Abstract
The functional outcome in preschool severe wheezers with eosinophilic airway inflammation and increased reticular basement membrane (RBM) thickness is unknown. We investigated the relationship between airway pathology at age 2 y and lung function at age 4–6 y in previous severe wheezers.
Severe wheezers previously investigated with endobronchial biopsy, and healthy children aged 4–6 y were recruited. Lung clearance index (LCI), conducting zone ventilation inhomogeneity (Scond), acinar ventilation inhomogeneity by multiple-breath washout; plethysmographic specific airways resistance, and FeNO were measured. Lung function was compared between wheezers and healthy controls, and in wheezers correlated with past RBM thickness and mucosal eosinophilia (EG2+ cells).
Seventy-two healthy controls and 28 previous severe wheezers were tested. Wheezers had significantly higher median LCI (6.8 vs. 6.6; p=0.001) and Scond (0.046 vs. 0.016; p<0.0005) than healthy controls. Past RBM thickness (r=0.474, p=0.047) and EG2+ cells (r=0.552, p=0.041) showed significant correlations with current FeNO, but no correlations were seen between past RBM thickness and current lung function.
RBM thickness and EG2+ cells at age 2 y show a significant positive association with FeNO at age 5 y. Although lung function was abnormal at age 5 y in severe wheezers, this did not correlate with past RBM thickness.
- ERS