Abstract
We studied the prevalence of subsequent respiratory symptoms and the relation between atopic status and bronchial reactivity in 200 index children and their controls 7 years after acute lower respiratory tract infections in infancy. Index children with recurrent symptoms differed from controls in respect of social and family characteristics and atopic background. Ventilatory function was diminished and bronchial reactivity increased. Symptom free index children also came from poorer environmental backgrounds, but did not otherwise differ from controls. 'Atopic' index children differed significantly from controls in respect of subsequent symptoms and ventilatory function and similar adverse trends were observed in 'non-atopic' index children. A comparable proportion of 'atopic' and 'non-atopic' index children showed bronchial reactivity (33.5% and 38.9% respectively). Index subgroups with and without bronchial reactivity had increased cough and wheeziness compared with respective matched controls. The former included children with 'established' asthma and the latter those with 'established' bronchitis. Atopic backgrounds were similar in both subgroups, with no differences between cases and controls. These findings suggest that atopic background and bronchial reactivity are not closely related but may contribute independently to the persistence of symptoms after respiratory infections in infancy. Bronchial reactivity may be a more useful basis than atopic status on which to separate children with episodic cough or wheeze, or both, into 'asthmatic' and 'bronchitic' subgroups.
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Selected References
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- Burrows B., Knudson R. J., Lebowitz M. D. The relationship of childhood respiratory illness to adult obstructive airway disease. Am Rev Respir Dis. 1977 May;115(5):751–760. doi: 10.1164/arrd.1977.115.5.751. [DOI] [PubMed] [Google Scholar]
- Burrows B., Lebowitz M. D. Characteristics of chronic bronchitis in a warm, dry region. Am Rev Respir Dis. 1975 Sep;112(3):365–370. doi: 10.1164/arrd.1975.112.3.365. [DOI] [PubMed] [Google Scholar]
- Cloutier M. M., Loughlin G. M. Chronic cough in children: a manifestation of airway hyperreactivity. Pediatrics. 1981 Jan;67(1):6–12. [PubMed] [Google Scholar]
- Colley J. R., Douglas J. W., Reid D. D. Respiratory disease in young adults: influence of early childhood lower respiratory tract illness, social class, air pollution, and smoking. Br Med J. 1973 Jul 28;3(5873):195–198. doi: 10.1136/bmj.3.5873.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Falliers C. J., de Cardoso R. R., Bane H. N., Coffey R., Middleton E., Jr Discordant allergic manifestations in monozygotic twins: genetic identity versus clinical, physiologic, and biochemical differences. J Allergy. 1971 Apr;47(4):207–219. doi: 10.1016/s0091-6749(71)80466-9. [DOI] [PubMed] [Google Scholar]
- Frick O. L., German D. F., Mills J. Development of allergy in children. I. Association with virus infections. J Allergy Clin Immunol. 1979 Apr;63(4):228–241. doi: 10.1016/0091-6749(79)90106-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gurwitz D., Mindorff C., Levison H. Increased incidence of bronchial reactivity in children with a history of bronchiolitis. J Pediatr. 1981 Apr;98(4):551–555. doi: 10.1016/s0022-3476(81)80758-5. [DOI] [PubMed] [Google Scholar]
- Hyde J. S., Saed A. M. Acute bronchiolitis and the asthmatic child. J Asthma Res. 1966 Dec;4(2):137–154. doi: 10.3109/02770906609100534. [DOI] [PubMed] [Google Scholar]
- Kattan M., Keens T. G., Lapierre J. G., Levison H., Bryan A. C., Reilly B. J. Pulmonary function abnormalities in symptom-free children after bronchiolitis. Pediatrics. 1977 May;59(5):683–688. [PubMed] [Google Scholar]
- Kiernan K. E., Colley J. R., Douglas J. W., Reid D. D. Chronic cough in young adults in relation to smoking habits, childhood environment and chest illness. Respiration. 1976;33(3):236–244. doi: 10.1159/000193738. [DOI] [PubMed] [Google Scholar]
- Laughlin J. J., Eigen H. Pulmonary function abnormalities in survivors of near drowning. J Pediatr. 1982 Jan;100(1):26–30. doi: 10.1016/s0022-3476(82)80230-8. [DOI] [PubMed] [Google Scholar]
- Loughlin G. M., Taussig L. M. Pulmonary function in children with a history of laryngotracheobronchitis. J Pediatr. 1979 Mar;94(3):365–369. doi: 10.1016/s0022-3476(79)80572-7. [DOI] [PubMed] [Google Scholar]
- McFadden E. R., Jr Exertional dyspnea and cough as preludes to acute attacks of bronchial asthma. N Engl J Med. 1975 Mar 13;292(11):555–559. doi: 10.1056/NEJM197503132921103. [DOI] [PubMed] [Google Scholar]
- Mellis C. M., Levison H. Bronchial reactivity in cystic fibrosis. Pediatrics. 1978 Mar;61(3):446–450. [PubMed] [Google Scholar]
- Milligan D. W., Levison H. Lung function in children following repair of tracheoesophageal fistula. J Pediatr. 1979 Jul;95(1):24–27. doi: 10.1016/s0022-3476(79)80076-1. [DOI] [PubMed] [Google Scholar]
- Mok J. Y., Simpson H. Outcome for acute bronchitis, bronchiolitis, and pneumonia in infancy. Arch Dis Child. 1984 Apr;59(4):306–309. doi: 10.1136/adc.59.4.306. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mok J. Y., Simpson H. Outcome of acute lower respiratory tract infection in infants: preliminary report of seven-year follow-up study. Br Med J (Clin Res Ed) 1982 Jul 31;285(6338):333–337. doi: 10.1136/bmj.285.6338.333. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pullan C. R., Hey E. N. Wheezing, asthma, and pulmonary dysfunction 10 years after infection with respiratory syncytial virus in infancy. Br Med J (Clin Res Ed) 1982 Jun 5;284(6330):1665–1669. doi: 10.1136/bmj.284.6330.1665. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rooney J. C., Williams H. E. The relationship between proved viral bronchiolitis and subsequent wheezing. J Pediatr. 1971 Nov;79(5):744–747. doi: 10.1016/s0022-3476(71)80385-2. [DOI] [PubMed] [Google Scholar]
- Silverman M., Anderson S. D. Standardization of exercise tests in asthmatic children. Arch Dis Child. 1972 Dec;47(256):882–889. doi: 10.1136/adc.47.256.882. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sims D. G., Downham M. A., Gardner P. S., Webb J. K., Weightman D. Study of 8-year-old children with a history of respiratory syncytial virus bronchiolitis in infancy. Br Med J. 1978 Jan 7;1(6104):11–14. doi: 10.1136/bmj.1.6104.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sims D. G., Gardner P. S., Weightman D., Turner M. W., Soothill J. F. Atopy does not predispose to RSV bronchiolitis or postbronchiolitic wheezing. Br Med J (Clin Res Ed) 1981 Jun 27;282(6282):2086–2088. doi: 10.1136/bmj.282.6282.2086. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smyth J. A., Tabachnik E., Duncan W. J., Reilly B. J., Levison H. Pulmonary function and bronchial hyperreactivity in long-term survivors of bronchopulmonary dysplasia. Pediatrics. 1981 Sep;68(3):336–340. [PubMed] [Google Scholar]
- Taussig L. M., Smith S. M., Blumenfeld R. Chronic bronchitis in childhood: what is it? Pediatrics. 1981 Jan;67(1):1–5. [PubMed] [Google Scholar]
- WITTIG H. J., GLASER J. The relationship between bronchiolitis and childhood asthma; a follow-up study of 100 cases of bronchiolitis. J Allergy. 1959 Jan-Feb;30(1):19–23. doi: 10.1016/0021-8707(59)90054-1. [DOI] [PubMed] [Google Scholar]
- Welliver R. C., Wong D. T., Sun M., Middleton E., Jr, Vaughan R. S., Ogra P. L. The development of respiratory syncytial virus-specific IgE and the release of histamine in nasopharyngeal secretions after infection. N Engl J Med. 1981 Oct 8;305(15):841–846. doi: 10.1056/NEJM198110083051501. [DOI] [PubMed] [Google Scholar]
- Zweiman B., Schoenwetter W. F., Pappano J. E., Jr, Tempest B., Hildreth E. A. Patterns of allergic respiratory disease in children with a past history of bronchiolitis. J Allergy Clin Immunol. 1971 Nov;48(5):283–289. doi: 10.1016/0091-6749(71)90029-7. [DOI] [PubMed] [Google Scholar]