TY - JOUR
T1 - Recurrent wheeze and its relationship with lung function and airway inflammation in preschool children
T2 - A cross-sectional study in South Korea
AU - Soh, Ji Eun
AU - Kim, Kyung Moon
AU - Kwon, Ji Won
AU - Kim, Hyung Young
AU - Seo, Ju Hee
AU - Kim, Hyo Bin
AU - Lee, So Yeon
AU - Jang, Gwang Cheon
AU - Song, Dae Jin
AU - Kim, Woo Kyung
AU - Jung, Young Ho
AU - Hong, Soo Jong
AU - Shim, Jung Yeon
N1 - Funding Information:
1Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea 2Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea 3Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea 4Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Republic of Korea 5Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea 6Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea 7Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Ilsan, Republic of Korea 8Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea 9Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Republic of Korea 10Department of Pediatrics, CHA Bundang Medical Center, Seongnam, Republic of Korea contributors DJS, WKK, YHJ, JWK and HYK were involved in the design of the work. JES and KMK contributed to drafting the work and analysis of data for the work. JYS revised the work critically for important intellectual content. SJH contributed to final approval of the version to be published. JHS, HBK, SYL and GCJ contributed to all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work were appropriately investigated and resolved. Funding This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare, Republic of Korea (A092076). competing interests None declared. ethics approval Institutional review boards of the University of Ulsan College of Medicine.
Publisher Copyright:
© Article author(s) 2017.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Background Relationship between recurrent wheeze and airway function and inflammation in preschool children is not fully known. Objective To investigate the relationship between recurrent wheeze and airway inflammation, lung function, airway hyper-reactivity (AHR) and atopy in preschool children. Design Observational study, comparing forced expiratory volume in 1 s (FEV 1), forced vital capacity (FVC) and mid-forced expiratory flow (FEF 25%-75%), dose-response slope (DRS), exhaled nitric oxide (eNO) and atopic sensitisation between children with recurrent wheeze and those without. Setting Population-based, cross-sectional study in Seoul and the Gyeonggi province of Korea conducted as a government-funded programme to perform standardised measurement of the prevalence of allergic diseases, and related factors, in preschool children. Participants 900 children aged 4-6 years. Primary and secondary outcome measures eNO, FEV 1 /FVC, FEF 25%-75%, DRS, atopic sensitisation and allergic diseases. Methods Children completed the modified International Study of Asthma and Allergies in Childhood questionnaire and underwent eNO assessments, spirometry, methacholine bronchial provocation tests and skin prick tests. Recurrent wheeze was defined as having a lifetime wheeze of more than three episodes, based on the questionnaire. The frequency of hospitalisation and emergency room visits was also obtained by means of the questionnaire. Current' wheeze was defined as having symptoms or treatments within the past 12 months. Results The prevalence of recurrent wheeze was 13.4%. Children with recurrent wheeze showed a higher prevalence of lifetime or current allergic rhinitis (p=0.01 and p=0.002, respectively) and lifetime atopic dermatitis (p=0.007). Children with recurrent wheeze showed lower FEV 1 /FVC (p=0.033) and FEF 25%-75% (p=0.004), and higher eNO levels (p=0.013) than those without recurrent wheeze. However, the DRS, prevalence of atopic sensitisation and serum IgE levels were not significantly different between the two groups. Conclusions Recurrent wheeze in preschool children may be associated with airway inflammation and diminished airway function, but not with AHR or atopy.
AB - Background Relationship between recurrent wheeze and airway function and inflammation in preschool children is not fully known. Objective To investigate the relationship between recurrent wheeze and airway inflammation, lung function, airway hyper-reactivity (AHR) and atopy in preschool children. Design Observational study, comparing forced expiratory volume in 1 s (FEV 1), forced vital capacity (FVC) and mid-forced expiratory flow (FEF 25%-75%), dose-response slope (DRS), exhaled nitric oxide (eNO) and atopic sensitisation between children with recurrent wheeze and those without. Setting Population-based, cross-sectional study in Seoul and the Gyeonggi province of Korea conducted as a government-funded programme to perform standardised measurement of the prevalence of allergic diseases, and related factors, in preschool children. Participants 900 children aged 4-6 years. Primary and secondary outcome measures eNO, FEV 1 /FVC, FEF 25%-75%, DRS, atopic sensitisation and allergic diseases. Methods Children completed the modified International Study of Asthma and Allergies in Childhood questionnaire and underwent eNO assessments, spirometry, methacholine bronchial provocation tests and skin prick tests. Recurrent wheeze was defined as having a lifetime wheeze of more than three episodes, based on the questionnaire. The frequency of hospitalisation and emergency room visits was also obtained by means of the questionnaire. Current' wheeze was defined as having symptoms or treatments within the past 12 months. Results The prevalence of recurrent wheeze was 13.4%. Children with recurrent wheeze showed a higher prevalence of lifetime or current allergic rhinitis (p=0.01 and p=0.002, respectively) and lifetime atopic dermatitis (p=0.007). Children with recurrent wheeze showed lower FEV 1 /FVC (p=0.033) and FEF 25%-75% (p=0.004), and higher eNO levels (p=0.013) than those without recurrent wheeze. However, the DRS, prevalence of atopic sensitisation and serum IgE levels were not significantly different between the two groups. Conclusions Recurrent wheeze in preschool children may be associated with airway inflammation and diminished airway function, but not with AHR or atopy.
KW - asthma
KW - epidemiology
KW - paediatric thoracic medicine
KW - respiratory physiology
UR - http://www.scopus.com/inward/record.url?scp=85031113698&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2017-018010
DO - 10.1136/bmjopen-2017-018010
M3 - Article
C2 - 28993393
AN - SCOPUS:85031113698
SN - 2044-6055
VL - 7
JO - BMJ Open
JF - BMJ Open
IS - 10
M1 - e018010
ER -