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Asthma phenotypes in children based on impaired lung function

Children with asthma and associated atopic dermatitis and allergic rhinitis showed reduced lung function from birth that was not driven by allergic sensitization, according to recent study results.

Karin C. Lødrup Carlsen, MD, PhD, head of research, Women and Children’s Division, Oslo University Hospital, and colleagues used tidal flow volume loops to measure lung function (given as z scores) in 329 children (52% boys) in the Environment and Asthma birth cohort study in Oslo, Norway, and by using spirometry at ages 10 and 16 years.

Karin C. Lødrup Carlsen

“Asthma phenotypes were classified on the basis of recurrent bronchial obstructions at 0 to 2 years, and asthma from the 2- to 10-year and 10- to 16-year intervals, and by combining asthma, atopic dermatitis [AD] and/or allergic rhinitis [AR] from 10 to 16 years, stratifying for allergic sensitization,” the researchers wrote.

Children with asthma in remission (n=42) were included in the study to bolster the comparability of phenotypes. The reference group comprised 231 children without bronchial obstruction or asthma.

“Lung function trajectories differed significantly for asthma comorbidity phenotypes for FEV₁, forced expiratory flow at 25% to 75% of forced vital capacity, and FEV₁/forced vital capacity (all P<.0001),” the researchers wrote.

In patients with asthma, AD and AR, significant lung function impairment was observed from birth through 16 years. In patients with asthma at 10 to 16 years or asthma in remission, lung function trajectories differed significantly for all three spirometric values when compared with patients who never had asthma (P<.0001); however, not between asthma groups.

Allergic sensitization and asthma phenotype lung function trajectories were not significantly associated.

“Lung function trajectories from birth through age 16 years reflected asthma phenotypes based on the comorbidities AD and AR but appear not to be driven by the presence of allergic sensitization,” the researchers concluded. “Lung function impairment from birth throughout childhood and adolescence was most pronounced in the adolescent asthma phenotype with both AD and AR.”

Disclosure: See the study for a full list of relevant financial disclosures.