Abstract
Background: We previously showed an association between neonatal bacterial airway colonization and increased risk of asthma in the first 5 years of life, suggesting an airway bacteria colonization-associated childhood asthma endotype.
Aims and objectives: To study the long-term trajectory of the colonization-associated childhood asthma endotype.
Methods: We investigated the association between airway colonization with S. pneumoniae, H. influenzae, and/or M. catarrhalis in one-month-old neonates from the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2000) mother-child cohort and development of asthma endpoints until age 18 years. Analyses were done with repeated measurement generalized estimating equations (GEE).
Results: Neonatal airway colonization was present in 66 (21%) of 319 children and was associated with an overall increased risk of asthma (GEE adjusted odds ratio, 4.01 (95% CI, 1.76-9.12, p<0.001)) and increased number of exacerbations the first 7 years of life (adjusted incidence rate ratio, 3.20 (95% CI, 1.38-7.44, 0<0.01)), but not from age 7 to 18 years. In colonized children, blood eosinophils were increased from age 6 months to 12 years (GEE adjusted geometric mean ratio, 1.24 (95% CI, 1.06-1.44), p<0.01), but not at age 18 years. There were no significant associations with lung function, bronchial reactivity, atopic dermatitis or other asthma and allergy-related endpoints.
Conclusions: Neonatal airway colonization is associated with a particular endotype characterized by early-onset asthma, exacerbations, and elevated blood eosinophils, which is most prominent in early childhood, thereafter diminishing, and is no longer evident by age 18 years.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 4348.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2022