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Published on: April 13, 2010
Determinants of airway responsiveness to histamine in children
S W Turner1, L J Palmer, P J Rye
1School of Pediatrics and Child Health, University of Western Australia, Perth, Australia. s.w.turner@abdn.ac.uk
Insights
Not all children with increased airway responsiveness (AR) have asthma. Factors like early respiratory illness and parental smoking also influence AR, suggesting asthma isn't the sole determinant.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Epidemiology
Background:
- Increased airway responsiveness (AR) is linked to asthma, but the association isn't exclusive.
- Identifying factors beyond physician-diagnosed asthma (PDA) associated with AR is crucial for understanding respiratory health.
- Longitudinal data collection is essential for tracking developmental influences on AR.
Purpose of the Study:
- To identify factors, apart from physician-diagnosed asthma (PDA), associated with increased airway responsiveness (AR) in children.
- To explore the relationship between early-life factors (atopy, lower respiratory tract illness) and later childhood AR.
- To investigate the interplay between atopy, PDA, and AR development.
Main Methods:
- Longitudinal study design tracking children from infancy to age 11.
- Assessment of airway responsiveness (AR) using dose-response slope (DRS).
- Data collection on atopy, lower respiratory tract illness (LRTI), tobacco smoke exposure, and PDA at ages 6 and 11.
Main Results:
- At age 6, DRS was associated with PDA, current atopy, and parental smoking.
- At age 11, DRS was associated with PDA, current atopy, and early LRTI (first six months).
- A significant interaction was observed between early atopy and later PDA in influencing AR.
Conclusions:
- Factors beyond asthma and atopy contribute to airway responsiveness levels in children.
- Early-onset atopy may influence airway responsiveness in children with asthma.
- These findings help explain the variable relationship observed between airway responsiveness and asthma diagnosis.
Abstract:
Increased airway responsiveness (AR) is associated with asthma, but not all individuals with increased AR have asthma. The aim of this study was to identify factors, other than physician-diagnosed asthma (PDA), which are associated with increased AR. In a longitudinal study, data were collected on atopy and lower respiratory tract illness (LRTI) in infancy, and AR (expressed as dose-response slope (DRS)), atopy, tobacco-smoke exposure and PDA in childhood. At age 6 yrs, DRS was assessed in 102 children, of whom 22 (22%) had PDA; the corresponding figures at 11 yrs of age were 176 and 29 (15%). At age 6 yrs, DRS was significantly associated with PDA, current atopy and parental smoking (n = 83). At age 11 yrs, DRS was significantly associated with PDA, current atopy and LRTI in the first six months (n = 75). There was a significant positive interaction between atopy at age 12 months and PDA age 11 yrs. In conclusion, these data suggest that factors other than asthma or atopy may determine the level of airway responsiveness in children. In children with asthma, airway responsiveness may be influenced by the early onset of atopy. The current findings may explain the inconsistent relationship between airway responsiveness and asthma.
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