Systemic neutrophil activation in acute preschool viral wheeze

Oommen, A; Patel, Rutu; Browning, M. C. K.; Grigg, Jonathan

doi:10.1136/adc.88.6.529

Cited by 32 publications

(19 citation statements)

References 23 publications

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“…Infants in the present study were from an unselected population and maternal atopy did not modify any of the associations found, which may explain the discrepancies. Although there is evidence that most asthma starts early in life [23], respiratory morbidity in the preschool child is mostly related to neutrophilic airway inflammation [24] and there is very little evidence of chronic eosinophilic bronchial inflammation in the first months of life [25].…”

Section: Discussionmentioning

confidence: 99%

Smoke exposure, airway symptoms and exhaled nitric oxide in infants: the Generation R study

Gabriele¹,

Asgarali²,

Jaddoe³

et al. 2008

Eur Respir J

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The effect of pre-and post-natal smoke exposure on exhaled nitric oxide fraction (FeNO) in infants was evaluated and the association between respiratory symptoms and FeNO in the first 2 months of life was investigated. The Generation R study is a population-based, prenatally recruited birth cohort.Exposures were assessed by means of questionnaires prospectively administered during pregnancy and after birth. Successful off-line FeNO measurements during tidal breathing were obtained in 187 infants (median age 6.9 weeks). The association between possible determinants and log FeNO was investigated with multiple linear regression analysis.Infants exposed pre-and post-natally to smoke showed lower FeNO than infants exposed only after birth (geometric mean difference (95% confidence interval) 1.5 (1.0-2.1) ppb) and never-exposed infants (1.4 (1.0-1.8) ppb). FeNO was reduced in infants with severe upper respiratory symptoms compared with infants with nonsevere symptoms (1.6 (1.0-2.4) ppb). Infants with symptoms of the lower respiratory tract had lower FeNO than asymptomatic infants (1.2 (1.0-1.50) ppb).In conclusion, the nature of the association between smoke exposure and exhaled nitric oxide fraction is dependent on timing and intensity of exposure. The occurrence and the severity of respiratory symptoms in the first 2 months of life are associated with lower exhaled nitric oxide fraction.

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Section: Discussionmentioning

confidence: 99%

Smoke exposure, airway symptoms and exhaled nitric oxide in infants: the Generation R study

Gabriele¹,

Asgarali²,

Jaddoe³

et al. 2008

Eur Respir J

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“…It is likely that there will be considerable overlap in these relationships between different clinical syndromes, as reviewed by Wenzel 55. An example where childhood and adult phenotypes might overlap is evidenced by the few opportunistic studies of viral-associated wheeze in young children that have demonstrated predominantly neutrophil- as opposed to eosinophil-mediated airway inflammation 56 57. These results suggest the presence of different pathological phenotypes of wheezing illness in young children and also hint at similarities with adult classifications of non-eosinophilic airway inflammation 38…”

Section: Clinical and Research Implicationsmentioning

confidence: 99%

The search for new asthma phenotypes

Henderson

Granell

Sterne

2009

Archives of Disease in Childhood

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“…Studies in infants found that FeNO was positively associated with recurrent wheezing [3][4][5], whereas lower FeNO was associated with virus-associated wheezing [6] and with upper and lower respiratory symptoms [7,8]. Indeed, respiratory morbidity in infants is mostly related to neutrophilic airway inflammation, which does not increase FeNO [9], and not to eosinophilic inflammation [10,11]. Previous studies in young children are difficult to compare as different inclusion criteria and methods of measuring FeNO have been used.…”

mentioning

confidence: 98%

Exhaled nitric oxide and the risk of wheezing in infancy: the Generation R Study

Gabriele

Jaddoe²,

Mastrigt³

et al. 2011

Eur Respir J

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We assessed whether exhaled nitric oxide fraction (FeNO), a marker of eosinophilic airway inflammation, at 6 months was associated with the risk of wheezing during the first 2 yrs of life.In the Generation R birth cohort, pre-and post-natal risk factors for respiratory morbidity and respiratory symptoms were assessed by questionnaires at 6 and 24 months. In 428 infants, off-line mixed oral/nasal FeNO was successfully measured during tidal breathing at 6 months. Complete data on FeNO and respiratory symptoms within the first 6 months of life were available for 294 infants.FeNO was higher in males, was positively associated with age and was negatively associated with upper and lower respiratory symptoms within the first 6 months. Logistic regression analysis showed that for every ppb increase of FeNO measured at 6 months, infants had a 1.06 (95% confidence interval 1.01-1.11)-fold increased risk of wheezing in the second year of life. High FeNO (.17.5 ppb) showed a limited added value in predicting wheezing in the second year.We conclude that FeNO at 6 months is positively associated with the risk of wheezing, but has limited added value in predicting wheezing in the second year of life in individual children.

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Systemic neutrophil activation in acute preschool viral wheeze

Cited by 32 publications

References 23 publications

Smoke exposure, airway symptoms and exhaled nitric oxide in infants: the Generation R study

Smoke exposure, airway symptoms and exhaled nitric oxide in infants: the Generation R study

The search for new asthma phenotypes

Exhaled nitric oxide and the risk of wheezing in infancy: the Generation R Study

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