Does decline of lung function in wheezy infants justify the early start of controller medications?
OBJECTIVE
To compare lung function in wheezy infants, with risk factors of asthma and with some immunological parameters which may be useful as predictors of subsequent asthma.


METHODS
The data of 241 infants aged 5–36 mo, with recurrent wheeze (≥3 episodes of physician confirmed wheeze) prior to receiving inhaled corticosteroids or anti-leukotrine agents was retrospectively analyzed. They were subdivided into 2 subgroups; those with asthma risk factors (132 patients) and those without (109 patients) Also, 67 healthy, age and sex matched children without recurrent wheezes were taken as control group. Total serum IgE, eosinophilic percentage, tPTEF/tE (time to peak expiratory flow to total expiratory time), total respiratory system compliance (Crs) and resistance of the respiratory system (Rrs) was done for patients and control groups.


RESULTS
Wheezy infants had a significantly higher eosinophilic percentage and total serum IgE as well as a significantly lower pulmonary function parameters when compared to healthy controls. Wheezy infants with positive family history of asthma and those who had not been breast fed showed significant reduction in the mean values of tPTEF/tE and increased both eosinophilic percentage and total serum IgE. Crs was significantly decreased in wheezy infants with positive seasonal variations and those who had increased both eosinophilic percentage and total serum IgE. Rrs showed significant increase in wheezy infants with positive family history of atopy and those who had increased eosinophilic percentage and increased total serum IgE.


CONCLUSIONS
Lung function, eosinophilic percentage, total serum IgE and asthma risk factors could be used as predictors for ongoing wheeze in this subset of children.
Allergy Unit, Faculty of Medicine, Mansoura University, Pin Code: 35516, Box 50, Mansoura, Egypt. magdyzedan@mans.edu.eg
Magdy
M
Zedan
Nehad
N
Nasef
Mohamed
M
El-Bayoumy
Mohamed
M
El-Assmy
Gehan
G
Attia
Mohamed
M
Zedan
Angi
A
AlWakeel
Shaimaa
S
Kandil
Wafaa
W
Laimon
Ashraf
A
Fouda
D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000503:physiopathology*; D008297:Male; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors