Prevalence and Determinants of Wheezing and Bronchodilatation in Children With Cystic Fibrosis: A Retrospective Cohort Study.

asthma bronchial hyperresponsiveness cystic fibrosis respiratory function tests wheezing

Journal

Frontiers in pediatrics
ISSN: 2296-2360
Titre abrégé: Front Pediatr
Pays: Switzerland
ID NLM: 101615492

Informations de publication

Date de publication:
2022
Historique:
received: 17 01 2022
accepted: 10 03 2022
entrez: 31 5 2022
pubmed: 1 6 2022
medline: 1 6 2022
Statut: epublish

Résumé

Many patients with cystic fibrosis (CF) wheeze, and are dubbed as having CF-asthma. Understanding the determinants of such wheezing may avoid unnecessary treatments and open newer treatment avenues. Main: To evaluate the prevalence and characteristics of wheezing and a positive bronchodilatory response (BDR) in children with CF. Secondary: To identify the predictive markers and the impact of current wheezing a positive BDR. A retrospective single-center study in children with CF. We determined the characteristics of physician-reported wheeze in patients <6 years, and a BDR in patients aged 6-17 years. Anthropometric, lung function, laboratory, genetic and microbiological data were recorded in all groups. Variables were compared using the Chi 125 preschool and 69 school-aged children and adolescents with CF were included in the study. 71.2% of patients <6 years of age had had at least one episode of wheezing: 26.3% of patients were Transient Early Wheezers, 12.6% Late Onset Wheezers and 37.9% were Persistent Wheezers. The prevalence of a positive BDR was 73.5, 48.5, and 52.9% in the 6-8 years, 10-12 years, and 15-17 years age groups, respectively. Allergic factors were not predictive of wheezing in preschoolers. In the 6-8 years age group, the sum of wheal diameters of allergic skin prick tests (SPT, house dust mite + cat + dog dander) was greater in those with a BDR vs. no BDR (4 [2.0-8.8] vs. 1 [0-7.0] mm, Wheezing and BDR are very frequent findings in children with CF. Current wheeze at the age of 6 years was associated with worse lung function. Labeling wheezing in CF as "CF-Asthma" is misleading since the determinants are different, and may lead to inappropriate prescriptions of inhaled steroids.

Sections du résumé

Background UNASSIGNED
Many patients with cystic fibrosis (CF) wheeze, and are dubbed as having CF-asthma. Understanding the determinants of such wheezing may avoid unnecessary treatments and open newer treatment avenues.
Objectives UNASSIGNED
Main: To evaluate the prevalence and characteristics of wheezing and a positive bronchodilatory response (BDR) in children with CF. Secondary: To identify the predictive markers and the impact of current wheezing a positive BDR.
Methods UNASSIGNED
A retrospective single-center study in children with CF. We determined the characteristics of physician-reported wheeze in patients <6 years, and a BDR in patients aged 6-17 years. Anthropometric, lung function, laboratory, genetic and microbiological data were recorded in all groups. Variables were compared using the Chi
Results UNASSIGNED
125 preschool and 69 school-aged children and adolescents with CF were included in the study. 71.2% of patients <6 years of age had had at least one episode of wheezing: 26.3% of patients were Transient Early Wheezers, 12.6% Late Onset Wheezers and 37.9% were Persistent Wheezers. The prevalence of a positive BDR was 73.5, 48.5, and 52.9% in the 6-8 years, 10-12 years, and 15-17 years age groups, respectively. Allergic factors were not predictive of wheezing in preschoolers. In the 6-8 years age group, the sum of wheal diameters of allergic skin prick tests (SPT, house dust mite + cat + dog dander) was greater in those with a BDR vs. no BDR (4 [2.0-8.8] vs. 1 [0-7.0] mm,
Conclusion UNASSIGNED
Wheezing and BDR are very frequent findings in children with CF. Current wheeze at the age of 6 years was associated with worse lung function. Labeling wheezing in CF as "CF-Asthma" is misleading since the determinants are different, and may lead to inappropriate prescriptions of inhaled steroids.

Identifiants

pubmed: 35633979
doi: 10.3389/fped.2022.856840
pmc: PMC9133441
doi:

Types de publication

Journal Article

Langues

eng

Pagination

856840

Informations de copyright

Copyright © 2022 Galodé, Ladipo, Andrieux, Feghali, Bui and Fayon.

Déclaration de conflit d'intérêts

MF is affiliated (but not employed) by the INSERM, CIC 1401. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Références

J Asthma Allergy. 2017 Mar 27;10:83-98
pubmed: 28392707
J Cyst Fibros. 2016 Sep;15(5):652-9
pubmed: 26826913
Am J Respir Crit Care Med. 2010 Nov 15;182(10):1251-61
pubmed: 20622026
Am J Physiol Lung Cell Mol Physiol. 2019 Nov 1;317(5):L690-L701
pubmed: 31508974
Radiology. 2009 Aug;252(2):577-86
pubmed: 19508990
Thorax. 1980 Nov;35(11):807-13
pubmed: 7221975
Cochrane Database Syst Rev. 2019 Jul 04;7:CD001915
pubmed: 31271656
JCI Insight. 2016 Apr 7;1(4):e86183
pubmed: 27158673
Am J Respir Crit Care Med. 2008 Apr 15;177(8):837-43
pubmed: 18218992
Cells. 2021 Nov 22;10(11):
pubmed: 34831482
J Allergy Clin Immunol. 2013 Dec;132(6):1303-10
pubmed: 23987795
Chest. 2002 Jul;122(1):47-55
pubmed: 12114338
J R Soc Med. 2003;96 Suppl 43:30-4
pubmed: 12906323
Am J Respir Crit Care Med. 2000 Oct;162(4 Pt 1):1403-6
pubmed: 11029352
Pediatrics. 1978 Mar;61(3):446-50
pubmed: 643418
Pediatr Pulmonol. 2005 Dec;40(6):500-10
pubmed: 16208679
Thorax. 2002 Aug;57(8):742-8
pubmed: 12149539
Eur Respir J. 1997 Dec;10(12):2772-7
pubmed: 9493659
J Pediatr. 1978 Nov;93(5):744-8
pubmed: 712474
Eur Respir J. 2005 Nov;26(5):948-68
pubmed: 16264058
Respirology. 2008 Jun;13(4):537-45
pubmed: 18410257
Thorax. 2005 Mar;60(3):226-8
pubmed: 15741440
Am J Respir Crit Care Med. 2022 Mar 1;205(5):540-549
pubmed: 34936849
Pediatr Pulmonol. 2012 Oct;47(10):966-72
pubmed: 22359344
Anaesth Crit Care Pain Med. 2018 Dec;37(6):607-614
pubmed: 30580775
Am J Respir Cell Mol Biol. 2009 Feb;40(2):217-22
pubmed: 18757309
Curr Opin Pulm Med. 2003 Nov;9(6):504-8
pubmed: 14534403
Pediatr Pulmonol. 1988;5(3):139-44
pubmed: 2973571
World J Gastroenterol. 2020 Nov 7;26(41):6322-6334
pubmed: 33244195
Clin Rev Allergy Immunol. 2002 Aug;23(1):77-85
pubmed: 12162108
Treat Respir Med. 2004;3(4):247-68
pubmed: 15350163
Arch Pediatr. 2016 Dec;23(12S):12S4-12S8
pubmed: 28231893
Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 2):S11-4
pubmed: 10934124
Med J Aust. 1980 Jul 26;2(2):77-8
pubmed: 7421655
J Allergy Clin Immunol. 2009 Nov;124(5):903-10.e1-7
pubmed: 19665765
N Engl J Med. 1995 Jan 19;332(3):133-8
pubmed: 7800004
Arch Pediatr. 2014 Jan;21(1):88-94
pubmed: 24309202
J Pediatr. 2009 Feb;154(2):183-8
pubmed: 18822427
Clin Exp Allergy. 2013 Dec;43(12):1395-405
pubmed: 24261948
Pediatr Pulmonol. 2014 Aug;49(8):745-50
pubmed: 24123917
Pediatr Pulmonol. 2014 Mar;49(3):205-13
pubmed: 24420817
Eur Respir J. 1992 Oct;5(9):1083-8
pubmed: 1426217
J Breath Res. 2018 Feb 20;12(2):026010
pubmed: 29146889
Am J Respir Crit Care Med. 1994 Mar;149(3 Pt 1):834-5
pubmed: 8155167
Cochrane Database Syst Rev. 2017 Dec 19;12:CD012102
pubmed: 29253920
Lancet Respir Med. 2013 Apr;1(2):137-47
pubmed: 24429094

Auteurs

Francois Galodé (F)

Paediatric Cystic Fibrosis Reference Center, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France.

O Ladipo (O)

Service de Pédiatrie, CHU de la Mère et de l'Enfant Lagune, Cotonou, Benin.

A Andrieux (A)

Paediatric Cystic Fibrosis Reference Center, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France.

H Feghali (H)

Paediatric Cystic Fibrosis Reference Center, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France.

S Bui (S)

Paediatric Cystic Fibrosis Reference Center, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France.

Michael Fayon (M)

Paediatric Cystic Fibrosis Reference Center, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France.
INSERM, Centre d'Investigation Clinique (CIC 1401), University of Bordeaux, Bordeaux, France.

Classifications MeSH