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Does Decline of Lung Function in Wheezy Infants Justify the Early Start of Controller Medications?

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Abstract

Objective

To compare lung function in wheezy infants, with risk factors of asthma and with some immunological parameters which may be useful as predictors of subsequent asthma.

Methods

The data of 241 infants aged 5–36 mo, with recurrent wheeze (≥3 episodes of physician confirmed wheeze) prior to receiving inhaled corticosteroids or anti-leukotrine agents was retrospectively analyzed. They were subdivided into 2 subgroups; those with asthma risk factors (132 patients) and those without (109 patients) Also, 67 healthy, age and sex matched children without recurrent wheezes were taken as control group. Total serum IgE, eosinophilic percentage, tPTEF/tE (time to peak expiratory flow to total expiratory time), total respiratory system compliance (Crs) and resistance of the respiratory system (Rrs) was done for patients and control groups.

Results

Wheezy infants had a significantly higher eosinophilic percentage and total serum IgE as well as a significantly lower pulmonary function parameters when compared to healthy controls. Wheezy infants with positive family history of asthma and those who had not been breast fed showed significant reduction in the mean values of tPTEF/tE and increased both eosinophilic percentage and total serum IgE. Crs was significantly decreased in wheezy infants with positive seasonal variations and those who had increased both eosinophilic percentage and total serum IgE. Rrs showed significant increase in wheezy infants with positive family history of atopy and those who had increased eosinophilic percentage and increased total serum IgE.

Conclusions

Lung function, eosinophilic percentage, total serum IgE and asthma risk factors could be used as predictors for ongoing wheeze in this subset of children.

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Abbreviations

tPTEF/tE:

Time to peak expiratory flow to total expiratory time

tE:

Total expiratory time

tI:

Total inspiratory time

Crs:

Respiratory system compliance

Rrs:

Resistance of the respiratory system

IgE:

Immunoglobulin E

References

  1. Taussig LM, Wright AL, Holberg CJ, Halonen M, Morgan WJ, Martinez FD. Tucson children’s respiratory study: 1980 to present. J Allergy Clin Immunol. 2003;111:661–75.

    Article  PubMed  Google Scholar 

  2. De Sario M, Di Domenicantonio R, Corbo G, et al. Characteristics of early transient, persistent, and late onset wheezers at 9 to 11 y of age. J Asthma. 2006;43:633–8.

    Article  PubMed  Google Scholar 

  3. Phelan PD, Robertson CF, Olinsky A. The Melbourne asthma study: 1964–1999. J Allergy Clin Immunol. 2002;109:189–94.

    Article  PubMed  Google Scholar 

  4. Sears MR, Greene JM, Willan AR, et al. A longitudinal, population-based, cohort study of childhood asthma followed to adulthood. N Engl J Med. 2003;349:1414–22.

    Article  PubMed  CAS  Google Scholar 

  5. Stern DA, Morgan WJ, Wright AL, Guerra S, Martinez FD. Poor airway function in early infancy and lung function by age 22 y: a non-selective longitudinal cohort study. Lancet. 2007;370:758–64.

    Article  PubMed  Google Scholar 

  6. Martinez FD, Morgan WJ, Wright AL, Holberg CJ, Taussig LM. Diminished lung function as a predisposing factor for wheezing respiratory illness in infants. N Engl J Med. 1988;319:1112–7.

    Article  PubMed  CAS  Google Scholar 

  7. Martinez FD, Morgan WJ, Wright AL, Holberg C, Taussig LM. Initial airway function is a risk factor for recurrent wheezing respiratory illnesses during the first 3 y of life. Group Health Medical Associates. Am Rev Respir Dis. 1991;143:312–6.

    PubMed  CAS  Google Scholar 

  8. Cutrera R, Filtchev SI, Merolla R, Willim G, Haluszka J, Ronchetti R. Analysis of expiratory pattern for monitoring bronchial obstruction in school-age children. Pediatr Pulmonol. 1991;10:6–10.

    Article  PubMed  CAS  Google Scholar 

  9. Morris MJ, Lane DJ. Tidal expiratory flow patterns in airflow obstruction. Thorax. 1981;36:135–42.

    Article  PubMed  CAS  Google Scholar 

  10. Bisgaard H, Bønnelykke K. Long-term studies of the natural history of asthma in childhood. J Allergy Clin Immunol. 2010;126:187–97.

    Article  PubMed  Google Scholar 

  11. Lodrup KC, Mowinckel P, Carlsen KH. Lung function measurements in awake compared to sleeping newborn infants. Pediatr Pulmonol. 1992;12:99–104.

    Article  PubMed  CAS  Google Scholar 

  12. Gappa M, Colin AA, Goetz I, Stocks J, ERS/ATS. Task force on standards for infant respiratory function testing. European Respiratory Society/American Thoracic Society. Passive respiratory mechanics: the occlusion techniques. Eur Respir J. 2001;17:141–8.

    Article  PubMed  CAS  Google Scholar 

  13. Van der Ent CK, Brackel HJ, van der Laag J, Bogaard JM. Tidal breathing analysis as a measure of airway obstruction in children 3 y of age and older. Am J Respir Crit Care Med. 1996;153:1253–8. http://www.ncbi.nlm.nih.gov/pubmed?term=Gappa%20M%2C%20Colin%20AA

    Google Scholar 

  14. Banovcin P, Seidenberg J, Von der Hardt H. Assessment of tidal breathing patterns for monitoring of bronchial obstruction in infants. Pediatr Res. 1995;38:218–20.

    Article  PubMed  CAS  Google Scholar 

  15. Lødrup Carlsen KC. Tidal breathing at all ages. Monaldi Arch Chest Dis. 2000;55:427–34. http://www.ncbi.nlm.nih.gov/pubmed/11213383

  16. Tortorolo L, Vento G, Matassa PG, Zecca E, Romagnoli C. Early changes of pulmonary mechanics to predict the severity of bronchopulmonary dysplasia in ventilated preterm infants. J Matern Fetal Neonatal Med. 2002;12:332–7.

    Article  PubMed  CAS  Google Scholar 

  17. Seddon PC, Davis GM, Coates AL. Do tidal expiratory flow patterns reflect lung mechanics in infants? Am J Respir Crit Care Med. 1996;153:1248–52.

    PubMed  CAS  Google Scholar 

  18. Oddy WH. The long-term effects of breast-feeding on asthma and atopic disease. Adv Exp Med Biol. 2009;639:237–51.

    Article  PubMed  CAS  Google Scholar 

  19. Håland G, Carlsen KC, Sandvik L, et al. Reduced lung function at birth and the risk of asthma at 10 y of age. N Engl J Med. 2006;355:1682–9.

    Article  Google Scholar 

  20. Dezateux C, Stocks J, Wade AM, Dundas I, Fletcher ME. Airway function at 1 y: association with premorbid airway function, wheezing, and maternal smoking. Thorax. 2001;56:680–6.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors thank Asmaa Mahran, senior resident of pediatric department of Mansuora University for revision and valuable comments for the manuscript

Conflict of Interest

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Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Nehad Nasef, Mohamed El-Bayoumy, Mohamed El-Assmy, Gehan Attia, Mohamed Zedan, Angi AlWakeel, Shaimaa Kandil, Wafaa Laimon & Ashraf Fouda

  2. Allergy Unit, Faculty of Medicine, Mansoura University, Pin Code: 35516, Box 50, Mansoura, Egypt

    Magdy Zedan

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  1. Magdy Zedan
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  2. Nehad Nasef
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  3. Mohamed El-Bayoumy
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  6. Mohamed Zedan
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  7. Angi AlWakeel
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  9. Wafaa Laimon
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  10. Ashraf Fouda
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Correspondence to Magdy Zedan.

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Zedan, M., Nasef, N., El-Bayoumy, M. et al. Does Decline of Lung Function in Wheezy Infants Justify the Early Start of Controller Medications?. Indian J Pediatr 79, 1176–1180 (2012). https://doi.org/10.1007/s12098-012-0694-z

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  • DOI: https://doi.org/10.1007/s12098-012-0694-z

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