Risk factors for irreversible airway obstruction after infant bronchiolitis.

Abstract

BACKGROUND:

Increasing evidence shows that environmental factors in childhood play a role in development of irreversible airway obstruction. We evaluated early-life and preschool-age risk factors for irreversible airway obstruction in adolescence after bronchiolitis in infancy.

METHODS:

This study is a secondary analysis of data collected during prospective long-term follow-up of our post-bronchiolitis cohort. Risk factor data were collected during hospitalisation and on follow-up visits at 5-7 and 10-13 years of ages. Lung function was measured from 103 participants with impulse oscillometry at 5-7 years of age and from 89 participants with flow-volume spirometry at 10-13 years of age.

RESULTS:

Asthma diagnosis at <12 months of age showed a significant association with irreversible airway obstruction at 10-13 years of age independently from current asthma. Irreversible airway obstruction was less frequent in children with variant than wild genotype of the Toll-like receptor 4(TLR4) rs4986790, but the significance was lost in logistic regression adjusted for current asthma and weight status. Higher post-bronchodilator respiratory system resistance at 5 Hz and lower baseline and post-bronchodilator reactance at 5 Hz by impulse oscillometry at 5-7 years of age were associated with irreversible airway obstruction at 10-13 years of age.

CONCLUSION:

Asthma diagnosis during the first living year and worse lung function at preschool age increased the risk for irreversible airway obstruction at 10-13 years of age after bronchiolitis. TLR4 rs4986790 polymorphism may be protective for development of irreversible airway obstruction after bronchiolitis.

• Authors: Riikka Riikonen, Matti Korppi, Sari Törmänen, Petri Koponen, Kirsi Nuolivirta, Merja Helminen, Qiushui He, Eero Lauhkonen
• Journal: Respiratory medicine (Respir Med) Vol. 187 Pg. 106545 (10 2021) ISSN: 1532-3064 [Electronic] England
• PMID: 34332337 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Elsevier Ltd. All rights reserved.

Chemical References

• TLR4 protein, human
• Toll-Like Receptor 4

Topics

• Adolescent
• Age Factors
• Airway Obstruction (diagnosis, epidemiology, etiology, genetics)
• Airway Resistance (physiology)
• Asthma (complications, physiopathology)
• Bronchiolitis (complications, physiopathology)
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Genotype
• Humans
• Male
• Oscillometry
• Polymorphism, Genetic
• Prospective Studies
• Risk Factors
• Spirometry
• Time Factors
• Toll-Like Receptor 4 (genetics)