Reduced lung function in infancy linked to asthma at age 8

A cohort of Finnish children who had reduced lung function in infancy were more likely to have had physician-diagnosed asthma or currently have asthma during follow-up at 8 years of age, according to study findings.

Forty-seven of 53 children with impaired lung function originally studied during infancy completed follow-up at a median age of 8.1 years. Physician-diagnosed asthma was present in 39 children (83%), current asthma in 25 (53%) and past asthma in 14 (30%). Ongoing asthma symptoms were observed in 27 (57%) children, seven (15%) of whom presented with ongoing wheeze. Of the patients with ongoing symptoms, multiple triggers were identified in 26 of them (96%), and the other patient (4%) had asthma caused by viruses.

Data for skin prick tests during infancy were available for 41 children; of those, atopy was present in 19 (46%) of them.

Forced vital capacity was significantly lower in the study cohort compared with healthy, age-matched nonasthmatic children, and airway responsiveness was increased in the study group. No differences, however, were seen in airway smooth muscle or reticular basement membrane, and the latter did not correlate with airway responsiveness.

Early onset of symptoms and infant exposure to smoking were risk factors for reduced lung function at an older age, and parents of the study children were more likely to report the use of inhaled corticosteroids.

“These data … underscore that the early pathologic processes that initiate asthma, which are as yet undescribed, are very different from the eosinophilic inflammation associated with ongoing disease and that very different approaches will be needed if asthma is to be prevented rather than treated once it has developed,” the researchers wrote.

Disclosure: One of the researchers reports being supported by the National Institute for Health Research Respiratory Disease Biomedical Research Unit at the Royal Brompton and Harefield National Health Service Foundation Trust and Imperial College London.