Longitudinal assessment of airway responsiveness from 1 month to 18 years in the PIAF birth cohort

Cox, D.; Mullane, D.; Zhang, Guicheng; Turner, Steve; Hayden, Catherine M.; Goldblatt, Jack; Landau, Lou; Souëf, Peter N. Le

doi:10.1183/13993003.00397-2015

Cited by 24 publications

(23 citation statements)

References 33 publications

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“…(15) Bronchial hyperresponsiveness can be present as early at 6 years of age and persist into adulthood and bronchoconstriction itself, irrespective of airway inflammation, may promote airway remodeling as well. (49, 50) It also has been observed that recurrent severe wheezing exacerbations during early life lead to airway remodeling and are associated with progressive reductions in lung function in school-age children and adults. (51, 52).…”

Section: Natural History Of Asthmamentioning

confidence: 99%

Microbes, allergic sensitization, and the natural history of asthma

Anderson

Jackson²

2017

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review Understanding factors that lead to asthma development in early life is essential to developing strategies aimed at primary or secondary prevention. Recent findings This article will review current evidence addressing the development of early life allergic sensitization in relation to microbes and the gut and airway microbiome. Wheezing illnesses, particularly viral, remain a significant risk factor for asthma inception; however, bacterial pathogens have recently emerged as an additional important contributor to asthma risk, either alone or as cofactors with viral infections. The combined influence and interaction of early life viral wheezing and aeroallergen sensitization is important, with allergic sensitization preceeding the onset of viral wheeze. Lastly, we review recent data from longitudinal studies regarding the development of irreversible airway obstruction and its impact on the natural history of asthma. Summary The development of asthma remains complex and incompletely understood. There is interplay between genetic predisposition and environmental exposures, including allergens and microbes. Interventions aimed at these risk factors during the preschool years may prevent the longitudinal course of asthma progression to irreversible airway obstruction.

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Section: Natural History Of Asthmamentioning

confidence: 99%

Microbes, allergic sensitization, and the natural history of asthma

Anderson

Jackson²

2017

Current Opinion in Allergy &Amp; Clinical Immunology

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“…Airway narrowing or AHR may exist temporarily in symptomatic children related to genetic and developmental factors in the first years of life 19 . AHR at an early age (<2 years) has been linked with exposure of tobacco 7 and atopy 6 .…”

Section: Discussionmentioning

confidence: 99%

Airway hyperresponsiveness, remodeling and inflammation in infants with wheeze

Malmström

Malmberg

Kotaniemi‐Syrjänen

et al. 2020

Clin Experimental Allergy

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Background:The relationship of airway hyperresponsiveness to airway remodeling and inflammation in infants with wheeze is unclear.Objective: To investigate airway hyperresponsiveness, remodeling and inflammation in infants with wheeze and troublesome breathing.Methods: Inclusion criteria were as follows: full-term, 3-23 months of age; doctor -diagnosed wheeze and persistent recurrent troublesome breathing; without obvious structural defect, suspicion of ciliary dyskinesia, cystic fibrosis, immune deficiency or specified use of corticosteroids. Airway hyperresponsiveness (AHR) was evaluated by performing a methacholine bronchial challenge test combined with whole body plethysmography and rapid thoracoabdominal compression. Endobronchial biopsies were analysed for remodeling (thickness of reticular basement membrane and amount of airway smooth muscle) and for inflammation (numbers of inflammatory cells). Correlation analyses were performed.Results: Forty-nine infants fulfilled the inclusion criteria for the present study.Median age was 1.06 years (IQR 0.6; 1.5). Lung function was impaired in 39/49 (80%) children, at the median age of 1.1 years. Methacholine challenge was successfully performed in 38/49 children. Impaired baseline lung function was correlated with AHR (P = .047, Spearman). In children with the most sensitive quartile of AHR, the percentage of median bronchial airway smooth muscle % and the number of bronchial mast cells in airway smooth muscle were not significantly higher compared to others (P = .057 and 0.056, respectively). No association was found between AHR and thickness of reticular basement membrane or inflammatory cells.Only a small group of children with both atopy and AHR (the most reactive quartile) had thicker airway smooth muscle area than non-atopics with AHR (P = .031). Conclusions and Clinical Relevance:These findings do not support the concept that AHR in very young children with wheeze is determined by eosinophilic inflammation or clear-cut remodeling although it is associated with impaired baseline lung function. The possible association of increased airway smooth muscle area among atopic children with AHR remains to be confirmed. K E Y W O R D S asthma, eosinophils, paediatrics, remodeling | 559 MALMSTRÖM eT AL. Oxygen saturation, pre provocation (%) 97 (96; 99) Oxygen saturation, post provocation (%) 94 (93; 95) B-eosinophils (10E9/L) 0.29 (0.16; 0.41) B-eosinophils (%) 3.0 (2.0; 4.0) S-IgE (kU/L) 20.5 (7.8; 52.3)Note: Data presented as median (interquartile range) or n (n%).Abberivations: FRC, functional residual capacity; PD, provocative dose; sGaw, specific airway conductance; V'maxFRC, maximal airflow at FRC.

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“…55 Interestingly, asthma at age 18 years was associated with increased airway responsiveness at 6, 12, and 18 years but not during infancy. Based on these results, the investigators concluded that increased airway responsiveness and its association with asthma at age 18 years is established between infancy and age 6 years.…”

Section: Airway Physiologic Alterationsmentioning

confidence: 92%

“…They proposed that airway responsiveness in early life is a reflection of the initial airway geometry and that airway responsiveness later in childhood increasingly reflects immunologic responses to environmental influences. 55 …”

Section: Airway Physiologic Alterationsmentioning

confidence: 99%

Lessons learned from birth cohort studies conducted in diverse environments

Jackson

Gern

Lemanske

2017

Journal of Allergy and Clinical Immunology

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Birth cohort studies have produced significant advances toward understanding how genetic and environmental factors contribute to the inception of asthma and related allergic diseases. Histopathologic, physiologic, microbiologic, and immunologic findings indicate that critical developmental windows exist in which these various factors either alone or in concert induce the expression of the childhood asthma phenotype. The microbiome in early life clearly influences immune development and asthma. Early environmental exposures, including those related to the home, parents, siblings, pets, and pests, are all likely to influence patterns of microbial colonization and also might shape immune responses to allergens and viruses. As with other contributing factors, there appear to be windows of opportunity in early life when microbial exposures have the greatest effect on these processes. Recent studies of bacterial metabolic products and their effects might suggest new strategies for immune modulation in early life.

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Longitudinal assessment of airway responsiveness from 1 month to 18 years in the PIAF birth cohort

Cited by 24 publications

References 33 publications

Microbes, allergic sensitization, and the natural history of asthma

Microbes, allergic sensitization, and the natural history of asthma

Airway hyperresponsiveness, remodeling and inflammation in infants with wheeze

Lessons learned from birth cohort studies conducted in diverse environments

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