Asthma medications taken during infancy linked to stunted growth

Infants given asthma medications during their first 2 years of age are likely to be stunted in later life, according to research presented today at the 54th Annual European Society for Paediatric Endocrinology Meeting. The findings highlight the importance of using these medicines in infants appropriately.

Inhaled corticosteroids (ICS) – medications used to treat conditions such as asthma – are frequently used in infants with recurrent wheezing. However, these medications may have harmful effects, for instance a reduced growth rate in development and a shorter height in adulthood.

In this study, researchers from Kuopio University Hospital and University of Eastern Finland analysed information on the height, weight and asthma medicine intake of 12,482 Finnish children aged 0-24 months. The researchers found that children who used inhaled corticosteroids during the first 2 years of life were too short for their age. This result was more evident in children taking the asthma medicine budesonide for more than 6 months.

Many factors that alter development in children, such as chronic illnesses and long-term use of oral corticosteroids, may cause a shorter than normal height in adulthood. "Previously, the impact of corticosteroids on growth was looked at in older children and was thought to alter growth only temporarily," said lead researcher Dr Antti Saari. "However, studies on inhaled corticosteroid use in infants are practically lacking and thus this has been questioned in the recent study. Our research shows a link between long-term treatment of ICS during infancy and stunted growth at or after the age of 2 in otherwise healthy children."

The group will next focus on assessing the impact of inhaled corticosteroids on growth in older children and observe them for longer time periods. "According to our research, we could only assess the impact of inhaled corticosteroids on growth in infancy until 2 to 3 years of age. The longitudinal impact of these medications is not clear and we would therefore like to investigate this further," said Dr Saari.

Research identifies specific bacteria linked to indoor water-damage and mold

Bacterial contamination in water-damaged buildings has been identified as a potential cause of health problems, including infection and respiratory conditions like asthma. Which specific bacteria contribute to these problems, however, has been unknown -- making it difficult for public health officials to develop tools to effectively address the underlying source of the problem. In a new study, a University of Cincinnati (UC) environmental health research team found evidence linking two specific strains of bacteria -- Stenotrophomonas and Mycobacterium -- to indoor mold from water damage. The research is part of the U.S. Department of Housing and Urban Development's investment in research to protect the health of children from hazards in the home.

"If we are going to understand the role of indoor bacteria in human health, we must be able to identify and quantify the relevant bacterial species contributing to the health problems," says Atin Adhikari, PhD, assistant professor of environmental health at the UC College of Medicine and principal investigator of the study.

"The association between bacterial contamination and respiratory health has lagged behind mold studies because it is difficult to determine which species of bacteria are growing in homes and most of the bacterial species are non-culturable and not identified yet," adds Adhikari. "These new data will help us more accurately target and combat the bacteria and to explore synergistic health effects of bacteria and molds growing in water damaged homes."

The UC-based team will report its findings June 18, 2012, at the American Society for Microbiology meeting in San Francisco.

For this study, Adhikari and UC postdoctoral fellow Eric Kettleson, PhD, analyzed samples collected from 42 homes from the Cincinnati Childhood Allergy and Air Pollution Study, a National Institute of Environmental Health Sciences-funded project examining the long-term effects of environmental exposures on respiratory health and allergy development in children.

Included homes fell into one of two categories -- "high mold" or "low mold" -- based on previously reported environmental relative moldiness index (ERMI), a DNA-based mold level analysis tool developed by the U.S. Environmental Protection Agency (EPA) that combines results of the analysis of 36 different types of mold into one index to describe a home's cumulative mold burden.

The team then compared the ERMI values and types of bacteria found in both high- and low-mold homes in an effort to better understand the environmental sources and home characteristics that influence indoor bacterial contamination.

They found strong correlations between Mycobacterium and visible mold and also between Stenotrophomonas and environmental relative moldiness index.

"Stenotrophomonas maltophilia -- an emerging multidrug-resistant global opportunistic pathogen -- was isolated from numerous environmental sources. Surprisingly, it was never assessed quantitatively in indoor home environments -- especially in water damaged homes where this can be a real concern and may cause inhalation exposure risks to occupants.Stenotrophomonas maltophilia is the first bacterial species associated with higher ERMI values in homes," adds Kettleson.

Source: University of Cincinnati Academic Health