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Atopy, cytokine production, and airway reactivity as predictors of pre‐school asthma and airway responsiveness
Author(s) -
Sarria Edgar E.,
Mattiello Rita,
Yao Weiguo,
Chakr Valentina,
Tiller Christina J.,
Kisling Jeffrey,
Tabbey Rebeka,
Yu Zhangsheng,
Kaplan Mark H.,
Tepper Robert S.
Publication year - 2014
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.22784
Subject(s) - medicine , atopy , spirometry , asthma , immunology , airway , immunoglobulin e , ragweed , methacholine , allergy , bronchodilator , cytokine , respiratory disease , lung , anesthesia , antibody
Summary Background Childhood asthma is often characterized by recurrent wheezing, airway hyper‐reactivity, atopy, and altered immune characteristics; however, our understanding of the development of these relationships from early in life remains unclear. The aim of our study was to evaluate whether atopy, cytokine production by peripheral blood mononuclear cells (PBMCs), and airway responsiveness, assessed in infants and toddlers, are associated with asthma and airway responsiveness at 4‐years of age. Methods Infants with eczema (N = 116), enrolled prior to wheezing, were assessed at entry (mean age of 10.7 months), at 1‐year follow‐up (N = 112), and at 4‐years of age (N = 94). Total serum IgE, specific IgE to allergens, and cytokines produced by stimulated PBMCs, were assessed at entry and 1‐year follow‐up. Spirometry was obtained at all 3‐visits, while airway reactivity to methacholine was assessed at entry and 1‐year follow‐up, and bronchodilator (BD) responsiveness, as well as current asthma was assessed at 4‐years of age. Results We found that pre‐school children with asthma had lower spirometry and a greater BD‐response. Serum IgE, particularly to egg and/or milk, and altered cytokine production by PBMCs at entry to the study were associated with asthma, lower spirometry, and greater airway responsiveness at 4‐years of age. In addition, we found that airway responsiveness, as well as spirometry, tracked from infancy to 4‐years of age. Conclusions While spirometry and airway responsiveness track longitudinally from early in life, atopy and cytokine production by PBMCs are associated not only with an increased risk of pre‐school asthma, but also lower spirometry and increased airway responsiveness. Pediatr Pulmonol. 2014; 49:132–139. © 2013 Wiley Periodicals, Inc.