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Published on: August 7, 2017
Transient childhood wheeze is associated with less atopy in adolescence
Caroline Jane Lodge1,2, Adrian John Lowe1,2, Michael John Abramson3
1Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia.
Insights
Childhood wheeze phenotypes significantly impact later allergic conditions. Persistent wheeze increases risks for eczema, hay fever, and sensitization, while early transient wheeze appears protective against these allergies.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Epidemiology
Background:
- The link between childhood wheeze phenotypes and non-asthma allergic conditions like hay fever and eczema is not well-established.
- This study investigates the long-term allergic outcomes associated with different childhood wheeze patterns up to late adolescence.
Purpose of the Study:
- To examine the relationship between distinct childhood wheeze phenotypes and allergic conditions (sensitization, eczema, hay fever, fractional exhaled nitric oxide) up to age 18.
- To identify specific wheeze patterns that predict increased or decreased risk of developing allergies later in life.
Main Methods:
- Utilized data from 620 children in the Melbourne Atopy Cohort Study.
- Defined five childhood wheeze phenotypes and analyzed their association with allergic outcomes at ages 12 and 18 using logistic and linear regression models.
Main Results:
- 'Early Persistent wheeze' correlated with higher risks of eczema and sensitization at age 12.
- 'Intermediate Onset wheeze' showed increased risks for eczema, hay fever, sensitization, and elevated fractional exhaled nitric oxide (FeNO) at ages 12 and 18.
- 'Late Onset wheeze' was linked to increased hay fever and sensitization risks.
- 'Early Transient wheeze' demonstrated a reduced risk for eczema, hay fever, and sensitization at age 18, along with lower FeNO levels.
Conclusions:
- Persistent childhood wheeze phenotypes are associated with allergic outcomes persisting into late adolescence.
- 'Intermediate Onset wheeze' represents the most atopic phenotype, while 'Early Transient wheeze' confers a protective effect against allergies.
- Findings may help reassure parents regarding the prognosis of wheezing infants and young children.
Background:
The relationships between childhood wheeze phenotypes and subsequent allergic conditions other than asthma, including hay fever, eczema and sensitization, have not been widely reported. We aimed to investigate this relationship up to late adolescence.
Methods:
Using five childhood wheeze phenotypes defined from 620 children in a high-atopy risk birth cohort (Melbourne Atopy Cohort Study), we investigated their relationships with sensitization, eczema, hay fever and fractional exhaled nitric oxide (FeNO) at ages 12 and/or 18 years using logistic and linear regression models.
Results:
'Early Persistent wheeze' was associated with the increased risk of eczema (odds ratio: 3.69; 95% CI: 1.23, 11.12) and sensitization (4.52; 1.50, 13.64) at 12 years. 'Intermediate Onset wheeze' was associated with the increased risk of eczema at 12 years (2.57; 1.11, 5.97), hay fever at 12 (2.87; 1.44, 5.74) and 18 years (2.19; 1.20, 4.02), sensitization at 12 (2.25; 1.17, 4.34) and 18 years (2.46; 1.18, 5.12), and raised FeNO at 18 years. 'Late Onset wheeze' was associated with the increased risk of hay fever at 12 (5.18; 1.11, 24.20) and 18 years (4.20; 1.03, 17.11) and sensitization at 12 years (3.27; 0.81, 13.27). In contrast, 'Early Transient wheeze' was associated with the reduced risk of eczema (0.44; 0.20, 0.96), hay fever (0.57; 0.33, 0.99) and sensitization (0.59; 0.35, 0.99) at 18 years and a lower FeNO compared with 'Never/Infrequent wheezers'.
Conclusions:
Persistent wheeze phenotypes were associated with allergic outcomes up to 18 years with 'Intermediate Onset wheeze' being the most atopic group. In contrast, 'Early Transient wheezers' had less risk of allergic outcomes at 18 years. This protective effect may reassure parents of wheezy infants and young children.
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