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Published on: August 7, 2017

Lung function, airway remodelling and inflammation in symptomatic infants: outcome at 3 years

Kristiina Malmström1, Anna S Pelkonen, L Pekka Malmberg

  • 1Department of Allergy, Helsinki University Central Hospital, P O Box 160, FI-00029 Helsinki, Finland. kristiina.malmstrom@fimnet.fi

Thorax
|January 5, 2011
PubMed

Insights

Early infant lung function deficits and airway pathology predict later respiratory symptoms and asthma medication use. Abnormal infant lung function and airway histology are linked to ongoing symptoms and treatment needs by age 3.

Area of Science:

  • Pediatric pulmonology
  • Respiratory medicine
  • Infant respiratory health

Background:

  • The relationship between early lung function, infant airway pathology, and outcomes in symptomatic infants remains unclear.
  • Investigating early lung function and airway histology is crucial for understanding the persistence of respiratory symptoms in infants.

Purpose of the Study:

  • To determine associations between early lung function, airway histology, and inflammation in symptomatic infants.
  • To evaluate the link between these early markers and respiratory symptoms, lung function, and inhaled asthma medication use at age 3.

Main Methods:

  • 53 infants with recurrent lower respiratory symptoms underwent lung function tests and bronchoscopy.
  • Follow-up at 3 years included symptom assessment, lung function testing (oscillometry), atopy testing, and medication purchase data.
  • Histological analysis focused on reticular basement membrane thickness and inflammatory cell density (mast cells, eosinophils).

Main Results:

  • 40 out of 50 children (80%) had ongoing airway symptoms at age 3.
  • Abnormal infant lung function correlated with persistent airway symptoms (p<0.001) and asthma medication use (p=0.009 for ICS, p=0.002 for beta-agonists).
  • Infant reticular basement membrane thickness (p=0.003) and mucosal mast cell density (p=0.018) predicted inhaled corticosteroid (ICS) use at age 3.

Conclusions:

  • Reduced lung function in infancy is associated with continued respiratory morbidity.
  • Thickened reticular basement membrane and increased mucosal mast cells in infants predict later treatment needs.
  • These findings highlight the importance of early lung function and airway pathology in predicting long-term respiratory outcomes in children.
Abstract

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