PT  - JOURNAL ARTICLE
AU  - Elpis Hatziagorou
AU  - Fotis Kirvassilis
AU  - Vasiliki Avramidou
AU  - Ilektra Touliou
AU  - John Tsanakas
TI  - Pulmonary function and inflammation discriminated by symptom-pattern phenotypes in preschool wheezers
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P4095
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P4095.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P4095.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Background: The discrimination of episodic and multiple-trigger wheezing is commonly used among preschoolers with wheeze. However, symptom-patterns of wheeze have not been related to pulmonary function tests or markers of airway inflammation.Objective: We investigated whether multiple-trigger wheezers were more likely to have abnormal FEV1, increased ventilation inhomogeneity (LCI) and increased fraction of exhaled nitric oxide (FeNO) than episodic wheezers. We also investigated whether multiple-trigger wheezers were more likely to have a positive reversibility test, than episodic wheezers.Methods: FeNO, LCI and FEV1 were measured in healthy children and those with recurrent wheeze aged 4 to 6 years.Results: Twenty-six control subjects and 25 wheezers (11 episodic and 14 multiple-trigger wheezers) were tested. FEV1 FeNO and LCI did not differ significantly among wheezers and healthy preschoolers. On average, LCI was abnormal in 18 wheezers (72%). Multiple-trigger wheezers had an average increase of 3. 1% (P < .0001) in LCI, compared with episodic wheezers. FEV1 and FeNO did not differ significantly among episodic and multiple trigger wheezers. The presence of current atopy was associated with higher FeNO (p =0,024) but did not influence pulmonary function and LCI significantly. Eight out of the 25 (32%) wheezers showed a significant increase in FEV1 and 15 out of the 25 (60%) wheezers showed a significant decrease in LCI, after administration of inhaled salbutamol.Conclusions: Multiple-trigger wheeze is associated with pulmonary function abnormalities independent of atopic status. LCI is the most sensitive indicator of abnormal pulmonary function in preschool wheezers.