Lung function trajectories from birth through puberty reflect asthma phenotypes with allergic comorbidity - 02/10/14
Abstract |
Background |
Childhood asthma phenotypes reflecting underlying developmental mechanisms are sought, with little information on asthma phenotypes based on allergic comorbidities.
Objective |
We asked whether lung function trajectories from birth to 16 years were associated with asthma phenotypes with comorbid allergic rhinitis and atopic dermatitis.
Methods |
Lung function (given as z scores) was measured at birth in 329 subjects in the “Environment and Childhood Asthma” birth cohort study in Oslo by using tidal flow volume loops, and at 10 and 16 years by using spirometry. Asthma phenotypes were classified on the basis of recurrent bronchial obstruction at 0 to 2 years, and asthma from the 2- to 10-year and 10- to 16-year intervals, and by combining asthma, atopic dermatitis, and/or allergic rhinitis from 10 to 16 years, stratifying for allergic sensitization. The reference group included 231 subjects without recurrent bronchial obstruction or asthma.
Results |
Lung function trajectories differed significantly for asthma comorbidity phenotypes for FEV1, forced expiratory flow at 25% to 75% of forced vital capacity, and FEV1/forced vital capacity (all P < .0001). Significant lung function impairment was observed from birth through 16 years among subjects with asthma, atopic dermatitis, and allergic rhinitis. Lung function trajectories in subjects with asthma at 10 to 16 years or asthma in remission differed significantly for all 3 spirometric values compared with the trajectories in those who never had asthma (P < .0001), but not between asthma groups. Allergic sensitization was not significantly associated with asthma phenotype lung function trajectories.
Conclusions |
The trajectory consisting of impaired lung function from birth throughout childhood in children with asthma, atopic dermatitis, and allergic rhinitis appears less likely to be driven by allergic sensitization, and may imply disease onset in utero, with clinical presentation later in childhood.
Le texte complet de cet article est disponible en PDF.Key words : Lung function trajectory, asthma, allergic disease, child, birth cohort
Abbreviations used : AD, AR, FEF25-75, FVC, rBO, TFV, tPTEF/tE
Plan
This study was performed within the Oslo Research Group of Asthma and Allergy in Childhood; the Lung and Environment (ORAACLE), a member of the Global Asthma and Allergy European Network (GA2LEN) and Mechanisms of the Development of ALLergy (MeDALL), a collaborative project conducted within the European Union under the Health Cooperation Work Programme of the 7th Framework programme (grant agreement no. 261357). The Environment and Childhood Asthma study has been funded through the 16 years by the following public funding bodies: The Norwegian Research Council, The Regional Health Board South East, Health and Rehabilitation, the European Union (Global Asthma and Allergy European Network and Mechanisms of the Development of ALLergy projects; MeDALL: grant no. 261357, GA2LEN: FOOD-CT-2004-506378), by unrestricted grants from the Norwegian Association of Asthma and Allergy, Rimi as well as by financing PhD students by the Kloster Foundation and AstraZeneca, and by providing IgE analyses by Thermo-Fisher, Uppsala, Sweden, in collaboration with Fürst Medical Laboratory, Oslo, Norway. |
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Disclosure of potential conflict of interest: K. C. Lødrup Carlsen has received research support from RegionHealth South East and Thermo Fischer and the Environment and Childhood Asthma study; and has received travel support from MeDALL (MeDALL: grant no. 261357). P. Mowinckel, G. Håland, V. Hovland, and A. Riiser have received research support from RegionHealth South East. K.-H. Carlsen has received research support from RegionHealth South East; is on the boards for Meda Pharmaceutical and Boehringer Ingelheim; and has received lecture fees from Meda Pharmaceuticals, Merck, and Nycomed. |
Vol 134 - N° 4
P. 917 - octobre 2014 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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