PT  - JOURNAL ARTICLE
AU  - Ramette, Alban
AU  - Spycher, Ben
AU  - Beardsmore, Caroline
AU  - Kuehni, Claudia
TI  - Causal relationships between infections and asthma throughout childhood: A path analysis approach
AID  - 10.1183/13993003.congress-2015.PA4512
DP  - 2015 Sep 01
TA  - European Respiratory Journal
PG  - PA4512
VI  - 46
IP  - suppl 59
4099  - https://publications.ersnet.org//content/46/suppl_59/PA4512.short
4100  - https://publications.ersnet.org//content/46/suppl_59/PA4512.full
SO  - Eur Respir J2015 Sep 01; 46
AB  - Introduction: Preschool wheeze is closely associated with respiratory infections, but it remains unclear how frequent preschool infections affect the risk of school-age asthma. Using path analysis, we explored causal relationships between asthma and infections in a cohort study.Methods: Respiratory symptoms were assessed by parental questionnaires in 1990, 1993, and 1998 in a population-based cohort study. Using path analysis we estimated temporal associations between infections and asthma at ages 0-5, 3-8 and 8-13 years. For each survey, we computed indicator scores for infection and asthma/wheezing illness, summarizing parental answers to all questions related to these dimensions.Results: We included 442 children who participated in all surveys. The final selected model (Fig. 1) indicated that asthma at school age originates from a balanced influence of i) current infections and ii) earlier asthma episodes. Preschool asthma was strongly associated with concurrent infections. We found no evidence of a direct effect of earlier infection on asthma at school age. Conclusion: Our findings suggest that school-age asthma is directly influenced by asthma history and indirectly by earlier infections episodes. We found no support for a protective effect of preschool infections on later asthma.Funding: SNF32003B-144068; SNF PDFMP3 137033; Asthma UK 07/048.