Related Experiment Videos
Lower respiratory illness in early childhood and lung function and bronchial reactivity in adolescent males
K Z Voter1, M M Henry, P W Stewart
1Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill 27514.
Insights
Recurrent preschool lower respiratory illness (LRI) in boys is linked to persistently reduced lung function in adolescence. Early childhood wheezing illnesses did not correlate with increased bronchial reactivity later in life.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Epidemiology
Background:
- Early childhood lower respiratory illness (LRI) may impact long-term respiratory health.
- Prospective documentation of LRI in early life is crucial for understanding developmental trajectories.
- Previous studies indicated potential links between early LRI and later lung function.
Purpose of the Study:
- To investigate the association between early childhood lower respiratory illness (LRI) and adolescent lung function and bronchial reactivity.
- To determine if preschool wheezing illnesses predict persistent deficits in lung function.
- To assess the relationship between early LRI and methacholine sensitivity in adolescence.
Main Methods:
- Longitudinal study of 57 boys followed from early childhood to adolescence (11-22 years).
- Prospective documentation of outpatient physician visits for wheezing and non-wheezing LRI during the first 6 years of life.
- Spirometry (FEV1, FEF25-75, FEV1/FVC) and methacholine challenge testing performed in adolescence.
Main Results:
- Boys with two or more preschool wheezing illnesses exhibited lower mean FEV1, FEF25-75, and FEV1/FVC in adolescence compared to those with zero or one episode.
- Lower spirometric performance in early assessment correlated with persistently lower performance four years later.
- Neither preschool wheezing nor non-wheezing LRI was associated with methacholine sensitivity; however, increased sensitivity correlated with lower spirometric performance.
Conclusions:
- Recurrent preschool wheezing illness is associated with persistently lower lung function in adolescent boys.
- Preschool wheezing illness experience remained a significant correlate of lung function even after adjusting for methacholine sensitivity.
- Early childhood wheezing illnesses did not appear to enhance bronchial reactivity (methacholine sensitivity) in adolescence.
Abstract:
We examined the relationship between lower respiratory illness (LRI) experience in early childhood and lung function and bronchial reactivity in 57 boys, 11 to 22 yr of age, whose histories of outpatient physician visits for wheezing and nonwheezing LRI had been documented prospectively during their first 6 yr of life. These boys were a subpopulation of 159 children whose early childhood LRI experience and spirometric performance had been studied an average of 4 yr previously. The majority of boys had been free of chronic respiratory symptoms in the 2 yr before evaluation. Boys with histories of 2 or more preschool wheezing illnesses had lower mean levels of performance for FEV1, FEF25-75, FEF50, FEF75, and FEV1/FVC than did boys who had zero or 1 preschool wheezing illness, replicating observations that had been made when the boys had been studied 4 yr previously. Boys with lower spirometric performance relative to the study population on initial testing continued to have lower relative levels of spirometric performance 4 yr later. Neither preschool wheezing nor nonwheezing illness experience was associated with the degree of methacholine sensitivity measured in adolescence. Increasing degrees of methacholine sensitivity were associated with lower levels of spirometric performance; however, preschool wheezing illness experience remained a significant correlate of spirometric performance after adjustment for level of methacholine sensitivity. We conclude that recurrent preschool wheezing illness in these adolescent boys was associated with persistently lower lung function, but not enhanced methacholine sensitivity, during the middle to late school years.