Predictors of remitting, periodic, and persistent childhood asthma

National Jewish Health, Denver, CO 80206, USA.
The Journal of allergy and clinical immunology (Impact Factor: 11.25). 02/2010; 125(2):359-366.e3. DOI: 10.1016/j.jaci.2009.10.037
Source: PubMed

ABSTRACT The course of mild to moderate persistent asthma in children is not clearly established.
To determine the rate and predictors for remitting, periodic, and persistent asthma in adolescence.
The Childhood Asthma Management Program (CAMP) was a 4.3-year randomized, double-masked, multicenter trial in children with mild to moderate persistent asthma that compared continuous therapy with either budesonide or nedocromil, each to placebo, followed by a 4-year observational follow-up period. Asthma activity during the observation period included remitting (no asthma activity in the last year), persistent (asthma activity in every quarter), and periodic asthma (neither remitting nor persistent).
Asthma was identified as remitting in 6%, periodic in 39%, and persistent in 55% of the 909 participants, with no effect noted from earlier anti-inflammatory treatment during the CAMP trial. Within all 3 asthma activity categories, improvements in airway hyperresponsiveness, eosinophilia, and asthma morbidity were observed over time. Features at entry into CAMP associated with remitting versus persistent asthma were lack of allergen sensitization and exposure to indoor allergens (odds ratio [OR], 3.23; P < .001), milder asthma (OR, 2.01; P = .03), older age (OR, 1.23; P = .01), less airway hyperresponsiveness (higher log methacholine FEV(1) PC(20) (OR, 1.39; P = .03), higher prebronchodilator FEV(1) percent predicted (OR, 1.05; P = .02), and lower forced vital capacity percent predicted (OR, 0.96; P = .04).
Remission of asthma in adolescence is infrequent and not affected by 4 years of anti-inflammatory controller therapy. Factors such as sensitization and exposure, low lung function, and airway greater hyperresponsiveness decrease the likelihood of remitting asthma.

Download full-text


Available from: Laura A Wilson, Jul 02, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Studies show that a significant proportion of young people suffering from childhood onset asthma later recovered, usually in adolescence. In this article we argue that an understanding of the differences between children who recover from asthma and those who do not would contribute to increased understanding of the pathogenic mechanisms of the disease and could provide new clues about prevention and treatment. We note that some researchers have recently published results from these kinds of investigations. This paper reports results regarding genetic determinants, distorted mechanisms of inflammation, and mind/body relationships. We also try to integrate findings from these 3 areas to formulate general conclusions about the pathogenesis of asthma.
    Medical science monitor: international medical journal of experimental and clinical research 01/2015; 21:570-575. DOI:10.12659/MSM.893575 · 1.22 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A novel multiple beam microstrip patch array is presented that combines the function of a beamformer and an array into one structure that gives a one dimensional beam set. The array comprises a set of series resonant patch arrays that are excited by a number of travelling wave feed lines. The beam directions are determined by small meander line phase shifting sections in each feed line. In this paper the array operation is described and the behaviour of the radiation pattern, gain, bandwidth and beam isolation are noted. Measured results for a 5 beam array at 8 GHz are given. The array gives significant simplification over other current multiple beam antennas and has potential use in several current application areas.
    Microwave Conference, 1989. 19th European; 10/1989
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Results are shown of calculations and measurements of the effectiveness of the betatron stochastic cooling systems in the debuncher ring of the antiproton source at Fermilab. This system cools each batch of injected antiprotons from ca. 8π mm mrad to less than 1π mm mrad rms emittance in the 2.4 seconds between production cycles. The conclusions concerning future improvements are summarized
    Particle Accelerator Conference, 1993., Proceedings of the 1993; 06/1993