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Airway hyperresponsiveness in young children with respiratory symptoms: A five-year follow-up

Satu Kalliola1, L Pekka Malmberg2, Kristiina Malmström2

  • 1Helsinki University Hospital, Children and Adolescents, Lohja Hospital, Finland.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|March 5, 2019
PubMed

Insights

Airway hyperresponsiveness (AHR) in wheezy infants predicts later asthma and exercise-induced bronchoconstriction. Early AHR suggests a persistent condition, not transient wheezing, in children.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Respiratory Medicine

Background:

  • Recurrent wheezing in infancy is often transient.
  • The role of airway hyperresponsiveness (AHR) in persistent respiratory symptoms is debated.

Purpose of the Study:

  • To determine if AHR in wheezy infants predicts doctor-diagnosed asthma (DDA) or AHR at age 6.
  • To investigate the long-term respiratory outcomes in infants with early wheezing and AHR.

Main Methods:

  • Followed 61 wheezy infants (6-24 months) to age 6.
  • Assessed lung function and AHR via methacholine challenge in infancy and at 6 years.
  • Used exercise challenge tests and skin prick tests for atopy at age 6.

Main Results:

  • 34% of children had DDA at age 6.
  • Infants with DDA showed higher methacholine reactivity (LOGDRS).
  • AHR in infancy correlated with AHR at age 6; early AHR predicted exercise-induced bronchoconstriction.

Conclusions:

  • Increased AHR in symptomatic infants is linked to persistent AHR, DDA, and exercise-induced bronchoconstriction at age 6.
  • Findings suggest early AHR is established early in life.
  • Early identification of AHR may aid in predicting long-term respiratory health.
Abstract

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