Katri Backman1, Kirsi Nuolivirta2, Hertta Ollikainen3, Matti Korppi4, Eija Piippo-Savolainen1. 1. Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland. 2. Seinäjoki Central Hospital, Seinäjoki, Finland. 3. University of Eastern Finland, Kuopio, Finland. 4. Center for Child Research, Tampere University and University Hospital, Tampere, Finland.
Abstract
BACKGROUND: Infant bronchiolitis may be the first manifestation of asthma. AIM: To evaluate the association of early-childhood risk or protective factors for asthma and lung function reduction in adults 30 years after bronchiolitis in infancy. METHODS: Forty-seven former bronchiolitis patients attended the clinical study at the median age of 29.5 years, including doctoral examination and measurement of post-bronchodilator lung function with flow-volume spirometry. Data on early-life risk factors including blood eosinophil counts on admission for bronchiolitis and on convalescence 4-6 weeks after bronchiolitis were available. RESULTS: Low blood eosinophil count <0.25 × 10E9/l on admission for bronchiolitis was a significant protective factor and high blood eosinophil count >0.45 × 10E9/l on convalescence was a significant risk factor for asthma in adulthood independently from atopic status in infancy. Parental asthma and high blood eosinophil count >0.45 × 10E9/l during bronchiolitis were significant risk factors for irreversible airway obstruction (FEV1/FVC ratio below the 5th percentile lower limit of normality after bronchodilation). CONCLUSION: Our adjusted analyses confirmed that eosinopenia during infant bronchiolitis predicted low asthma risk and eosinophilia outside infection predicted high asthma risk up to the age of 28-31 years. Parental asthma and eosinophilia during bronchiolitis were recognized as risk factors for irreversible airway obstruction.
BACKGROUND:Infantbronchiolitis may be the first manifestation of asthma. AIM: To evaluate the association of early-childhood risk or protective factors for asthma and lung function reduction in adults 30 years after bronchiolitis in infancy. METHODS: Forty-seven former bronchiolitispatients attended the clinical study at the median age of 29.5 years, including doctoral examination and measurement of post-bronchodilator lung function with flow-volume spirometry. Data on early-life risk factors including blood eosinophil counts on admission for bronchiolitis and on convalescence 4-6 weeks after bronchiolitis were available. RESULTS: Low blood eosinophil count <0.25 × 10E9/l on admission for bronchiolitis was a significant protective factor and high blood eosinophil count >0.45 × 10E9/l on convalescence was a significant risk factor for asthma in adulthood independently from atopic status in infancy. Parental asthma and high blood eosinophil count >0.45 × 10E9/l during bronchiolitis were significant risk factors for irreversible airway obstruction (FEV1/FVC ratio below the 5th percentile lower limit of normality after bronchodilation). CONCLUSION: Our adjusted analyses confirmed that eosinopenia during infantbronchiolitis predicted low asthma risk and eosinophilia outside infection predicted high asthma risk up to the age of 28-31 years. Parental asthma and eosinophilia during bronchiolitis were recognized as risk factors for irreversible airway obstruction.
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