TY - JOUR T1 - The burden of severe asthma in childhood and adolescence: results from the paediatric U-BIOPRED cohorts JF - European Respiratory Journal JO - Eur Respir J SP - 1322 LP - 1333 DO - 10.1183/13993003.00780-2015 VL - 46 IS - 5 AU - Louise Fleming AU - Clare Murray AU - Aruna T. Bansal AU - Simone Hashimoto AU - Hans Bisgaard AU - Andrew Bush AU - Urs Frey AU - Gunilla Hedlin AU - Florian Singer AU - Wim M. van Aalderen AU - Nadja H. Vissing AU - Zaraquiza Zolkipli AU - Anna Selby AU - Stephen Fowler AU - Dominick Shaw AU - Kian Fan Chung AU - Ana R. Sousa AU - Scott Wagers AU - Julie Corfield AU - Ioannis Pandis AU - Anthony Rowe AU - Elena Formaggio AU - Peter J. Sterk AU - Graham Roberts Y1 - 2015/11/01 UR - http://erj.ersjournals.com/content/46/5/1322.abstract N2 - U-BIOPRED aims to characterise paediatric and adult severe asthma using conventional and innovative systems biology approaches.A total of 99 school-age children with severe asthma and 81 preschoolers with severe wheeze were compared with 49 school-age children with mild/moderate asthma and 53 preschoolers with mild/moderate wheeze in a cross-sectional study.Despite high-dose treatment, the severe cohorts had more severe exacerbations compared with the mild/moderate ones (annual medians: school-aged 3.0 versus 1.1, preschool 3.9 versus 1.8; p<0.001). Exhaled tobacco exposure was common in the severe wheeze cohort. Almost all participants in each cohort were atopic and had a normal body mass index. Asthma-related quality of life, as assessed by the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), was worse in the severe cohorts (mean±se school-age PAQLQ: 4.77±0.15 versus 5.80±0.19; preschool PACQLQ: 4.27±0.18 versus 6.04±0.18; both p≤0.001); however, mild/moderate cohorts also had significant morbidity. Impaired quality of life was associated with poor control and airway obstruction. Otherwise, the severe and mild/moderate cohorts were clinically very similar.Children with severe preschool wheeze or severe asthma are usually atopic and have impaired quality of life that is associated with poor control and airflow limitation: a very different phenotype from adult severe asthma. In-depth phenotyping of these children, integrating clinical data with high-dimensional biomarkers, may help to improve and tailor their clinical management.Children with severe preschool wheeze or severe asthma are usually atopic and have impaired quality of life http://ow.ly/RrrGE ER -