Dataset Information

Airway responsiveness in mild to moderate childhood asthma: sex influences on the natural history.

ABSTRACT:

Rationale

Airway responsiveness is a prognostic marker for asthma symptoms in later life.

Objectives

To evaluate characteristics responsible for persistence of airway responsiveness in children with asthma.

Methods

A total of 1,041 children, initially aged 5-12 years, with mild to moderate persistent asthma enrolled in the Childhood Asthma Management Program (CAMP) were studied prospectively for 8.6 +/- 1.8 years with methacholine challenges yearly.

Measurements and main results

Least squares geometric mean models were fit to determine effects of sex and age on airway responsiveness (provocative concentration producing 20% decrease in FEV(1) [PC(20)]). Multiple linear regression analysis was performed to determine factors at baseline and over time, which were associated with PC(20) at end of follow-up. A total of 7,748 methacholine challenges were analyzed. PC(20) increased with age, with boys having greater increase after age 11 years than girls (P < 0.001). The divergence coincided with the mean age for Tanner stage 2. Postpubertal girls had greater airway responsiveness, even after adjustment for FEV(1) and other potential confounders. Although multivariable regression analyses noted a variety of factors that influenced airway responsivness in both sexes, a history of hay fever (beta= -0.30, P = 0.005), respiratory allergy (beta= -0.32, P = 0.006), or recent inhaled corticosteroid usage (beta= -0.18, P = 0.02) were associated with decrements in final log PC(20) only in girls.

Conclusions

Airway responsiveness (PC(20)) is more severe in the postpubertal female with asthma than in males. Although there are factors associated with airway responsiveness in both males and females, sex-specific factors may contribute to new insights into asthma pathogenesis.

SUBMITTER: Tantisira KG

PROVIDER: S-EPMC2542438 | biostudies-literature | 2008 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Airway responsiveness in mild to moderate childhood asthma: sex influences on the natural history.

Tantisira Kelan G KG Colvin Ryan R Tonascia James J Strunk Robert C RC Weiss Scott T ST Fuhlbrigge Anne L AL

American journal of respiratory and critical care medicine 20080417 4

<h4>Rationale</h4>Airway responsiveness is a prognostic marker for asthma symptoms in later life.<h4>Objectives</h4>To evaluate characteristics responsible for persistence of airway responsiveness in children with asthma.<h4>Methods</h4>A total of 1,041 children, initially aged 5-12 years, with mild to moderate persistent asthma enrolled in the Childhood Asthma Management Program (CAMP) were studied prospectively for 8.6 +/- 1.8 years with methacholine challenges yearly.<h4>Measurements and main ...[more]

PMID: 18420965

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Project description:Psychosocial factors have been found to impact airway pathophysiology in respiratory disease with considerable consistency. Influences on airway mechanics have been studied particularly well. The goal of this article is to review the literature on airway responses to psychological stimulation, discuss potential pathways of influence, and present a well-established emotion-induction paradigm to study airway obstruction elicited by unpleasant stimuli. Observational studies have found systematic associations between lung function and daily mood changes. The laboratory-based paradigm of bronchoconstrictive suggestion has been used successfully to elicit airway obstruction in a substantial proportion of asthmatic individuals. Other studies have demonstrated modulation of airway responses to standard airway challenges with exercise, allergens, or pharmacological agents by psychological factors. Standardized emotion-induction techniques have consistently shown airway constriction during unpleasant stimulation, with surgery, blood, and injury stimuli being particularly powerful. Findings with various forms of stress induction have been more mixed. A number of methodological factors may account for variability across studies, such as choice of measurement technique, temporal association between stimulation and measurement, and the specific quality and intensity of the stimulus material, in particular the extent of implied action-orientation. Research has also begun to elucidate physiological processes associated with psychologically induced airway responses, with vagal excitation and ventilatory influences being the most likely candidate pathways, whereas the role of specific central nervous system pathways and inflammatory processes has been less studied. The technique of emotion-induction using films has the potential to become a standardized challenge paradigm for the further exploration of airway hyperresponsiveness mediated by central nervous system processes.

Dataset Information

Airway responsiveness in mild to moderate childhood asthma: sex influences on the natural history.

Rationale

Objectives

Methods

Measurements and main results

Conclusions

Publications

Airway responsiveness in mild to moderate childhood asthma: sex influences on the natural history.

Similar Datasets

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