Maternal smoking affects lung function and airway inflammation in young children with multiple-trigger wheeze - 27/02/13
, Anna S. Pelkonen, MD, PhD a, L. Pekka Malmberg, MD, PhD a, Seppo Sarna, PhD b, Mauri Hämäläinen, PhD c, d, Ilkka Mononen, MD, PhD c, d, Mika J. Mäkelä, MD, PhD a
Corresponding author: Satu Kalliola, MD, Skin and Allergy Hospital, Helsinki University Hospital, PO Box 160, Helsinki FIN-00029 HUS, Finland.Abstract |
Background |
Exposure to tobacco smoke is a well-known risk factor for childhood asthma and reduced lung function, but the effect on airway inflammation in preschool-aged children is unclear.
Objective |
To examine the effect of parental smoking on lung function and fractional concentration of exhaled nitric oxide (Feno) in relation to both parental reports and children’s urine cotinine concentrations in preschool-aged children with multiple-trigger wheeze.
Methods |
A total of 105 3- to 7-year-old children with multiple-trigger wheeze and lung function abnormalities were recruited. Lung function was assessed by impulse oscillometry, and Feno measurements were performed. Exposure to tobacco smoke was determined by parental reports and measurement of children’s urinary cotinine concentrations.
Results |
Forty-three percent of the children were exposed to environmental tobacco smoke according to parental reports. The Feno level was significantly higher in children with a smoking mother (n = 27) than in children with a nonsmoking mother (23.4 vs 12.5 ppb, P = .006). The Feno level expressed as z score and the cotinine level correlated significantly (P = .03). Respiratory resistance at 5 Hz was higher in children exposed to maternal smoking than in others (0.99 vs 0.88 kPas/L, P = .005). Urinary cotinine concentrations reflected well parental reports on their daily smoking and increased relative to the number of cigarettes smoked in the family (P < .01). Atopy was found in 75% of the children, but it was not associated with the Feno value (P = .65).
Conclusion |
Maternal smoking was associated with increased Feno value and poorer lung function in steroid-naive preschool children with multiple-trigger wheeze. Larger controlled trials are needed to generalize the results.
Le texte complet de cet article est disponible en PDF.Key words : Pediatric asthma, environmental tobacco smoke, exhaled nitric oxide, cotinine, lung function
Abbreviations used : ETS, Feno, IOS, Rrs5
Plan
| This work was supported by Helsinki University Central Hospital Research Funds, the Sigrid Juselius Foundation, and Nummela Sanatoriums Stiftelse. |
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| Disclosure of potential conflict of interest: S. Kalliola has received research support from Helsinki University Central Hospital Research Funds, the Sigrid Juselius Foundation, and Nummela Sanatoriums Stiftelse. L.P. Malmberg has received lecture fees from OrionPharma and GlaxoSmithKline. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 131 - N° 3
P. 730-735 - mars 2013 Retour au numéro
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