Risk factors for the persistence of respiratory symptoms in childhood asthma

Bahceciler, Nerin N.; Barlan, Işıl; Nuhoğlu, Yonca; Başaran, Müjdat

doi:10.1016/s1081-1206(10)62494-5

Cited by 21 publications

(13 citation statements)

References 18 publications

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“…78.43% of the patients were atopic, confirming previous observations on the proportion of atopics to non-atopics among the asthmatic patients [16]. According to Bahceciler et al [17], allergen sensitivity is a risk factor for the persistence of respiratory symptoms. We proved that in non-atopic patients suffering from asthma, the decline in lung function increases, which is in contrast to a study showing the opposite results [18].…”

Section: Discussionsupporting

confidence: 75%

Long-Term Deterioration of Lung Function in Asthmatic Outpatients

Kupczyk¹,

Kupryś²,

Górski³

et al. 2004

Respiration

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Background: Although the long-term deterioration of lung function in asthmatic patients has been described, the exact mechanism remains to be determined. Objectives: The aim of this study was to find correlations between age, sex, atopic status, duration of asthma, asthma severity and the decline in pulmonary function. Method: The medical histories of 1,006 randomly chosen asthmatic outpatients were studied and retrospective data on asthma duration, spirometry results, treatment and symptomatology were gathered. A screening spirometry was performed. Results: 598 women and 408 men (age: 44.59, range 12–95 years) participated in the study. Intermittent asthma was diagnosed in 35.4%, chronic mild asthma in 33.4%, moderate asthma in 23.8% and severe asthma in 7.45% of the patients. Statistically significant correlations between patient age, asthma duration and lung function measurements were found. Linear regression revealed the following differences in lung functions per year of asthma duration: FEV₁: –0.882% of predicted; FVC: –0.509% of predicted; FEV₁/FVC: –0.324% of predicted. The unadjusted annual decline was 80.1 ml/year (p = 0.00003) in FEV₁ and 20.5 ml/year (p = 0.036) in FVC. A multiple regression model revealed that asthma severity appears to be the strongest factor influencing pulmonary function (β = –0.55, p < 0.001 for FEV₁). Also, significant associations between pulmonary function measurements, patient age, atopic status and male sex were noted. Conclusions: The results of this large cohort study show that asthmatic patients develop a progressive decline in pulmonary function correlated with age, sex, duration of asthma and asthma severity. Early diagnosis and intervention is necessary to ameliorate any potential negative impact of asthma on lung function.

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Section: Discussionsupporting

confidence: 75%

Long-Term Deterioration of Lung Function in Asthmatic Outpatients

Kupczyk¹,

Kupryś²,

Górski³

et al. 2004

Respiration

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“…During maximal expiration, proximal airways contribute mostly to measurements assessed during the early phase of expiration, including FEV1, whereas distal airways are believed to contribute most to the end of expiration [71]. Therefore, FEF25-75% and FEF50% have been suggested to reflect distal airway obstruction and have been used in epidemiological and therapeutic studies involving asthmatic subjects [72][73][74][75]. However, FEF25-75% and FEF50% are highly variable spirometric tests [76].…”

Section: Noninvasive Measurements Spirometry and Plethysmographymentioning

confidence: 99%

Update on the roles of distal airways in asthma

Burgel¹,

Blic²,

Chanez³

et al. 2009

Eur Respir Rev

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The present review is the summary of an expert workshop that took place in Vence (France) in 2007 on the role of distal airways in asthma. The evidence showing inflammation and remodelling in distal airways, and their possible involvement in asthma control and natural history, was reviewed. The usefulness and limitations of various techniques used for assessing distal airways were also evaluated, including pulmonary function tests and imaging. Finally, the available data studying the benefit of treatment better targeting distal airways in asthma was examined. It was concluded that both proximal and distal airways were involved in asthma and that distal airways were the major determinant of airflow obstruction. Inflammation in distal airways appeared more intense in severe and uncontrolled asthma. Distal airways were poorly attained by conventional aerosol of asthma medications owing to their granulometry, being composed of 3-5 mm particles. Both proximal and distal airways might be targeted either by delivering medications systemically or by aerosol of extra-fine particles. Extra-fine aerosols of long-acting b-agonists, inhaled corticosteroids or inhaled corticosteroid/long-acting b-agonist combinations have been shown in short-term studies to be not inferior to non-extra-fine aerosols of comparators. However, available studies have not yet demonstrated that extra-fine inhaled medications offer increased benefit compared with usual aerosols in asthmatic patients.

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“…We had previously evaluated 279 asthmatic children who had been followed up for 3 years at Marmara University Pediatric Allergy and Immunology Division [11]. We randomly selected 100 patients from this previous study subjects but we could reach 74 patients and 62 of them accepted to attend the study.…”

Section: Subjectsmentioning

confidence: 99%

“…At the end of 1 month, the dose was decreased to 400 mcg/day, if an improvement had been achieved. The dose was then tapered during follow-up visits (every 2-3 months) to the lowest dose needed to control symptoms [11].…”

Section: Follow-up and Therapymentioning

confidence: 99%