Risk Factors For Rate of Decline in Forced Expiratory Volume in One Second in Children and Adolescents with Cystic Fibrosis

Konstan, Michael W.; Morgan, Wayne J.; Butler, Steven M.; Pasta, David J.; Craib, Marcia L.; Silva, Stefanie J.; Stokes, Dennis C.; Wohl, Mary Ellen B.; Wagener, Jeffrey S.; Regelmann, Warren E.; Johnson, Charles A.

doi:10.1016/j.jpeds.2007.03.006

Cited by 405 publications

(363 citation statements)

References 23 publications

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“…In preschool aged non-CF children with an increased risk of asthma, early treatment with inhaled corticosteroids reduced wheezing and improved lung function, but once steroid therapy was withdrawn, symptoms and lung dysfunction returned [14]. A multivariate analysis of risk factors for lung function decline in ESCF found that wheezing among patients age 9-17 years predicted lower rates of decline, which was counterintuitive [16]. This protective effect of wheeze might be due to increased clinical attention and intervention .…”

Section: Discussionmentioning

confidence: 99%

Early Childhood Wheezing Is Associated With Lower Lung Function In Cystic Fibrosis

Ren

Rosenfeld

Konstan

et al. 2012

D16. Cystic Fibrosis: Biomarkers, Outcome Measures, and Pathogenesis

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Objective-To study the association between wheezing in children with cystic fibrosis (CF) and lung function in later life.Methods-We used data from the Epidemiologic Study of CF, a longitudinal observational study from 1994-2005. Wheezing phenotypes were defined as: no wheezing in the first 6 years of life (NW), transient wheezing (TW; wheezing <3 years old, but no wheezing after 3), late wheezing (LW; wheezing only after age 3 years), and persistent wheezing (PW; wheezing both before and after age 3 years). A linear regression model was developed predicting the best forced expiratory volume in 1 second (FEV 1 ) at age 6 or 7 years (6-<8) for each wheezing phenotype.Results-1,302 children met the cohort inclusion criteria; 61% of the cohort had wheezing in the first 6 years of life. A history of any wheezing in the first 6 years of life was associated with a significantly lower FEV 1 at 6-<8 years compared to children with NW. The FEV 1 of children with NW at age 6-<8 years was 104% predicted, whereas the mean FEV 1 in TW, LW, and PW groups was 98%, 100%, and 96% predicted respectively (P<0.05 compared to NW).Conclusions-Childhood wheezing in CF is common and is associated with lower lung function at age 6-<8 years. Our results identify a clinical feature in early childhood CF associated with lower lung function in later life.

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Section: Discussionmentioning

confidence: 99%

Early Childhood Wheezing Is Associated With Lower Lung Function In Cystic Fibrosis

Ren

Rosenfeld

Konstan

et al. 2012

D16. Cystic Fibrosis: Biomarkers, Outcome Measures, and Pathogenesis

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“…FEV1 decreases and IgG increases with factors contributing to lung morbidity and overall mortality in CF. These were consistently shown to be age, female gender, pancreatic insufficient phenotype, infection/colonization, worse nutritional status (Konstan et al, 2007), F508del homozygous genotype (Kerem et al, 1990) and additional diagnosis of CFRD (Schaedel et al, 2002). On the contrary, IgG and FEV1 were reported to decrease and increase, respectively, upon treatment with anti-inflammatory agents, such as oral steroids (Auerbach et al, 1985), and are most likely being positively influenced by the recently documented immunomodulatory effect of macrolides (Shinkai et al, 2008).…”

Section: Inverse Relation Between Vitamin D and Serum Igg T Pincikovamentioning

confidence: 99%

Inverse relation between vitamin D and serum total immunoglobulin G in the Scandinavian Cystic Fibrosis Nutritional Study

Pincikova

Nilsson²,

Moen³

et al. 2010

Eur J Clin Nutr

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Background/Objectives: The hallmark of cystic fibrosis (CF) is chronic lung inflammation. The severity of lung disease is closely correlated with immunoglobulin G (IgG) levels. Beyond its contribution to the bone health, the importance of vitamin D has not been fully recognized owing to the lack of human studies providing evidence of its benefit. In the context of the recently described immunomodulatory functions of vitamin D, we aimed to assess the relationship between vitamin D and IgG levels. Subjects/Methods: Eight hundred and ninety-six CF patients were included (0.53-65.9 years) from seven centers in Denmark, Norway and Sweden. Serum 25-hydroxyvitamin D (25OHD) and total IgG were measured, spirometry was carried out and vitamin D intake data were gathered using a 7-day dietary food record. Multiple linear regression analyses were performed for IgG and forced expiratory volume in 1ls (FEV1) as dependent variables, and serum 25OHD, daily food and supplemented vitamin D sources of intake as independent variables. The model was controlled for age, gender, genotype, CF-related diabetes, season, infection/colonization status, long-term oral corticosteroid treatment, long-term treatment with macrolide antibiotics, pancreatic insufficient phenotype and body mass index z-score. Results: Serum total IgG levels were negatively associated with serum 25OHD (adjusted R 2 ¼ 0.376; beta ¼ À0.02; Po0.001), supplemented vitamin D intake per kg bodyweight (adjusted R 2 ¼ 0.375; beta ¼ À0.82; Po0.001) and total vitamin D intake per kg bodyweight (adjusted R 2 ¼ 0.398; beta ¼ À0.60; P ¼ 0.002). Serum 25OHD was positively associated with FEV1 (adjusted R 2 ¼ 0.308; beta ¼ 0.0007; P ¼ 0.025). Conclusions: Increasing vitamin D intake may positively modulate inflammation in CF. This study supports the proposed role of vitamin D in the immune system during infection and substantiates prospective studies.

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“…Although cross-sectional studies are most commonly reported in the literature, longitudinal analyses are essential for the validation of biomarkers of inflammation as correlates of disease severity and progression. Because the greatest rate of decline in lung function occurs in late childhood and adolescent years (13), it stands to reason that changes in airway inflammation may play a significant role in this decline.…”

mentioning

confidence: 99%

Sputum Biomarkers of Inflammation and Lung Function Decline in Children with Cystic Fibrosis

Sagel

Wagner²,

Anthony³

et al. 2012

Am J Respir Crit Care Med

217

213

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Risk Factors For Rate of Decline in Forced Expiratory Volume in One Second in Children and Adolescents with Cystic Fibrosis

Cited by 405 publications

References 23 publications

Early Childhood Wheezing Is Associated With Lower Lung Function In Cystic Fibrosis

Early Childhood Wheezing Is Associated With Lower Lung Function In Cystic Fibrosis

Inverse relation between vitamin D and serum total immunoglobulin G in the Scandinavian Cystic Fibrosis Nutritional Study

Sputum Biomarkers of Inflammation and Lung Function Decline in Children with Cystic Fibrosis

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