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SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
11/20/06
Lung growth rate in children with chronic mild to moderate asthma
Summary
Background - Previous studies in the Childhood Asthma Management Program (CAMP) project suggested that lung growth rates (LGR) are impaired in children with persistent asthma (PA) of mild to moderate degree. But how does this compare with LGR patterns in healthy children without asthma?
Findings - Strunk et al reported continuing findings in the CAMP project. Sequential pulmonary function findings in 1041 children (ages 5-18 years) with mild-moderate PA were compared with those in children without asthma followed in the Harvard Six Cities Studies (H6CS). They found that the follow-up FEV-1/FVC ratio was lower in asthmatics than non-asthmatics for both boys and girls with an attendant increase in the FVC of asthmatics. However, the mean FEV-1 was lower in the asthmatics than in non-asthmatics only for the boys. The frequency of abnormal FEV-1/FVC ratios was greater with increasing ages of the asthmatic children.
Similar lower than normal FEV-1/FVC ratios were seen in the asthmatic children whether they were treated for over 4 years with budesonide, nedocromil or placebo.
Reference
J Allergy Clin Immunol 2006;118:1040-7
Editor's Comments
These findings are not too surprising in face of previous studies in the CAMP project. The longer follow-up and different marker of lung growth in this report (FEV-1/FVC ratio vs post-bronchodilator FVC in the earlier CAMP study report) do provide additional information suggesting progressive loss of lung function. Some other studies have suggested that decrements in lung function in childhood asthma are based on severity and occur mainly by age 6-7 years. However, the smaller study population in those studies may have had milder disease.
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