Asthma Progression and Airway Inflammation Assessed by Lung Function in Children with Asthma

Baek, Hey Sung; Cheong, Ji Young; Oh, Jae Won; Lee, Ha Baik

Abstract

PURPOSE
The social and economic impact of asthma is remarkable worldwide. To date, there have been many unanswered questions about factors related to asthma progression and persistence. This study focused on possible risk factors for persistent asthma that had developed between infancy and late childhood.
METHODS
Sixty-seven children with persistent mild-to-moderate asthma were enrolled in this study. They were classified into 2 groups according to the Global Initiative for Asthma (GINA) guideline 2006: early-onset (<3 years, n=28) and late-onset (>3 years, n=39) asthmatics. All patients were interviewed on the personal and familial history of atopy, breast feeding, parental smoking and the recent use of inhaled corticosteroids. We performed spirometry, and skin prick tests and measured body mass index, serum allergen-specific IgE, serum eosinophil counts and serum ECP in asthmatics. All asthmatics underwent the bronchial challenge by methacholine inhalation and outdoor free running.
RESULTS
Risk factors such as eczema and frequent wheezing were more common in early-onset asthmatics than in late-onset asthmatics (P<0.05). However, there was no difference between the 2 groups in the overall incidence of airway hyperresponsiveness (AHR) determined by the PC20 and postexercise decrease of FEV1 (P>0.05). Inhaled corticosteroids were more frequently used in early-onset asthmatics than in late-onset asthmatics (P<0.0001). A reciprocal relationship between FEV1/FVC and the duration of asthma was also detected in persistent asthmatics (n=57, r=-0.398, P=0.002).
CONCLUSION
The results of this study suggest that atopic dermatitis and frequent wheezing may be important risk factors for the persistence of asthma and lung function decline from early to late childhood.