PMID- 31424170
OWN - NLM
STAT- MEDLINE
DCOM- 20200422
LR  - 20201101
IS  - 1099-0496 (Electronic)
IS  - 8755-6863 (Print)
IS  - 1099-0496 (Linking)
VI  - 54
IP  - 11
DP  - 2019 Nov
TI  - Clinical significance of the bronchodilator response in children with severe 
      asthma.
PG  - 1694-1703
LID - 10.1002/ppul.24473 [doi]
AB  - BACKGROUND: Our objective was to determine those characteristics associated with 
      reversibility of airflow obstruction and response to maximal bronchodilation in 
      children with severe asthma through the Severe Asthma Research Program (SARP). 
      METHODS: We performed a cross-sectional analysis evaluating children ages 6 to 17 
      years with nonsevere asthma (NSA) and severe asthma (SA). Participants underwent 
      spirometry before and after 180 microg of albuterol to determine reversibility (>/=12% 
      increase in FEV(1) ). Participants were then given escalating doses up to 720 microg 
      of albuterol to determine their maximum reversibility. RESULTS: We evaluated 230 
      children (n = 129 SA, n = 101 NSA) from five centers across the United States in 
      the SARP I and II cohorts. SA (odds ratio [OR], 2.08, 95% confidence interval 
      [CI], 1.05-4.13), second-hand smoke exposure (OR, 2.81, 95%CI, 1.23-6.43), and 
      fractional exhaled nitric oxide (FeNO; OR, 1.97, 95%CI, 1.35-2.87) were 
      associated with increased odds of airway reversibility after maximal 
      bronchodilation, while higher prebronchodilator (BD) FEV(1) % predicted (OR, 
      0.91, 95%CI, 0.88-0.94) was associated with decreased odds. In an analysis using 
      the SARP III cohort (n = 186), blood neutrophils, immunoglobulin E (IgE), and 
      FEV(1) % predicted were significantly associated with BD reversibility. In 
      addition, children with BD response have greater healthcare utilization. BD 
      reversibility was associated with reduced lung function at enrollment and 1-year 
      follow-up though less decline in lung function over 1 year compared to those 
      without reversibility. CONCLUSIONS: Lung function, that is FEV(1) % predicted, is 
      a predictor of BD response in children with asthma. Additionally, smoke exposure, 
      higher FeNO or IgE level, and low peripheral blood neutrophils are associated 
      with a greater likelihood of BD reversibility. BD response can identify a 
      phenotype of pediatric asthma associated with low lung function and poor asthma 
      control.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Coverstone, Andrea M
AU  - Coverstone AM
AUID- ORCID: 0000-0002-9666-4885
AD  - Department of Pediatrics, Washington University School of Medicine in Saint 
      Louis, St. Louis, Missouri.
FAU - Bacharier, Leonard B
AU  - Bacharier LB
AD  - Department of Pediatrics, Washington University School of Medicine in Saint 
      Louis, St. Louis, Missouri.
FAU - Wilson, Bradley S
AU  - Wilson BS
AD  - Department of Ophthalmology and Visual Sciences, Washington University School of 
      Medicine in Saint Louis, St. Louis, Missouri.
FAU - Fitzpatrick, Anne M
AU  - Fitzpatrick AM
AD  - Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
FAU - Teague, William Gerald
AU  - Teague WG
AD  - Department of Pediatrics, University of Virginia School of Medicine, 
      Charlottesville, Virginia.
FAU - Phipatanakul, Wanda
AU  - Phipatanakul W
AD  - Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, 
      Boston, Massachusetts.
FAU - Wenzel, Sally E
AU  - Wenzel SE
AD  - Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, 
      Pennsylvania.
FAU - Gaston, Benjamin M
AU  - Gaston BM
AD  - Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western 
      Reserve University, Cleveland, Ohio.
FAU - Bleecker, Eugene R
AU  - Bleecker ER
AD  - Department of Medicine, University of Arizona, Tucson, Arizona.
FAU - Moore, Wendy C
AU  - Moore WC
AD  - Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, 
      North Carolina.
FAU - Ramratnam, Sima
AU  - Ramratnam S
AD  - Department of Pediatrics, University of Wisconsin School of Medicine, Madison, 
      Wisconsin.
FAU - Jarjour, Nizar N
AU  - Jarjour NN
AD  - Department of Medicine, University of Wisconsin School of Medicine, Madison, 
      Wisconsin.
FAU - Ly, Ngoc P
AU  - Ly NP
AD  - Department of Pediatrics, University of California, San Francisco, San Francisco, 
      California.
FAU - Fahy, John V
AU  - Fahy JV
AD  - Department of Medicine, University of California, San Francisco, San Francisco, 
      California.
FAU - Mauger, David T
AU  - Mauger DT
AD  - Department of Public Health Sciences, Pennsylvania State University, Hershey, 
      Pennsylvania.
FAU - Schechtman, Kenneth B
AU  - Schechtman KB
AD  - Department of Medicine, Washington University School of Medicine in Saint Louis, 
      St. Louis, Missouri.
FAU - Yin-DeClue, Huiqing
AU  - Yin-DeClue H
AD  - Department of Medicine, Washington University School of Medicine in Saint Louis, 
      St. Louis, Missouri.
FAU - Boomer, Jonathan S
AU  - Boomer JS
AD  - Department of Medicine, Washington University School of Medicine in Saint Louis, 
      St. Louis, Missouri.
FAU - Castro, Mario
AU  - Castro M
AD  - Department of Medicine, Washington University School of Medicine in Saint Louis, 
      St. Louis, Missouri.
LA  - eng
GR  - U10 HL109257/HL/NHLBI NIH HHS/United States
GR  - U10 HL109250/HL/NHLBI NIH HHS/United States
GR  - U10 HL109086/HL/NHLBI NIH HHS/United States
GR  - U10 HL109168/HL/NHLBI NIH HHS/United States
GR  - 5UL1 TR000448/TR/NCATS NIH HHS/United States
GR  - U10 HL109172/HL/NHLBI NIH HHS/United States
GR  - U10 HL109164/HL/NHLBI NIH HHS/United States
GR  - UL1 TR000448/TR/NCATS NIH HHS/United States
GR  - UL1 TR002345/TR/NCATS NIH HHS/United States
GR  - U10 HL109152/HL/NHLBI NIH HHS/United States
GR  - U10 HL109146/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20190819
PL  - United States
TA  - Pediatr Pulmonol
JT  - Pediatric pulmonology
JID - 8510590
RN  - 0 (Bronchodilator Agents)
RN  - 31C4KY9ESH (Nitric Oxide)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - QF8SVZ843E (Albuterol)
SB  - IM
MH  - Adolescent
MH  - Albuterol/*administration & dosage/pharmacology
MH  - Asthma/*drug therapy/physiopathology
MH  - Breath Tests
MH  - Bronchodilator Agents/*administration & dosage/pharmacology
MH  - Child
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Forced Expiratory Volume/*drug effects
MH  - Humans
MH  - Immunoglobulin E
MH  - Lung/physiopathology
MH  - Male
MH  - Nitric Oxide/analysis
MH  - Odds Ratio
MH  - Patient Acuity
MH  - Phenotype
MH  - Spirometry
PMC - PMC7015037
MID - NIHMS1061516
OTO - NOTNLM
OT  - asthma
OT  - bronchodilator response
OT  - pediatrics
EDAT- 2019/08/20 06:00
MHDA- 2020/04/23 06:00
PMCR- 2020/11/01
CRDT- 2019/08/20 06:00
PHST- 2019/01/29 00:00 [received]
PHST- 2019/07/12 00:00 [accepted]
PHST- 2019/08/20 06:00 [pubmed]
PHST- 2020/04/23 06:00 [medline]
PHST- 2019/08/20 06:00 [entrez]
PHST- 2020/11/01 00:00 [pmc-release]
AID - 10.1002/ppul.24473 [doi]
PST - ppublish
SO  - Pediatr Pulmonol. 2019 Nov;54(11):1694-1703. doi: 10.1002/ppul.24473. Epub 2019 
      Aug 19.