Allergy Asthma Respir Dis.  2015 Sep;3(5):326-333. 10.4168/aard.2015.3.5.326.

Clinical characteristics related to onset age of wheeze in school-age children and adolescents with asthma

Affiliations
  • 1Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
  • 2Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Pediatrics, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
  • 4Department of Pediatrics, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea.
  • 5Department of Pediatrics, Busan St. Mary's Medical Center, Busan, Korea.
  • 6Department of Pediatrics, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea. hlchung@cu.ac.kr

Abstract

PURPOSE
We aimed to investigate the clinical characteristics and their relationship with the onset age of wheeze in school-age children and adolescents with asthma.
METHODS
Three hundred twenty-six patients, aged 6 to 19 years, diagnosed with asthma at 6 hospitals from Seoul, Gyeonggi, Daegu, and Busan were enrolled. They were categorized into 3 groups by the onset age of wheeze: group A, early onset (age <3 years); group B, preschool onset (age 3-6 years); group C, late onset (age > or =6 years). Clinical characteristics including atopic sensitization, family history, combined allergic diseases, severity of asthma, and influence of asthma on daily life were examined. A history of hospitalization for early lower respiratory infection (LRI) and environmental tobacco smoking were studied and lung function tests were also performed.
RESULTS
There was no difference in demographics, prevalence of atopy, combined allergic diseases, and family history of allergy between 3 groups. A history of sever LRI in early life was more common in groups A and B compared with group C. Sensitization to Dermatophagoides pteronyssinus was more prevalent in groups A and B than in group C. Forced expiratory flow between 25% to 75% (FEF(25%-75%)) was lower in groups A and B than in group C, and methacholine PC20 (provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second) was lowest in group B. Significantly lower FEF(25%-75%) and methacholine PC20 were observed in the patients who had been hospitalized with LRI in early life.
CONCLUSION
Our study shows significant difference in lung function and atopic sensitization in relation to the onset age of wheeze in school-age children and adolescents with asthma, and suggests that early LRI might contribute to the development of asthma in early life.

Keyword

Asthma; Child; Adolescent

MeSH Terms

Adolescent*
Age of Onset*
Asthma*
Busan
Child*
Daegu
Demography
Dermatophagoides pteronyssinus
Forced Expiratory Volume
Gyeonggi-do
Hospitalization
Humans
Hypersensitivity
Lung
Methacholine Chloride
Prevalence
Respiratory Function Tests
Seoul
Smoking
Methacholine Chloride

Figure

  • Fig. 1 Compliance to treatment in three asthma groups. Group A, early onset (age <3 yr); group B, preschool onset (age 3-6 yr); group C, late onset (age ≥6 yr).


Reference

1. Gluckman PD, Hanson MA, Cooper C, Thornburg KL. Effect of in utero and early-life conditions on adult health and disease. N Engl J Med. 2008; 359:61–73.
Article
2. Saglani S, Bush A. The early-life origins of asthma. Curr Opin Allergy Clin Immunol. 2007; 7:83–90.
Article
3. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995; 332:133–138.
4. Taussig LM, Wright AL, Holberg CJ, Halonen M, Morgan WJ, Martinez FD. Tucson Children's Respiratory Study: 1980 to present. J Allergy Clin Immunol. 2003; 111:661–675.
Article
5. Beigelman A, Bacharier LB. The role of early life viral bronchiolitis in the inception of asthma. Curr Opin Allergy Clin Immunol. 2013; 13:211–216.
Article
6. Sears MR, Greene JM, Willan AR, Wiecek EM, Taylor DR, Flannery EM, et al. A longitudinal, population-based, cohort study of childhood asthma followed to adulthood. N Engl J Med. 2003; 349:1414–1422.
Article
7. Morgan WJ, Stern DA, Sherrill DL, Guerra S, Holberg CJ, Guilbert TW, et al. Outcome of asthma and wheezing in the first 6 years of life: follow-up through adolescence. Am J Respir Crit Care Med. 2005; 172:1253–1258.
Article
8. Hyvärinen MK, Kotaniemi-Syrjanen A, Reijonen TM, Korhonen K, Korppi MO. Teenage asthma after severe early childhood wheezing: an 11-year prospective follow-up. Pediatr Pulmonol. 2005; 40:316–323.
Article
9. Ahn K, Kim J, Kwon HJ, Chae Y, Hahm MI, Lee KJ, et al. The prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in Korean children: nationwide cross-sectional survey using complex sampling design. J Korean Med Assoc. 2011; 54:769–778.
Article
10. Savenije OE, Granell R, Caudri D, Koppelman GH, Smit HA, Wijga A, et al. Comparison of childhood wheezing phenotypes in 2 birth cohorts: ALSPAC and PIAMA. J Allergy Clin Immunol. 2011; 127:1505–1512.e14.
Article
11. Siroux V, Curt F, Oryszczyn MP, Maccario J, Kauffmann F. Role of gender and hormone-related events on IgE, atopy, and eosinophils in the Epidemiological Study on the Genetics and Environment of Asthma, bronchial hyperresponsiveness and atopy. J Allergy Clin Immunol. 2004; 114:491–498.
Article
12. Osman M, Tagiyeva N, Wassall HJ, Ninan TK, Devenny AM, McNeill G, et al. Changing trends in sex specific prevalence rates for childhood asthma, eczema, and hay fever. Pediatr Pulmonol. 2007; 42:60–65.
Article
13. Pawankar R, Zernotti ME. Rhinosinusitis in children and asthma severity. Curr Opin Allergy Clin Immunol. 2009; 9:151–153.
Article
14. Michelow IC, Olsen K, Lozano J, Rollins NK, Duffy LB, Ziegler T, et al. Epidemiology and clinical characteristics of community-acquired pneumonia in hospitalized children. Pediatrics. 2004; 113:701–707.
Article
15. Matsuno O, Ono E, Takenaka R, Okubo T, Takatani K, Ueno T, et al. Asthma and sinusitis: association and implication. Int Arch Allergy Immunol. 2008; 147:52–58.
Article
16. Bidat E, Sznajder M, Fermanian C, Guichoux-Treps N, Feuillet-Dassonval C, Baranes T, et al. A diagnostic questionnaire for the hyperventilation syndrome in children. Rev Mal Respir. 2008; 25:829–838.
17. Low K, Lau KK, Holmes P, Crossett M, Vallance N, Phyland D, et al. Abnormal vocal cord function in difficult-to-treat asthma. Am J Respir Crit Care Med. 2011; 184:50–56.
Article
18. Stein RT, Martinez FD. sthma phenotypes in childhood: lessons from an epidemiological approach. Paediatr Respir Rev. 2004; 5:155–161.
19. Henderson J, Granell R, Heron J, Sherriff A, Simpson A, Woodcock A, et al. Associations of wheezing phenotypes in the first 6 years of life with atopy, lung function and airway responsiveness in mid-childhood. Thorax. 2008; 63:974–980.
Article
20. Brunekreef B, Smit J, de Jongste J, Neijens H, Gerritsen J, Postma D, et al. The prevention and incidence of asthma and mite allergy (PIAMA) birth cohort study: design and first results. Pediatr Allergy Immunol. 2002; 13:Suppl 15. 55–60.
Article
21. ODriscoll BR, Hopkinson LC, Denning DW. Mold sensitization is common amongst patients with severe asthma requiring multiple hospital admissions. BMC Pulm Med. 2005; 5:4.
Article
22. Luciano L, Lenzi J, McDonald KM, Rosa S, Damiani G, Corsello G, et al. Empirical validation of the "Pediatric Asthma Hospitalization Rate" indicator. Ital J Pediatr. 2014; 40:7.
Article
23. Barcala FJ, Vinas JA, Cuadrado LV, Bourdin A, Dobano JM, Takkouche B. Trends in hospital admissions due to asthma in north-west Spain from 1995 to 2007. Allergol Immunopathol (Madr). 2010; 38:254–258.
Article
24. Murray CS, Poletti G, Kebadze T, Morris J, Woodcock A, Johnston SL, et al. Study of modifiable risk factors for asthma exacerbations: virus infection and allergen exposure increase the risk of asthma hospital admissions in children. Thorax. 2006; 61:376–382.
Article
25. Murray CS, Simpson A, Custovic A. Allergens, viruses, and asthma exacerbations. Proc Am Thorac Soc. 2004; 1:99–104.
Article
26. Sly PD, Kusel M, Holt PG. Do early-life viral infections cause asthma? J Allergy Clin Immunol. 2010; 125:1202–1205.
Article
27. Jackson DJ, Lemanske RF Jr. The role of respiratory virus infections in childhood asthma inception. Immunol Allergy Clin North Am. 2010; 30:513–522.
Article
28. Carroll KN, Wu P, Gebretsadik T, Griffin MR, Dupont WD, Mitchel EF, et al. The severity-dependent relationship of infant bronchiolitis on the risk and morbidity of early childhood asthma. J Allergy Clin Immunol. 2009; 123:1055–1061. 1061.e1
Article
29. Pattenden S, Antova T, Neuberger M, Nikiforov B, De Sario M, Grize L, et al. Parental smoking and children's respiratory health: independent effects of prenatal and postnatal exposure. Tob Control. 2006; 15:294–301.
Article
30. De Sario M, Di Domenicantonio R, Corbo G, Forastiere F, Pistelli R, Rusconi F, et al. Characteristics of early transient, persistent, and late onset wheezers at 9 to 11 years of age. J Asthma. 2006; 43:633–638.
Article
31. Goksör E, Gustafsson PM, Alm B, Amark M, Wennergren G. Reduced airway function in early adulthood among subjects with wheezing disorder before two years of age. Pediatr Pulmonol. 2008; 43:396–403.
Article
32. Slattery MJ, Essex MJ. Specificity in the association of anxiety, depression, and atopic disorders in a community sample of adolescents. J Psychiatr Res. 2011; 45:788–795.
Article
33. Lu Y, Mak KK, van Bever HP, Ng TP, Mak A, Ho RC. Prevalence of anxiety and depressive symptoms in adolescents with asthma: a meta-analysis and meta-regression. Pediatr Allergy Immunol. 2012; 23:707–715.
Article
34. Lu Y, Ho R, Lim TK, Kuan WS, Goh DY, Mahadevan M, et al. Psychiatric comorbidities in Asian adolescent asthma patients and the contributions of neuroticism and perceived stress. J Adolesc Health. 2014; 55:267–275.
Article
35. Letitre SL, de Groot EP, Draaisma E, Brand PL. Anxiety, depression and self-esteem in children with well-controlled asthma: case-control study. Arch Dis Child. 2014; 99:744–748.
Article
36. Santos-Silva R, Melo C, Goncalves D, Coelho J, Carvalho F. Comparison between exercise performance in asthmatic children and healthy controls: physical activity questionnaire application. Rev Port Pneumol. 2014; 20:138–145.
Article
37. Guilbert TW, Bacharier LB, Fitzpatrick AM. Severe asthma in children. J Allergy Clin Immunol Pract. 2014; 2:489–500.
Article
38. Fitzpatrick AM, Gaston BM, Erzurum SC, Teague WG. National Institutes of Health/National Heart, Lung, and Blood Institute Severe Asthma Research Program. National Heart, Lung, and Blood Institute Severe Asthma Research Program. Features of severe asthma in school-age children: atopy and increased exhaled nitric oxide. J Allergy Clin Immunol. 2006; 118:1218–1225.
Article
Full Text Links
  • AARD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr