| Title | Airway Responsiveness in Mild to Moderate Childhood Asthma: Gender Influences on the Natural History. | | Author(s) | Tantisira KG, Colvin R, Tonascia J, Strunk RC, Weiss ST, Fuhlbrigge AL, Childhood Asthma Management Program Research Group | | Institution | Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Pumonary Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Center for Genomic Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. | | Source | Am J Respir Crit Care Med 2008 Apr 17. | | Abstract | RATIONALE: Airway responsiveness is a prognostic marker for asthma symptoms in later life.
OBJECTIVES: To evaluate characteristics responsible for persistence of airway responsiveness in asthmatic children. Methods, Measurements, and
MAIN RESULTS: 1041 children initially aged 5-12 with mild to moderate persistent asthma enrolled in the Childhood Asthma Management Program (CAMP) were studied prospectively for 8.6 +/- 1.8 years with methacholine challenges yearly. Least squares geometric mean models were fit to determine effects of gender and age on airway responsiveness (provocative concentration producing 20% decrease in FEV1 or PC20). Multiple linear regression analysis was performed to determine factors at baseline and over time which were associated with PC20 at end of follow-up. 7748 methacholine challenges were analyzed. PC20 increased with age, with boys having greater increase after age 11 years than girls (p<0.001). The divergence coincided with the mean age for Tanner stage 2. Post-pubertal girls had greater airway responsiveness, even after adjustment for FEV1 and other potential confounders. While multivariable regression analyses noted a variety of factors that influenced airway responsivness in both genders, a history of hayfever (beta= -0.30, p=0.005), respiratory allergy (beta= -0.32, p=0.006), or recent inhaled corticosteroid usage (beta= -0.18, p=0.02) were associated with decrements in final log PC20 only in girls.
CONCLUSIONS: Airway responsiveness (PC20) is more severe in the post-pubertal asthmatic female than in males. While there are factors associated with airway responsiveness in both males and females, gender specific factors may contribute to new insights into asthma pathogenesis. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 18420965 |
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