Outgrown asthma does not mean no airways inflammation

Warke, T.J.; Fitch, P.S.; Brown, Vanessa; Taylor, Robert H.; Lyons, Jeremy; Ennis, Madeleine; Shields, Michael

doi:10.1183/09031936.02.00882002

Cited by 57 publications

(50 citation statements)

References 20 publications

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“…Instead, we found greater numbers of airway eosinophils in older teenagers with previous TVW, compared to peers who had never wheezed. This contrasts with results from WARKE et al [10], who found low-level eosinophilic airway inflammation only in younger children with outgrown atopic wheeze but not in children with EVW. In this study children were considerably younger and childhood wheeze phenotype was assigned retrospectively; lung function was not reported.…”

contrasting

confidence: 56%

“…We also wanted to investigate if it was only present in individuals with previous PW, or also in adolescents with former TVW. Based on previous findings [10], we expected to find airway eosinophils in teenagers with previous PW only.…”

mentioning

confidence: 99%

“…Little is known about the natural course of such inflammatory changes after the symptoms have resolved. A study of young schoolchildren (aged <10 years) with outgrown "viral" and "atopic" wheeze found low-grade eosinophilic airway inflammation in children with previous atopic wheeze only [10]. Although many children become asymptomatic at school-age, asthma frequently recurs in adulthood, often after long intervals [11].…”

mentioning

confidence: 99%

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Airway eosinophils in older teenagers with outgrown preschool wheeze: a pilot study

et al. 2015

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Preschool wheezing affects one-third of all children growing up in the UK [1]. It varies in clinical presentation and severity, and there is evidence to suggest the co-existence of different wheeze phenotypes [2], some of which have been associated with adult asthma and chronic obstructive pulmonary disease [3]. Using data from the Leicester Respiratory Cohort studies [4], we have previously applied objective data-driven methods to distinguish three distinct preschool wheeze phenotypes: "atopic" and "non-atopic" persistent wheeze (PW) and transient viral wheeze (TVW) [5]. In children with PW, attacks of wheeze with and without colds were observed both at preschool age (0-5 years) and when followed-up at early school-age (4-8 years). Children with TVW, triggered predominantly by colds, had symptoms at age 0-5 years but not at age 4-8 years. Prognosis 5 years later (aged 8-13 years) was markedly better in children with TVW compared to the two PW phenotypes [6].

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confidence: 56%

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confidence: 99%

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confidence: 99%

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Airway eosinophils in older teenagers with outgrown preschool wheeze: a pilot study

et al. 2015

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“…Indeed, a recent study 8 showed that asthma patients with a comparable definition of remission 7 had higher numbers of eosinophils, T cells, mast cells, and IL-5 in the airway mucosa than healthy control subjects. Another study 31 found higher numbers of eosinophils in the bronchoalveolar lavage fluid of atopic children who had apparently outgrown their asthma (no wheezing for 12 months and no current medication) compared with controls. Thus, simply asking patients whether they have asthma symptoms and use asthma treatment is unreliable for determining airway inflammation as well as asthma remission.…”

Section: Discussionmentioning

confidence: 95%

Childhood factors associated with asthma remission after 30 year follow up

Vonk

2004

Thorax

133

117

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“…9,26,27 However, indicators of inflammation, airway obstruction, and airway remodeling are often persistent among children reported to be in clinical remission from asthma and may explain the risk of relapse. 28,29 In the current study, we used data from all annual surveys to define persistent asthma, periodic asthma, and remission. The objective data collected (lung function, bronchial hyperreactivity, and total IgE) support the validity of this questionnaire-based classification.…”

Section: Discussionmentioning

confidence: 99%

Remission and Persistence of Asthma Followed From 7 to 19 Years of Age

Andersson

Hedman²,

Bjerg

et al. 2013

Pediatrics

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BACKGROUND AND OBJECTIVE: To date, a limited number of population-based studies have prospectively evaluated the remission of childhood asthma. This work was intended to study the remission and persistence of childhood asthma and related factors. METHODS: In 1996, a questionnaire was distributed to the parents of all children aged 7 to 8 years in 3 municipalities in northern Sweden, and 3430 (97%) participated. After a validation study, 248 children were identified as having asthma; these children were reassessed annually until age 19 years when 205 (83%) remained. During the follow-up period lung function, bronchial challenge testing, and skin prick tests were performed. Remission was defined as no use of asthma medication and no wheeze during the past 12 months as reported at endpoint and in the 2 annual surveys preceding endpoint (ie, for ≥3 years). RESULTS: At age 19 years, 21% were in remission, 38% had periodic asthma, and 41% persistent asthma. Remission was more common among boys. Sensitization to furred animals and a more severe asthma (asthma score ≥2) at age 7 to 8 years were both inversely associated with remission, odds ratio 0.14 (95% confidence interval 0.04–0.55) and 0.19 (0.07–0.54), respectively. Among children with these 2 characteristics, 82% had persistent asthma during adolescence. Asthma heredity, damp housing, rural living, and smoking were not associated with remission. CONCLUSIONS: The probability of remission of childhood asthma from age 7- to 8-years to age 19 years was largely determined by sensitization status, particularly sensitization to animals, asthma severity, and female gender, factors all inversely related to remission.

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Outgrown asthma does not mean no airways inflammation

Cited by 57 publications

References 20 publications

Airway eosinophils in older teenagers with outgrown preschool wheeze: a pilot study

Airway eosinophils in older teenagers with outgrown preschool wheeze: a pilot study

Childhood factors associated with asthma remission after 30 year follow up

Remission and Persistence of Asthma Followed From 7 to 19 Years of Age

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