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Lung structure and function of infants with recurrent wheeze when asymptomatic

Depts of ¹ Paediatric Pulmonology and Critical Care, ³ Biostatistics and ⁴ Radiology, Indiana University Medical Center, Indianapolis, IN, USA, ² Dept of Paediatric Pulmonology, Hospital del Niño Jesús, Faculty of Medicine, National University of Tucumán, Tucumán, Argentina, ⁵ Dept of Radiology, Vancouver General Hospital, and ⁶ James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada.

CORRESPONDENCE: R. S. Tepper, Dept of Paediatrics, Section of Paediatric Pulmonology, James Whitcomb Riley Hospital for Children, 702 Barnhill Drive, Room 4270, Indianapolis, IN 46202, USA. Fax: 1 3172745791. E-mail: rtepper{at}iupui.edu

Keywords: Airway structure, infants, lung function, lung tissue density

Received: August 14, 2007
Accepted August 4, 2008

Infants with recurrent wheeze have repeated episodes of airways obstruction; however, relatively little is known about the structure and function of their lungs when not symptomatic. The current authors evaluated whether infants with recurrent wheeze have smaller airway lumens or thickened airway walls, as well as decreased airway function.

High-resolution computed tomography images 1 mm thick were obtained at three anatomic locations at an elevated lung volume and at functional residual capacity. Forced expiratory flows were also measured in subjects with recurrent wheeze.

Airway lumen, wall areas and lung tissue density were not significantly different for recurrent wheeze (n = 17) and control (n = 14) subjects; however, subjects with recurrent wheeze had lower forced expiratory flows than predicted. Similar findings were obtained when subjects were grouped by exposure to tobacco smoke.

These findings indicate that infants with recurrent wheeze, as well as exposure to tobacco smoke, have lower airway function when not symptomatic. The lower forced expiratory flows may result from a degree of airway narrowing that could not be resolved with the methodology employed or from other mechanisms, such as more collapsible airways or decreased pulmonary elastic recoil.