BACKGROUND: Predicting school-age asthma from obstructive airways disease (OAD) in early life is difficult, even when parental and children's atopic manifestations are taken into consideration. OBJECTIVE: To assess if the severity of OAD in the first 2 years of life predicts asthma at 10 years of age. METHODS: From a nested case control study within the Environment and Childhood Asthma study, 233 2-year-old subjects with recurrent (> or = 2 episodes) bronchial obstruction (rBO+) and 216 subjects without bronchial obstruction (rBO-) underwent clinical examination, parental interview, treadmill test and metacholine bronchial hyperresponsiveness (BHR) measurement at 10 years. A severity score at 2 years was calculated by frequency, persistence of bronchial obstruction and hospital admissions because of OAD. MAIN OUTCOMES: Current asthma at 10 years (asthma with symptoms and/or asthma medication during the past year and/or positive treadmill test). Secondary outcome was metacholine BHR at 10 years. RESULTS: Compared with rBO- subjects, adjusted odds ratio (95% CI) of current asthma among rBO+ was 7.9 (4.1, 15.3), and among rBO+ with a severity score of > 5, 20.2 (9.9, 41.3). In receiver operated characteristic analysis, positive and negative predictive values demonstrated the applicability and value of the score, with an optimal cut-off at severity score 5. Children with severity score > 5 had severe BHR more often (PD20 metacholine < 1 micromol) than children with a lower or 0 score (p = 0.0041). CONCLUSION: Using a simple scoring system, a high severity score of OAD by 2 years of age is a strong risk factor for, and may predict, current asthma at 10 years of age.
BACKGROUND: Predicting school-age asthma from obstructive airways disease (OAD) in early life is difficult, even when parental and children's atopic manifestations are taken into consideration. OBJECTIVE: To assess if the severity of OAD in the first 2 years of life predicts asthma at 10 years of age. METHODS: From a nested case control study within the Environment and Childhood Asthma study, 233 2-year-old subjects with recurrent (> or = 2 episodes) bronchial obstruction (rBO+) and 216 subjects without bronchial obstruction (rBO-) underwent clinical examination, parental interview, treadmill test and metacholine bronchial hyperresponsiveness (BHR) measurement at 10 years. A severity score at 2 years was calculated by frequency, persistence of bronchial obstruction and hospital admissions because of OAD. MAIN OUTCOMES: Current asthma at 10 years (asthma with symptoms and/or asthma medication during the past year and/or positive treadmill test). Secondary outcome was metacholine BHR at 10 years. RESULTS: Compared with rBO- subjects, adjusted odds ratio (95% CI) of current asthma among rBO+ was 7.9 (4.1, 15.3), and among rBO+ with a severity score of > 5, 20.2 (9.9, 41.3). In receiver operated characteristic analysis, positive and negative predictive values demonstrated the applicability and value of the score, with an optimal cut-off at severity score 5. Children with severity score > 5 had severe BHR more often (PD20 metacholine < 1 micromol) than children with a lower or 0 score (p = 0.0041). CONCLUSION: Using a simple scoring system, a high severity score of OAD by 2 years of age is a strong risk factor for, and may predict, current asthma at 10 years of age.
Authors: Peter D Sly; Attilio L Boner; Bengt Björksten; Andy Bush; Adnan Custovic; Philippe A Eigenmann; James E Gern; Jorrit Gerritsen; Eckard Hamelmann; Peter J Helms; Robert F Lemanske; Fernando Martinez; Soren Pedersen; Harald Renz; Hugh Sampson; Erika von Mutius; Ulrich Wahn; Patrick G Holt Journal: Lancet Date: 2008-09-20 Impact factor: 79.321
Authors: Jocelyn M Biagini Myers; Eric Schauberger; Hua He; Lisa J Martin; John Kroner; Gregory M Hill; Patrick H Ryan; Grace K LeMasters; David I Bernstein; James E Lockey; S Hasan Arshad; Ramesh Kurukulaaratchy; Gurjit K Khurana Hershey Journal: J Allergy Clin Immunol Date: 2018-12-13 Impact factor: 10.793
Authors: Daniel J Jackson; Ronald E Gangnon; Michael D Evans; Kathy A Roberg; Elizabeth L Anderson; Tressa E Pappas; Magnolia C Printz; Wai-Ming Lee; Peter A Shult; Erik Reisdorf; Kirsten T Carlson-Dakes; Lisa P Salazar; Douglas F DaSilva; Christopher J Tisler; James E Gern; Robert F Lemanske Journal: Am J Respir Crit Care Med Date: 2008-06-19 Impact factor: 21.405