September 16, 2017

Early Life Respiratory Infections Give Rise to Lung Dysfunction Later in Life

By Alex Morrisson

MILAN, Italy -- September 16, 2017 -- Children who contract respiratory tract infections when they are young appear to have a greater risk of developing lung dysfunction and asthma later in life, according to a study presented at the 2017 International Congress of the European Respiratory Society (ERS).

Evelien van Meel, MD, Erasmus University Medical Centre, Rotterdam, the Netherlands, and colleagues reviewed long-term outcomes of 154,942 European children and found that those who had had upper respiratory infections, such as colds, sinusitis, laryngitis, tonsillitis, pharyngitis, and otitis by age 5 had a 1.5-fold increased risk of developing asthma in later life.

In addition, children who had suffered from lower respiratory tract infections, such as bronchitis, bronchiolitis, pneumonia, and general chest infections had a 2-fold to 4-fold increased risk of developing asthma in later life and were also more likely to have worse lung function.

“These findings support the hypothesis that early-life respiratory tract infections may influence the development of respiratory illnesses in the longer term,” said Dr. van Meel. “In particular, lower respiratory tract infections in early life seem to have the greatest adverse effect on lung function and the risk of asthma.”

“However, at this stage we cannot say for certain whether the relationship is causal,” she added. “Further studies that measure lung function and wheezing from birth onwards are needed to explore whether the infections cause asthma and lower lung function, or whether wheezing and lower lung function may be predisposing these children to develop the infections. Studies that aim to prevent or treat respiratory tract infections at an early stage -- perhaps by vaccination -- would also help to shed light on this.”

The researchers scrutinised reports collected on 37 groups of children who were born between 1989 and 2013. Children were included in the meta-analysis if data were available on respiratory tract infections in early life (from age 6 months to 5 years).

The researchers adjusted their analysis to take account of factors that could affect the results, such as socio-economic status, lifestyle, birth weight, gestational age at birth, gender, age, height, and ethnicity.

Upper respiratory tract infections were not associated with worse lung function in later life. However, lower respiratory tract infections at almost all ages were associated with worse lung function, as indicated by lower scores for several lung function tests.

[Presentation title: Early-Life Respiratory Tract Infections and the Risk of Lower Lung Function and Asthma: a Meta-Analysis of 154,492 Children. Abstract OA499]

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