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Clinical and Pathologic Factors Predicting Future Asthma in Wheezing Children. A Longitudinal Study
Matteo Bonato1, Erica Bazzan1, Deborah Snijders2
11 Department of Cardiac, Thoracic and Vascular Sciences, University of Padova and Padova City Hospital, Padova, Italy.
Summary
Predicting childhood asthma: Multitrigger wheeze, lower birth weight, and thickened basement membranes in early wheezing infants indicate a higher risk for developing asthma later in life.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Immunology
Background:
- Wheezing in infancy is common, but not all infants develop asthma.
- Up to 50% of children with wheeze outgrow symptoms by school age.
- Predicting which infants will develop persistent asthma remains a challenge.
Purpose of the Study:
- To identify clinical and pathological factors predicting asthma development in children with early wheeze.
- To assess the association between wheeze characteristics, birth factors, and airway changes with future asthma diagnosis.
Main Methods:
- Prospective follow-up of 80 children (mean age 3.8 years) with clinically indicated bronchoscopy for 5 years.
- Collection of clinical data (wheeze type, birth weight, breastfeeding, IgE) and analysis of bronchial biopsies (structural and inflammatory changes).
Main Results:
- Multitrigger wheeze at baseline predicted higher asthma likelihood at follow-up (P=0.04).
- Lower birth weight (P=0.02) and reduced breastfeeding (P=0.02) were associated with asthma development.
- Increased basement membrane thickness (P=0.001) and airway eosinophils (P=0.026) were observed in children who developed asthma.
Conclusions:
- Multitrigger wheeze and reduced birth weight are significant clinical predictors of childhood asthma.
- Basement membrane thickening in early life is strongly associated with asthma development, indicating the role of airway remodeling.
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