Long-term outcomes in pediatric asthma - a Twitter summary from the 2012 WSAAI meeting

This summary was compiled from the tweets posted by @MatthewBowdish, an allergist/immunologist, who attended the 2012 Western Society of Allergy, Asthma and Immunology (WSAAI) meeting. The tweets were labeled #WSAAI. The text was edited and modified by me.

Long-term outcome in pediatric asthma

Fernando Martinez discussed long-term outcomes in asthma:

Asthma is a “developmental disease” - children who develop symptoms before age 3 are more likely to develop persistent asthma.

Modified Asthma Predictive Index (mAPI) (click to enlarge the image):

A positive mAPI greatly increased future asthma probability (eg, 30% pretest probability to 90% posttest probability) http://buff.ly/ZJfMgQ

What makes a child a transient or persistent wheezer?

Prognosis for wheeze (even severe) in 1st year of life is generally good. Children who continue to wheeze as they age obviously have worse long-term prognosis (persistent wheezers are “worse” than later-onset wheezers).

A 2012 study described 2 "new" phenotypes for young children with wheezing: "boys atopic multiple-trigger" and "girls nonatopic uncontrolled wheeze". JACI, 2012.

Most of the lung function loss in patients at age 26 happens in the first 6 years of life. There is already evidence of airway remodeling by age 3! Level of lung function at age 2 months is the strongest predictor of lung function in the 20s.

Almost all “true” asthma diagnosed between ages 16-22 years occurs in females, and most of them had cold air BHR at age 6.

One of the greatest predictors of asthma symptoms by age 6 is RV infection in the first 3 years of life.

Low Th1 genes and IFN gene expression families lead to greater airflow limitation. Thus, alteration in innate immune responses is associated with increase in asthma.

Gene-environment interactions are becoming more important in our explanations of asthma phenotypes.

The well-known 'united airways' concept implies that patients with allergic rhinitis have a higher risk of developing asthma.

This summary was compiled from some of the tweets posted by @MatthewBowdish . The tweets were labeled #WSAAI and they reached more than 3,000 people. I would strongly encourage you to post updates on Twitter from the CME conferences that you are planning to attend in the future. Here is how to do it: Twitter for Physicians: How to use Twitter to keep track of the latest news and scientific meetings, and share information with colleagues and patients.

Disclaimer: The text was edited, modified, and added to by me.

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