Characteristics of Atopy and Pulmonary Functions According to the Wheezing Phenotype in Preschool Children.
- Author:
Young Hwa SONG
1
;
Byoung Ju KIM
;
Ji Won KWON
;
Jinho YU
;
Soo Jong HONG
Author Information
1. Department of Pediatrics, Childhood Asthma & Atopy Center, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea. sjhong@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Wheezing;
Phenotype;
Asthma;
Pulmonary Function;
Bronchial Hyperresponsiveness;
Atopy;
Preschool Children
- MeSH:
Aged;
Airway Remodeling;
Asthma;
Biomarkers;
Child;
Child, Preschool;
Dermatophagoides farinae;
Dermatophagoides pteronyssinus;
Humans;
Immunoglobulin E;
Methacholine Chloride;
Phenotype;
Prospective Studies;
Respiratory Sounds
- From:Pediatric Allergy and Respiratory Disease
2009;19(4):335-344
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The wheezing phenotype in early childhood is heterogeneous and does not always develop asthma. However, the severity of the disease associated with these phenotypes has not been extensively studied in Korean children. METHODS: Two hundred seventy-two children with recurrent wheezing aged 3-6 yrears who visited the Childhood Asthma and Atopy Center in Asan Medical Center from January 1998 to August 2007 were enrolled and followed up prospectively. The patients were divided into 3 groups: early-onset persistent wheezers (E/P) with asthma, E/P wheezers without asthma and late-onset wheezers with asthma. We investigated asthma-related biomarkers, pulmonary function and methacholine challenge at the age of 7. RESULTS: FEF(25-75%) in the E/P wheezers with asthma was significantly lower than that in the late-onset wheezers with asthma. However, there was no significant difference in FEF(25-75%) between the E/P wheezers with asthna and those without. The E/P wheezers with asthma and the late-onset wheezers with asthma demonstrated enhanced Bronchial Hyperrsponsiveness (BHR) compared with E/P wheezers without asthma. Dermatophagoides farinae (D.f) or Dermatophagoides pteronyssinus (D.p)-specific IgE and sum of specific IgE in the late-onset wheezers with asthma were significantly higher than in the E/P wheezers with or without asthma. CONCLUSION: The E/P wheezers with asthma and late-onset wheezers with asthma were associated with high levels of atopy and BHR, even though the late-onset wheezers with asthma were more related to atopy. The E/P wheezers with asthma showed decreased pulmonary function. These findings suggest that the development of asthma in Korean preschool children may be strongly associated with atopy and that E/P wheezers with asthma may show airway remodeling even before the age of 7.
