Relationship between past airway pathology and current lung function in preschool wheezers

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Pediatric Allergy and Immunology

Background:

• Preschool severe wheeze is a significant clinical problem.
• The long-term functional consequences of airway pathology, including eosinophilic inflammation and reticular basement membrane (RBM) thickness, remain unclear.

Purpose of the Study:

• To investigate the relationship between airway pathology at age 2 years and lung function at ages 4-6 years in children with a history of severe wheeze.
• To compare lung function between children with a history of severe wheeze and healthy controls.

Main Methods:

• Recruitment of children aged 4-6 years with a history of severe wheeze and healthy controls.
• Assessment of lung function using lung clearance index (LCI), ventilation inhomogeneity (S(cond)), and exhaled nitric oxide fraction (F(eNO)).
• Correlation analysis between airway pathology (RBM thickness, eosinophilia) at age 2 years and lung function parameters at age 4-6 years.

Main Results:

• Children with a history of severe wheeze exhibited significantly higher LCI and S(cond) compared to healthy controls.
• Past RBM thickness and eosinophil counts (EG2+ cells) at age 2 years were significantly correlated with current F(eNO) at age 5 years.
• No significant correlation was found between RBM thickness at age 2 years and current lung function parameters at age 5 years.

Conclusions:

• Children with a history of severe wheeze demonstrate persistent lung function abnormalities.
• Early airway inflammation and RBM thickening are associated with elevated exhaled nitric oxide levels later in childhood.
• Airway pathology in early childhood does not appear to predict the degree of lung function impairment in later childhood for severe wheezers.