Longitudinal assessment of loss and gain of lung function in childhood asthma

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Asthma Research

Background:

• Childhood asthma affects lung function in a significant percentage of children.
• Longitudinal tracking of lung function is crucial for understanding disease progression.
• Previous studies highlight the prevalence of lung function decline in pediatric asthma.

Purpose of the Study:

• To assess lung function trajectories in children with mild to moderate asthma.
• To analyze serial measurements of forced expiratory volume in 1 second (FEV1) in out-of-hospital follow-up.
• To identify patterns of lung function change over time in pediatric asthma patients.

Main Methods:

• A single-center cohort of 295 children with asthma (aged 8+) with at least 10 spirometry tests was analyzed.
• Annualized rates of change (slopes) for prebronchodilator FEV1 (percent predicted) were calculated.
• Three functional trajectories were defined: positive, negative, and null slopes, with FEV1 variability assessed by standard deviation.

Main Results:

• 68.8% of children exhibited stable lung function (null slope).
• 27.8% showed reduced lung growth or function loss (negative slope).
• Children with function loss had better initial FEV1 and lower FEV1 variability, but lower lung function at the last visit.

Conclusions:

• Better initial FEV1 and reduced FEV1 variability are associated with loss of lung function or reduced lung growth in asthmatic children.
• These findings emphasize the importance of monitoring lung function variability in pediatric asthma management.
• Understanding these trajectories can inform personalized treatment strategies for children with asthma.