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Published on: August 7, 2017
Metabolomic profile in preschool children with transient wheezing and early onset asthma
Ana Caroline C Dela Bianca Melo1, Décio Medeiros Peixoto2, Ricardo Oliveira Silva2
1Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego, 1235, Cidade Universitária, Recife, Pernambuco, Brazil; caroldbianca@gmail.com.
Insights
Metabolomic analysis accurately distinguishes persistent from transient wheezing in preschoolers. This early diagnosis method identifies specific metabolites in plasma, aiding in asthma management.
Area of Science:
- Pediatric Allergy and Immunology
- Metabolomics
- Respiratory Medicine
Background:
- Early diagnosis of childhood asthma remains a significant clinical challenge.
- Differentiating persistent from transient wheezing in preschoolers is crucial for appropriate management.
- Metabolomic profiling offers a potential tool for objective diagnostic differentiation.
Purpose of the Study:
- To investigate the utility of plasma metabolomic analysis in distinguishing persistent wheezing from transient wheezing in preschool children.
- To identify specific metabolic biomarkers associated with persistent recurrent wheezing.
Main Methods:
- A case-control study involving 29 children (aged 4-6 years) with recurrent wheezing.
- Participants were categorized into persistent wheezers and transient wheezers based on clinical criteria.
- Plasma samples were analyzed using hydrogen-1 Nuclear Magnetic Resonance (NMR) spectroscopy.
Main Results:
- Metabolomic analysis achieved a 93.1% accuracy in differentiating between persistent and transient wheezers.
- Persistent wheezers exhibited significantly higher sensitization to aeroallergens and a positive asthma predictive index.
- Elevated levels of valine, citrate, lipids, and lipoproteins were observed in persistent wheezers.
Conclusions:
- Plasma metabolomic profiling, particularly 1H NMR spectroscopy, is a promising method for early and accurate diagnosis of persistent asthma in preschoolers.
- Specific metabolites like valine and citrate, along with lipid profiles, can serve as biomarkers for persistent wheezing.
- This approach may facilitate timely intervention and improve long-term outcomes for children with asthma.
Introduction:
Early diagnosis of childhood asthma is a challenge; so we questioned whether metabolomic analysis could differentiate persistent recurrent wheezing from transient wheezing in preschoolers.
Methods:
Case-control study with individuals aged 4-6 years and 11 months with three or more episodes of wheezing due to bronchospasm was carried out in an allergy outpatient clinic and metabolomics laboratory from July 2021 to February 2023. Two groups were formed: persistent wheezers with multiple trigger attacks after the fourth year of life; and transient wheezers without wheezing for at least 12 months after the third year of life. Those with other wheezing disorders were excluded.
Results:
This study was carried out on 29 children with a mean age of 4.9 (±0.6) years-19 (65%) persistent wheezers and 10 (35%) transient wheezers. Sensitization to aeroallergens and the positive asthma predictive index were significantly higher among persistent wheezers. From the plasma hydrogen-1 NMR (1H NMR) spectra, five best subsets were selected to discriminate between the two groups with an accuracy rate of 93.1%. Among the metabolites, valine and citrate showed higher signals and lipids and lipoproteins were higher in persistent wheezers.
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