Associations between markers of respiratory morbidity in European children

Abstract

School-aged children often experience acute respiratory symptoms. In a multicentre European study, the association between chronic respiratory symptoms (reported in a questionnaire), skin-prick test results, and lung function, and the occurrence of acute respiratory morbidity, was examined among children aged 6-12 yrs with chronic respiratory symptoms. Children with chronic respiratory symptoms, living in 10 European countries, were selected from a parent-completed questionnaire (n=4,307). Atopy was measured with skin-prick tests, and lung function with spirometry. A total of 1,854 (86% of those in the initial cohort) children kept a successful daily diary regarding their respiratory symptoms for 2-3 months. In multivariate logistic regression analyses, children with asthmatic symptoms, particularly those with doctor-diagnosed asthma, had a greater risk of occurrence of lower respiratory symptoms (odds ratio (OR): 6.12; 95% confidence interval (CI): 4.99-8.35) than children with a dry nocturnal cough as their only symptom. Atopy, particularly a positive reaction to indoor allergens, was significantly associated with occurrence of lower respiratory symptoms. For atopy the OR was 1.62 (95% CI: 1.34-1.96). A reduced level of maximal mid-expiratory flow was associated with an increased risk of lower respiratory symptoms, cough and phlegm. The associations were similar in Scandinavia, Central Eastern, Western and Southern Europe. To conclude, asthmatic symptoms reported in a questionnaire, atopic status and a reduced level of maximal mid-expiratory flow were associated with the occurrence of acute respiratory symptoms, especially those of lower respiratory symptoms.

Bronchial and alveolar nitric oxide in exercise‐induced bronchoconstriction in asthmatic children

“…These patients have been shown to represent a partic-ular subgroup of asthmatic patients, particularly those with intermittent, but potentially severe asthma, especially when sensitive to indoor allergens [30]. A positive reaction to indoor allergens has been shown to be significantly associated with the occurrence of more severe asthma [31,32], and this was clearly the case in our patients. More severe EIB and a trend towards higher levels of different NO parameters, particularly for J NO and C alv , have been in fact found in subjects sensitive to perennial allergens.…”

Severity, control, and responsiveness in asthma

“…Questionnaires include specific questions about daytime symptoms, nocturnal awakenings, exercise tolerance, time lost from work or school, and health care use. The markers assessed include measures of airflow obstruction (peak flow, FEV 1 , and the average rate of exhalation of the middle 50% of forced vital capacity), 29,44,45 of bronchial reactivity (as to methacholine, exercise, adenosine, or mannitol), 46 and of systemic or bronchial inflammation (blood or sputum eosinophil numbers or fractional concentration of nitric oxide in exhaled air). 34,40,47 These tools for assessing asthma severity and control are promising, but the elements necessary for the composite measure to be precise, efficient, comprehensive, and easily applied are not yet completely defined.…”

Seasonal allergies and suicidality: results from the National Comorbidity Survey Replication

“…Atopy was associated with seasonality in suicide, with those with a history of atopy having a higher risk of committing suicide in the first half of the year in Finland (3). Atopy, measured by history of allergies and skin‐prick tests, was also associated with depression in women, in a dose–response fashion, and in men where the association seemed restricted to the most severe tier of depression (4). Female offsprings of mothers with a history of atopy also showed a higher lifetime risk of depression, compared with offspring on mothers without atopy, pointing to a possible maternal lineage of transmission (5).…”