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Neonatal rhinorrhea, heart rate variability, and childhood exercise-induced wheeze

Sophie Berger1, Nicolò Pini2,3, Maristella Lucchini2,3

  • 1Division of Pulmonology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY.

The Journal of Allergy and Clinical Immunology. Global
|October 2, 2023
PubMed

Insights

Infant rhinorrhea and parasympathetic nervous system dysfunction in infancy may predict exercise-induced wheeze (EIW) in school-aged girls. The ratio of heart rate variability during sleep (RMSSDQS:AS) is a key biomarker for this association.

Area of Science:

  • Pediatric Pulmonology
  • Autonomic Nervous System Research
  • Asthma Etiology

Background:

  • Infant rhinorrhea is increasingly linked to childhood exercise-induced wheeze (EIW) via the parasympathetic nervous system.
  • The ratio of successive heart rate differences during quiet versus active sleep (RMSSDQS:AS) is a novel biomarker in pediatric asthma.

Purpose of the Study:

  • To determine if neonatal rhinorrhea predicts childhood EIW independently of other respiratory symptoms.
  • To investigate if neonatal RMSSDQS:AS predicts childhood EIW.
  • To examine if RMSSDQS:AS mediates the association between neonatal rhinorrhea and childhood EIW.

Main Methods:

  • Prospective birth cohort study (PASS/ECHO) with electrocardiogram data from the first month of life.
  • Parental reports of infant rhinorrhea at 1 month and childhood EIW at ages 4-11 years.
  • Analysis of heart rate variability and logistic regression models adjusted for confounders.

Main Results:

  • Neonatal rhinorrhea predicted childhood EIW (RR=2.22), particularly in females (RR=3.38).
  • RMSSDQS:AS predicted EIW (RR=2.36) and mediated the rhinorrhea-EIW link in females.
  • Females with higher RMSSDQS:AS and rhinorrhea had a significantly higher incidence of EIW (30% vs 1.8%).

Conclusions:

  • Infant rhinorrhea and parasympathetic nervous system dysregulation may underlie EIW development in school-aged girls.
  • RMSSDQS:AS serves as a potential biomarker for identifying at-risk infants.
  • Findings suggest potential targets for early intervention in pediatric asthma.
Abstract

Keywords:
Asthmaexercise induced asthmaheart rate variability and sleep statesparasympathetic nervous systemrhinitiswatery eyes

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