Childhood measles contributes to post-bronchodilator airflow obstruction in middle-aged adults: A cohort study.

Abstract

BACKGROUND AND OBJECTIVE:

Chronic obstructive pulmonary disease (COPD) has potential origins in childhood but an association between childhood measles and post-bronchodilator (BD) airflow obstruction (AO) has not yet been shown. We investigated whether childhood measles contributed to post-BD AO through interactions with asthma and/or smoking in a non-immunized middle-aged population.

METHODS:

The population-based Tasmanian Longitudinal Health Study (TAHS) cohort born in 1961 (n = 8583) underwent spirometry in 1968 before immunization was introduced. A history of childhood measles infection was obtained from school medical records. During the fifth decade follow-up (n = 5729 responses), a subgroup underwent further lung function measurements (n = 1389). Relevant main associations and interactions by asthma and/or smoking on post-BD forced expiratory volume in 1 s/forced vital capacity (FEV1 /FVC; continuous variable) and AO (FEV1 /FVC < lower limit of normal) were estimated by multiple regression.

RESULTS:

Sixty-nine percent (n = 950) had a history of childhood measles. Childhood measles augmented the combined adverse effect of current clinical asthma and smoking at least 10 pack-years on post-BD FEV1 /FVC ratio in middle age (z-score: -0.70 (95% CI: -1.1 to -0.3) vs -1.36 (-1.6 to -1.1), three-way interaction: P = 0.009), especially for those with childhood-onset asthma. For never- and ever-smokers of <10 pack-years who had current asthma symptoms, compared with those without childhood measles, paradoxically, the odds for post-BD AO was not significant in the presence of childhood measles (OR: 12.0 (95% CI: 3.4-42) vs 2.17 (0.9-5.3)).

CONCLUSION:

Childhood measles infection appears to compound the associations between smoking, current asthma and post-BD AO. Differences between asthma subgroups provide further insight into the complex aetiology of obstructive lung diseases for middle-aged adults.

• Authors: Jennifer L Perret, Melanie C Matheson, Lyle C Gurrin, David P Johns, John A Burgess, Bruce R Thompson, Adrian J Lowe, James Markos, Stephen S Morrison, Christine F McDonald, Richard Wood-Baker, Cecilie Svanes, Paul S Thomas, John L Hopper, Graham G Giles, Michael J Abramson, E Haydn Walters, Shyamali C Dharmage
• Journal: Respirology (Carlton, Vic.) (Respirology) Vol. 23 Issue 8 Pg. 780-787 (08 2018) ISSN: 1440-1843 [Electronic] Australia
• PMID: 29560611 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2018 Asian Pacific Society of Respirology.

Chemical References

• Bronchodilator Agents

Topics

• Adult
• Asthma (complications, physiopathology)
• Bronchodilator Agents (pharmacology)
• Cohort Studies
• Female
• Forced Expiratory Volume (drug effects)
• Humans
• Longitudinal Studies
• Male
• Measles (complications, physiopathology)
• Middle Aged
• Multivariate Analysis
• Pulmonary Disease, Chronic Obstructive (physiopathology)
• Smoking (adverse effects, physiopathology)
• Vital Capacity (drug effects)