Björn Nordlund1,2, Anna James3, Christina Ebersjö4,5, Gunilla Hedlin1,2, Eva B Broström4,5. 1. Astrid Lindgren Children's Hospital, Lung and Allergy Unit, Karolinska University Hospital, Stockholm, Sweden. 2. Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. 3. Experimental Asthma and Allergy Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. 4. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. 5. Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
Abstract
BACKGROUND: The long-term respiratory characteristics of ex-preterm children with bronchopulmonary dysplasia (BPD) are not established. The objective of this study was to describe hallmarks of BPD at school age in comparison to children with atopic asthma. METHODS: This study was a cross-sectional descriptive comparative study in a hospital-based setting. Thirty schoolchildren diagnosed with BPD (10.4 years/born at 26.6 weeks' gestation) and 30 age- and sex-matched children with asthma and sensitized to airborne allergens (IgE >0.35 kUA /L) were analyzed. Measurements included fraction of exhaled nitric oxide (FENO, ppb), dynamic and static lung function, and bronchial provocation with methacholine (PD:20) and mannitol (PD:15), as well as an evaluation of respiratory symptoms using the asthma control test (C-ACT). RESULTS: Lung function measures (FEV1% 77 vs 84, FEV1/FVC% 85 vs 91, FEF50% 61 vs 80) and carbon monoxide diffusion capacity (DLCO%, 81 vs 88) were all reduced in children with BPD compared to asthma (P values <0.042). FENO values were also significantly lower in children with BPD (12 vs 23, P = 0.019). The proportion of positive methacholine tests (74% vs 93%, P = 0.14) was comparable between BPD and asthma. However, less responsiveness towards mannitol (19% vs 61%, P = 0.007) and fewer self-reported symptoms (C-ACT, median 26 vs 24, P = 0.003) were found in the BPD group. CONCLUSION: Respiratory hallmarks of BPD at school-age were reduced lung function, limited responsiveness towards indirectly acting mannitol but hyper-responsiveness towards direct acting methacholine and impairment in diffusion capacity. Children with BPD displayed less evidence of airway inflammation compared with atopic asthma.
BACKGROUND: The long-term respiratory characteristics of ex-preterm children with bronchopulmonary dysplasia (BPD) are not established. The objective of this study was to describe hallmarks of BPD at school age in comparison to children with atopic asthma. METHODS: This study was a cross-sectional descriptive comparative study in a hospital-based setting. Thirty schoolchildren diagnosed with BPD (10.4 years/born at 26.6 weeks' gestation) and 30 age- and sex-matched children with asthma and sensitized to airborne allergens (IgE >0.35 kUA /L) were analyzed. Measurements included fraction of exhaled nitric oxide (FENO, ppb), dynamic and static lung function, and bronchial provocation with methacholine (PD:20) and mannitol (PD:15), as well as an evaluation of respiratory symptoms using the asthma control test (C-ACT). RESULTS: Lung function measures (FEV1% 77 vs 84, FEV1/FVC% 85 vs 91, FEF50% 61 vs 80) and carbon monoxide diffusion capacity (DLCO%, 81 vs 88) were all reduced in children with BPD compared to asthma (P values <0.042). FENO values were also significantly lower in children with BPD (12 vs 23, P = 0.019). The proportion of positive methacholine tests (74% vs 93%, P = 0.14) was comparable between BPD and asthma. However, less responsiveness towards mannitol (19% vs 61%, P = 0.007) and fewer self-reported symptoms (C-ACT, median 26 vs 24, P = 0.003) were found in the BPD group. CONCLUSION: Respiratory hallmarks of BPD at school-age were reduced lung function, limited responsiveness towards indirectly acting mannitol but hyper-responsiveness towards direct acting methacholine and impairment in diffusion capacity. Children with BPD displayed less evidence of airway inflammation compared with atopic asthma.
Authors: Ewa Henckel; Anna James; Jon R Konradsen; Björn Nordlund; Malin Kjellberg; Eva Berggren-Broström; Gunilla Hedlin; Sofie Degerman; Kajsa Bohlin Journal: Children (Basel) Date: 2021-01-24
Authors: Hana B Ruran; Gary Adamkiewicz; Amparito Cunningham; Carter R Petty; Kimberly F Greco; Sigfus Gunnlaugsson; Natalie Stamatiadis; Gabriella Sierra; Jose Vallarino; Marty Alvarez; Lystra P Hayden; Catherine A Sheils; Edie Weller; Wanda Phipatanakul; Jonathan M Gaffin Journal: BMJ Open Respir Res Date: 2021-06
Authors: Anna J James; Björn Nordlund; Jon R Konradsen; Christina Ebersjö; Sven-Erik Dahlén; Eva Berggren Broström; Gunilla Hedlin Journal: Acta Paediatr Date: 2020-09-01 Impact factor: 2.299