Factors Associated with Asthma Severity in Children: Data from the French COBRAPed Cohort.


Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
05 2021
Historique:
received: 01 05 2020
revised: 30 11 2020
accepted: 09 12 2020
pubmed: 29 12 2020
medline: 25 5 2021
entrez: 28 12 2020
Statut: ppublish

Résumé

Severe asthma (SA) in children is a complex, heterogeneous disease, associated with a considerable burden. However, factors influencing asthma severity are poorly described and may differ according to age. To determine whether factors associated with asthma severity differ between preschoolers with severe recurrent wheeze (SRW) and school-age children with SA. Data from the French multicenter prospective observational cohort of preschool (3-6 years) children with SRW and nonsevere recurrent wheeze (NSRW) and school-age (7-11 years) children with SA and nonsevere asthma (NSA) (Pediatric Cohort of Bronchial Obstruction and Asthma) were analyzed. A total of 131 preschool children (92 SRW and 49 NSRW) and 207 school-age children (92 SA and 115 NSA) were included. In both univariable and multivariable analysis, SRW was associated with second-hand smoke exposure (multivariable analysis: odds ratio [95% CI], 29.8 [3.57-3910]) and exposure to mold/dampness at home (multivariable analysis: odds ratio [95% CI], 4.22 [1.25-18.2]) compared with NSRW. At school-age, history of atopic dermatitis and food allergy was more frequent in children with SA than in those with NSA. Multivariable analysis confirmed that SA was associated with a history of food allergy (odds ratio [95% CI], 5.01 [2.23-11.9]). Our data suggest that factors influencing asthma severity may differ according to age. In preschool children with SRW, second-hand smoke and exposure to mold are predominant, whereas associated allergic disorders are mainly involved in SA at school-age.

Sections du résumé

BACKGROUND
Severe asthma (SA) in children is a complex, heterogeneous disease, associated with a considerable burden. However, factors influencing asthma severity are poorly described and may differ according to age.
OBJECTIVE
To determine whether factors associated with asthma severity differ between preschoolers with severe recurrent wheeze (SRW) and school-age children with SA.
METHODS
Data from the French multicenter prospective observational cohort of preschool (3-6 years) children with SRW and nonsevere recurrent wheeze (NSRW) and school-age (7-11 years) children with SA and nonsevere asthma (NSA) (Pediatric Cohort of Bronchial Obstruction and Asthma) were analyzed.
RESULTS
A total of 131 preschool children (92 SRW and 49 NSRW) and 207 school-age children (92 SA and 115 NSA) were included. In both univariable and multivariable analysis, SRW was associated with second-hand smoke exposure (multivariable analysis: odds ratio [95% CI], 29.8 [3.57-3910]) and exposure to mold/dampness at home (multivariable analysis: odds ratio [95% CI], 4.22 [1.25-18.2]) compared with NSRW. At school-age, history of atopic dermatitis and food allergy was more frequent in children with SA than in those with NSA. Multivariable analysis confirmed that SA was associated with a history of food allergy (odds ratio [95% CI], 5.01 [2.23-11.9]).
CONCLUSIONS
Our data suggest that factors influencing asthma severity may differ according to age. In preschool children with SRW, second-hand smoke and exposure to mold are predominant, whereas associated allergic disorders are mainly involved in SA at school-age.

Identifiants

pubmed: 33359443
pii: S2213-2198(20)31359-3
doi: 10.1016/j.jaip.2020.12.027
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT02114034']

Types de publication

Journal Article Multicenter Study Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1969-1979

Investigateurs

Rola Abou-Taam (R)
Muriel Le Bourgeois (M)
Alice Hadchouel-Duvergé (A)
David Drummond (D)
Christophe Delacourt (C)
Marie-Alexandra Alyanakian (MA)
Lucienne Chatennoud (L)
Caroline Thumerelle (C)
Clémence Mordacq (C)
Irina Badiu-Decleyre (I)
Cécile Bonnel (C)
Laure Delbecque (L)
Laurent Beghin (L)
Graziella Mingardi (G)
Caroline Tournegros (C)
Léa Roditis (L)
Stéphanie Wanin (S)
Marie Noelle Lebras (MN)
Stéphane Debelleix (S)
Valérie Siao (V)
Marine Servat (M)
Guillaume Simon (G)
Patricia El Boustany (P)
Emmanuelle Bosdure (E)
Julie Mazenq (J)
Isabelle Cabon (I)
Camille Ohlmann (C)
Stéphanie Vrielynck (S)
Virginie Jubin (V)
Sylvie-Anne André Gomez (SA)
Marie-Christine Werck Gallois (MC)

Informations de copyright

Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Auteurs

Guillaume Lezmi (G)

Université de Paris, Institut Necker-Enfants Malades, Equipe Immunorégulation et Immunopathologie, Inserm UMR1151, CNRS UMR8253, Paris, France; Service de Pneumologie et Allergologie Pédiatriques, AP-HP, Hôpital Necker-Enfants Malades, Paris, France.

Stéphanie Lejeune (S)

Univ. Lille, CHU Lille, Pediatric Pulmonology and Allergy Department, Hôpital Jeanne de Flandre, Lille, France; Univ. Lille, LIRIC UMR 995 Inserm, Clinical Investigation Center, CIC-1403-Inserm-CHU, Lille, France.

Isabelle Pin (I)

Pédiatrie, CHU Grenoble Alpes, INSERM, Institute for Advanced Biosciences, Université Grenoble Alpes, Grenoble, France.

Sylvain Blanchon (S)

Children Hospital, Pediatric Pulmonology and Allergology Unit, CHU Toulouse, Toulouse, France.

Naïm Bouazza (N)

Paris Descartes Necker, Cochin Clinical Research Unit, Assistance Publique-Hôpitaux de Paris, Paris, France.

Valérie Jolaine (V)

Paris Descartes Necker, Cochin Clinical Research Unit, Assistance Publique-Hôpitaux de Paris, Paris, France.

Christophe Marguet (C)

EA3830-GHRV, Rouen University, Pediatric Respiratory and Allergic Diseases, CF Reference Center, Rouen University Hospital-Charles Nicolle, Rouen, France.

Véronique Houdoin (V)

Robert Debré Hospital, Pediatric Pulmonology and Allergology, University of Paris, Paris, France; University of Paris Diderot, Sorbonne Paris Cité, INSERM UMR S976, Paris, France.

Patrick Berger (P)

Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, Bordeaux, France.

Michael Fayon (M)

CHU de Bordeaux, Unité de pneumologie pédiatrique, Centre d'Investigation Clinique (CIC 1401), Bordeaux, France.

Jean-Christophe Dubus (JC)

Unité de pneumopédiatrie CHU Timone-Enfants, Aix-Marseille Université, IRD MEPHI, IHU Méditerranée-Infection, Marseille, France.

Philippe Reix (P)

Service de Pneumologie, Allergologie et Mucoviscidose Pédiatrique, CHU de Lyon, Lyon, France; UMR 5558 (EMET), CNRS, LBBE, Université de Lyon, Villeurbanne, France.

Mathieu Pellan (M)

Service de Pédiatrie, CHU Jean Verdier, Bondy, France.

Jacques Brouard (J)

Service de Pédiatrie Médicale, CHU Caen, Caen, France; Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Normandie Université, Caen, France.

Raphael Chiron (R)

Pediatric Department, Montpellier University Hospital, Montpellier, France.

Lisa Giovannini-Chami (L)

Pediatric Pulmonology Department, Lenval University Hospital, Nice, France.

Antoine Deschildre (A)

Univ. Lille, CHU Lille, Pediatric Pulmonology and Allergy Department, Hôpital Jeanne de Flandre, Lille, France; Univ. Lille, LIRIC UMR 995 Inserm, Clinical Investigation Center, CIC-1403-Inserm-CHU, Lille, France.

Jacques de Blic (J)

Université de Paris, Institut Necker-Enfants Malades, Equipe Immunorégulation et Immunopathologie, Inserm UMR1151, CNRS UMR8253, Paris, France; Service de Pneumologie et Allergologie Pédiatriques, AP-HP, Hôpital Necker-Enfants Malades, Paris, France. Electronic address: deblicj@gmail.com.

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