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Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
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Respiratory allergy and the relationship between early childhood lower respiratory illness and subsequent lung

F W Henderson1, P W Stewart, M R Burchinal

  • 1Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill 27599-7220.

The American Review of Respiratory Disease
|February 1, 1992
PubMed

Insights

Boys with recurrent wheezing lower respiratory illness (LRI) before age six showed reduced small airway function. Dust mite allergy significantly impacted this lung function decline in boys with early wheezing LRI.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Respiratory Medicine

Background:

  • Lower respiratory illness (LRI) in early childhood can impact long-term lung function.
  • Wheezing-associated LRI is a common concern in school-aged children.
  • The role of allergy in persistent small airway dysfunction requires further investigation.

Purpose of the Study:

  • To investigate the association between allergy, specifically to common inhalant allergens, and small airway function in children with a history of recurrent wheezing LRI.
  • To determine if specific allergens, such as dust mites, are linked to reduced lung function.
  • To explore the independent effects of early wheezing history and allergy on bronchial hyperreactivity.

Main Methods:

  • Longitudinal study of 159 children with documented outpatient visits for LRI since infancy.
  • Radioallergosorbent testing (RAST) for seven common inhalant allergens in 126 subjects.
  • Spirometry and methacholine challenge tests performed on a subset of 49 boys over a 4-year interval.

Main Results:

  • Boys with two or more wheezing LRI episodes before age six exhibited lower mean small airway function.
  • Increasing RAST scores, particularly for dust mite allergy, correlated with reduced small airway function in boys with recurrent preschool wheezing.
  • Dust mite allergy was linked to increased bronchial hyperreactivity, independent of early LRI history.

Conclusions:

  • Recurrent preschool wheezing and dust mite allergy are significant factors associated with reduced small airway function in boys.
  • Allergy, especially to dust mites, plays a crucial role in the development of persistent small airway dysfunction.
  • Early identification and management of allergy in children with a history of wheezing LRI may be important for lung health.

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