Characterization of Asthma Trajectories from Infancy to Young Adulthood

Ödling, Maria; Wang, Gang; Andersson, Niklas; Hallberg, Jenny; Janson, Christer; Bergström, Anna; Kull, Inger

doi:10.1016/j.jaip.2021.02.007

Cited by 27 publications

(37 citation statements)

References 49 publications

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“…About one-third of the children in our study belonged to relatively bad asthma symptom trajectories in two distinct groups. We did not find any previous study in Australia that showed the trajectories of asthma symptoms in children; however, there are several studies reported earlier from the UK, Canada and Sweden 24 25 28 51. One Canadian birth cohort study where they followed children from birth to 10 years showed three to four distinct trajectories, including transient, early-onset chronic and late-onset chronic asthma 28.…”

Section: Discussioncontrasting

confidence: 59%

“…We also found a similarity of the results of our study to a large birth cohort from Sweden, where they showed the trajectories followed transient and persistent patterns when this developed from the first year of life. 51 Our study has identified two distinct trajectory groups where children had asthma symptom over their first 14/15 years of life. One is the persistent or chronic pattern of asthma symptom and the other is the transient type.…”

Section: Discussionmentioning

confidence: 85%

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Trajectories of asthma symptom presenting as wheezing and their associations with family environmental factors among children in Australia: evidence from a national birth cohort study

et al. 2022

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ObjectivesAsthma is one of the greatest health burdens, yet contributors to asthma symptom trajectories are understudied in Australian children. We aimed to assess the trajectories of asthma symptom and their associations with several family environmental factors during the childhood period in Australia.DesignSecondary analysis from a cross-sequential cohort study.SettingNationwide representative data from the ‘Longitudinal Study of Australian Children (LSAC)’.ParticipantsParticipants from the LSAC birth cohort.Outcome measuresAsthma symptom trajectory groups.MethodsAsthma symptom presenting as wheezing, family environmental factors and sociodemographic data (2004–2018) were obtained from the LSAC. Group-based trajectory modelling was applied to identify asthma symptom trajectories and multivariable logistic regression models were used to assess the associations between these and environmental factors.ResultsOf 5107 children in the LSAC cohort, 3846 were included in our final analysis. We identified three distinct asthma symptom trajectories from age 0/1 year to 14/15 years: ‘low/no’ (69%), ‘transient high’ (17%) and ‘persistent high’ (14%). Compared with the ‘low/no’ group, children exposed to ‘moderate and declining’ (relative risk ratio (RRR): 2.22, 95% CI 1.94 to 2.54; RRR: 1.26, 95% CI 1.08 to 1.46) and ‘high and persistent’ prevalence of maternal smoking (RRR: 1.41, 95% CI 1.23 to 1.60; RRR: 1.26, 95% CI 1.10 to 1.44) were at increased risk of being classified into the ‘transient high’ and ‘persistent high’ trajectories of asthma symptom. Persistently bad external dwelling conditions (RRR: 1.27, 95% CI 1.07 to 1.51) were associated with ‘transient high’ trajectory while ‘moderate and increasing’ conditions of cluttered homes (RRR: 1.37, 95% CI 1.20 to 1.56) were associated with ‘persistent high’ trajectory of asthma symptom. Exposure to tobacco smoke inside the house also increased the risk of being in the ‘persistent high’ trajectory group (RRR: 1.30, 95% CI 1.12 to 1.50).ConclusionPoor home environment increased the risk of asthma symptom during childhood. Improving home environment and reducing exposure to tobacco smoke may facilitate a favourable asthma symptom trajectory during childhood.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 85%

Trajectories of asthma symptom presenting as wheezing and their associations with family environmental factors among children in Australia: evidence from a national birth cohort study

et al. 2022

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“…In the Swedish BAMSE cohort, Ödling et al investigated the course of asthma between 1 and 24 years of age and found four trajectories using LCA: never/infrequent asthma; early-onset transient asthma; adolescent-onset asthma; and persistent asthma. 47 When focusing on the age range 8-24 years, the BAMSE trajectories are comparable to the wheeze trajectories found in SOLAR.…”

Section: Sensitivity Analysesmentioning

confidence: 55%

Trajectories of asthma and allergy symptoms from childhood to adulthood

Forster

Ege

Gerlich

et al. 2021

Allergy

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Background Phenotypes of asthma and allergic diseases are mainly studied separately for children and adults. To explore the role of adolescence and young adulthood, we investigated symptom trajectories at the transition from childhood into adulthood. Methods Latent class analysis (LCA) was conducted in a population initially recruited for the German arm of Phase II of the International Study of Asthma and Allergies in Childhood and followed‐up three times until their early 30s (N=2267). Indicators included in LCA were 12‐month prevalences of symptoms of wheeze, rhinoconjunctivitis, and eczema. Latent classes were further characterised regarding important traits such as skin prick tests. Logistic regression models were used to investigate associations with environmental determinants such as smoking and occupational exposures. Results Six latent classes were identified: an asymptomatic one as well as three with single and two with co‐occurring symptoms. All trajectories essentially established between baseline assessment at around 10 years and the first follow‐up at around 17 years. Probabilities for symptoms increased from childhood to adolescence, especially for wheeze‐related latent classes, while they remained constant in adulthood. Wheeze‐related latent classes were also positively associated with exposures during adolescence (e.g. active smoking). Conclusion Distinct trajectories of asthma and allergy symptoms establish from childhood through adolescence and stabilize during early adulthood. This pattern was most notable in wheeze‐related latent classes which also showed the strongest positive associations with environmental exposures in adolescence/young adulthood. Therefore, not only childhood but also adolescence is relevant for disease development and offers considerable potential for prevention and health promotion.

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“…One-third of classes 3 and 4 had eczema in early childhood and were sensitive to food allergens. More than two-thirds of both classes were sensitized to inhalant allergens during adolescence and young adulthood [79]. By identifying and systematizing the different phenotypes of each allergic disease in this way, it is possible to predict the sequence of allergic disease progression more accurately at the individual level.…”

Section: Atopic March and Challenges In Epidemiological Studiesmentioning

confidence: 99%

Current Insights into Atopic March

et al. 2021

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The incidence of allergic diseases is increasing, and research on their epidemiology, pathophysiology, and the prevention of onset is urgently needed. The onset of allergic disease begins in infancy with atopic dermatitis and food allergy and develops into allergic asthma and allergic rhinitis in childhood; the process is defined as “atopic march”. Atopic march is caused by multiple immunological pathways, including allergen exposure, environmental pollutants, skin barrier dysfunction, type 2 inflammation, and oxidative stress, which promote the progression of atopic march. Using recent evidence, herein, we explain the involvement of allergic inflammatory conditions and oxidative stress in the process of atopic march, its epidemiology, and methods for prevention of onset.

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Characterization of Asthma Trajectories from Infancy to Young Adulthood

Cited by 27 publications

References 49 publications

Trajectories of asthma symptom presenting as wheezing and their associations with family environmental factors among children in Australia: evidence from a national birth cohort study

Trajectories of asthma symptom presenting as wheezing and their associations with family environmental factors among children in Australia: evidence from a national birth cohort study

Trajectories of asthma and allergy symptoms from childhood to adulthood

Current Insights into Atopic March

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