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Bronchial reactivity and asthma over adolescence

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Abid Raza1,2, Vereesh Patil1,2, Graham Roberts1,2, Susan Ewart4, Wilfried Karmaus3, Hongmei Zhang3, Ramesh Kurukulaaratchy1,2 and Hasan Arshad1,2
1David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Isle of Wight, United Kingdom, 2Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom, 3Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TNUnited States, 4Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MIUnited States


Background: Bronchial reactivity decreases over the adolescent period, but how that relates to persistent asthma is unknown. We describe the association of persistent bronchial reactivity to asthma groups over adolescence.

Methods: The Isle of Wight Birth Cohort (N = 1456) was reviewed at 1, 2, 4, 10 and 18-years. Questionnaires on physician diagnosis of asthma, wheeze and asthma treatment were collected alongside methacholine bronchial challenges in 784 and 585 subjects at 10 and 18 years respectively. Asthma and bronchial hyper-reactivity reactivity groups were defined as “no asthma/no BHR” (no asthma or no BHR at 10 and 18 years), “persistent asthma / persistent BHR” (asthma or BHR at age 10 and 18), “remission asthma / BHR” (asthma or BHR at age 10 but not at 18) and “adolescent-onset asthma/ adolescent-onset BHR” (asthma or BHR at age 18 but not at age 10).

Read More : An observational study of physiotherapy for children with asthma

Results: Bronchial reactivity was found in 30% (236/784) and 7.5% (44/585) of the cohort at 10 and 18 years respectively. Data on asthma and BHR were available for 406 subjects at 10 and 18 years. BHR over adolescence comprised of 7% (n=30) persistent BHR, 68% (274) no BHR, 24% (97) remission BHR and 1% (5) adolescent onset BHR. Most persistent BHR 63% (19/30) was observed in persistent asthma, with 10% (3/30) remission asthma and 20% (6/30) adolescent-onset asthma and 7% (2/30) in no asthma group. Among asthma groups 56% (15/27) of remission, 34% (21/62) of persistent, 53% (20/38) adolescent-onset asthma demonstrated no BHR over 10 to 18 year period.

Conclusion: We confirm earlier diminishing airway reactivity over the adolescent period. Persistent BHR was mostly seen with persistence of asthma while over half of remission asthma lacked BHR over adolescence.


Source : http://erj.ersjournals.com/content/48/suppl_60/PA320
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PDPI Malang. 19/12/17.




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