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Asthma-like symptoms in young children increase the risk of COPD - 04/02/21

Doi : 10.1016/j.jaci.2020.05.043 
Hans Bisgaard, MD, DMSc a, , Sarah Nørgaard, MSc a, Astrid Sevelsted, PhD a, Bo Lund Chawes, MD, PhD, DMSc a, Jakob Stokholm, MD, PhD a, Erik Lykke Mortensen, Cand Psych b, Charlotte Suppli Ulrik, MD, DMSc c, Klaus Bønnelykke, MD, PhD a
a Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark 
b Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark 
c Respiratory Research Unit Hvidovre, Department of Respiratory Medicine, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark 

Corresponding author: Hans Bisgaard, MD, DMSc, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen. Ledreborg Allé 34, DK-2820 Gentofte, Denmark.Copenhagen Prospective Studies on Asthma in ChildhoodHerlev and Gentofte HospitalUniversity of Copenhagen. Ledreborg Allé 34GentofteDK-2820Denmark

Abstract

Background

Chronic obstructive pulmonary disease (COPD) may originate in early life and share disease mechanisms with asthma-like symptoms in early childhood. This possibility remains unexplored on account of the lack of long-term prospective studies from infancy to the onset of COPD.

Objective

We aimed to investigate the relationship between asthma-like symptoms in young children and development of COPD.

Methods

In a population-based cohort of women who gave birth at the central hospital in Copenhagen during period from 1959 to 1961, we investigated data from 3290 mother-child pairs who attended examinations during pregnancy and when the children were aged 1, 3, and 6 years. COPD was assessed from the Danish national registries on hospitalizations and prescription medication since 1994. A subgroup of 930 individuals underwent spirometry testing at age 50 years.

Results

Of the 3290 children, 1 in 4 had a history of asthma-like symptoms in early childhood. The adjusted hazard ratio for hospitalization for COPD was 1.88 (95% CI = 1.32-2.68), and the odds ratio for prescription of long-acting muscarinic antagonists was 2.27 (95% CI = 1.38-3.70). Asthma-like symptoms in early childhood were also associated with a reduced FEV1 percent predicted and an FEV1-to–forced vital capacity ratio at age 50 years (–3.36% [95% CI = –5.47 to –1.24] and –1.28 [95% CI = –2.17 to –0.38], respectively) and with COPD defined according to Global Initiative for Chronic Obstructive Lung Disease stage higher than 1 (odds ratio = 1.96 [95% CI = 1.13-3.34]).

Conclusion

This 60-year prospective follow-up of a mother-child cohort demonstrated a doubled risk for COPD from childhood asthma-like symptoms.

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Graphical abstract




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Key words : Asthma, COPD, cohort study

Abbreviations used : aHR, aOR, ATC, COPD, COPSAC1960, FVC, GOLD, LAMA


Mappa


 All funding received by Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, is listed on www.copsac.com. The Lundbeck Foundation (grant R16-A1694), the Ministry of Health (grant 903516), the Danish Council for Strategic Research (grant 0603-00280B), and the Capital Region Research Foundation have provided core support to the COPSAC research center. Helsefonden (grant 19-B-0044) and Kong Christian den Tiendes Fond provided funding for this study. No funding sources had any involvement in this study.
 Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest. The funding agencies did not have any role in design and conduct of the study; collection, management, and interpretation of the data; or preparation, review, and approval of the manuscript. No pharmaceutical company was involved in the study. We are aware of and comply with recognized codes of good research practice, including the Danish Code of Conduct for Research Integrity. We comply with national and international rules on the safety and rights of patients and healthy subjects, including good clinical practice (GCP) as defined in the EU Directive on Good Clinical Practice, the International Conference on Harmonization good clinical practice guidelines, and the Declaration of Helsinki. We follow national and international legislation on general data protection regulation, the Danish Act on Processing of Personal Data, and the practice of the Danish Data Inspectorate.


© 2020  Pubblicato da Elsevier Masson SAS.
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