Paul D Robinson1,2, Gregory G King1,3,4, Malcolm R Sears5, Chuen Y Hong6, Robert J Hancox7. 1. Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia. 2. Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia. 3. NHMRC Centre of Excellence in Severe Asthma, The University of Sydney, Sydney, New South Wales, Australia. 4. Department of Respiratory Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia. 5. Firestone Institute for Respiratory Health, Michael de Groote School of Medicine, McMaster University and St Joseph's Healthcare, Hamilton, Ontario, Canada. 6. Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand. 7. Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Abstract
BACKGROUND AND OBJECTIVE: Peripheral airway involvement in asthma remains poorly understood. We investigated impulse oscillometry (IOS) measures of peripheral airway function in a population-based birth cohort. METHODS: Pre- and post-bronchodilator spirometry and IOS measures of respiratory resistance and reactance were measured in 915 participants at age 38 years. RESULTS: Current asthma was associated with impairments in both spirometry and IOS parameters. These impairments were greater in men and in those with childhood persistent asthma. Spirometry and IOS values for those whose asthma was in remission were not different to non-asthmatic participants. There were significant changes in IOS in both asthmatic and non-asthmatic participants after bronchodilator, but between-group differences persisted. Higher BMIs were associated with impairments in IOS but not spirometry. Cumulative tobacco use was associated with spirometric airflow obstruction in both sexes, whereas cannabis use was associated with impairments in IOS in women. Despite higher lifetime exposure, there were few associations between cannabis and IOS in men. CONCLUSION: Asthma is associated with abnormalities in IOS measures of peripheral airway dysfunction. This association is stronger in men and in those with asthma persisting since childhood. Tobacco and cannabis use are associated with different patterns of spirometry and IOS abnormalities and may affect the bronchial tree at different airway generations with differences in susceptibility between sexes.
BACKGROUND AND OBJECTIVE: Peripheral airway involvement in asthma remains poorly understood. We investigated impulse oscillometry (IOS) measures of peripheral airway function in a population-based birth cohort. METHODS: Pre- and post-bronchodilator spirometry and IOS measures of respiratory resistance and reactance were measured in 915 participants at age 38 years. RESULTS: Current asthma was associated with impairments in both spirometry and IOS parameters. These impairments were greater in men and in those with childhood persistent asthma. Spirometry and IOS values for those whose asthma was in remission were not different to non-asthmatic participants. There were significant changes in IOS in both asthmatic and non-asthmatic participants after bronchodilator, but between-group differences persisted. Higher BMIs were associated with impairments in IOS but not spirometry. Cumulative tobacco use was associated with spirometric airflow obstruction in both sexes, whereas cannabis use was associated with impairments in IOS in women. Despite higher lifetime exposure, there were few associations between cannabis and IOS in men. CONCLUSION:Asthma is associated with abnormalities in IOS measures of peripheral airway dysfunction. This association is stronger in men and in those with asthma persisting since childhood. Tobacco and cannabis use are associated with different patterns of spirometry and IOS abnormalities and may affect the bronchial tree at different airway generations with differences in susceptibility between sexes.
Authors: Nicole Probst-Hensch; Ayoung Jeong; Daiana Stolz; Marco Pons; Paola M Soccal; Robert Bettschart; Deborah Jarvis; John W Holloway; Florian Kronenberg; Medea Imboden; Christian Schindler; Gianfranco F Lovison Journal: Front Public Health Date: 2021-05-11