Childhood measles contributes to post-bronchodilator airflow obstruction in middle-aged adults: A cohort study.

2018-03-20

Perret, Jennifer L

Matheson, Melanie C

Gurrin, Lyle C

Johns, David P

Burgess, John A

Thompson, Bruce R

Lowe, Adrian J

Markos, James

Morrison, Stephen S

McDonald, Christine F

Wood-Baker, Richard

Svanes, Cecilie

Thomas, Paul S

Hopper, John L

Giles, Graham G

Abramson, Michael J

Walters, E Haydn

Dharmage, Shyamali C

asthma-COPD overlap

childhood measles

current adult asthma

interaction

smoking

Journal Article

0000-0001-7034-0615

0000-0002-1575-6850

0000-0001-6481-3391

0000-0002-9954-0538

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10.1111/resp.13297

Chronic obstructive pulmonary disease (COPD) has potential origins in childhood but an association between childhood measles and post-bronchodilator (BD) airflow obstruction (AO) has not yet been shown. We investigated whether childhood measles contributed to post-BD AO through interactions with asthma and/or smoking in a non-immunized middle-aged population. The population-based Tasmanian Longitudinal Health Study (TAHS) cohort born in 1961 (n = 8583) underwent spirometry in 1968 before immunization was introduced. A history of childhood measles infection was obtained from school medical records. During the fifth decade follow-up (n = 5729 responses), a subgroup underwent further lung function measurements (n = 1389). Relevant main associations and interactions by asthma and/or smoking on post-BD forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC; continuous variable) and AO (FEV1/FVC < lower limit of normal) were estimated by multiple regression. Sixty-nine percent (n = 950) had a history of childhood measles. Childhood measles augmented the combined adverse effect of current clinical asthma and smoking at least 10 pack-years on post-BD FEV1/FVC ratio in middle age (z-score: -0.70 (95% CI: -1.1 to -0.3) vs -1.36 (-1.6 to -1.1), three-way interaction: P = 0.009), especially for those with childhood-onset asthma. For never- and ever-smokers of <10 pack-years who had current asthma symptoms, compared with those without childhood measles, paradoxically, the odds for post-BD AO was not significant in the presence of childhood measles (OR: 12.0 (95% CI: 3.4-42) vs 2.17 (0.9-5.3)). Childhood measles infection appears to compound the associations between smoking, current asthma and post-BD AO. Differences between asthma subgroups provide further insight into the complex aetiology of obstructive lung diseases for middle-aged adults.

link

Respirology 2018; 23(8): 780-787

Respirology