Document Detail

Lung function, airway remodelling and inflammation in symptomatic infants: outcome at 3 years.
MedLine Citation:
PMID:  21199817     Owner:  NLM     Status:  In-Data-Review    
Background Relationships between early deficits of lung function, infant airway pathology and outcome in symptomatic infants are unclear. A study was undertaken to determine the associations between early lung function, airway histology and inflammation in symptomatic infants with the continuance of respiratory symptoms, lung function and subsequent use of inhaled asthma medication at the age of 3&emsp14;years. Methods 53 children who underwent lung function measurements and bronchoscopy following referral to a specialist children's hospital for recurrent lower respiratory symptoms at a mean age of 1&emsp14;year were followed up at 3&emsp14;years of age. Assessments were made of respiratory symptoms during the previous year, lung function by oscillometry and atopy by skin prick testing. Individual data on the purchase of asthma medications were obtained from the Social Insurance Institution for the 12&emsp14;months preceding the follow-up visit. Results 50 children (94%) were re-evaluated, of whom 40 had ongoing airway symptoms. 11/39 (28%) who underwent successful oscillometry had reduced lung function, 31/50 (62%) used inhaled corticosteroids (ICS) regularly and 12/50 (24%) used ICS intermittently. Abnormal lung function at infancy was associated with ongoing airway symptoms (p<0.001) and with the purchase of ICS (p=0.009) and β agonists (p=0.002). Reticular basement membrane thickness in infancy and the numbers of mucosal mast cells, but not eosinophils, correlated significantly with the amount of ICS purchased at 3&emsp14;years (p=0.003 and p=0.018, respectively). Conclusions Reduced lung function, thickening of the reticular basement membrane and increased density of mucosal mast cells in infancy are associated with respiratory morbidity and treatment needs at age 3&emsp14;years in this highly selected group of children.
Kristiina Malmström; Anna S Pelkonen; L Pekka Malmberg; Seppo Sarna; Harry Lindahl; Merja Kajosaari; Markku Turpeinen; Sejal Saglani; Andy Bush; Tari Haahtela; Peter K Jeffery; Mika J Mäkelä
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Publication Detail:
Type:  Journal Article     Date:  2011-01-02
Journal Detail:
Title:  Thorax     Volume:  66     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  157-62     Citation Subset:  IM    
Department of Allergy, Helsinki University Central Hospital; P O Box 160, FI-00029 Helsinki, Finland.
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