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E L Anderson - One of the best experts on this subject based on the ideXlab platform.
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decreased lung function after preschool Wheezing rhinovirus illnesses in children at risk to develop asthma
The Journal of Allergy and Clinical Immunology, 2011Co-Authors: Theresa W Guilbert, Daniel J Jackson, Michael D Evans, K A Roberg, E L Anderson, Anne Marie Singh, Zoran Danov, Ryan M Burton, T E Pappas, Ronald E GangnonAbstract:Background Preschool rhinovirus (RV) Wheezing illnesses predict an increased risk of childhood asthma; however, it is not clear how specific viral illnesses in early life relate to lung function later on in childhood. Objective To determine the relationship of virus-specific Wheezing illnesses and lung function in a longitudinal cohort of children at risk for asthma. Methods Two hundred thirty-eight children were followed prospectively from birth to 8 years of age. Early life viral Wheezing respiratory illnesses were assessed by using standard techniques, and lung function was assessed annually by using spirometry and impulse oscillometry. The relationships of these virus-specific Wheezing illnesses and lung function were assessed by using mixed-effect linear regression. Results Children with RV Wheezing illness demonstrated significantly decreased spirometry values, FEV 1 ( P = .001), FEV 0.5 ( P 25-75 ( P P 25-75 ( P = .05) compared with children without asthma. Conclusion Among outpatient viral Wheezing illnesses in early childhood, those caused by RV infections are the most significant predictors of decreased lung function up to age 8 years in a high-risk birth cohort. Whether low lung function is a cause and/or effect of RV Wheezing illnesses is yet to be determined.
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Wheezing rhinovirus illnesses in early life predict asthma development in high risk children
American Journal of Respiratory and Critical Care Medicine, 2008Co-Authors: Daniel J Jackson, Ronald E Gangnon, Michael D Evans, Peter Shult, K A Roberg, E L Anderson, T E Pappas, Magnolia C Printz, Waiming Lee, Erik ReisdorfAbstract:Rationale: Virus-induced Wheezing episodes in infancy often precede the development of asthma. Whether infections with specific viral pathogens confer differential future asthma risk is incompletely understood. Objectives: To define the relationship between specific viral illnesses and early childhood asthma development. Methods: A total of 259 children were followed prospectively from birth to 6 years of age. The etiology and timing of specific viral Wheezing respiratory illnesses during early childhood were assessed using nasal lavage, culture, and multiplex reverse transcriptase–polymerase chain reaction. The relationships of these virus-specific Wheezing illnesses and other risk factors to the development of asthma were analyzed. Measurements and Main Results: Viral etiologies were identified in 90% of Wheezing illnesses. From birth to age 3 years, Wheezing with respiratory syncytial virus (RSV) (odds ratio [OR], 2.6), rhinovirus (RV) (OR, 9.8), or both RV and RSV (OR , 10) was associated with increased asthma risk at age 6 years. In Year 1, both RV Wheezing (OR, 2.8) and aeroallergen sensitization (OR, 3.6) independently increased asthma risk at age 6 years. By age 3 years, Wheezing with RV (OR, 25.6) was more strongly associated with asthma at age 6 years than aeroallergen sensitization (OR, 3.4). Nearly 90% (26 of 30) of children who wheezed with RV in Year 3 had asthma at 6 years of age. Conclusions: Among outpatient viral Wheezing illnesses in infancy and early childhood, those caused by RV infections are the most significant predictors of the subsequent development of asthma at age 6 years in a high-risk birth cohort.
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Wheezing rhinovirus illnesses in early life predict asthma development in high risk children
American Journal of Respiratory and Critical Care Medicine, 2008Co-Authors: Daniel J Jackson, Ronald E Gangnon, Michael D Evans, Peter Shult, Erik Reisdorf, K A Roberg, E L Anderson, T E Pappas, Magnolia C Printz, Kirsten T CarlsondakesAbstract:Rationale: Virus-induced Wheezing episodes in infancy often precede the development of asthma. Whether infections with specific viral pathogens confer differential future asthma risk is incompletely understood.Objectives: To define the relationship between specific viral illnesses and early childhood asthma development.Methods: A total of 259 children were followed prospectively from birth to 6 years of age. The etiology and timing of specific viral Wheezing respiratory illnesses during early childhood were assessed using nasal lavage, culture, and multiplex reverse transcriptase–polymerase chain reaction. The relationships of these virus-specific Wheezing illnesses and other risk factors to the development of asthma were analyzed.Measurements and Main Results: Viral etiologies were identified in 90% of Wheezing illnesses. From birth to age 3 years, Wheezing with respiratory syncytial virus (RSV) (odds ratio [OR], 2.6), rhinovirus (RV) (OR, 9.8), or both RV and RSV (OR , 10) was associated with increased ...
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rhinovirus illnesses during infancy predict subsequent childhood Wheezing
The Journal of Allergy and Clinical Immunology, 2005Co-Authors: Robert F Lemanske, Daniel J Jackson, Ronald E Gangnon, Michael D Evans, Zhanhai Li, Peter Shult, Carol J Kirk, Erik Reisdorf, K A Roberg, E L AndersonAbstract:Background The contribution of viral respiratory infections during infancy to the development of subsequent Wheezing and/or allergic diseases in early childhood is not established. Objective To evaluate these relationships prospectively from birth to 3 years of age in 285 children genetically at high risk for developing allergic respiratory diseases. Methods By using nasal lavage, the relationship of timing, severity, and etiology of viral respiratory infections during infancy to Wheezing in the 3rd year of life was evaluated. In addition, genetic and environmental factors that could modify risk of infections and Wheezing prevalence were analyzed. Results Risk factors for 3rd year Wheezing were passive smoke exposure (odds ratio [OR]=2.1), older siblings (OR=2.5), allergic sensitization to foods at age 1 year (OR=2.0), any moderate to severe respiratory illness without Wheezing during infancy (OR=3.6), and at least 1 Wheezing illness with respiratory syncytial virus (RSV; OR=3.0), rhinovirus (OR=10) and/or non–rhinovirus/RSV pathogens (OR=3.9) during infancy. When viral etiology was considered, 1st-year Wheezing illnesses caused by rhinovirus infection were the strongest predictor of subsequent 3rd year Wheezing (OR=6.6; P P Conclusion In this population of children at increased risk of developing allergies and asthma, the most significant risk factor for the development of preschool childhood Wheezing is the occurrence of symptomatic rhinovirus illnesses during infancy that are clinically and prognostically informative based on their seasonal nature.
Ronald E Gangnon - One of the best experts on this subject based on the ideXlab platform.
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decreased lung function after preschool Wheezing rhinovirus illnesses in children at risk to develop asthma
The Journal of Allergy and Clinical Immunology, 2011Co-Authors: Theresa W Guilbert, Daniel J Jackson, Michael D Evans, K A Roberg, E L Anderson, Anne Marie Singh, Zoran Danov, Ryan M Burton, T E Pappas, Ronald E GangnonAbstract:Background Preschool rhinovirus (RV) Wheezing illnesses predict an increased risk of childhood asthma; however, it is not clear how specific viral illnesses in early life relate to lung function later on in childhood. Objective To determine the relationship of virus-specific Wheezing illnesses and lung function in a longitudinal cohort of children at risk for asthma. Methods Two hundred thirty-eight children were followed prospectively from birth to 8 years of age. Early life viral Wheezing respiratory illnesses were assessed by using standard techniques, and lung function was assessed annually by using spirometry and impulse oscillometry. The relationships of these virus-specific Wheezing illnesses and lung function were assessed by using mixed-effect linear regression. Results Children with RV Wheezing illness demonstrated significantly decreased spirometry values, FEV 1 ( P = .001), FEV 0.5 ( P 25-75 ( P P 25-75 ( P = .05) compared with children without asthma. Conclusion Among outpatient viral Wheezing illnesses in early childhood, those caused by RV infections are the most significant predictors of decreased lung function up to age 8 years in a high-risk birth cohort. Whether low lung function is a cause and/or effect of RV Wheezing illnesses is yet to be determined.
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Wheezing rhinovirus illnesses in early life predict asthma development in high risk children
American Journal of Respiratory and Critical Care Medicine, 2008Co-Authors: Daniel J Jackson, Ronald E Gangnon, Michael D Evans, Peter Shult, K A Roberg, E L Anderson, T E Pappas, Magnolia C Printz, Waiming Lee, Erik ReisdorfAbstract:Rationale: Virus-induced Wheezing episodes in infancy often precede the development of asthma. Whether infections with specific viral pathogens confer differential future asthma risk is incompletely understood. Objectives: To define the relationship between specific viral illnesses and early childhood asthma development. Methods: A total of 259 children were followed prospectively from birth to 6 years of age. The etiology and timing of specific viral Wheezing respiratory illnesses during early childhood were assessed using nasal lavage, culture, and multiplex reverse transcriptase–polymerase chain reaction. The relationships of these virus-specific Wheezing illnesses and other risk factors to the development of asthma were analyzed. Measurements and Main Results: Viral etiologies were identified in 90% of Wheezing illnesses. From birth to age 3 years, Wheezing with respiratory syncytial virus (RSV) (odds ratio [OR], 2.6), rhinovirus (RV) (OR, 9.8), or both RV and RSV (OR , 10) was associated with increased asthma risk at age 6 years. In Year 1, both RV Wheezing (OR, 2.8) and aeroallergen sensitization (OR, 3.6) independently increased asthma risk at age 6 years. By age 3 years, Wheezing with RV (OR, 25.6) was more strongly associated with asthma at age 6 years than aeroallergen sensitization (OR, 3.4). Nearly 90% (26 of 30) of children who wheezed with RV in Year 3 had asthma at 6 years of age. Conclusions: Among outpatient viral Wheezing illnesses in infancy and early childhood, those caused by RV infections are the most significant predictors of the subsequent development of asthma at age 6 years in a high-risk birth cohort.
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Wheezing rhinovirus illnesses in early life predict asthma development in high risk children
American Journal of Respiratory and Critical Care Medicine, 2008Co-Authors: Daniel J Jackson, Ronald E Gangnon, Michael D Evans, Peter Shult, Erik Reisdorf, K A Roberg, E L Anderson, T E Pappas, Magnolia C Printz, Kirsten T CarlsondakesAbstract:Rationale: Virus-induced Wheezing episodes in infancy often precede the development of asthma. Whether infections with specific viral pathogens confer differential future asthma risk is incompletely understood.Objectives: To define the relationship between specific viral illnesses and early childhood asthma development.Methods: A total of 259 children were followed prospectively from birth to 6 years of age. The etiology and timing of specific viral Wheezing respiratory illnesses during early childhood were assessed using nasal lavage, culture, and multiplex reverse transcriptase–polymerase chain reaction. The relationships of these virus-specific Wheezing illnesses and other risk factors to the development of asthma were analyzed.Measurements and Main Results: Viral etiologies were identified in 90% of Wheezing illnesses. From birth to age 3 years, Wheezing with respiratory syncytial virus (RSV) (odds ratio [OR], 2.6), rhinovirus (RV) (OR, 9.8), or both RV and RSV (OR , 10) was associated with increased ...
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rhinovirus illnesses during infancy predict subsequent childhood Wheezing
The Journal of Allergy and Clinical Immunology, 2005Co-Authors: Robert F Lemanske, Daniel J Jackson, Ronald E Gangnon, Michael D Evans, Zhanhai Li, Peter Shult, Carol J Kirk, Erik Reisdorf, K A Roberg, E L AndersonAbstract:Background The contribution of viral respiratory infections during infancy to the development of subsequent Wheezing and/or allergic diseases in early childhood is not established. Objective To evaluate these relationships prospectively from birth to 3 years of age in 285 children genetically at high risk for developing allergic respiratory diseases. Methods By using nasal lavage, the relationship of timing, severity, and etiology of viral respiratory infections during infancy to Wheezing in the 3rd year of life was evaluated. In addition, genetic and environmental factors that could modify risk of infections and Wheezing prevalence were analyzed. Results Risk factors for 3rd year Wheezing were passive smoke exposure (odds ratio [OR]=2.1), older siblings (OR=2.5), allergic sensitization to foods at age 1 year (OR=2.0), any moderate to severe respiratory illness without Wheezing during infancy (OR=3.6), and at least 1 Wheezing illness with respiratory syncytial virus (RSV; OR=3.0), rhinovirus (OR=10) and/or non–rhinovirus/RSV pathogens (OR=3.9) during infancy. When viral etiology was considered, 1st-year Wheezing illnesses caused by rhinovirus infection were the strongest predictor of subsequent 3rd year Wheezing (OR=6.6; P P Conclusion In this population of children at increased risk of developing allergies and asthma, the most significant risk factor for the development of preschool childhood Wheezing is the occurrence of symptomatic rhinovirus illnesses during infancy that are clinically and prognostically informative based on their seasonal nature.
Peter W Heymann - One of the best experts on this subject based on the ideXlab platform.
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viral infections in relation to age atopy and season of admission among children hospitalized for Wheezing
The Journal of Allergy and Clinical Immunology, 2004Co-Authors: Peter W Heymann, Holliday T Carper, Deborah D Murphy, James T Patrie, Thomas A E Plattsmills, A P Mclaughlin, Elizabeth A Erwin, Marcus S Shaker, Martha Hellems, Jehanna PeerzadaAbstract:Abstract Background Viral respiratory tract infections and atopy are associated with attacks of Wheezing during childhood. However, information about the relationship between viral infections and atopy among children whose attacks of Wheezing lead to hospitalization is unclear. Objective To evaluate the prevalence of viral respiratory tract pathogens among infants and children hospitalized for Wheezing and to analyze the results in relation to the patient's age, atopic characteristics, and season of admission. Methods This was a case-control study of children (age 2 months to 18 years) admitted for Wheezing to the University of Virginia Medical Center over a period of 12 months. Children without Wheezing were enrolled as controls. Nasal secretions were evaluated for viral pathogens by using cultures, PCR tests, and antigen detection. Total IgE and specific IgE antibody to common aeroallergens was measured in serum. Results Seventy percent of children hospitalized for Wheezing before age 3 years (n=79) were admitted between December and March, whereas 46% of children age 3 to 18 years (n=54) were hospitalized between September and November. Among children younger than 3 years, viral pathogens were detected in 84% (66/79) of Wheezing children and 55% (42/77) of controls ( P P P P Conclusions Viral infections were the dominant risk factor for Wheezing among children hospitalized before 3 years of age. By comparison, a large majority of the Wheezing children age 3 to 18 years had striking atopic characteristics that may be critical as a risk factor for hospitalization and an adverse response to viral infections, especially infections caused by rhinovirus.
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rhinovirus and respiratory syncytial virus in Wheezing children requiring emergency care ige and eosinophil analyses
American Journal of Respiratory and Critical Care Medicine, 1999Co-Authors: Gary P Rakes, Jim Mark Ingram, Gates E Hoover, Juan C Zambrano, Eurico Arruda, Frederick G Hayden, Thomas A E Plattsmills, Peter W HeymannAbstract:This cross-sectional emergency department study of 70 Wheezing children and 59 control subjects (2 mo to 16 yr of age) examined the prevalence of respiratory viruses and their relationship to age, atopic status, and eosinophil markers. Nasal washes were cultured for respiratory viruses, assayed for respiratory syncytial virus (RSV) antigen, and tested for coronavirus and rhinovirus RNA using reverse transcription-PCR (RT-PCR). Also evaluated were eosinophil numbers and eosinophil cationic protein (ECP) in both nasal washes and serum, along with total IgE and specific IgE antibody in serum. Respiratory viruses were detected in 82% (18 of 22) of Wheezing infants younger than 2 yr of age and in 83% (40 of 48) of older Wheezing children. The predominant pathogens were RSV in infants (detected in 68% of Wheezing subjects) and rhinovirus in older Wheezing children (71%), and both were strongly associated with Wheezing (p < 0.005). RSV was largely limited to Wheezing children younger than 24 mo of age, but rhinovirus was detected by RT-PCR in 41% of all infants and in 35% of nonWheezing control subjects older than 2 yr of age. After 2 yr of age the strongest odds for Wheezing were observed among those who had a positive RT-PCR test for rhinovirus together with a positive serum radioallergosorbent testing (RAST), nasal eosinophilia, or elevated nasal ECP (odds ratios = 17, 21, and 25, respectively). Results from this study demonstrate that a large majority of emergent Wheezing illnesses during childhood (2 to 16 yr of age) can be linked to infection with rhinovirus, and that these Wheezing attacks are most likely in those who have rhinovirus together with evidence of atopy or eosinophilic airway inflammation.
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risk factors for acute Wheezing in infants and children viruses passive smoke and ige antibodies to inhalant allergens
Pediatrics, 1993Co-Authors: A L Duff, Frederick G Hayden, Thomas A E Plattsmills, E S Pomeranz, Lawrence E Gelber, G W Price, H Farris, Peter W HeymannAbstract:Objective. To examine the prevalence of viral infection, passive smoke exposure, and IgE antibody to inhaled allergens in infants and children treated for acute Wheezing. Design. Case-control study of actively Wheezing children who were compared with children without respiratory tract symptoms. Setting. University of Virginia Pediatric Emergency Room. Patients. Convenience sample of 99 Wheezing patients (2 months to 16 years of age) and 57 control patients (6 months to 16 years of age). Measurements and results. Serum IgE antibody to inhalant allergens, measured by radioallergosorbent test (RAST), was uncommon in Wheezing and control patients under age 2. After 2 years of age, the percentage of RAST-positive patients increased markedly and was significantly higher in Wheezing patients than controls after age 4 (72%, n = 54, and 30%, n = 40, respectively, P Conclusion. Wheezing children younger than 2 years of age had a high rate of viral infection and a low rate of IgE antibody to inhalant allergens. When these children were exposed to passive smoke, salivary cotinine levels were elevated suggesting heavy exposure. After 2 years of age, sensitization to inhaled allergens became increasingly important and viruses remained a significant risk factor for Wheezing. These data support recommendations to reduce tobacco smoke exposure at home, especially for young patients, and to consider sensitization to inhaled allergens and allergen avoidance in Wheezing children at an early age, particularly after age 2 years.
Daniel J Jackson - One of the best experts on this subject based on the ideXlab platform.
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decreased lung function after preschool Wheezing rhinovirus illnesses in children at risk to develop asthma
The Journal of Allergy and Clinical Immunology, 2011Co-Authors: Theresa W Guilbert, Daniel J Jackson, Michael D Evans, K A Roberg, E L Anderson, Anne Marie Singh, Zoran Danov, Ryan M Burton, T E Pappas, Ronald E GangnonAbstract:Background Preschool rhinovirus (RV) Wheezing illnesses predict an increased risk of childhood asthma; however, it is not clear how specific viral illnesses in early life relate to lung function later on in childhood. Objective To determine the relationship of virus-specific Wheezing illnesses and lung function in a longitudinal cohort of children at risk for asthma. Methods Two hundred thirty-eight children were followed prospectively from birth to 8 years of age. Early life viral Wheezing respiratory illnesses were assessed by using standard techniques, and lung function was assessed annually by using spirometry and impulse oscillometry. The relationships of these virus-specific Wheezing illnesses and lung function were assessed by using mixed-effect linear regression. Results Children with RV Wheezing illness demonstrated significantly decreased spirometry values, FEV 1 ( P = .001), FEV 0.5 ( P 25-75 ( P P 25-75 ( P = .05) compared with children without asthma. Conclusion Among outpatient viral Wheezing illnesses in early childhood, those caused by RV infections are the most significant predictors of decreased lung function up to age 8 years in a high-risk birth cohort. Whether low lung function is a cause and/or effect of RV Wheezing illnesses is yet to be determined.
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Wheezing rhinovirus illnesses in early life predict asthma development in high risk children
American Journal of Respiratory and Critical Care Medicine, 2008Co-Authors: Daniel J Jackson, Ronald E Gangnon, Michael D Evans, Peter Shult, K A Roberg, E L Anderson, T E Pappas, Magnolia C Printz, Waiming Lee, Erik ReisdorfAbstract:Rationale: Virus-induced Wheezing episodes in infancy often precede the development of asthma. Whether infections with specific viral pathogens confer differential future asthma risk is incompletely understood. Objectives: To define the relationship between specific viral illnesses and early childhood asthma development. Methods: A total of 259 children were followed prospectively from birth to 6 years of age. The etiology and timing of specific viral Wheezing respiratory illnesses during early childhood were assessed using nasal lavage, culture, and multiplex reverse transcriptase–polymerase chain reaction. The relationships of these virus-specific Wheezing illnesses and other risk factors to the development of asthma were analyzed. Measurements and Main Results: Viral etiologies were identified in 90% of Wheezing illnesses. From birth to age 3 years, Wheezing with respiratory syncytial virus (RSV) (odds ratio [OR], 2.6), rhinovirus (RV) (OR, 9.8), or both RV and RSV (OR , 10) was associated with increased asthma risk at age 6 years. In Year 1, both RV Wheezing (OR, 2.8) and aeroallergen sensitization (OR, 3.6) independently increased asthma risk at age 6 years. By age 3 years, Wheezing with RV (OR, 25.6) was more strongly associated with asthma at age 6 years than aeroallergen sensitization (OR, 3.4). Nearly 90% (26 of 30) of children who wheezed with RV in Year 3 had asthma at 6 years of age. Conclusions: Among outpatient viral Wheezing illnesses in infancy and early childhood, those caused by RV infections are the most significant predictors of the subsequent development of asthma at age 6 years in a high-risk birth cohort.
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Wheezing rhinovirus illnesses in early life predict asthma development in high risk children
American Journal of Respiratory and Critical Care Medicine, 2008Co-Authors: Daniel J Jackson, Ronald E Gangnon, Michael D Evans, Peter Shult, Erik Reisdorf, K A Roberg, E L Anderson, T E Pappas, Magnolia C Printz, Kirsten T CarlsondakesAbstract:Rationale: Virus-induced Wheezing episodes in infancy often precede the development of asthma. Whether infections with specific viral pathogens confer differential future asthma risk is incompletely understood.Objectives: To define the relationship between specific viral illnesses and early childhood asthma development.Methods: A total of 259 children were followed prospectively from birth to 6 years of age. The etiology and timing of specific viral Wheezing respiratory illnesses during early childhood were assessed using nasal lavage, culture, and multiplex reverse transcriptase–polymerase chain reaction. The relationships of these virus-specific Wheezing illnesses and other risk factors to the development of asthma were analyzed.Measurements and Main Results: Viral etiologies were identified in 90% of Wheezing illnesses. From birth to age 3 years, Wheezing with respiratory syncytial virus (RSV) (odds ratio [OR], 2.6), rhinovirus (RV) (OR, 9.8), or both RV and RSV (OR , 10) was associated with increased ...
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rhinovirus illnesses during infancy predict subsequent childhood Wheezing
The Journal of Allergy and Clinical Immunology, 2005Co-Authors: Robert F Lemanske, Daniel J Jackson, Ronald E Gangnon, Michael D Evans, Zhanhai Li, Peter Shult, Carol J Kirk, Erik Reisdorf, K A Roberg, E L AndersonAbstract:Background The contribution of viral respiratory infections during infancy to the development of subsequent Wheezing and/or allergic diseases in early childhood is not established. Objective To evaluate these relationships prospectively from birth to 3 years of age in 285 children genetically at high risk for developing allergic respiratory diseases. Methods By using nasal lavage, the relationship of timing, severity, and etiology of viral respiratory infections during infancy to Wheezing in the 3rd year of life was evaluated. In addition, genetic and environmental factors that could modify risk of infections and Wheezing prevalence were analyzed. Results Risk factors for 3rd year Wheezing were passive smoke exposure (odds ratio [OR]=2.1), older siblings (OR=2.5), allergic sensitization to foods at age 1 year (OR=2.0), any moderate to severe respiratory illness without Wheezing during infancy (OR=3.6), and at least 1 Wheezing illness with respiratory syncytial virus (RSV; OR=3.0), rhinovirus (OR=10) and/or non–rhinovirus/RSV pathogens (OR=3.9) during infancy. When viral etiology was considered, 1st-year Wheezing illnesses caused by rhinovirus infection were the strongest predictor of subsequent 3rd year Wheezing (OR=6.6; P P Conclusion In this population of children at increased risk of developing allergies and asthma, the most significant risk factor for the development of preschool childhood Wheezing is the occurrence of symptomatic rhinovirus illnesses during infancy that are clinically and prognostically informative based on their seasonal nature.
Tuomas Jartti - One of the best experts on this subject based on the ideXlab platform.
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short and long term efficacy of prednisolone for first acute rhinovirus induced Wheezing episode
The Journal of Allergy and Clinical Immunology, 2015Co-Authors: Tuomas Jartti, Riitta Nieminen, Pasi Lehtinen, Tytti Vuorinen, Tero Vahlberg, Carlos A Camargo, James E Gern, Olli RuuskanenAbstract:Background Rhinovirus-induced Wheezing is an important risk factor for recurrent Wheezing. There are no randomized controlled trials on the effect of systemic corticosteroids in patients with this disease. Objective We sought to study the short- and long-term effects of prednisolone treatment of the first acute, moderate-to-severe, rhinovirus-induced Wheezing episode in young children. Methods After confirming rhinovirus from nasopharyngeal aspirate by using PCR, 79 children with a first Wheezing episode at age 3 to 23 months were randomized to receive oral prednisolone (first dose of 2 mg/kg, followed by 2 mg/kg/d in 2 divided doses for 3 days) or placebo. The trial was double blind throughout the 12-month follow-up. The primary outcomes were long term: new physician-confirmed Wheezing episode within 2 months, number of physician-confirmed Wheezing episodes within 12 months, and initiation of regular controller medication for asthma symptoms within 12 months. The primary interaction analysis examined rhinovirus load. Results Seventy-four patients completed the study (mean age, 13 months; 28% atopic). Long-term outcomes did not differ between groups (all P ≥ .30). For short-term outcomes, the prednisolone group had less cough, rhinitis, noisy breathing, severe breathing difficulties, and nocturnal respiratory symptoms at home within 2 weeks (all P P Conclusions Prednisolone cannot be routinely recommended for all young children experiencing their first acute, moderate-to-severe, rhinovirus-induced Wheezing episode. Prednisolone might be beneficial in a subgroup of children with high viral loads.
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Prednisolone reduces recurrent Wheezing after first rhinovirus wheeze: a 7‐year follow‐up
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2013Co-Authors: Minna Lukkarinen, Pasi Lehtinen, Tytti Vuorinen, Olli Ruuskanen, Heikki Lukkarinen, Tuomas JarttiAbstract:Background To better understand the role of human rhinovirus-associated wheeze as a risk factor for childhood recurrent Wheezing, a cohort of young children experiencing their first Wheezing episode was followed until school age. Methods All 111 hospitalized Wheezing children (median age, 12 months) were initially participated in a randomized, double-blind, placebo-controlled, parallel trial on the efficacy of oral prednisolone. In this 7-yr follow-up, risk factors for recurrent Wheezing were analysed, and then, the efficacy of prednisolone was evaluated overall and in pre-specified subgroups post-hoc. The main outcome was time to recurrent Wheezing. Results The strongest independent risk factor for recurrent Wheezing was rhinovirus detection (hazard ratio 3.54; 95% confidence interval 1.51–8.30) followed by sensitization (3.47; 1.55–8.30, respectively) age
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prednisolone reduces recurrent Wheezing after a first Wheezing episode associated with rhinovirus infection or eczema
The Journal of Allergy and Clinical Immunology, 2007Co-Authors: Pasi Lehtinen, Tytti Vuorinen, Aino Ruohola, Olli Ruuskanen, Timo Vanto, Tuomas JarttiAbstract:Background Rhinovirus-induced early Wheezing has been suggested as a new important risk factor for recurrent Wheezing. Objective We sought to investigate the risk factors for recurrent Wheezing and to determine post hoc the efficacy of prednisolone in risk groups. Methods We followed for 1 year 118 children (median age, 1.1 years) who had had their first episode of Wheezing and had participated in a trial comparing prednisolone with placebo in hospitalized children. Demographics and laboratory data were obtained at study entry. The follow-up outcome was recurrent Wheezing (3 physician-confirmed episodes). Results Recurrent Wheezing was diagnosed in 44 (37%) children. Independent risk factors were age P = .007 for interaction). Prednisolone was associated with less recurrent Wheezing in the rhinovirus group (0.19; 95% CI, 0.05-0.71), but not in the RSV (2.12; 95% CI, 0.46-9.76) or in the RSV/rhinovirus-negative groups (2.03; 95% CI, 0.83-5.00; P = .017 for interaction). Conclusion Rhinovirus-induced early Wheezing is a major viral risk factor for recurrent Wheezing. Prednisolone may prevent recurrent Wheezing in rhinovirus-affected first-time wheezers. The presence of eczema may also influence the response to prednisolone. Clinical implications A prospective trial is needed to test the hypothesis that prednisolone reduces recurrent Wheezing in rhinovirus-affected Wheezing children.
