Predictive value of childhood airway hyperresponsiveness to indirect stimuli: 10-year longitudinal study

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Lajunen , K T , Malmberg , L P , Kalliola , S , Kotaniemi-Syrjänen , A , Pelkonen , L A S & Mäkelä , M J 2020 , ' Predictive value of childhood airway hyperresponsiveness to indirect stimuli: 10-year longitudinal study ' , Pediatric Allergy and Immunology , vol. 31 , no. 7 , pp. 767-773 .

Title: Predictive value of childhood airway hyperresponsiveness to indirect stimuli: 10-year longitudinal study
Author: Lajunen, Katariina Tytti; Malmberg, Leo Pekka; Kalliola, Satu; Kotaniemi-Syrjänen, Anne; Pelkonen, L. Anna Susanna; Mäkelä, Mika Juhani
Contributor organization: Department of Dermatology, Allergology and Venereology
University of Helsinki
Helsinki University Hospital Area
HUS Inflammation Center
HUS Children and Adolescents
Children's Hospital
Lohja Hospital Area
Date: 2020-10
Language: eng
Number of pages: 7
Belongs to series: Pediatric Allergy and Immunology
ISSN: 0905-6157
Abstract: Abstract Background Airway hyperresponsiveness (AHR) is a common feature in asthma. The use of AHR in predicting active asthma or the persistence of AHR in childhood is poorly understood. By analyzing longitudinal connections including different measures of AHR, lung function, and inflammation markers, we sought to identify the best available method for predicting persistence of AHR and identification of later active asthma. Methods We tested 105 asthmatic children aged 3-7 years with fractional exhaled nitric oxide (FeNO), impulse oscillometry (IOS), and AHR evaluated by indirect methods (hypertonic saline and exercise challenge). Ten years later, 64 children participated in the follow-up visit and were tested with FeNO, IOS, spirometry, and methacholine challenge. At both study visits, blood samples were collected, and a questionnaire was completed. Results Asthma was in remission in 66% of patients at adolescence. AHR measured by hypertonic saline challenge at preschool age was associated with asthma symptoms (OR 10.2; 95%CI 2.8, 37.3) but not with AHR estimated with methacholine challenge 10 years later. AHR measured by exercise challenge was not associated with AHR or recent asthma symptoms in adolescence. Preschool eosinophilia continued until adolescence in 87% of patients but was not associated with AHR or subjective signs of asthma 10 years later. Wheezy preschoolers with atopy had a higher risk for AHR in adolescence (OR 4.1; 95%CI 1.0, 16.2). Conclusion Results from hypertonic saline challenge are associated with persistent asthma symptoms even after a decade. AHR measured by indirect methods at preschool age did not predict AHR in adolescence.
Subject: 3123 Gynaecology and paediatrics
Airway hyper-responsiveness
Lung function
Methacholine challenge
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: unspecified
Usage restriction: openAccess
Self-archived version: acceptedVersion

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