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Published on: August 7, 2017
Childhood asthma-predictive phenotype
Theresa W Guilbert1, David T Mauger2, Robert F Lemanske3
1Pulmonary Medicine Division, Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio.
Insights
Identifying the asthma-predictive phenotype in children is crucial. This phenotype involves recurrent early childhood wheezing and specific risk factors indicating persistent asthma symptoms later in life.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Epidemiology
Background:
- Recurrent wheezing is common in early childhood, but persistence into later childhood varies.
- The asthma-predictive phenotype identifies children with early wheezing and risk factors for persistent asthma.
- Existing phenotypes are difficult to clinically differentiate due to evolving symptoms and risk factors.
Purpose of the Study:
- To define and characterize the asthma-predictive phenotype in children.
- To identify key clinical features and risk factors associated with persistent childhood asthma.
Main Methods:
- Retrospective analysis of large, longitudinal cohort studies.
- Evaluation of genetic, environmental, developmental, and host factors.
- Assessment of clinical characteristics and early life risk factors.
Main Results:
- Key distinguishing features include male sex, history of wheezing with lower respiratory tract infections, parental asthma, and atopic dermatitis.
- Early sensitization to allergens (food or aeroallergens) and lower early-life lung function are significant indicators.
- Interactions between various factors influence asthma development, severity, and persistence.
Conclusions:
- The asthma-predictive phenotype is characterized by a combination of early-life symptoms and specific risk factors.
- Accurate identification of this phenotype aids in predicting persistent asthma in children.
- Understanding contributing factors is essential for managing and potentially preventing long-term asthma.
Abstract:
Wheezing is a fairly common symptom in early childhood, but only some of these toddlers will experience continued wheezing symptoms in later childhood. The definition of the asthma-predictive phenotype is in children with frequent, recurrent wheezing in early life who have risk factors associated with the continuation of asthma symptoms in later life. Several asthma-predictive phenotypes were developed retrospectively based on large, longitudinal cohort studies; however, it can be difficult to differentiate these phenotypes clinically as the expression of symptoms, and risk factors can change with time. Genetic, environmental, developmental, and host factors and their interactions may contribute to the development, severity, and persistence of the asthma phenotype over time. Key characteristics that distinguish the childhood asthma-predictive phenotype include the following: male sex; a history of wheezing, with lower respiratory tract infections; history of parental asthma; history of atopic dermatitis; eosinophilia; early sensitization to food or aeroallergens; or lower lung function in early life.
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