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Airway inflammation, lung function and wheezing phenotypes in preschool children

Kim D.G. van de Kant, Maran Jansen, Ester M.M. Klaassen, Chris P. van der Grinten, Ger T. Rijkers, Jean W.M. Muris, Onno C.P. van Schayck, Quirijn Jobsis, Edward Dompeling
European Respiratory Journal 2011 38: 1409; DOI:
Kim D.G. van de Kant
1Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, Netherlands
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Maran Jansen
1Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, Netherlands
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Ester M.M. Klaassen
1Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, Netherlands
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Chris P. van der Grinten
2Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
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Ger T. Rijkers
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Jean W.M. Muris
5General Practice, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, Netherlands
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Onno C.P. van Schayck
5General Practice, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, Netherlands
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Quirijn Jobsis
1Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, Netherlands
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Edward Dompeling
1Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, Netherlands
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Abstract

Background: Wheeze is a common symptom in preschool children. Currently, it is difficult to predict whether wheezing symptoms will pass or will persist and develop into asthma in later childhood.

Aim: To prospectively study whether inflammatory markers in exhaled breath condensate (EBC) and pre- and post-bronchodilator interrupter resistance (Rint) assessed at preschool age, are able to predict wheezing phenotypes at five years of age.

Methods: Children (N=227) from the ADEM study [1] were included. At preschool age (median (IQR): 3.3 (2.8-3.8) years), pre- and post bronchodilator Rint was assessed. EBC was collected using a closed-glass condenser system. Inflammatory markers ((Interleukin (IL)-2, IL-4, IL-8, IL-10, sICAM) were measured using multiplex immunoassay. Wheezing phenotypes were determined at five years of age via annual questionnaires.

Results: Children were classified as; never- (n=47), early-transient- (n=89), intermittent- (n=46), and persistent wheezers (n=45) [2,3]. Children with persistent- and intermittent wheeze had elevated levels of all interleukins compared with never wheezers (p<0.05). Moreover, children in the never- and transient wheeze group had slightly lower levels of baseline Rint compared with persistent wheezers (Median (IQR) 1.3 (1.1-1.7) and 1.4 (1.2-1.6) vs. 1.5 (1.3-1.9) kPa·s/L, p<0.10).

Conclusions: Children of the intermittent- and persistent wheeze group at age 5 years already had elevated inflammatory markers at preschool age, indicating augmented airway inflammation in these children.

References:

  • 1. van de Kant et al. BMC Public Health 2009; 9:210.

  • 2. Martinez FD et al. N Engl J Med 1995; 332:133-8.

  • 3. Sears MR et al. N Engl J Med 2003; 349:1414-22.

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    Airway inflammation, lung function and wheezing phenotypes in preschool children
    Kim D.G. van de Kant, Maran Jansen, Ester M.M. Klaassen, Chris P. van der Grinten, Ger T. Rijkers, Jean W.M. Muris, Onno C.P. van Schayck, Quirijn Jobsis, Edward Dompeling
    European Respiratory Journal Sep 2011, 38 (Suppl 55) 1409;

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    Airway inflammation, lung function and wheezing phenotypes in preschool children
    Kim D.G. van de Kant, Maran Jansen, Ester M.M. Klaassen, Chris P. van der Grinten, Ger T. Rijkers, Jean W.M. Muris, Onno C.P. van Schayck, Quirijn Jobsis, Edward Dompeling
    European Respiratory Journal Sep 2011, 38 (Suppl 55) 1409;
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