Inhaled budesonide for chronic wheezing under 18 months of age.

Noble, Valerie; Ruggins, N R; Everard, Mark L.; Milner, Anthony

doi:10.1136/adc.67.3.285

Cited by 101 publications

(43 citation statements)

References 25 publications

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“…Randomised, double-blind, placebo-controlled clinical trials suggest the beneficial effect of ICS therapy on lung function in children with chronic wheezing [6], persistent wheezing after bronchiolitis [7,8] and severe infantile asthma [9,10]. However, other studies report no such improvement in lung function of infants with recurrent wheezing [11].…”

mentioning

confidence: 89%

Effect of inhaled steroids on lung function in young children: a cohort study

Devulapalli¹,

Haaland²,

Pettersen³

et al. 2004

Eur Respir J

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The objectives of the present study were to determine the use of inhaled corticosteroids (ICS) for treating recurrent bronchial obstruction (rBO) in young children up to 2 yrs of age and to assess possible modifying effects of ICS on lung function in young children with rBO. From an observational, noninterventional birth cohort of 3,754 newborn children (3,697 with complete questionnaire data by 2 yrs of age), 306 children with documented rBO by age 2 yrs (cases) were identified along with 306 matched controls.Two tidal flow/volume measurements were taken, one at presentation of disease (children were steroid naïve) and one at 2 yrs of age (mean age 11.2 and 25.6 months, respectively), from: 21 cases who subsequently received ICS (ICSz); 33 who did not (ICS-); and in 15 controls. The mean¡SD duration of ICS treatment was 10.3¡6.5 months. The main outcomes were treatment with ICS and baseline ratio of time to peak expiratory flow/total expiratory time (tPTEF/tE).From the entire cohort, 77 children (2.1%) and 21% of children with rBO had received ICS by 2 yrs of age. Baseline tPTEF/tE was significantly lower at the first visit only in ICSz as compared to ICS-subjects, as well as in ICSz and ICS-as compared to controls. The mean difference in baseline tPTEF/tE from first to second visit was borderline statistically significant in the ICSz group only and correlated significantly with duration of ICS treatment.The present observational cohort study demonstrated that one-fifth of young children with recurrent bronchial obstruction had received inhaled corticosteroids. Early inhaled corticosteroid treatment improved lung function by age 2 yrs, mostly in those with the longest duration of treatment.

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mentioning

confidence: 89%

Effect of inhaled steroids on lung function in young children: a cohort study

Devulapalli¹,

Haaland²,

Pettersen³

et al. 2004

Eur Respir J

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“…Symptom scores were calculated using a scoring system as previously described by NOBLE et al [27]. Respiratory symptoms (cough, wheeze and shortness of breath) were recorded for each day and night of the 4-week treatment period.…”

Section: Symptom Scoresmentioning

confidence: 99%

The effect of montelukast on lung function and exhaled nitric oxide in infants with early childhood asthma

Straub¹

2005

Eur Respir J

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Effective treatment of respiratory symptoms, airway inflammation and impairment of lung function is the goal of any asthma therapy. Although montelukast has been shown to be a possible add-on therapy for anti-inflammatory treatment in older children, its efficacy in infants and young children is not well known. The aim of this study was to investigate its effect in infants and young children with early childhood asthma.In a prospective randomised double-blind placebo-controlled study, 24 young children (10-26 months) with wheeze, allergy and a positive family history of asthma consistent with the diagnosis of early childhood asthma were randomised to receive montelukast 4 mg or placebo. The forced expiratory volume in 0.5 seconds (FEV0.5) was measured using the raised volume rapid thoracic compression technique, and fractional exhaled nitric oxide (FeNO) and symptom scores were determined.No change was noted in FEV0.5, FeNO or symptom score in the placebo group following the treatment period. In contrast, significant improvements in mean¡SD FEV0.5 (189.0¡37.8 and 214.4¡44.9 mL before and after treatment, respectively), FeNO (29.8¡10.0 and 19.0¡8.5 ppb) and median symptom score (5.5 and 1.5) were noted following treatment with montelukast.In conclusion, montelukast has a positive effect on lung function, airway inflammation and symptom scores in very young children with early childhood asthma.

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“…14 Asthma in early childhood is notoriously difficult to distinguish from viral wheeze, which is unlikely to progresses to true asthma. 21 Our criteria for an asthma diagnosis are based on previous studies demonstrating that atopy and/or symptoms between episodes 22,23 and eczema 24 are significant indicators of asthma in young infants with wheezing, especially persistent asthma with onset in early childhood. 25 Even though this is far from the strict asthma criteria used in older children and adults, the criteria used are probably the best available without using infant lung function tests and invasive methods.…”

Section: Figurementioning

confidence: 99%

“…Bacterial DNA was extracted from 150 mL saliva (QIAamp DNA Stool Mini Kit; Qiagen, Hildens, Germany) according to the manufacturer' s instructions, but included shaking (1200 rpm) with 2-mm glass beads (10-12 beads/ sample) for 30 minutes at 5°C after addition of the ASL buffer. Extracted DNA, 50 ng as measured by spectrophotometry (version 3.3; NanoDrop Technologies, Wilmington, DE), was mixed with 0.3 mM of the 16S rRNA universal primers ENV1 (59-6-FAM-AGA GTT TGA TII TGG CTC AG -39; Escherichia coli 16S rRNA gene sequence nucleotide positions [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] and ENV 2 (59-CGG ITA CCT TGT TAC GAC TT-39; E coli 16S rRNA gene sequence nucleotide positions 1511-1492), 25 mL Hot Start Taq Master Mix (2.5 U Taq DNA polymerase, 1.5 mM MgCl 2 , 200 mM dNTP) (Qiagen), 1 mM MgCl 2 , and water to a final volume of 50 mL. The ENV1 primer was labeled with 6-FAM fluorescent dye.…”

Section: Analysis Of Infants' Salivary Microbiotamentioning

confidence: 99%

Pacifier Cleaning Practices and Risk of Allergy Development

Hesselmar¹,

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Infants with a diverse gut microbial flora are less likely to develop eczema and allergy.WHAT THIS STUDY ADDS: Parental sucking of their infant' s pacifier is associated with a reduced risk of allergy development and an altered oral flora in their child. Transfer of oral microbes from parent to infant via the pacifier might be used in primary prevention. abstract OBJECTIVE: Immune stimulation through exposure to commensal microbes may protect against allergy development. Oral microbes may be transferred from parents to infants via pacifiers. We investigated whether pacifier cleaning practices affected the risk of allergy development. METHODS:A birth-cohort of 184 infants was examined for clinical allergy and sensitization to airborne and food allergens at 18 and 36 months of age and, in addition, promptly on occurrence of symptoms. Pacifier use and pacifier cleaning practices were recorded during interviews with the parents when the children were 6 months old. The oral microbiota of the infants was characterized by analysis of saliva samples collected at 4 months of age. RESULTS: Children whose parents "cleaned" their pacifier by sucking it (n = 65) were less likely to have asthma (odds ratio [OR] 0.12; 95% confidence interval [CI] 0.01-0.99), eczema (OR 0.37; 95% CI 0.15-0.91), and sensitization (OR 0.37; 95% CI 0.10-1.27) at 18 months of age than children whose parents did not use this cleaning technique (n = 58). Protection against eczema remained at age 36 months (hazard ratio 0.51; P = .04). Vaginal delivery and parental pacifier sucking yielded independent and additive protective effects against eczema development. The salivary microbiota differed between children whose parents cleaned their pacifier by sucking it and children whose parents did not use this practice.CONCLUSIONS: Parental sucking of their infant' s pacifier may reduce the risk of allergy development, possibly via immune stimulation by microbes transferred to the infant via the parent' s saliva. Pediatrics

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Inhaled budesonide for chronic wheezing under 18 months of age.

Cited by 101 publications

References 25 publications

Effect of inhaled steroids on lung function in young children: a cohort study

Effect of inhaled steroids on lung function in young children: a cohort study

The effect of montelukast on lung function and exhaled nitric oxide in infants with early childhood asthma

Pacifier Cleaning Practices and Risk of Allergy Development

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