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Children with Asthma Have Fixed Airway Obstruction through Childhood Unaffected by Exacerbations

Henrik W Hallas1, Bo L Chawes1, Lambang Arianto1

  • 1COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.

The Journal of Allergy and Clinical Immunology. in Practice
|November 11, 2019
PubMed

Insights

Asthmatic children with exacerbations show fixed airway obstruction from infancy. Exacerbations appear to be a consequence, not a cause, of reduced airway caliber in childhood asthma.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Asthma Research

Background:

  • Asthma in children can follow varied disease courses, with or without exacerbations.
  • The impact of asthma exacerbations on lung function development throughout childhood remains unclear.

Purpose of the Study:

  • To investigate and compare lung function trajectories in children with asthma, differentiating between those who experience exacerbations and those who do not, from birth to adolescence.

Main Methods:

  • Utilized data from the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) birth cohort.
  • Repeatedly assessed lung function and bronchial reactivity from 1 month to 13 years.
  • Employed mixed-effects models to analyze lung function trajectories, defining exacerbations by specific clinical criteria.

Main Results:

  • Children with asthma experiencing exacerbations exhibited a trajectory of increased, fixed airway obstruction compared to those without exacerbations.
  • Significant differences were observed in airway resistance (sRawz) and maximal mid-expiratory flow (MMEFz).
  • No significant differences in forced expiratory volume (FEVz) or bronchial reactivity (PDz) were found, and exacerbations did not alter lung function trajectories.

Conclusions:

  • Children with asthma who have exacerbations demonstrate increased airway obstruction from infancy through childhood.
  • This airway obstruction follows a fixed trajectory and does not appear to progress due to exacerbations.
  • Findings suggest asthma exacerbations are a consequence, rather than a cause, of diminished airway caliber in childhood.
Abstract

Keywords:
AsthmaBirth cohortBronchial reactivityExacerbationLung function

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