The natural history of asthma

Barbee, Robert A.; Murphy, Shirley

doi:10.1016/s0091-6749(98)70006-5

Cited by 67 publications

(43 citation statements)

References 54 publications

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“…In addition, our results are consistent with others, and suggest that perennial rhinitis is a greater risk factor for the development of AHR than seasonal rhinitis [24]. Another considerable factor in the development of AHR is the sensitization to HDM [28, 29]. Because houses are heated and less well ventilated during fall and winter, the HDM concentrations can increase; this could have contributed to the increased AHR we saw in sensitized subjects.…”

Section: Discussionsupporting

confidence: 90%

Influence of Natural Exposure to Pollens and Domestic Animals on Airway Responsiveness and Inflammation in Sensitized Non-Asthmatic Subjects

Boulay¹,

Boulet²

2002

Int Arch Allergy Immunol

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Background: Atopy may be a risk factor in the development of asthma. Indoor allergens are considered to be more potent asthma inducers than outdoor ones such as pollens. Lower airway inflammation may be present in non-asthmatic subjects during natural exposure to relevant allergens and may eventually lead to the development of asthma. Aims: To document seasonal variation in lower airway responsiveness and inflammation in sensitized non-asthmatic subjects, during natural exposure to allergens, and to determine whether it is more marked in those exposed to animals to which they are sensitized. Methods: Twenty-two atopic subjects were seen during and out of the pollen season. All (but the controls) were sensitized to domestic animals, and to trees, grasses or ragweed. Eleven were not exposed to animals at home and 8 were exposed. They were compared with 3 normal controls. A respiratory questionnaire was administered, allergy skin prick tests, spirometry, methacholine challenge, blood and induced sputum with differential cell counts were obtained during the pollen season for all subjects. These tests were repeated out of the pollen season. Results: Throughout the study, none of the subjects had asthma symptoms. Mean PC₂₀ was significantly lower in subjects exposed to animals compared with unexposed subjects or controls, both during and out of the pollen season. In season, subjects exposed to animals had significantly higher sputum eosinophil numbers than unexposed or normal control subjects. Conclusions: Non-asthmatic atopic subjects show variable degrees of airway responsiveness and inflammation. However, subjects exposed to animals show higher airway eosinophilia, which may suggest they are at increased risk of developing airway hyperresponsiveness and asthma.

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Section: Discussionsupporting

confidence: 90%

Influence of Natural Exposure to Pollens and Domestic Animals on Airway Responsiveness and Inflammation in Sensitized Non-Asthmatic Subjects

Boulay¹,

Boulet²

2002

Int Arch Allergy Immunol

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“…The pattern of allergy expression differs with age, with the greatest incidence of food allergy and atopic eczema peaking by 1 year of age while asthma and allergic rhinitis continue to rise until around 15 years of age [5]. Many childhood allergies persist with about 50% of childhood asthma sufferers and 80% of hay fever sufferers continuing to have symptoms into adulthood [6,7]. The cost to the health care system and the burden for the family are high [8,9] and it is estimated that asthma alone costs Europe €25 billion per year [10].…”

Section: Introductionmentioning

confidence: 99%

Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches

2014

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Abstract:Objectives: To investigate the relationship between maternal diet during pregnancy and lactation and development of atopic disorders in childhood. Methods:We included studies published up to August 2011 which either assessed food-based maternal dietary interventions or examined associations between maternal dietary intake during pregnancy and/or lactation and allergic outcomes (eczema, asthma, hay fever and sensitization) in their children. Results:We included 43 studies (over 40 000 children): 11 intervention studies (including seven RCTs), 27 prospective cohort studies, four retrospective cohort studies and one case-control study.In the RCTs, no significant difference was noted overall in the prevalence of eczema and asthma in the offspring of women on diets free from common food allergens during pregnancy. The prospective cohorts investigated a large number of potential associations, but reported few significant associations between maternal dietary intake and development of allergy. Maternal diets rich in fruits and vegetables, fish and foods containing vitamin D and 'Mediterranean' dietary patterns were among the few consistent associations with lower risk of allergic disease in their children. Foods associated with higher risk included vegetable oils and margarine, nuts and fast food. Conclusion:This review did not find widespread or consistent links between mother's dietary intake and atopic outcomes in their children. However, maternal consumption of 'Mediterranean' dietary patterns, diets rich in fruits and vegetables, fish and vitamin D containing foods were suggestive of benefit, requiring further evaluation.

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“…Unfortunately, clinical remission is followed by a relapse later in life in a considerable proportion of subjects [1,2]. The authors recently found ongoing airways inflammation during clinical remission of atopic asthma [3,4].…”

mentioning

confidence: 99%

Dyspnoea perception during clinical remission of atopic asthma

Toorn¹,

Overbeek²,

Hoogsteden³

et al. 2002

European Respiratory Journal

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Symptoms of atopic asthma often disappear around puberty. The authors recently demonstrated that this clinical remission is accompanied with ongoing airways inflammation in most subjects. The discrepancy between lack of symptoms and persistent airway inflammation suggests that perception of the symptoms is unclear. In the present study, young adults in clinical remission of atopic asthma assigned themselves a modified Borg score during methacholine and adenosine-59-monophosphate induced bronchoconstriction. Borg scores of subjects in clinical remission were compared with those of symptomatic asthmatic subjects. A marked variation in the Borg scores at a 20% fall in the forced expiratory volume in one second was found. Significant differences in Borg scores between remission patients and asthmatics could not be detected.It was concluded that perception of dyspnoea, induced with methacholine and adenosine challenge, is similar in young adults in clinical remission of atopic asthma compared to that of patients with symptomatic asthma. Hence, an unclear perception seems to be an unlikely explanation for the discrepancy between lack of symptoms and ongoing inflammation. Other factors, including both physical and psychological ones, may play a role in the apparent absence of symptoms, thereby potentially leading to undertreatment.

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The natural history of asthma

Cited by 67 publications

References 54 publications

Influence of Natural Exposure to Pollens and Domestic Animals on Airway Responsiveness and Inflammation in Sensitized Non-Asthmatic Subjects

Influence of Natural Exposure to Pollens and Domestic Animals on Airway Responsiveness and Inflammation in Sensitized Non-Asthmatic Subjects

Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches

Dyspnoea perception during clinical remission of atopic asthma

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