Abstract
It is unclear why some children with persistent wheeze continue wheezing into adulthood whilst in other subjects wheezing subsides. To assess this the Isle of Wight Birth Cohort (n=1,456) was reviewed at 1, 2, 4, 10 and 18-years with recording of current wheeze at each visit. At 10-years, 4 wheeze phenotypes were defined. Persistent-Wheezers (PW) wheezed in the first 4 years of life and at 10-years (n = 125). We have previously shown that this group suffered significantly in childhood. We studied them further at 18-years and compared those in this group who were still wheezing (n = 72) versus those who were not (n =53) to identify factors associated with ongoing disease in PW.
The results showed that those still wheezing at 18 were more likely to be atopic (74% vs 36% p=0.001) and have rhinitis (76% vs 36.2% p<0.001) at 18, be female (56% vs 25.5% p =0.001), be diagnosed with asthma aged 10 (84% vs 68% p=0.042) and 18 (95% vs 6.5% p<0.001).They were less likely to have smoke exposure at 4 (43% vs 63% p=0.036) and 10 (41% vs 61% p=0.049) years but had comparable personal smoking prevalence at 18 and cumulative tobacco exposure over the first 18 years of life. They showed higher levels of exhaled nitric oxide (mean Log10 1.6 vs 1.4 p=0.028) at 18 plus bronchial hyper reactivity (log10 DRS+10) at 10 (1.9 vs 1.5 p=0.003) and at 18 (1.4 vs 1.1 p=0.001).
The persistence of PW from childhood into young adulthood is associated with clearly identifiable factors which could help flag up the risk of ongoing disease into adulthood. Whether addressing these factors in childhood can reduce the burden of ongoing disease into adulthood is a matter for future research focus.
- Copyright ©the authors 2016
