixed-effect linear regression. Results Children with RV wheezing illness demonstrated significantly decreased spirometry values, FEV1 (P = .001), FEV0.5 (P < .001), FEF25-75 (P < .001), and also had abnormal impulse oscillometry measures—more negative reactance at 5 Hz (P < .001)—compared with those who did not wheeze with RV. Children who wheezed with respiratory syncytial virus or other viral illnesses did not have any significant differences in spirometric or impulse oscillometry indices when compared with children who did not. Children diagnosed with asthma at ages 6 or 8 years had significantly decreased FEF25-75 (P = .05) compared with children without asthma. Conclusion Among outpatient viral wheezing illnesses in early childhood, those caused by RV infections are the most significant predictors of decreased lung function up to age 8 years in a high-risk birth cohort. Whether low lung function is a cause and/or effect of RV wheezing illnesses is yet to be determined.
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Bertelsen RJ, Carlsen KCL, Carlsen KH, Granum B, Doekes G, Håland G, Mowinckel P, Løvik M. Childhood asthma and early life exposure to indoor allergens, endotoxin and beta(1,3)-glucans. Clin Exp Allergy 2010; 40:307-16. [PMID: 20210808 DOI: 10.1111/j.1365-2222.2009.03424.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Divergent results have been reported regarding early life exposure to indoor environmental agents and the risk of asthma and allergic sensitization later in life. OBJECTIVE To assess whether early exposure to indoor allergens, beta(1,3)-glucans and endotoxin modifies the risk of allergic diseases at 10 years of age. METHODS The concentrations of mite, cat and dog allergens, endotoxin and beta(1,3)-glucans were determined in dust from the homes of 260 two-year-old children with lung function measured at birth (tidal flow volume loops) in the Environment and Childhood Asthma study in Oslo. At 10 years, the health status was assessed in a follow-up study including a structured interview of the parents and an extended clinical examination. RESULTS Cat and dog keeping at 2 years of age was reported in 6.5% and 5.5% of the families, respectively. Mite allergens were detected in only 4/260 dust samples. The adjusted odds ratio for asthma at age 10 was 1.20 (95% confidence interval: 1.01-1.43) and 1.22 (1.02-1.46) for bronchial hyperresponsiveness (BHR) per 10 microg/g dust increase in cat allergen exposure at 2 years of age. No association was seen with allergic sensitization. Moreover, endotoxin and beta(1,3)-glucan exposure did not modify the risk of asthma or allergic sensitization. None of the measured environmental factors were associated with lung function at 10 years of age or a relative change in lung function from birth. CONCLUSION In a community with a low prevalence of pet keeping and low mite allergen levels, exposure to cat allergens early in life increased the risk of late childhood asthma and BHR, but not the risk of allergic sensitization. No risk modification was seen for dog allergens, endotoxin and beta(1,3)-glucans.
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Affiliation(s)
- R J Bertelsen
- Department of Environmental Immunology, Division of Environmental Medicine, Norwegian Institute of Public Health, Oslo, Norway.
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Respiratory tract infections and lung function in early life--"Cling together, swing together". Allergol Immunopathol (Madr) 2010; 38:107-9. [PMID: 20434824 DOI: 10.1016/j.aller.2010.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Accepted: 02/18/2010] [Indexed: 11/22/2022]
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