January 2011

Winter Bulletin Online Now
The Winter edition of our Section Bulletin is online now. Check it out for great articles on bronchial thermoplasy and impulse oscillometry in the pediatric lab, plus a review of the section meeting at the AARC Congress by our new chair, Matthew O’Brien, and a profile of our 2010 Specialty Practitioner of the Year.

Lung Function in Symptomatic Infants: What’s Going On at Age Three?
A new study out of Finland looks at the associations between early lung function, airway histology, and inflammation in symptomatic infants who were first assessed at age one and then followed up at age three. Among the 50 children in the study, 40 had ongoing airway symptoms. Inhaled corticosteroids (ICS) were used regularly by 31 (62%) and intermittently by 12 (24%). Reduced lung function was seen in 11 out of 39 (28%) who underwent successful oscillometry. Ongoing airway symptoms were linked to abnormal lung function at infancy and with the purchase of both ICS and beta agonists. A significant correlation was seen between the amount of ICS purchased at age three and reticular basement membrane thickness in infancy and the number of mucosal mast cells, but not with eosinophils. The study appeared in the Jan. 2 Epub edition of Thorax. READ ABSTRACT

Indoor NO2 Linked to Worsening Asthma
Higher levels of indoor nitrogen dioxide (NO2) may be affecting children with asthma, report New Zealand investigators publishing in the Dec. 22 Epub edition of the European Respiratory Journal. They examined NO2 levels and their impact on pediatric asthma in 409 households taking part in a randomized community trial. Results linked greater daily reports of lower and upper respiratory tract symptoms, more frequent cough and wheeze, more frequent reliever use during the day, and a decrease in morning and evening FEV1 readings with higher indoor NO2 levels. However, use of preventer medication was not affected. No association was seen between outdoor NO2 levels and respiratory tract symptoms, asthma symptoms, medication use, or lung function measures. The authors conclude, “These findings indicate that reducing NO2 exposure indoors is important in improving the respiratory health of children with asthma.” READ ABSTRACT

No Correlation Seen Between PFT Variables and Invasive Hemodynamic Measurements of PAH
Mayo Clinic researchers who set out to determine whether the relationship between the DLCO and pulmonary arterial pressures can be strengthened by normalizing the DLCO to spirometric variables find invasive hemodynamic measurements of pulmonary arterial hypertension (PAH) do not correlate with PFT variables, even when corrected for spirometric volumes, and regardless of the subgroup of ventilatory physiology or clinical diagnosis. The study was carried out in 138 patients who had undergone right heart catheterization for the evaluation of suspected PAH and for whom complete PFTs were available. The research appears in this month’s Clinical Respiratory Journal. READ ABSTRACT

Asthma in Obese May Have Different Phenotype Based on FENO Levels
Do obese asthma patients have a different phenotype of asthma that can be assessed by the fraction of exhaled nitric oxide (FENO)? That’s the question Swedish researchers asked in a study involving 2187 men and women age 25-74 who were participating in a randomly selected study. Results showed an association between wheezing and raised FENO and atopy in non-obese subjects, while obese subjects with wheezing had lower FENO than obese subjects without wheezing. Obese subjects with and without wheezing had similar prevalence of atopy. The authors conclude, “Wheezing was significantly associated with reduced FENO in obese subjects, whereas there was a positive association between wheezing and FENO among the non-obese, indicating a possible difference in asthma phenotype, based on body weight.” The study was published in the Dec. 23 Epub edition of CHEST. READ ABSTRACT