Source: Annual Congress 2008 - Treatment and outcome of childhood asthma: new perspectives
Disease area: Airway diseases, Paediatric lung diseases

Abstract

Background: Reduced lung function is a feature of chronic asthma which becomes apparent at schoolage. We investigated the role of allergic sensitization and allergen exposure early in life for the course of asthma and the development of lung function up to puberty.
Methods: Our Allergy study followed 503 school children from birth to age 18 years. Parental interviews on asthma and measurements of specific IgE were performed regularly. Allergen exposure was assessed at 1.5, 3, 4, 5 years, lung function was assessed at age 8, 11, 14 years, at 8 years a bronchoprovocative test on effort was performed.
Results: School children with repeated wheeze but no atopy lost their symptoms over schoolage in 90.4% of cases and retained normal lung function at puberty. In contrast, sensitization to perennial (house dust mite, cat and dog) allergens developing in the first 3 years of life predicted the loss of lung function at schoolage (FEV1/FVC: 90.0 ±7.0 vs 92.5 ±6.1, p=0.003; MEF50: 91.8 ±23.9 vs 101.5 ±23.1, p=0.002 for sensitized vs not sensitized) and the development of airway hyperresponsiveness. Concomitant exposure to high levels of perennial allergens early in life aggravated this process. Sensitization and exposure occurring later in life had much weaker effects and sensitization to seasonal allergens did not play a role.
Conclusion: The chronic course of children asthma characterized by airway hyperresponsiveness and loss of lung function at schoolage is determined by continuing allergic airway inflammation amplified by perennial exposure to these allergens early in life.

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Citations should be made in the following way:
S. Kamenov, J. Moskovljevic, B. Kamenov (Nis, Serbia And Montenegro). Asthma chronicity in school children determines continuing allergic inflammation. Eur Respir J 2008; 32: Suppl. 52, 4599

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