Bronchodilation and bronchoconstriction: Predictors of future lung function in childhood asthma

Kelan G. Tantisira, Anne L. Fuhlbrigge, James A Tonascia, Mark L Van Natta, Robert S. Zeiger, Robert C. Strunk, Stanley J. Szefler, Scott T. Weiss

Research output: Contribution to journalArticle

Abstract

Background: Persistently low levels of lung function are associated with subsequent symptoms in patients with asthma as children. Objectives: We hypothesized that objective measures of baseline pulmonary function would be independently associated with future lung function in the Childhood Asthma Management Program and that these associations might vary with treatment. Methods: We evaluated the association of FEV 1, airway responsiveness, and bronchodilator response at randomization as predictors of longitudinal growth in FEV 1 at the 48-month follow-up visit in the 1041 Childhood Asthma Management Program participants. Results: Baseline levels of airway responsiveness and bronchodilator response were significantly associated with baseline level of lung function. In multivariate models, higher bronchodilator response (β = 0.22; P <.0001), log PC 20 (β = 1.82; P <.0001), and FEV 1 (β = 0.58; P <.0001) at randomization were each associated with higher levels of prebronchodilator FEV 1, as a percent of predicted, after 4 years. Similar associations were noted for prebronchodilator forced vital capacity and FEV 1/forced vital capacity ratio. Baseline bronchodilator response was a particularly powerful predictor of lung function improvements while on inhaled corticosteroids, whereas airway responsiveness was a better predictor in subjects not randomized to any controller medications. Conclusion: We conclude that baseline bronchodilator response, airway responsiveness, and level of FEV 1 are independent predictors of subsequent level of FEV 1 in childhood asthma and may have treatment-specific prognostic significance for persistence of symptoms into early adulthood. Clinical implications: In asthma, bronchodilator and bronchoconstrictor responses are independent predictors of future lung function and should not be used interchangeably; bronchodilator response may indicate good response to inhaled corticosteroids.

Original languageEnglish (US)
Pages (from-to)1264-1271
Number of pages8
JournalThe Journal of Allergy and Clinical Immunology
Volume117
Issue number6
DOIs
StatePublished - Jun 2006

Fingerprint

Bronchoconstriction
Bronchodilator Agents
Asthma
Lung
Vital Capacity
Random Allocation
Adrenal Cortex Hormones
Bronchoconstrictor Agents
Therapeutics
Growth

Keywords

  • asthma
  • bronchodilator
  • corticosteroid
  • FEV
  • methacholine
  • natural history
  • PC

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Bronchodilation and bronchoconstriction : Predictors of future lung function in childhood asthma. / Tantisira, Kelan G.; Fuhlbrigge, Anne L.; Tonascia, James A; Van Natta, Mark L; Zeiger, Robert S.; Strunk, Robert C.; Szefler, Stanley J.; Weiss, Scott T.

In: The Journal of Allergy and Clinical Immunology, Vol. 117, No. 6, 06.2006, p. 1264-1271.

Research output: Contribution to journalArticle

Tantisira, Kelan G. ; Fuhlbrigge, Anne L. ; Tonascia, James A ; Van Natta, Mark L ; Zeiger, Robert S. ; Strunk, Robert C. ; Szefler, Stanley J. ; Weiss, Scott T. / Bronchodilation and bronchoconstriction : Predictors of future lung function in childhood asthma. In: The Journal of Allergy and Clinical Immunology. 2006 ; Vol. 117, No. 6. pp. 1264-1271.
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