Khalil W Savary1, Rachel L Miller2, Emilio Arteaga-Solis3, Lori Hoepner4, Luis M Acosta5, Frederica P Perera5, Andrew G Rundle6, Inge F Goldstein6, Matthew S Perzanowski7. 1. Division of Pulmonology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York; Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York. 2. Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York. 3. Division of Pulmonology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York. 4. Data Coordinating Center, Mailman School of Public Health, New York, New York; Department of Environmental and Occupational Health Sciences, SUNY Downstate School of Public Health, Brooklyn, New York. 5. Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York. 6. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York. 7. Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York. Electronic address: mp2217@cumc.columbia.edu.
Abstract
BACKGROUND: Rhinitis and conjunctivitis are often linked to asthma development through an allergic pathway. However, runny nose and watery eyes can result from nonallergic mechanisms. These mechanisms can also underlie exercise-induced wheeze (EIW), which has been associated with urgent medical visits for asthma, independent of other indicators of asthma severity or control. OBJECTIVE: To test the hypothesis that rhinitis or watery eyes without cold symptoms (RWWC) in infancy predict development of EIW and urgent respiratory-related medical visits at school age, independent of seroatopy. METHODS: Within a prospective birth cohort of low-income, urban children (n = 332), RWWC was queried during the first year of life. Relative risks (RRs) for EIW, emergency department (ED) visits, and hospitalizations for asthma and other breathing difficulties at 5 to 7 years of age were estimated with multivariable models. Seroatopy was determined at 7 years of age. RESULTS: Infant RWWC was common (49% of children) and predicted school-age EIW (RR, 2.8; P < .001), ED visits (RR, 1.8; P = .001), and hospitalizations (RR, 9.8; P = .002). These associations were independent of infant wheeze. They were also independent of birth order, an indicator of increased risk of exposure to viruses in infancy, and infant ear infections, an indicator of sequelae of upper airway infections. The association between infant RWWC and ED visits at 5 to 7 years of age was attenuated (RR, 1.2; P = .23) when EIW at 5 to 7 years of age was included in the model, suggesting EIW mediates the association. Adjustment for seroatopy did not diminish the magnitudes of any of these associations. CONCLUSION: These findings suggest a nonallergic connection between infant nonwheeze symptoms and important consequences of urban respiratory health by school age through EIW.
BACKGROUND:Rhinitis and conjunctivitis are often linked to asthma development through an allergic pathway. However, runny nose and watery eyes can result from nonallergic mechanisms. These mechanisms can also underlie exercise-induced wheeze (EIW), which has been associated with urgent medical visits for asthma, independent of other indicators of asthma severity or control. OBJECTIVE: To test the hypothesis that rhinitis or watery eyes without cold symptoms (RWWC) in infancy predict development of EIW and urgent respiratory-related medical visits at school age, independent of seroatopy. METHODS: Within a prospective birth cohort of low-income, urban children (n = 332), RWWC was queried during the first year of life. Relative risks (RRs) for EIW, emergency department (ED) visits, and hospitalizations for asthma and other breathing difficulties at 5 to 7 years of age were estimated with multivariable models. Seroatopy was determined at 7 years of age. RESULTS:Infant RWWC was common (49% of children) and predicted school-age EIW (RR, 2.8; P < .001), ED visits (RR, 1.8; P = .001), and hospitalizations (RR, 9.8; P = .002). These associations were independent of infant wheeze. They were also independent of birth order, an indicator of increased risk of exposure to viruses in infancy, and infantear infections, an indicator of sequelae of upper airway infections. The association between infant RWWC and ED visits at 5 to 7 years of age was attenuated (RR, 1.2; P = .23) when EIW at 5 to 7 years of age was included in the model, suggesting EIW mediates the association. Adjustment for seroatopy did not diminish the magnitudes of any of these associations. CONCLUSION: These findings suggest a nonallergic connection between infant nonwheeze symptoms and important consequences of urban respiratory health by school age through EIW.
Authors: Matthew S Perzanowski; Khalil W Savary; Emilio Arteaga-Solis; Laura A Lautenbacher; Natalie H Brito; Virginia A Rauh; J David Nugent; Amy J Elliott; Michael M Myers; William P Fifer Journal: Am J Respir Crit Care Med Date: 2018-08-15 Impact factor: 21.405
Authors: Laura A Conrad; Natalie Buchinsky; Luis M Acosta; J David Nugent; Khalil W Savary; Rachel L Miller; Nurdant Emanet; Julie Herbstman; Beatrice Beebe; Michael M Myers; William P Fifer; Matthew S Perzanowski Journal: J Asthma Allergy Date: 2021-11-09