Document Detail


Prediction of asthma in symptomatic preschool children using exhaled nitric oxide, Rint and specific IgE.
MedLine Citation:
PMID:  20805175     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE: For clinicians it remains very difficult to predict whether preschool children with symptoms suggestive of asthma will develop asthma in later childhood. OBJECTIVE: To investigate whether measurement of fraction of exhaled nitric oxide (FE(NO)), interrupter resistance (Rint) or specific immunoglobulin E (IgE) in 4-year-old children with suggestive symptoms can predict asthma symptoms up to age 8 years. METHODS: Children were recruited from the PIAMA birth cohort. All children with symptoms suggestive of asthma at age 3 or 4 years, who were invited for medical examination at age 4 (n=848), were eligible. Associations of FE(NO) (n=308), Rint (n=482) and specific IgE (n=380) at 4 years with wheezing and asthma at the ages of 5-8 years were assessed using repeated measurement analyses. The added predictive value of these objective tests was then investigated by including parameters for clinical history in the model. RESULTS: FE(NO) and specific IgE measured at 4 years were associated with wheezing and asthma at 8 years. Both tests also remained significant predictors after mutual adjustment and adjustment for clinical history: OR on wheezing at 8 years for FE(NO) ((10)log-scale, per IQR) 1.6 (95% CI 1.1 to 2.2) and for specific IgE 2.8 (95% CI 1.9 to 4.1). Rint was significantly associated with wheezing at age 6, but not at 7 and 8 years. CONCLUSIONS: In preschool children with symptoms suggestive of asthma, both FE(NO) and specific IgE measured at age 4, but not Rint, improved the prediction of asthma symptoms until the age of 8 years, independent of clinical history.
Authors:
Daan Caudri; Alet H Wijga; Maarten O Hoekstra; Marjan Kerkhof; Gerard H Koppelman; Bert Brunekreef; Henriette A Smit; Johan C de Jongste
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thorax     Volume:  65     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-10-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  801-7     Citation Subset:  IM    
Affiliation:
Department of Pediatrics/Respiratory Medicine, Erasmus University, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Airway Resistance / physiology*
Asthma / diagnosis*
Biological Markers / metabolism
Breath Tests / methods
Child
Child, Preschool
Disease Progression
Female
Follow-Up Studies
Humans
Immunoglobulin E / biosynthesis*
Male
Nitric Oxide / metabolism*
Predictive Value of Tests
Prognosis
Respiratory Sounds / diagnosis
Chemical
Reg. No./Substance:
0/Biological Markers; 10102-43-9/Nitric Oxide; 37341-29-0/Immunoglobulin E

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