Pediatric allergy and respiratory disease (소아알레르기 및 호흡기학회지)

The Korean Academy of Pediatric Allergy and Respiratory Diseasse (대한소아알레르기호흡기학회)
권호 표지

Risk Factors f or Persistent Wheezing in Infants with Recurrent Wheezing

반복적인 영아 천명에서 지속성 천명으로의 진행에 관여하는 위험 인자

Yang, Hyeon-Jong;Hong, Yong-Hee;Jeon, You-Hoon;Pyun, Bok-Yang
양현종;홍용희;전유훈;편복양

  • Published : 2007.03.01
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Abstract

Purpose : The purpose of our study was to investigate the risk factors in developing persistent wheezing in infants with recurrent wheezing. Methods : Two hundred thirty two infants with recurrent wheezing under two years old visited to Pediatric Allergy and Respiratory Center in Soonchunhyang University Hospital from August 1998 to May 2002 were enrolled and investigated until May 2006, retrospectively. The patients were divided into two groups; persistent wheezer group (PW) who had recurrent wheezing until six years old and transient wheezer group (TW) who didn't have wheezing after three years old. The patients' demographics and laboratory data such as serum total IgE, specific IgE (Dp, Df, dog hair, egg white, milk, soy) and peripheral blood eosinophil count at the first visit were analysed to investigate the risk factors for developing persistent wheezing. Results : PW was 115 (49.5%) and TW was 117 (50.5%) out of 232 infants with recurrent wheezing. In comparison analysis between PW and TW, there were no significant differences in age (months), serum total IgE, peripheral blood eosinophil (P=0.319), birth weight, and gestational age. However, increased serum total IgE (OR 1.72; 95% CI 1.01-2.90), sensitization to Dp (3.6, 1.14-11.39) and egg white (2.96, 1.49-5.89), family history of allergic diseases (2.35, 1.33-4.13), personal history of atopic dermatitis (2.08, 1.11-3.89), and not having older siblings (2.93, 1.64-5.24) had statistic significance. Among these results, not having older sibling (adjusted OR 2.74, 1.46-5.13) and having family history of allergic diseases (adjusted OR 2.69, 1.39-5.18) had strong significance by regnession a nalysis. Conclusion : Early intervention of infants with high risk factors for developing persistent wheezing may improve their outcome. Therefore early intervention of infants with high risk factors will be necessary for preventing develop childhood asthma.

Keywords

References

  1. Henderson FW, Clyde WA, Collier AM, Denny FW, Senior RJ, Sheaffer CI, et al. The etiologic and epidermiologic spectrum of bronchiolitis in pediatric practice. J Pediatr 1979;95:183-90 https://doi.org/10.1016/S0022-3476(79)80649-6
  2. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. N Engl J Med 1995;332:133-8 https://doi.org/10.1056/NEJM199501193320301
  3. Castro-Rodriguez JA, Holberg CJ, Wright AL, Martinez FD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med 2000;162:1403-6 https://doi.org/10.1164/ajrccm.162.4.9912111
  4. Guilbert TW, Morgan WJ, Zeiger RS, Bacharier LB, Boehmer SJ, Martinez FD, et al. Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma. J Allergy Clin Immunol 2004;114:1282-7 https://doi.org/10.1016/j.jaci.2004.09.020
  5. Song AR, Chung HL. Bronchial asthma after early infant bronchiolitis: a follow-up until 5 years of age. Pediatr Allergy Respir Dis (Korea) 2001;11:16-23
  6. Jang JY, Kim HB, Lee SY, Kim JH, Kim BS, Hong SJ, et al. Asthma predictive index in children with recurrent wheezing. Korean J Pediatr 2006;49:298-304 https://doi.org/10.3345/kjp.2006.49.3.298
  7. Kim MR, Oh CS, Pyun BY, Lee SJ. Study of the predictive factors to bronchial asthma in wheezy infants. Korean J Asthma Allergy Clin Immunol 1991;11:411-7
  8. Silverman M, Wilson NM. Wheezing disorders in infancy. In: Silverman M, editor. Childhood asthma and other wheezing disorders. 1st ed. London: Chapman & Hall, 1995:375-400
  9. You JH, Yoo Y, Kim DK, Kang H, Koh YY. Bronchial responsiveness and serum eosinophil cationic protein levels in preschool children with recurrent wheezing. Ann Allergy Asthma Immunol 2005;94:686-92 https://doi.org/10.1016/S1081-1206(10)61329-4
  10. Taussig LM, Wright AL, Holberg CJ, Halonen M, Morgan WJ, Martinez FD. Tucson Children's Respiratory Study: 1980 to present. J Allergy Clin Immunol 2003;111:661-75 https://doi.org/10.1067/mai.2003.162
  11. Rhodes HL, Thomas P, Sporik R, Holgate ST, Cogswell JJ. A birth cohort study of subjects at risk of atopy: twenty-two-year follow-up of wheeze and atopic status. Am J Respir Crit Care Med 2002;165:176-80 https://doi.org/10.1164/ajrccm.165.2.2104032
  12. Rhodes HL, Sporik R, Thomas P, Holgate ST, Cogswell JJ. Early life risk factors for adult asthma: a birth cohort study of subjects at risk. J Allergy Clin Immunol 2001;108:720-5 https://doi.org/10.1067/mai.2001.119151
  13. Stettler N, Tershakovec AM, Zemel BS, Leonard MB, Boston RC, Stallings VA, et al. Early risk factors for increased adiposity: a cohort study of African American subjects followed from birth to young adulthood. Am J Clin Nutr 2000;72:378-83 https://doi.org/10.1093/ajcn/72.2.378
  14. Nam SY, Yoon HS, Kim WK. Prevalence of allergic disease in kindergarten age children in korea. Pediatr Allergy Respir Dis(korea) 2005;15:439-45
  15. Lewis S, Richards D, Bynner J, Butler N, Britton J. Prospective study of risk factors for early and persistent wheezing in childhood. Eur Respir J 1995;8:349-56 https://doi.org/10.1183/09031936.95.08030349
  16. Kotaniemi-Syrjanen A, Reijonen TM, Romppanen J, Korhonen K, Savolainen K, Korppi M. Allergen-specific immunoglobulin E antibodies in wheezing infants: the risk for asthma in later childhood. Pediatrics 2003;111:e255-61 https://doi.org/10.1542/peds.111.3.e255
  17. Zeiger RS, Heller S. The development and prediction of atopy in high-risk children: follow-up at age seven years in a prospective randomized study of combined maternal and infant food allergen avoidance. J Allergy Clin Immunol 1995;95:1179-90 https://doi.org/10.1016/S0091-6749(95)70074-9
  18. Price GW, Hogan AD, Farris AH, Burks AW, Platts-Mills TA, Heymann PW. Sensitization (IgE antibody) to food allergens in wheezing infants and children. J Allergy Clin Immunol 1995;96:266-70 https://doi.org/10.1016/S0091-6749(95)70020-X
  19. Reijonen TM, Kotaniemi-Syrjanen A, Korhonen K, Korppi M. Predictors of asthma three years after hospital admission for wheezing in infancy. Pediatrics 2000;106:1406-12 https://doi.org/10.1542/peds.106.6.1406
  20. Koh YY, Jeong JW, Lim HS. The effect of level of exposure to house dust mites on the development of asthma after early childhood wheezing. Pediatr Allergy Respir Dis(korea) 2001;11:7-15
  21. Kim YG, Koh YY, Lee MH, Jung JH, Jee YK, Kim YY, et al. The influences of parental atopy and bronchial hyperresponsiveness on the development of asthma after early childhood wheezing. Korean J Asthma, Allergy Clin Immunol 1998;18:647-55
  22. Rona RJ, Duran-Tauleria E, Chinn S. Family size, atopic disorders in parents, asthma in children, and ethnicity. J Allergy Clin Immunol 1997;99:454-60 https://doi.org/10.1016/S0091-6749(97)70070-8
  23. Cole Johnson C, Ownby DR, Havstad SL, Peterson EL. Family history, dust mite exposure in early childhood, and risk for pediatric atopy and asthma. J Allergy Clin Immunol 2004;114:105-10 https://doi.org/10.1016/j.jaci.2004.04.007
  24. Pyun BY, Kim CH, Lee DH, Lee SJ, Lee KS, Cho TH. A study of maternal-fetal transmission of allergic disease. Korean J Asthma, Allergy Clin Immunol 1992;12:291-302
  25. Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol 2003;112:118-27 https://doi.org/10.1016/j.jaci.2003.09.033
  26. Ohshima Y, Yamada A, Hiraoka M, Katamura K, Ito S, Mayumi M, et al. Early sensitization to house dust mite is a major risk factor for subsequent development of bronchial asthma in Japanese infants with atopic dermatitis: results of a 4-year follow up study. Ann Allergy Asthma Immunol 2002;89:265-70 https://doi.org/10.1016/S1081-1206(10)61953-9
  27. Illi S, von Mutius E, Lau S, Nickel R, Gruber C, Wahn U, et al. Multicenter Allergy Study Group. The natural course of atopic dermatitis from birth to age 7 years and the association with asthma. J Allergy Clin Immunol 2004;113:925-31 https://doi.org/10.1016/j.jaci.2004.01.778
  28. Guilbert TW, Morgan WJ, Zeiger RS, Mauger DT, Boehmer SJ, Martinez FD, et al. Long-term inhaled corticosteroids in preschool children at high risk for asthma. N Engl J Med 2006;354:1985-97 https://doi.org/10.1056/NEJMoa051378
  29. Linneberg A, Simonsen JB, Petersen J, Stensballe LG, Benn CS. Differential effects of risk factors on infant wheeze and atopic dermatitis emphasize a different etiology. J Allergy Clin Immunol 2006;117:184-9 https://doi.org/10.1016/j.jaci.2005.09.042
  30. Iikura Y, Naspitz CK, Mikawa H, Talarichoficho S, Baba M, Sole D, et al. Prevention of asthma by ketotifen in infants with atopic dermatitis. Ann Allergy Asthma Immunol 1992;68:233-6
  31. Anonymous. Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomised, placebo-controlled trial: first results of ETACearly treatment of the atopic child. Pediatr Allergy Immunol 1998;9:116-24 https://doi.org/10.1111/j.1399-3038.1998.tb00356.x
  32. Ponsonby AL, Couper D, Dwyer T, Carmichael A. Cross sectional study of the relation between sibling number and asthma, hay fever, and eczema. Arch Dis Child 1998;79:328-33 https://doi.org/10.1136/adc.79.4.328
  33. Ball TM, Castro-Rodriguez JA, Griffith KA, Holberg CJ, Martinez FD, Wright AL. Siblings, day-care attendance, and the risk of asthma and wheezing during childhood. N Engl J Med 2000;343:538-43 https://doi.org/10.1056/NEJM200008243430803
  34. Friedman NJ, Zeiger RS. The role of breast-feeding in the development of allergies and asthma. J Allergy Clin Immunol 2005;115:1238-48 https://doi.org/10.1016/j.jaci.2005.01.069
  35. Boyle RJ, Tang ML. The role of probiotics in the management of allergic disease. Clin Exp Allergy 2006;36:568-76 https://doi.org/10.1111/j.1365-2222.2006.02472.x
  36. Laubereau B, Filipiak-Pittroff B, von Berg A, Grubl A, Reinhardt D, Wichmann HE, et al. Caesarean section and gastrointestinal symptoms, atopic dermatitis, and sensitization during he first year of life. Arch Dis Child 2004;89:993-7 https://doi.org/10.1136/adc.2003.043265
  37. Kim DY, Shin YS, Kong DY, Pyun BY. Comparison of Lactobaccilus casei in stool between children with atopic dermatitis and normal control. Pediatr Allergy Respir Dis(Korea) 2004;14:160-6