Lung function measurements in children - copsac

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who do not develop RSV bronchiolitis. The risk factors for neonatal lung function was studied in the COPSAC cohort in a recent publication (29) and showed that high body mass index in newborns and mothers smoking were associated with reduced lung function, also that parental atopic disease (mother’s or father’s eczema, urticaria or allergic rhinitis or father’s asthma) did not affect the neonatal lung function and bronchial responsiveness. In our study group of infants less than 2 years of age the mean age of the infants diagnosed with RSV bronchiolitis was 8 months (30), which is higher than reported by other study groups. Other studies have limited the group of interest to children less than 12 months of age and accordingly reported even lower age of RSV infection (35, 62-65). The incidence of bronchiolits (5%) was higher reported in most studies (1-3%) (5-7, 48, 66, 67). This suggests a genetic component in RSV bronchiolitis as all mothers had asthma. Predisposition to asthma and atopy has been associated with increased risk of lower respiratory tract infection and hospitalization for RSV infection (64, 68, 69). Young et al (1995) found 7% of a cohort (253 infants) with the diagnosis of bronchiolitis before 2 years of age (only 2 infants were hospitalized and confirmed for RSV infection); 71% had a family history of atopy (18). A twin cohort study showed that the severity of RSV infection was determined partly by genetic factors (16%); family environment accounted for 73% and nonshared environment for 11% of the individual susceptibility to develop severe respiratory syncytial virus infection (70, 71). A Danish case-control study has also supported that asthmatic disposition and wheezing were strong determinants of subsequent respiratory syncytial virus hospitalization in children
hand a previous study from the COPSAC cohort showed that neonates colonized in the hypopharyngeal region with S. pneumonia, H. influenza, or M. catarrharlis, or with a combination, were at increased risk for recurrent wheeze and asthma early in life (23). Future studies may consider coinfections with other viral or bacterial infections responsible for different response to RSV infection and the development of asthma (77). Conclusions Bronchial hyperresponsiveness in newborns were not predictive of later development of RSV bronchiolitis nor did baseline lung function seem to predict though the confidence limit of comparison was wide. This study suggests that the distinguishing feature is not a mechanical but maybe an environmental exposure or genetic disposition. 9
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Lung function measurements in child
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Contents Acknowledgements .........
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Acknowledgements The thesis was wri
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Introduction Symptoms of chronic re
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pulmonary function test obtained by
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I. Accuracy of Wholebody Plethysmog
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Methods Designs Study I: Six center
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"Loops" on the screen showed the re
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We included age in the analysis of
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Normative data (study I) Mean sRaw
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Additional results sRaw measurement
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After correcting the factory settin
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Normative data In the second part o
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II. -III. Lung function measurement
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of a diagnosis of asthma: Frequent
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Figure 8: Familial predisposition t
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Total twins 12.349 twin pairs Born
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Methods Designs Study II: Hospital
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Children less than 7 years were tes
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Ethics The two studies were approve
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FEV 0.5 (ml) Table 4: Baseline char
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lung symptoms, 19% said it was the
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symptoms in response to verified RS
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epigenetic factors. Acute environme
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detection changes in lung function
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that small airways were not the dis
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onciolitis. There is an increasing
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further studies are needed to inves
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Summary The Ph.D. thesis is based o
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Danish summary (Dansk resumé) Denn
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References Reference List (1) Lum S
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(25) Aurora P, Gustafsson P, Bush A
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(50) Klug B, Bisgaard H. Repeatabil
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(76) Meissner HC. Economic impact o
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(101) Young S, Arnott J, O'Keeffe P
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(125) Bisgaard H, Hermansen MN, Lol
Page 74 and 75: (151) Walton RP, Johnston SL. Role
Page 76 and 77: disease in otherwise healthy infant
Page 78 and 79: changes in asthma control. Am J Res
Page 81: Paper I
Page 84 and 85: CHEST Original Research Accuracy of
Page 86 and 87: Figure 1. Center agreement study: l
Page 88 and 89: observer as well as a common observ
Page 90 and 91: sRaw (kPa*s) Figure 1 Online: Cente
Page 93 and 94: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Page 95 and 96: 54 55 56 57 INTRODUCTION Respirator
Page 97 and 98: 97 98 99 100 Lung function test Chi
Page 99 and 100: 141 142 143 144 Mean gestational ag
Page 101 and 102: 186 187 188 189 190 The discordant
Page 103 and 104: 232 233 234 235 236 237 viruses and
Page 105 and 106: 278 ACKNOWLEDGMENTS 279 280 281 282
Page 107 and 108: 335 336 (21) Bisgaard H, Nielsen KG
Page 109 and 110: 394 395 396 (42) Wu P, Dupont WD, G
Page 111 and 112: 455 456 457 (64) Bisgaard H, Herman
Page 113 and 114: 488 489 Table 1: Comparison of clin
Page 115: Paper III
Page 118 and 119: Abstract Background: Two-three perc
Page 120 and 121: RA 08 TSM 133; Respiratory Care Cen
Page 122 and 123: prospectively if baseline lung func
Page 126 and 127: Acknowledgements We thank all the c
Page 128 and 129: (24) ATS/ERS statement: raised volu
Page 130 and 131: (53) Stein RT, Sherrill D, Morgan W
Page 132 and 133: Figure 1: Flow chart COPSAC cohort
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Lung function measurements in children - copsac

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