Document Detail


Bronchodilation and bronchoconstriction: predictors of future lung function in childhood asthma.
MedLine Citation:
PMID:  16750985     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Persistently low levels of lung function are associated with subsequent symptoms in patients with asthma as children. OBJECTIVES: We hypothesized that objective measures of baseline pulmonary function would be independently associated with future lung function in the Childhood Asthma Management Program and that these associations might vary with treatment. METHODS: We evaluated the association of FEV1, airway responsiveness, and bronchodilator response at randomization as predictors of longitudinal growth in FEV1 at the 48-month follow-up visit in the 1041 Childhood Asthma Management Program participants. RESULTS: Baseline levels of airway responsiveness and bronchodilator response were significantly associated with baseline level of lung function. In multivariate models, higher bronchodilator response (beta = 0.22; P < .0001), log PC20 (beta = 1.82; P < .0001), and FEV1 (beta = 0.58; P < .0001) at randomization were each associated with higher levels of prebronchodilator FEV1, as a percent of predicted, after 4 years. Similar associations were noted for prebronchodilator forced vital capacity and FEV1/forced vital capacity ratio. Baseline bronchodilator response was a particularly powerful predictor of lung function improvements while on inhaled corticosteroids, whereas airway responsiveness was a better predictor in subjects not randomized to any controller medications. CONCLUSION: We conclude that baseline bronchodilator response, airway responsiveness, and level of FEV1 are independent predictors of subsequent level of FEV1 in childhood asthma and may have treatment-specific prognostic significance for persistence of symptoms into early adulthood. CLINICAL IMPLICATIONS: In asthma, bronchodilator and bronchoconstrictor responses are independent predictors of future lung function and should not be used interchangeably; bronchodilator response may indicate good response to inhaled corticosteroids.
Authors:
Kelan G Tantisira; Anne L Fuhlbrigge; James Tonascia; Mark Van Natta; Robert S Zeiger; Robert C Strunk; Stanley J Szefler; Scott T Weiss;
Related Documents :
2782735 - An investigation of the effects of heat and water exchange in the recovery period after...
10457105 - Effects of exposure to gas cooking in childhood and adulthood on respiratory symptoms, ...
11504695 - Airway inflammation in nonasthmatic amateur runners.
21481515 - Exercise related cardiac arrest in amateur athletes on the tennis court.
11805685 - Halovest dynamic loads: full crossover comparison of three vest types.
22843115 - Effect of ischemic preconditioning on lactate accumulation and running performance.
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2006-04-27
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  117     ISSN:  0091-6749     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-05     Completed Date:  2006-07-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1264-71     Citation Subset:  AIM; IM    
Affiliation:
Channing Laboratory, Pulmonary Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. kelan.tantisira@channing.harvard.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Asthma / diagnosis*,  drug therapy,  physiopathology
Bronchoconstriction / drug effects*
Bronchodilator Agents / pharmacology*
Child
Double-Blind Method
Female
Humans
Lung / drug effects*,  physiopathology
Male
Multicenter Studies as Topic
Predictive Value of Tests
Prognosis
Respiratory Function Tests
Grant Support
ID/Acronym/Agency:
M01 RR00051/RR/NCRR NIH HHS; M01RR00051/RR/NCRR NIH HHS; M01RR0099718-24/RR/NCRR NIH HHS; M01RR07219-14/RR/NCRR NIH HHS; P01 HL67664/HL/NHLBI NIH HHS; RR00036/RR/NCRR NIH HHS; U01 HL65899/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Bronchodilator Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Bronchodilator responses in Chinese children from asthma index families and the general population.
Next Document:  Daily home measurements of exhaled nitric oxide in asthmatic children during natural birch pollen ex...