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.
- © 2011 ERS
