Featured Research

from universities, journals, and other organizations

Repeated preschool wheeze may set stage for long-term damage in lung function

Date:
May 7, 2014
Source:
Universite de Montreal
Summary:
Children who wheeze are at risk of developing damage that will affect their lung function by the age of 6 years, according to researchers. These appear to be persistent, even if asthma symptoms seem to disappear at least temporarily by school age in several cases. Children with recurrent symptoms that are severe enough to warrant a visit to the emergency department are particularly at risk of seeing their lung function affected.

Children who wheeze are at risk of developing damage that will affect their lung function by the age of 6 years, according to researchers at CHU Sainte-Justine Hospital and the University of Montreal. These appear to be persistent, even if asthma symptoms seem to disappear at least temporarily by school age in several cases. Children with recurrent symptoms that are severe enough to warrant a visit to the emergency department are particularly at risk of seeing their lung function affected. This may persist in adulthood and into their forties, even if they have gone through a period of asthma remission during their childhood or adolescence. Preschool wheezing could be a risk factor for to chronic obstructive pulmonary disease.

The findings were published in The Lancet by researchers and pediatricians Drs. Francine M. Ducharme and Sze Man Tse following a review of the outcomes of clinical studies undertaken on preschoolers over close to 25 years. Wheezing is a symptom characterized by a whistling sound when breathing and it affects 20% to 25% of Canadian children under 6 years of age. Under-sixes visit the emergency three times more than all other age groups, resulting in at least one yearly emergency department visit for 2%-4% of them, a sizable number of whom will subsequently be admitted to hospital.

"Repeated wheezing is most often caused by asthma. However, the diagnosis is challenging because before 6 years of age, children are too young to go through the standard confirmatory lung-function test -- spirometry," says Dr. Ducharme. "Yet the period before six years of age is clearly a period of increased vulnerability and is probably the best time to intervene -- and possibly -- prevent lasting damage."

Damage resulting from lack of long-term therapy

These data track the natural evolution of the asthma, as today's ill adults were the preschoolers 20 to 40 years ago: at that time, few effective treatments were available. "Our study shows that the most effective treatment of young children is the long-term use of low doses of inhaled corticosteroids. However, it is alarming to see that few young children are currently receiving over the long term, this treatment that has been known to be effective. So even today, these children are at risk of long-term damage to their lung," says Dr. Ducharme.

The importance of diagnosis In many cases, asthmatic children are wrongly diagnosed as having bronchitis or pneumonia. "This is why it's essential to correctly diagnose the causes of childhood wheezing," Dre Sze Man Tse says. "In other cases, due to a lack of information, doctors hesitate to prescribe long-term treatment, and parents hesitate to administer it. If these children were treated daily with inhaled corticosteroids, they would avoid repeated ER visits and their quality of life would be improved, as would their whole family's." It is not yet known if the treatment prevents long-term damage.

A public health priority

Genetic factors, colds, exposure to tobacco and very early childhood rapid weight gain are known risk factors for repeated wheezing. "Early intervention to reduce medium and long-term lung damage resulting from preschool wheezing should be a public health priority," says Dre Ducharme. "Knowing that 48% of preschool children will wheeze at least once before the age of 6 years, and that a large proportion of them are improperly diagnosed or do not receive the inhaled corticosteroid whose effectiveness is well beyond any scientific doubt, we see in turn the great, needless expense for the health system and the risk of life-long, irreversible damage to these children."

Long-term preventative effect

CHU Sainte-Justine Hospital is one of few Canadian specialized paediatric centres that follows these patients with pulmonary function tests specially adapted for children 3 years and up, which enables their medication to be more carefully adjusted. "We can see these children's pulmonary function improve with treatment," says Dr. Ducharme. "We are currently studying whether the early and sustained administration of inhaled corticosteroids during childhood, the reduction of viral infections, and the control of various environmental factors before and after birth could have an effect on the occurrence, frequency or persistence of asthma until adulthood. These studies will also look at the financial impact of these interventions on health care costs."


Story Source:

The above story is based on materials provided by Universite de Montreal. Note: Materials may be edited for content and length.


Journal Reference:

  1. Francine M Ducharme, Sze M Tse, Bhupendrasinh Chauhan. Diagnosis, management, and prognosis of preschool wheeze. The Lancet, 2014; 383 (9928): 1593 DOI: 10.1016/S0140-6736(14)60615-2

Cite This Page:

Universite de Montreal. "Repeated preschool wheeze may set stage for long-term damage in lung function." ScienceDaily. ScienceDaily, 7 May 2014. <www.sciencedaily.com/releases/2014/05/140507095318.htm>.
Universite de Montreal. (2014, May 7). Repeated preschool wheeze may set stage for long-term damage in lung function. ScienceDaily. Retrieved July 23, 2014 from www.sciencedaily.com/releases/2014/05/140507095318.htm
Universite de Montreal. "Repeated preschool wheeze may set stage for long-term damage in lung function." ScienceDaily. www.sciencedaily.com/releases/2014/05/140507095318.htm (accessed July 23, 2014).

Share This




More Health & Medicine News

Wednesday, July 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Courts Conflicted Over Healthcare Law

Courts Conflicted Over Healthcare Law

AP (July 22, 2014) Two federal appeals courts issued conflicting rulings Tuesday on the legality of the federally-run healthcare exchange that operates in 36 states. (July 22) Video provided by AP
Powered by NewsLook.com
Why Do People Believe We Only Use 10 Percent Of Our Brains?

Why Do People Believe We Only Use 10 Percent Of Our Brains?

Newsy (July 22, 2014) The new sci-fi thriller "Lucy" is making people question whether we really use all our brainpower. But, as scientists have insisted for years, we do. Video provided by Newsy
Powered by NewsLook.com
Scientists Find New Way To Make Human Platelets

Scientists Find New Way To Make Human Platelets

Newsy (July 22, 2014) Boston scientists have discovered a new way to create fully functioning human platelets using a bioreactor and human stem cells. Video provided by Newsy
Powered by NewsLook.com
Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins