Abnormal lung function at preschool age asthma in adolescence?

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Longitudinal Health Studies

Background:

• Asthma frequently emerges in early childhood, yet predicting its persistence poses a diagnostic challenge.
• Early identification of children at risk for persistent asthma is crucial for timely intervention and management.

Purpose of the Study:

• To investigate the association between preschool lung function measurements using impulse oscillometry (IOS) and the development of asthma in adolescence.
• To evaluate if early IOS parameters can predict long-term asthma outcomes in children.

Main Methods:

• A longitudinal study involving 255 preschool children (aged 4-7 years) with asthma-like symptoms, assessed using IOS, exercise challenge, and bronchodilation tests.
• Follow-up assessments at ages 12-16 years included spirometry, bronchodilation, and questionnaires on asthma symptoms and medication; atopy was determined by skin prick tests.

Main Results:

• Abnormal baseline IOS values in preschool were significantly correlated with reduced lung function, increased asthma medication use, and persistent asthma symptoms in adolescence.
• Specifically, abnormal R5 IOS measurements (z-score ≥1.645 SD) in preschool predicted abnormal FEV1/FVC ratios (OR 9.2) and asthma symptoms (OR 9.9) in adolescence.
• Positive exercise challenge and a modified asthma-predictive index in preschool predicted asthma symptoms and medication needs, but not abnormal lung function at follow-up.

Conclusions:

• Abnormal impulse oscillometry (IOS) findings in preschool-aged children are associated with persistent asthma and impaired lung function in adolescence.
• Preschool IOS may serve as a valuable tool for identifying children at high risk for developing persistent asthma.