Growth Problems in Children with Asthma

Undernutrition during fetal and postnatal life is still a major problem in many low- and middle-income countries. Even in high-income countries malnutrition may exist in cases of intrauterine growth retardation, as well as in chronic conditions such as anorexia nervosa and inflammatory bowel disease. Children adopted from developing countries are often chronically malnourished. Nutritional rehabilitation, resulting in catch-up growth, is often complicated by influences originating in fetal life as well as during postnatal growth. This may result in hormonal and metabolic changes as well as alterations in pubertal development. The present review focuses on fetal, postnatal and fetal-postnatal undernutrition and subsequent catch-up growth as well as catch-up growth in relation to pubertal development. Catch-up growth in children can be associated with early puberty following fetal or combined fetal-postnatal undernutrition. However, early puberty does not seem to occur following catch-up growth after isolated postnatal undernutrition. Gonadotropins have been reported to be elevated in prepubertal adopted girls as well as during catch-up growth in animals. Even if other factors may contribute, linear catch-up growth seems to be associated with the timing of pubertal development. The mechanisms behind this are still unknown. Future research may elucidate how to carry out nutritional rehabilitation without risk for early pubertal development.

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“…Growth problems sometimes occur in children with poorly controlled asthma [47]. There may be a chronic delay of both growth and puberty.…”

Section: Postnatal Undernutrition Growth and Pubertymentioning

confidence: 99%

Is Early Puberty Triggered by Catch-Up Growth Following Undernutrition?

Proos

Gustafsson

2012

IJERPH

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“…Daily intake of systemic corticosteroids has been shown to suppress growth rate until treatment is discontinued irrespective of the dose, whereas in case of inhaled corticosteroids, the effect depends on the dose, schedule and method of administration. Moreover, growth inhibition caused by systemic corticosteroids can be minimized by discontinuation of therapy before adolescence [ 5 ]. An important problem related to steroids is also resistance to steroids in severe asthma, which may result from the incorrect diagnosis of patients, as well as psychological problems and non-compliance with medical recommendations by patients [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Does Vitamin D Work Synergistically with Anti-Asthmatic Drugs in Airway Remodeling?

Sobczak¹,

Pawliczak²

2022

IJMS

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Vitamin D is commonly known for its properties of airway remodeling inhibition. Due to this, we decided to analyze the action of calcitriol with anti-asthmatic drugs in airway remodeling. The HFL1 cell line was treated with calcitriol, beclomethasone 17-propionate, montelukast sodium, LTD4 and TGF-β in different combinations. Real-time PCR was used to analyzed the expression of ACTA2, CDH-1, Vimentin, ADAM33, MMP-9 and CysLTR1 on the mRNA level, whereas Western blot was used to analyze gene expression on the protein level. One-way analysis variants, the Kruskal-Wallis test, Student’s t-test or Welch’s t-test were used for statistical analysis. Concerning the results, pre-treatment with calcitriol increased the inhibitory effect of beclomethasone 17-propionate and montelukast sodium on the expression of ACTA2 (p = 0.0072), Vimentin (p = 0.0002) and CysLTR1 (p = 0.0204), and 1,25(OH)2D3 had an influence on the effects of beclomethasone 17-propionate and montelukast sodium and of CDH1 expression (p = 0.0076). On the protein level, pre-treatment with calcitriol with beclomethasone 17-propionate and montelukast sodium treatment decreased ACTA2 expression in comparison to the LT (LTD4 and TGF-β) control group (p = 0.0191). Hence, our study not only confirms that vitamin D may inhibit airway remodeling, but also shows that vitamin D has a synergistic effect with anti-asthmatic drugs.

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“…Characterized by airway hyper-reactivity and inflammation, as well as reversible airflow obstruction, asthma was found to affect more than 272 million people worldwide in 2017, with a particularly high prevalence among children (~ 7.0%) [ 1 , 2 ]. Given the large population of children with asthma, there have been long-lasting debates and concerns regarding the potential impact of asthma on growth [ 3 ]. Possible mechanisms linking together asthma and impaired growth might include disturbance of bone maturation resulting from the atopy status [ 4 ], nutritional deprivation induced by food allergy prevention and physical inactiveness to avoid the possibility of exercise-induced bronchoconstriction [ 5 ], and potential growth retardation due to the use of glucocorticoids [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

The influence of childhood asthma on adult height: evidence from the UK Biobank

Chen

Yang

Hou

et al. 2022

BMC Med

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Background To elucidate the influence of childhood asthma on adult height after consideration of genetic heterogeneity in height. Methods Based on the UK Biobank, we conducted a matched cohort study, including 13,602 European individuals with asthma diagnosed before 18 years old and 136,008 matched unexposed individuals without such an experience. Ascertainment of asthma was based on self-reported data (97.6%) or clinical diagnosis in healthcare registers (2.4%). We studied three height outcomes, including (1) the attained adult height (in centimeters), (2) the height deviation measured as the difference between a person’s rank of genetically determined height (based on generated polygenetic risk score) and their rank of attained adult height in the study population (deviation in % of height order after standardization), and (3) the presence of height deficit comparing genetically determined and attained height (yes or no). We applied linear mixed-effect models to assess the associations of asthma diagnosed at different ages with attained adult height and height deviation, and conditional logistic regression models to estimate the associations of asthma with the risk of height deficit. Results 40.07% (59,944/149,610) of the study participants were born before 1950, and most of them were men (57.65%). After controlling for multiple covariates, childhood asthma was associated with shorter attained adult height, irrespective of age at asthma diagnosis. However, in the analysis of height deviation (deviation in %), we observed the greatest height deviation among individuals with asthma diagnosed before 4 years of age (− 2.57 [95% CI − 4.14 to − 1.00] and − 2.80 [95% CI − 4.06 to − 1.54] for the age of ≤ 2 and 3–4 years, respectively). The magnitude of height deviation in relation to asthma declined thereafter and became null after age 6. Similarly, there was a statistically significant height deficit in relation to an asthma diagnosis at ages ≤ 2 and 3–4 (odds ratios = 1.21, 95% CI 1.04 to 1.40, and 1.15, 95% CI 1.02 to 1.29) but not thereafter. The result pattern was similar when separately analyzing asthma with or without inhaled glucocorticoid (ICS) use, despite that the estimates were consistently stronger among asthma individuals who used ICS. Conclusions Our results suggest a notable association of childhood asthma, primarily asthma diagnosed at an early age, with adult height, after consideration of genetic heterogeneity in height and use of ICS. This finding highlights the need for surveillance on the growth problems among children with asthma.

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Growth Problems in Children with Asthma

Cited by 16 publications

References 27 publications

Is Early Puberty Triggered by Catch-Up Growth Following Undernutrition?

Is Early Puberty Triggered by Catch-Up Growth Following Undernutrition?

Does Vitamin D Work Synergistically with Anti-Asthmatic Drugs in Airway Remodeling?

The influence of childhood asthma on adult height: evidence from the UK Biobank

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