Decreased lung function after preschool wheezing rhinovirus illnesses in children at risk to develop asthma - 28/08/11
, Anne Marie Singh, MD a, b, Zoran Danov, MD e, Michael D. Evans, MS c, Daniel J. Jackson, MD a, b, Ryan Burton, BS a, b, Kathy A. Roberg, RN a, Elizabeth L. Anderson, RN a, Tressa E. Pappas, BS a, Ronald Gangnon, PhD c, d, James E. Gern, MD a, Robert F. Lemanske, MD a, b
Reprint requests: Theresa W. Guilbert, MD, MS, Department of Pediatrics, University of Wisconsin–Madison, 600 Highland Avenue, K4/944, CSC-4108, Madison, WI 53716.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.
Le texte complet de cet article est disponible en PDF.Key words : Rhinovirus, respiratory syncytial virus, wheezing, asthma, spirometry, impulse oscillometry
Abbreviations used : ATS, COAST, FEIA, IOS, RSV, RV
Plan
| This study was supported by National Institutes of Health (NIH) grants R01 HL61879, P01 HL70831, and M01 RR03186. |
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| Disclosure of potential conflict of interest: T. W. Guilbert has consultant arrangements with GlaxoSmithKline, AstraZeneca, MAP Pharmaceutical, Merck/Schering-Plough, and Genentech/Novartis; has received honororia from Peerpoint Medical Education Institute; has received research support from Altus Pharmaceuticals, Inspire Pharmaceuticals, the NHLBI, and the NIH; and is a member of the American Lung Association, the American Thoracic Society, and the American Academy of Pediatrics. D. J. Jackson has received research support from the AAAAI/GlaxoSmithKline. J. E. Gern has stock options in EraGen Biosciences. R. F. Lemanske, Jr has consultant arrangements with Merck & Co, Inc, AstraZeneca, and GlaxoSmithKline; is an author for Up to Date; and is on the speakers' bureau for the Michigan Public Health Institute. R. Burton has consultant arrangements with Carefusion (ERT). The rest of the authors have declared that they have no conflict of interest. |
Vol 128 - N° 3
P. 532 - septembre 2011 Retour au numéro
Article précédent
- IFNG genotype and sex interact to influence the risk of childhood asthma
- Dagan A. Loisel, Zheng Tan, Christopher J. Tisler, Michael D. Evans, Ronald E. Gangnon, Daniel J. Jackson, James E. Gern, Robert F. Lemanske, Carole Ober
- Downregulation of glutathione S-transferase pi in asthma contributes to enhanced oxidative stress
- Kathy T. Schroer, Aaron M. Gibson, Umasundari Sivaprasad, Stacey A. Bass, Mark B. Ericksen, Marsha Wills-Karp, Tim LeCras, Anne M. Fitzpatrick, Lou Ann S. Brown, Keith F. Stringer, Gurjit K. Khurana Hershey
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