Early Illness Plus Sensitization May Spell Trouble for Lungs

Medscape

09-06-2025

Sensitization by age 2 years to an allergen such as cow's milk, egg white, peanut, cat dander, or dust mites may influence how early-life respiratory tract infections affect lung function in adulthood, new research showed. Among sensitized children, each additional month of respiratory tract infection in the first 2 years of life was associated with poorer lung function at age 25 years.
METHODOLOGY:
Researchers analyzed data from a prospective cohort study in Australia that recruited 620 infants (51.1% boys) born between 1990 and 1994 who had at least one parent or sibling with self-reported allergic disease, including asthma.
Parents answered questions until the children were 2 years old about how often their child had had a cough, rattle, or wheeze in the past month.
Skin prick testing was used to determine allergic sensitization at age 2 years.
When participants were 18 and 25 years old, the researchers assessed lung function using spirometry.
TAKEAWAY:
At age 25 years among the participants with sensitization, each additional month of respiratory tract infection early in life was associated with a decrease in the forced expiratory volume in 1 second (Z-score, -0.06; P = .055).
= .055). Among nonsensitized participants, each additional month of respiratory illness was associated with an increase in lung function (Z-score, 0.07; P = .012).
= .012). Findings were similar at age 18 years and for other measures of lung function, but there was less evidence of an interaction at age 12 years.
IN PRACTICE:
'Even in the absence of reported chronic respiratory symptoms, close monitoring and prevention of recurrent respiratory infections in children with sensitization may help minimize disease progression and functional impairment, and thereby enable attainment of optimal adult lung function,' the authors of the study wrote.
SOURCE:
Shyamali C. Dharmage, MD, PhD, with The University of Melbourne, Melbourne, Australia was the corresponding author of the study, which was published online on June 2 in Pediatric Allergy and Immunology.
LIMITATIONS:
The study relied on parent reports of respiratory tract infection. The researchers were unable to adjust for gestational age or birthweight because of missing data. Sensitization was assessed against a limited number of allergens.
DISCLOSURES:
The authors reported having no conflicts of interest.