Childhood wheezing phenotypes influence asthma, lung function and exhaled nitric oxide fraction in adolescence

The objective of this study was to examine the associations of childhood wheezing phenotypes with asthma, lung function and exhaled nitric oxide fraction (FeNO) in adolescence.In a population-based, prospective cohort study of 6841 children, we used latent class analysis to identify wheezing phenotypes during the first 7 years of life. Physician-diagnosed asthma, spirometry and FeNO were assessed at 14–15 years.Compared with never/infrequent wheeze, intermediate-onset and persistent wheeze were consistently strongest associated with higher risk of asthma (risk ratio (95% CI) 10.9 (8.97–13.16) and 9.13 (7.74–10.77), respectively), lower forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio (mean difference in standard deviation units (SDU) (95% CI) −0.34 (−0.54– −0.14) and −0.50 (−0.62– −0.38), respectively), lower forced expiratory flow at 25–75% of FVC (FEF25–75%) (mean difference in SDU (95% CI) −0.30 (−0.49– −0.10) and −0.42 (−0.54– −0.30), respectively) and increased FEV1 bronchodilator reversibility (mean difference in SDU (95% CI) 0.12 (0.02–0.22) and 0.13 (0.06–0.19), respectively). Prolonged early and persistent wheeze were associated with a decline in FEV1/FVC ratio and FEF25–75% between 8–9 and 14–15 years. Intermediate-onset, late-onset and persistent wheeze were associated with higher FeNO ratios (ratio of geometric means (95% CI) 1.90 (1.59–2.29), 1.57 (1.39–1.77) and 1.37 (1.22–1.53), respectively, compared with never/infrequent wheeze).Early-onset wheezing phenotypes persisting after 18 months of age show the strongest associations with asthma, lower lung function, even worsening from mid-childhood, and higher FeNO levels in adolescence.

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Predictors of accelerated decline in lung function in adult-onset asthma

European Respiratory Journal ◽

10.1183/13993003.01785-2017 ◽

2018 ◽

Vol 51 (2) ◽

pp. 1701785 ◽

Cited By ~ 25

Author(s):

Hanneke Coumou ◽

Guus A. Westerhof ◽

Selma B. de Nijs ◽

Aeilko H. Zwinderman ◽

Elisabeth H. Bel

Keyword(s):

Nitric Oxide ◽

Risk Factors ◽

Body Mass Index ◽

Lung Function ◽

Body Mass ◽

Forced Expiratory Volume ◽

Exhaled Nitric Oxide ◽

Cross Sectional ◽

Inflammatory Parameters ◽

New Onset

Little is known about the prognosis of adults with new-onset asthma. Cross-sectional studies suggest that these patients may exhibit accelerated decline in forced expiratory volume in 1 s (FEV1). However, risk factors for accelerated decline in lung function have not yet been identified.We aimed to identify these risk factors in a prospective 5-year follow-up study in 200 adults with newly diagnosed asthma. In the current study, clinical, functional and inflammatory parameters were assessed annually for 5 years. Linear mixed-effects models were used to identify predictors.Evaluable lung function sets of 141 patients were available. Median (interquartile range) change in post-bronchodilator FEV1 was −17.5 (−54.2 to +22.4) mL per year. Accelerated decline in FEV1 was defined by the lower quartile of decline (>54.2 mL per year). Nasal polyps, number of blood and sputum eosinophils, body mass index, and level of exhaled nitric oxide were univariably associated with decline in lung function. Only the latter two were independently associated. Using cut-off values to identify patients at highest risk showed accelerated decline in FEV1 in all patients with combined exhaled nitric oxide fraction (FeNO) ≥57 ppb and body mass index (BMI) ≤23 kg·m−2.We conclude that adults with new-onset asthma with both high levels of exhaled nitric oxide and low BMI are at risk of accelerated decline in lung function.

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Early childhood growth is associated with lung function at 7 years: a prospective population-based study

European Respiratory Journal ◽

10.1183/13993003.00157-2020 ◽

2020 ◽

Vol 56 (6) ◽

pp. 2000157

Author(s):

Gabriela P. Peralta ◽

Alicia Abellan ◽

Parisa Montazeri ◽

Mikel Basterrechea ◽

Ana Esplugues ◽

...

Keyword(s):

Early Childhood ◽

Lung Function ◽

Latent Class ◽

Postnatal Growth ◽

Population Based ◽

Forced Expiratory Volume ◽

Airflow Limitation ◽

Birth Size ◽

Childhood Growth ◽

Bmi Trajectories

Previous studies have related early postnatal growth with later lung function but their interpretation is limited by the methods used to assess a child's growth. We aimed to assess the association of early childhood growth, measured by body mass index (BMI) trajectories up to 4 years, with lung function at 7 years.We included 1257 children from the Spanish Infancia y Medio Ambiente population-based birth cohort. Early childhood growth was classified into five categories based on BMI trajectories up to 4 years previously identified using latent class growth analysis. These trajectories differed in birth size (“lower”, “average”, “higher”) and in BMI gain velocity (“slower”, “accelerated”). We related these trajectories to lung function (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC and forced expiratory flow at 25%–75% of FVC (FEF25–75%)) at 7 years, using multivariable mixed regression.Compared to children with average birth size and slower BMI gain (reference), children with higher birth size and accelerated BMI gain had a higher FVC % pred (3.3%, 95% CI 1.0%–5.6%) and a lower FEV1/FVC % pred (−1.5%, 95% CI −2.9%–−0.1%) at 7 years. Similar associations were observed for children with lower birth size and accelerated BMI gain. Children with lower birth size and slower BMI gain had lower FVC % pred at 7 years. No association was found for FEF25–75%.Independently of birth size, children with accelerated BMI gain in early childhood had higher lung function at 7 years but showed airflow limitation. Children with lower birth size and slower BMI gain in early childhood had lower lung function at 7 years.

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Lung Function Monitoring; A Randomized Agreement Study

The Open Respiratory Medicine Journal ◽

10.2174/1874306401610010051 ◽

2016 ◽

Vol 10 (1) ◽

pp. 51-57 ◽

Cited By ~ 1

Author(s):

Sveinung Berntsen ◽

Solvor B. Stølevik ◽

Petter Mowinckel ◽

Wenche Nystad ◽

Trine Stensrud

Keyword(s):

Lung Function ◽

Confidence Interval ◽

Peak Expiratory Flow ◽

Forced Vital Capacity ◽

Vital Capacity ◽

Forced Expiratory Volume ◽

Mean Difference ◽

Forced Expiratory Flow ◽

Expiratory Flow ◽

Agreement Study

Objective: To determine the agreement between devices and repeatability within devices of the forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and forced expiratory flow at 50% of FVC (FEF50) values measured using the four spirometers included in the study. Methods: 50 (24 women) participants (20-64 years of age) completed maximum forced expiratory flow manoeuvres and measurements were performed using the following devices: MasterScreen, SensorMedics, Oxycon Pro and SpiroUSB. The order of the instruments tested was randomized and blinded for both the participants and the technicians. Re-testing was conducted on a following day within 72 hours at the same time of the day. Results: The devices which obtained the most comparable values for all lung function variables were SensorMedics and Oxycon Pro, and MasterScreen and SpiroUSB. For FEV1, mean difference was 0.04 L (95% confidence interval; -0.05, 0.14) and 0.00 L (-0.06, 0.06), respectively. When using the criterion of FVC and FEV1 ≤ 0.150 L for acceptable repeatability, 67% of the comparisons of the measured lung function values obtained by the four devices were acceptable. Overall, Oxycon Pro obtained most frequently values of the lung function variables with highest precision as indicated by the coefficients of repeatability (CR), followed by MasterScreen, SensorMedics and SpiroUSB (e.g. min-max CR for FEV1; 0.27-0.46). Conclusion: The present study confirms that measurements obtained by the same device at different times can be compared; however, measured lung function values may differ depending on spirometers used.

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PS-172 Serum 25-hydroxyvitamin D In Relation To Lung Function And Exhaled Nitric Oxide In Children

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-307384.468 ◽

2014 ◽

Vol 99 (Suppl 2) ◽

pp. A173.2-A173

Author(s):

J Huang ◽

TC Yao ◽

W Yeh ◽

S Lai ◽

S Liao ◽

...

Keyword(s):

Nitric Oxide ◽

Lung Function ◽

Exhaled Nitric Oxide ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

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Respiratory Symptoms, Exhaled Nitric Oxide, and Lung Function Among Workers in Tanzanian Coffee Factories

Journal of Occupational and Environmental Medicine ◽

10.1097/jom.0b013e318285f453 ◽

2013 ◽

Vol 55 (5) ◽

pp. 544-551 ◽

Cited By ~ 12

Author(s):

Gloria Sakwari ◽

Simon H.D. Mamuya ◽

Magne Bråtveit ◽

Bente E. Moen

Keyword(s):

Nitric Oxide ◽

Lung Function ◽

Respiratory Symptoms ◽

Exhaled Nitric Oxide

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L-Citrulline as Add-On Therapy to Increase Exhaled Nitric Oxide and Improve Lung Function and Asthma Control in Obese Asthmatics

10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a7088 ◽

2019 ◽

Author(s):

F. Holguin ◽

S. Sharma ◽

D.E. Winnica ◽

K. Wasil ◽

V.L. Smith ◽

...

Keyword(s):

Nitric Oxide ◽

Lung Function ◽

Asthma Control ◽

Exhaled Nitric Oxide ◽

Improve Lung Function

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Global Lung Function Initiative 2012 reference equations for spirometry in the Norwegian population

European Respiratory Journal ◽

10.1183/13993003.00443-2016 ◽

2016 ◽

Vol 48 (6) ◽

pp. 1602-1611 ◽

Cited By ~ 33

Author(s):

Arnulf Langhammer ◽

Ane Johannessen ◽

Turid L. Holmen ◽

Hasse Melbye ◽

Sanja Stanojevic ◽

...

Keyword(s):

Lung Function ◽

Reference Values ◽

Vital Capacity ◽

Population Based ◽

Forced Expiratory Volume ◽

Female Adolescents ◽

Norwegian Population ◽

Reference Equations ◽

Z Scores ◽

Lower Limit Of Normal

We studied the fit of the Global Lung Function Initiative (GLI) all-age reference values to Norwegians, compared them with currently used references (European Community for Steel and Coal (ECSC) and Zapletal) and estimated the prevalence of obstructive lung disease.Spirometry data collected in 30 239 subjects (51.7% females) aged 12–90 years in three population-based studies were converted to z-scores.We studied healthy non-smokers comprising 2438 adults (57.4% females) aged 20–90 years and 8725 (47.7% female) adolescents aged 12–19 years. The GLI-2012 prediction equations fitted the Norwegian data satisfactorily. Median±sd z-scores were respectively 0.02±1.03, 0.01±1.04 and −0.04±0.91 for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC in males, and −0.01±1.02, 0.07±0.97 and −0.21±0.82 in females. The ECSC and Zapletal references significantly underestimated FEV1 and FVC. Stricter criteria of obstruction (FEV1/FVC <GLI-2012 lower limit of normal (LLN)) carried a substantially higher risk of obstructive characteristics than FEV1/FVC <0.7 and >GLI-2012 LLN. Corresponding comparison regarding myocardial infarction showed a four-fold higher risk for women.The GLI-2012 reference values fit the Norwegian data satisfactorily and are recommended for use in Norway. Correspondingly, the FEV1/FVC GLI-2012 LLN identifies higher risk of obstructive characteristics than FEV1/FVC <0.7.

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Correlation study of cytokine levels in alveolar lavage fluid with exhaled nitric oxide and lung function in children with bronchial asthma

Translational Pediatrics ◽

10.21037/tp-21-322 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Ying Lou ◽

Qiuping Ke ◽

Huailiang Cui ◽

Ying Shang ◽

Chengsheng Yang

Keyword(s):

Nitric Oxide ◽

Lung Function ◽

Bronchial Asthma ◽

Lavage Fluid ◽

Correlation Study ◽

Exhaled Nitric Oxide ◽

Cytokine Levels

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Associations between blood eosinophils and decline in lung function among adults with and without asthma

European Respiratory Journal ◽

10.1183/13993003.02536-2017 ◽

2018 ◽

Vol 51 (4) ◽

pp. 1702536 ◽

Cited By ~ 29

Author(s):

Robert J. Hancox ◽

Ian D. Pavord ◽

Malcolm R. Sears

Keyword(s):

Lung Function ◽

Vital Capacity ◽

Airflow Obstruction ◽

Population Based ◽

Forced Expiratory Volume ◽

Lung Function Decline ◽

Characteristic Features ◽

Predicted Values ◽

Blood Eosinophils ◽

Eosinophil Counts

Eosinophilic inflammation and airway remodelling are characteristic features of asthma, but the association between them is unclear. We assessed associations between blood eosinophils and lung function decline in a population-based cohort of young adults.We used linear mixed models to analyse associations between blood eosinophils and spirometry at 21, 26, 32 and 38 years adjusting for sex, smoking, asthma and spirometry at age 18 years. We further analysed associations between mean eosinophil counts and changes in spirometry from ages 21 to 38 years.Higher eosinophils were associated with lower forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratios and lower FEV1 % predicted values for both pre- and post-bronchodilator spirometry (all p-values ≤0.048). Although eosinophil counts were higher in participants with asthma, the associations between eosinophils and spirometry were similar among participants without asthma or wheeze. Participants with mean eosinophil counts >0.4×109 cells·L−1 between 21 and 38 years had greater declines in FEV1/FVC ratios (difference 1.8%, 95% CI 0.7–2.9%; p=0.001) and FEV1 values (difference 3.4% pred, 95% CI 1.5–5.4% pred); p=0.001) than those with lower counts.Blood eosinophils are associated with airflow obstruction and enhanced decline in lung function, independently of asthma and smoking. Eosinophilia is a risk factor for airflow obstruction even in those without symptoms.

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