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Auricular Acupressure as an Adjuvant Treatment for Wheezing in Stable Chronic Obstructive Pulmonary Disease
Published on: May 10, 2024
Reduced airway function in early adulthood among subjects with wheezing disorder before two years of age
Emma Goksör1, Per M Gustafsson, Bernt Alm
1Department of Paediatrics, Göteborg University, Queen Silvia Children's Hospital, Göteborg, Sweden. emma.goksor@vgregion.se
Insights
Children with early-life wheezing show reduced airway function in adulthood. Female gender and current asthma are key risk factors for this persistent lung impairment.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Longitudinal Cohort Studies
Background:
- Infant wheezing is a common respiratory issue with potential long-term consequences.
- Understanding the persistence of respiratory symptoms and lung function deficits into adulthood is crucial for effective management.
Purpose of the Study:
- To compare adult airway function in individuals with a history of infant wheezing against age-matched controls.
- To identify factors contributing to differences in lung function.
Main Methods:
- Prospective study of 101 children hospitalized for wheezing before age two.
- Re-evaluation at ages 17-20 years using spirometry, bronchial hyper-responsiveness testing, and allergy assessments.
- Comparison with a control group of 294 age-matched individuals.
Main Results:
- Cohort subjects exhibited significantly lower FEV1/FVC ratios and MEF50 compared to controls.
- Reduced lung function was most pronounced in females with current asthma.
- Independent risk factors for reduced airway function included female gender, early wheezing history, and current bronchial hyper-responsiveness.
Conclusions:
- Individuals with a history of early-life wheezing demonstrate impaired airway function in early adulthood.
- Female sex and current asthma are significant predictors of persistent reduced lung function.
Aim:
To compare airway function in early adulthood in subjects with wheezing in infancy with age-matched controls and to analyze what accounts for a possible difference.
Methods:
Asthma development has been prospectively studied in 101 children hospitalized due to wheezing before the age of two. The cohort was re-investigated at age 17-20 years and tested with spirometry and for bronchial hyper-responsiveness and allergic sensitization. An age-matched population (n = 294) was used for comparison.
Results:
The cohort had a significantly lower FEV(1)/FVC ratio and MEF(50), both pre- and post-bronchodilation, compared with the controls, P < 0.01. The reduction in airway function was most evident in current asthmatic female subjects, but a reduced pre-bronchodilation FEV(1)/FVC ratio was also seen in symptom-free cohort subjects, P = 0.03. In the multivariate analysis, female gender was the most prominent independent risk factor for reduced airway function in early adulthood, pre-bronchodilation OR 4.0 (1.4-11.3) and post-bronchodilation OR 8.8 (1.8-42.0). In addition, a history of early wheezing, that is, belonging to the cohort, was an independent risk factor for reduced airway function pre-bronchodilation, OR 3.3 (1.3-8.7). Furthermore, there was an association between current bronchial hyper-responsiveness and an increased risk of reduced airway function post-bronchodilation, OR 7.3 (2.0-26.6).
Conclusion:
Reduced airway function in early adulthood was found in subjects with wheezing early in life, compared with age-matched controls. The reduction was most prominent in females with current asthma.
Related Concept Videos
Asthma I: Introduction
Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features
Asthma III: Clinical Manifestations
Asthma-I: Introduction
Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Asthma-III: Symptoms and Complications
Classification of Asthma
