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Predictors of lung function in infants at high risk of atopy: effect of allergen avoidance
E Tauber1, C Gartner, G Halmerbauer
1Vienna University Children's Hospital, Austria.
Insights
Infant lung function in high-risk children is linked to weight gain and nasal eosinophilic cationic protein (ECP), not allergy avoidance interventions. Early lung function predictors in infants of atopic parents were identified.
Area of Science:
- Pediatrics
- Allergy and Immunology
- Pulmonology
Background:
- Children with atopic parents have a higher risk of developing bronchial asthma.
- Early detection of lung function abnormalities in asthmatic children is now possible.
- Prevention strategies often focus on high-risk infant populations.
Purpose of the Study:
- To identify predictors of lung function development in high-risk infants.
- To examine the impact of an allergy avoidance study on infant lung function.
- To correlate early inflammatory markers and growth parameters with later lung function.
Main Methods:
- A cohort of 60 infants with atopic parents was studied.
- Measurements included upper airway inflammation (at 4 weeks), respiratory symptoms (6-12 months), and lung function (Vmax, FRC at 18 months) using rapid thoracoabdominal compression.
- Infants were divided into an allergen avoidance group (28) and a control group (32).
Main Results:
- No significant differences in Vmax or FRC were found between the intervention and control groups (P = 0.382).
- Multiple linear regression indicated that weight gain since birth (beta = -35.35 ml s(-1) kg(-1), P = 0.022) and eosinophilic cationic protein (ECP) levels (beta = -0.95 ml s(-1) microl(-1), P = 0.044) were significant predictors of Vmax FRC.
- The allergy avoidance intervention was not a significant predictor of lung function.
Conclusions:
- Infant lung function at 18 months in high-risk children is associated with weight gain and nasal ECP levels.
- Allergen avoidance interventions did not significantly alter lung function outcomes in this cohort.
- Early growth and inflammatory markers may be more influential than allergen avoidance on early lung function development in infants of atopic parents.
Abstract:
Children of atopic parents are recognised as being at higher risk of developing bronchial asthma, drawing the attention of prevention strategies towards this population. Due to recent advances, lung function abnormalities in asthmatic children may now be measured early in life. The aim ofthis investigation was to examine possible predictors of lung function development in a sub sample of high-risk infants who took part in an allergy avoidance study In 60 babies of atopic parents, measurements of upper airways inflammation were performed at 4 weeks of age, respiratory symptoms were assessed at 6 and 12 months of age, and lung function (Vmax, FRC) was measured at 18 months by the rapid thoracoabdominal compression technique. Twenty-eight babies were enrolled in an allergen avoidance program, and 32 recruited as controls. No significant differences were detected for V'max,FRC between the intervention group (mean 331 ml s(-1)) and the control group (359 ml s(-1)), P = 0.382. A multiple linear regression model could explain levels of V'max FRC by weight gain since birth (beta = -35.35 ml s(-1) kg(-1), P = 0.022) and by eosinophilic cationic protein (ECP) (beta = -0.95 ml s(-1) microl(-1), P = 0.044), but not by intervention. Lung function measured at the age of 18 months in high-risk children is associated with weight gain and nasal ECF.