American Thoracic Society Journal news tips for October (second issue)

November 08, 2001

Future SIDS victims show more frequent airway obstruction

Future victims of SIDS, mostly boys, demonstrated more frequent episodes of airway obstruction during a sleep test and showed less decrease in obstructive sleep apnea as they aged than did normal babies. SIDS is the sudden death of an infant younger than 1 year of age that remains unexplained after a thorough case investigation which includes a complete autopsy, examination of the death scene, and review of the baby's clinical history. In 1998, the problem caused the death of 2,529 babies in the U.S. In this study, researchers in Belgium, using sleep test results, compared the breathing characteristics of 40 infants who subsequently died of SIDS within days or weeks with those of 607 healthy babies. The children, who were between the ages of 2 and 19 weeks at the time of the sleep laboratory study, were matched by sex and age with the controls. All polygraphic studies were performed using the same standard protocol. Data from this research showed that episodes of breathing cessation (apneas) did not exceed 15 seconds in the infants. Breathing stoppage was rare in the 607 healthy control infants, but was found significantly more often in the 40 infants who subsequently died of SIDS. Also, the decrease in the frequency of apneic episodes as the babies grew older was smaller in the SIDS infants. The study appears in the second of two October issues of the ATS peer-reviewed American Journal of Respiratory and Critical Care Medicine.

COPD patients' siblings who smoke have a high probability of airway obstruction

Siblings who smoke showed a significant risk of airflow obstruction if their parents suffer from severe COPD, an illness that usually manifests itself as both bronchitis and severe emphysema. A slowly progressive lung disease characterized by gradual loss of lung function, COPD is caused primarily by smoking in the U.S. and throughout most of the developed world. British researchers demonstrated that 44 (34.9 percent) of 126 current or ex-smoking siblings of COPD patients had airflow obstruction in keeping with COPD. In addition, 36 of the siblings also had forced expiratory volume in 1 second lung function test results of less than 80 percent of the predicted value, which was also in keeping with COPD. In another part of the research, 111 current or ex-smoking siblings were matched for age, sex, and smoking history with 419 control subjects who had no known history of COPD. The prevalence of COPD in the sibling group was 31.5 percent in contrast with 9.3 percent for the control subjects. According to the author, one- quarter of the siblings who completed the ATS questionnaire and had a simple lung function test were non-smokers. They showed essentially normal lung function, which reinforced the "clear message that irreversible airflow obstruction is linked to tobacco smoking." The research is published in the second of two October issues of the ATS-peer reviewed American Journal of Respiratory and Critical Care Medicine.

Anti-IgE clinical trials confirm effective treatment for allergic asthma

Phase II and Phase III clinical trial results for anti-immunoglobulin E (IgE) monoclonal antibody confirm that it is an effective treatment for patients with symptomatic moderate to severe allergic asthma, according to an expert writing in the second issue for October of the ATS peer-reviewed journal. William W. Busse, M.D., Professor of Medicine, University of Wisconsin Medical School, Madison, points out that the clinical trials have shown that the administration of the anti-IgE, called omalizumab, is associated with fewer asthma exacerbations per patient despite a significant reduction in their corticosteroid dose. Also, the new compound has provided stable symptom control in spite of reductions in rescue-medication use, and has upgraded the quality of life scores of patients as compared with those on placebo. According to Dr. Busse, IgE-mediated events play an important role in the inflammatory processes that are believed to underlie the symptoms of allergic asthma. A highly specific monoclonal antibody was developed that binds to circulating IgE and prevents it from making contact with receptors on effector cells. About the clinical studies of this anti-IgE, Dr. Busse said: "Collectively, these results provide convincing evidence that omalizumab is efficacious and safe for the treatment of asthma." The article appears in the second issue for October of the ATS peer-reviewed American Journal of Respiratory and Critical Care Medicine.
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For the complete text of articles, please see the ATS Journal Online Website at http://www.atsjournals.org For contact information on a specific investigator, to request a complimentary journalist subscription to ATS journals online, or if you would like additional details from postal or e-mail news releases provided only to journalists, contact Cathy Carlomagno at 212-315-6442 or by e-mail at ccarlomagno@thoracic.org

American Thoracic Society

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