Irreversible lung function deficits in young adults with a history of childhood asthma

Susan L. Limb, Kathryn C. Brown, Robert A Wood, Robert A Wise, Peyton A. Eggleston, James A Tonascia, N Franklin Adkinson

Research output: Contribution to journalArticle

Abstract

Background: Asthma, traditionally characterized as reversible airway obstruction, might lead to structural changes and permanent impairment. Objective: We sought to study the frequency, severity, and reversibility of pulmonary deficits in adults with a history of moderate-to-severe childhood allergic asthma. Methods: Subjects (n = 121) previously enrolled in a randomized trial of immunotherapy for childhood asthma were recalled. Eighty-four young adults (age, 17-30 years; 78% male) were reevaluated by means of spirometry. Subjects with a postbronchodilator FEV1, forced vital capacity, or FEV1/forced vital capacity ratio less than or equal to the 5th percentile or 2 or more indices less than or equal to the 10th percentile (National Health and Nutrition Examination Survey III normative data) were invited to undergo complete pulmonary function testing, physical examination, and chest radiography after 1 week of 1 mg/kg daily prednisone. Results: Of 84 subjects reevaluated, 40 (48%) had one or more spirometric indices less than or equal to the 5th and 10th percentiles (P <.0001). Twenty-eight of the 40 subjects were reassessed after prednisone treatment, of whom 21 (75%) did not improve. Adult and childhood (age 5-12 years) spirometric results were positively correlated (r = 0.49-0.72, P <.001). Abnormal adult spirometric results were associated with a longer duration of asthma at enrollment in the original trial (4.6 vs 6 years, P = .02), increased childhood methacholine sensitivity (PC20, 0.11 vs 0.18 mg/mL; P = .01), and birth prematurity (adjusted odds ratio, 10.7; 95% CI, 1.4-84.5). Immunotherapy status was unrelated to adult lung function. Conclusions: Many adults with a history of moderate-to-severe allergic asthma in childhood have irreversible lung function deficits. Childhood spirometry, duration of asthma, methacholine sensitivity, and birth prematurity might identify such individuals at a young age.

Original languageEnglish (US)
Pages (from-to)1213-1219
Number of pages7
JournalThe Journal of Allergy and Clinical Immunology
Volume116
Issue number6
DOIs
StatePublished - Dec 2005

Fingerprint

Young Adult
Asthma
Lung
Methacholine Chloride
Spirometry
Vital Capacity
Prednisone
Immunotherapy
Parturition
Nutrition Surveys
Airway Obstruction
Radiography
Physical Examination
Thorax
Odds Ratio
Therapeutics

Keywords

  • Childhood asthma
  • Methacholine sensitivity
  • Pulmonary function test
  • Spirometry

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Irreversible lung function deficits in young adults with a history of childhood asthma. / Limb, Susan L.; Brown, Kathryn C.; Wood, Robert A; Wise, Robert A; Eggleston, Peyton A.; Tonascia, James A; Adkinson, N Franklin.

In: The Journal of Allergy and Clinical Immunology, Vol. 116, No. 6, 12.2005, p. 1213-1219.

Research output: Contribution to journalArticle

@article{4777ff2042f94611859f4c57aeb7eb82,
title = "Irreversible lung function deficits in young adults with a history of childhood asthma",
abstract = "Background: Asthma, traditionally characterized as reversible airway obstruction, might lead to structural changes and permanent impairment. Objective: We sought to study the frequency, severity, and reversibility of pulmonary deficits in adults with a history of moderate-to-severe childhood allergic asthma. Methods: Subjects (n = 121) previously enrolled in a randomized trial of immunotherapy for childhood asthma were recalled. Eighty-four young adults (age, 17-30 years; 78{\%} male) were reevaluated by means of spirometry. Subjects with a postbronchodilator FEV1, forced vital capacity, or FEV1/forced vital capacity ratio less than or equal to the 5th percentile or 2 or more indices less than or equal to the 10th percentile (National Health and Nutrition Examination Survey III normative data) were invited to undergo complete pulmonary function testing, physical examination, and chest radiography after 1 week of 1 mg/kg daily prednisone. Results: Of 84 subjects reevaluated, 40 (48{\%}) had one or more spirometric indices less than or equal to the 5th and 10th percentiles (P <.0001). Twenty-eight of the 40 subjects were reassessed after prednisone treatment, of whom 21 (75{\%}) did not improve. Adult and childhood (age 5-12 years) spirometric results were positively correlated (r = 0.49-0.72, P <.001). Abnormal adult spirometric results were associated with a longer duration of asthma at enrollment in the original trial (4.6 vs 6 years, P = .02), increased childhood methacholine sensitivity (PC20, 0.11 vs 0.18 mg/mL; P = .01), and birth prematurity (adjusted odds ratio, 10.7; 95{\%} CI, 1.4-84.5). Immunotherapy status was unrelated to adult lung function. Conclusions: Many adults with a history of moderate-to-severe allergic asthma in childhood have irreversible lung function deficits. Childhood spirometry, duration of asthma, methacholine sensitivity, and birth prematurity might identify such individuals at a young age.",
keywords = "Childhood asthma, Methacholine sensitivity, Pulmonary function test, Spirometry",
author = "Limb, {Susan L.} and Brown, {Kathryn C.} and Wood, {Robert A} and Wise, {Robert A} and Eggleston, {Peyton A.} and Tonascia, {James A} and Adkinson, {N Franklin}",
year = "2005",
month = "12",
doi = "10.1016/j.jaci.2005.09.024",
language = "English (US)",
volume = "116",
pages = "1213--1219",
journal = "Journal of Allergy and Clinical Immunology",
issn = "0091-6749",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Irreversible lung function deficits in young adults with a history of childhood asthma

AU - Limb, Susan L.

AU - Brown, Kathryn C.

AU - Wood, Robert A

AU - Wise, Robert A

AU - Eggleston, Peyton A.

AU - Tonascia, James A

AU - Adkinson, N Franklin

PY - 2005/12

Y1 - 2005/12

N2 - Background: Asthma, traditionally characterized as reversible airway obstruction, might lead to structural changes and permanent impairment. Objective: We sought to study the frequency, severity, and reversibility of pulmonary deficits in adults with a history of moderate-to-severe childhood allergic asthma. Methods: Subjects (n = 121) previously enrolled in a randomized trial of immunotherapy for childhood asthma were recalled. Eighty-four young adults (age, 17-30 years; 78% male) were reevaluated by means of spirometry. Subjects with a postbronchodilator FEV1, forced vital capacity, or FEV1/forced vital capacity ratio less than or equal to the 5th percentile or 2 or more indices less than or equal to the 10th percentile (National Health and Nutrition Examination Survey III normative data) were invited to undergo complete pulmonary function testing, physical examination, and chest radiography after 1 week of 1 mg/kg daily prednisone. Results: Of 84 subjects reevaluated, 40 (48%) had one or more spirometric indices less than or equal to the 5th and 10th percentiles (P <.0001). Twenty-eight of the 40 subjects were reassessed after prednisone treatment, of whom 21 (75%) did not improve. Adult and childhood (age 5-12 years) spirometric results were positively correlated (r = 0.49-0.72, P <.001). Abnormal adult spirometric results were associated with a longer duration of asthma at enrollment in the original trial (4.6 vs 6 years, P = .02), increased childhood methacholine sensitivity (PC20, 0.11 vs 0.18 mg/mL; P = .01), and birth prematurity (adjusted odds ratio, 10.7; 95% CI, 1.4-84.5). Immunotherapy status was unrelated to adult lung function. Conclusions: Many adults with a history of moderate-to-severe allergic asthma in childhood have irreversible lung function deficits. Childhood spirometry, duration of asthma, methacholine sensitivity, and birth prematurity might identify such individuals at a young age.

AB - Background: Asthma, traditionally characterized as reversible airway obstruction, might lead to structural changes and permanent impairment. Objective: We sought to study the frequency, severity, and reversibility of pulmonary deficits in adults with a history of moderate-to-severe childhood allergic asthma. Methods: Subjects (n = 121) previously enrolled in a randomized trial of immunotherapy for childhood asthma were recalled. Eighty-four young adults (age, 17-30 years; 78% male) were reevaluated by means of spirometry. Subjects with a postbronchodilator FEV1, forced vital capacity, or FEV1/forced vital capacity ratio less than or equal to the 5th percentile or 2 or more indices less than or equal to the 10th percentile (National Health and Nutrition Examination Survey III normative data) were invited to undergo complete pulmonary function testing, physical examination, and chest radiography after 1 week of 1 mg/kg daily prednisone. Results: Of 84 subjects reevaluated, 40 (48%) had one or more spirometric indices less than or equal to the 5th and 10th percentiles (P <.0001). Twenty-eight of the 40 subjects were reassessed after prednisone treatment, of whom 21 (75%) did not improve. Adult and childhood (age 5-12 years) spirometric results were positively correlated (r = 0.49-0.72, P <.001). Abnormal adult spirometric results were associated with a longer duration of asthma at enrollment in the original trial (4.6 vs 6 years, P = .02), increased childhood methacholine sensitivity (PC20, 0.11 vs 0.18 mg/mL; P = .01), and birth prematurity (adjusted odds ratio, 10.7; 95% CI, 1.4-84.5). Immunotherapy status was unrelated to adult lung function. Conclusions: Many adults with a history of moderate-to-severe allergic asthma in childhood have irreversible lung function deficits. Childhood spirometry, duration of asthma, methacholine sensitivity, and birth prematurity might identify such individuals at a young age.

KW - Childhood asthma

KW - Methacholine sensitivity

KW - Pulmonary function test

KW - Spirometry

UR - http://www.scopus.com/inward/record.url?scp=28444469176&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=28444469176&partnerID=8YFLogxK

U2 - 10.1016/j.jaci.2005.09.024

DO - 10.1016/j.jaci.2005.09.024

M3 - Article

VL - 116

SP - 1213

EP - 1219

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

SN - 0091-6749

IS - 6

ER -