• Family History Plays Role in Child’s Airway Constriction
Children with asthma whose fathers have a history of the disease are at significantly greater risk for serious airway constriction than children whose fathers have no such history, according to an article published in the September 1, 2005, issue of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine.

Reporting the results of a 5-year study, Benjamin A. Raby, MD, MPH, along with five associates from the Channing Laboratory at Brigham and Women’s Hospital in Boston, said that paternal asthma was strongly associated with childhood airway hyperresponsiveness (AHR), an exaggerated constricting response to various stimuli that characterizes asthma. “Among individuals with asthma, AHR is directly correlated with pulmonary symptoms and disease severity,” Raby said. “It is also an important determinant of long-term outcome, not only with respect to asthma symptoms, but also to airway growth and maturation, as well as lung function decline.”

• Inhaled Corticosteroids Benefit COPD Patients
Researchers involved in two different studies designed to reduce potentially biased results among chronic obstructive pulmonary disease (COPD) patients who used inhaled corticosteroids (ICS) reported a 30% reduction in risk for either rehospitalization or death from the disease. Writing in the August 15, 2005, issue of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine, Joan B. Soriano, MD, PhD, of Worldwide Epidemiology at GlaxoSmithKline Research and Development in Collegeville, Pa, along with three associates, described the effectiveness of inhaled corticosteroids for reducing rehospitalization and mortality, using the United Kingdom’s General Practice Research Database. “With different study designs reducing potential bias, we consistently found an association between ICS use and the reduction of risk of rehospitalization and death,” Soriano said.

In an editorial on the study in the same issue, Jonathan M. Samet, MD, of the Johns Hopkins Bloomberg School of Public Health in Baltimore, wrote: “This pair of endpoints (mortality and hospitalization) is particularly crucial to the evaluation of inhaled corticosteroids because a beneficial effect would indicate an improved natural history, the most crucial objective of therapy.” .

Drug Shows Promise for Treating Lung Disease
An anti-inflammatory drug called roflumilast could become a new therapeutic strategy for patients with chronic obstructive pulmonary disease (COPD), according to the results of a randomized trial, published in the August 13 issue of The Lancet. The researchers found that roflumilast improved lung function and reduced worsening of respiratory symptoms when compared with placebo. They also found that patients using the drug had greater improvements in health-related quality of life than those assigned the placebo.

Klaus Rabe, MD, lead author of the study and chairman of the Department of Pulmonology at Leiden University in The Netherlands, concluded that “roflumilast was effective in improving lung function and reducing exacerbations in a population of patients with moderate to severe COPD. The phosphodiesterase-4 inhibitor class shows promise as a new therapeutic strategy for patients with COPD.”

Kids With SDB Benefit From Nonsurgical Treatment
An oral therapy has proved a viable alternative to the removal of tonsils and adenoids in children with sleep-disordered breathing (SDB).

In a 16-week study involving 24 young children, researchers employed montelukast, an anti-inflammatory agent used to treat asthma and allergic rhinitis. They found that the oral therapy significantly reduced the children’s adenoid size, as well as decreased their respiratory sleep disturbances. Writing in the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine, David Gozal, MD, along with three associates from Kosair Children’s Hospital Research Institute at the University of Louisville in Kentucky, pointed out that the major concept emanating from this study supports the existence of a chronic inflammatory process in children with SDB.

Childhood Cancers Linked to Air Pollution
Children living in areas with higher concentrations of engine exhaust emission and close to an emissions source were 12 times as likely to die from cancer, according to recent findings.

In a study published in the Journal of Epidemiology and Community Health, the postal addresses of 22,500 children who died of cancer in Britain between 1955 and 1980 were linked to emissions hot spots for specific chemicals. These locations were identified from published maps of atmospheric pollution levels. The combination of living in a hot spot and close to an emissions source, such as a bus or coach station, put children at greatest risk. Researchers found the chemicals 1.3-butadiene and carbon monoxide to be among the primary culprits.

Counseling Does Not Help Pregnant Smokers Quit
Motivational interviewing by specially trained midwives does not help pregnant smokers quit, according to research reported in the August 13 issue of the British Medical Journal. One third of pregnant women smoke, and current guidelines recommend that they be offered intensive support to help them quit. Motivational interviewing—a one-to-one counseling style designed for treating addictions—is widely taught on smoking cessation training courses, but may not apply during pregnancy.

Viagra Ingredient Shows Hope for Treating PAH
Sildenafil citrate, the active ingredient in Viagra®, may prove helpful in treating children with pulmonary arterial hypertension (PAH), according to an article published on August 29 in The Wall Street Journal. Marketed by New York-based Pfizer Inc as Revatio™, sildenafil citrate is currently approved for treating PAH in adults. Pfizer is now researching whether the drug can be used to treat children with the disorder.

Characterized by dangerously high pressure in the blood vessels that lead from the heart to the lungs, PAH can cause difficulty breathing, dizziness, and fatigue. According to the article, early tests of the drug “helped ill children increase by about 60% the distance they could walk in 6 minutes.”