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Childhood wheeze phenotypes show less than expected growth in FEV1 across adolescence.
Am J Respir Crit Care Med. 2014 Jun 01; 189(11):1351-8.AJ

Abstract

RATIONALE

Better characterization of childhood wheeze phenotypes using newer statistical methods provides a basis for addressing the heterogeneity of childhood asthma. Outcomes of these phenotypes beyond childhood are unknown.

OBJECTIVES

To determine if adolescent respiratory symptoms, lung function, and changes in lung function over adolescence differ by childhood wheeze phenotypes defined through latent class analysis.

METHODS

A prospective birth cohort (Melbourne Atopy Cohort Study) followed 620 high allergy-risk children, recording respiratory symptoms and spirometry at 12 and 18 years. Regression analyses identified relationships between wheeze phenotypes (never/infrequent, early transient, early persistent, intermediate onset, and late onset) and lung function, change in lung function (12-18 yr), respiratory symptoms, and asthma. The baseline classification was never/infrequent wheeze.

MEASUREMENTS AND MAIN RESULTS

Deficits in expected growth of lung function, measured by change in prebronchodilator FEV1 between 12 and 18 years, were found for early persistent (reduced 290 ml; 95% confidence interval [CI], 82-498), intermediate-onset (reduced 210 ml; 95% CI, 62-359), and late-onset wheeze (reduced 255 ml; 95% CI, 69-442). Intermediate-onset wheezers had persistent FEV1 deficit after bronchodilator at 18 years (reduced 198 ml; 46,350). Current asthma risk was increased for all phenotypes except early transient, which was also not associated with lung function deficits at 12 or 18 years.

CONCLUSIONS

Persistent wheeze phenotypes in childhood were associated with reduced growth in prebronchodilator FEV1 over adolescence. Intermediate-onset wheezers showed irreversible airflow limitation by 18 years. Conversely, early transient wheeze was a benign condition with no sequelae for respiratory health by age 18.

Authors+Show Affiliations

1 Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24796409

Citation

Lodge, Caroline J., et al. "Childhood Wheeze Phenotypes Show Less Than Expected Growth in FEV1 Across Adolescence." American Journal of Respiratory and Critical Care Medicine, vol. 189, no. 11, 2014, pp. 1351-8.
Lodge CJ, Lowe AJ, Allen KJ, et al. Childhood wheeze phenotypes show less than expected growth in FEV1 across adolescence. Am J Respir Crit Care Med. 2014;189(11):1351-8.
Lodge, C. J., Lowe, A. J., Allen, K. J., Zaloumis, S., Gurrin, L. C., Matheson, M. C., Axelrad, C., Welsh, L., Bennett, C. M., Hopper, J., Thomas, P. S., Hill, D. J., Hosking, C. S., Svanes, C., Abramson, M. J., & Dharmage, S. C. (2014). Childhood wheeze phenotypes show less than expected growth in FEV1 across adolescence. American Journal of Respiratory and Critical Care Medicine, 189(11), 1351-8. https://doi.org/10.1164/rccm.201308-1487OC
Lodge CJ, et al. Childhood Wheeze Phenotypes Show Less Than Expected Growth in FEV1 Across Adolescence. Am J Respir Crit Care Med. 2014 Jun 1;189(11):1351-8. PubMed PMID: 24796409.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Childhood wheeze phenotypes show less than expected growth in FEV1 across adolescence. AU - Lodge,Caroline J, AU - Lowe,Adrian J, AU - Allen,Katrina J, AU - Zaloumis,Sophie, AU - Gurrin,Lyle C, AU - Matheson,Melanie C, AU - Axelrad,Christine, AU - Welsh,Liam, AU - Bennett,Catherine M, AU - Hopper,John, AU - Thomas,Paul S, AU - Hill,David J, AU - Hosking,Cliff S, AU - Svanes,Cecilie, AU - Abramson,Michael J, AU - Dharmage,Shyamali C, PY - 2014/5/7/entrez PY - 2014/5/7/pubmed PY - 2014/8/13/medline SP - 1351 EP - 8 JF - American journal of respiratory and critical care medicine JO - Am J Respir Crit Care Med VL - 189 IS - 11 N2 - RATIONALE: Better characterization of childhood wheeze phenotypes using newer statistical methods provides a basis for addressing the heterogeneity of childhood asthma. Outcomes of these phenotypes beyond childhood are unknown. OBJECTIVES: To determine if adolescent respiratory symptoms, lung function, and changes in lung function over adolescence differ by childhood wheeze phenotypes defined through latent class analysis. METHODS: A prospective birth cohort (Melbourne Atopy Cohort Study) followed 620 high allergy-risk children, recording respiratory symptoms and spirometry at 12 and 18 years. Regression analyses identified relationships between wheeze phenotypes (never/infrequent, early transient, early persistent, intermediate onset, and late onset) and lung function, change in lung function (12-18 yr), respiratory symptoms, and asthma. The baseline classification was never/infrequent wheeze. MEASUREMENTS AND MAIN RESULTS: Deficits in expected growth of lung function, measured by change in prebronchodilator FEV1 between 12 and 18 years, were found for early persistent (reduced 290 ml; 95% confidence interval [CI], 82-498), intermediate-onset (reduced 210 ml; 95% CI, 62-359), and late-onset wheeze (reduced 255 ml; 95% CI, 69-442). Intermediate-onset wheezers had persistent FEV1 deficit after bronchodilator at 18 years (reduced 198 ml; 46,350). Current asthma risk was increased for all phenotypes except early transient, which was also not associated with lung function deficits at 12 or 18 years. CONCLUSIONS: Persistent wheeze phenotypes in childhood were associated with reduced growth in prebronchodilator FEV1 over adolescence. Intermediate-onset wheezers showed irreversible airflow limitation by 18 years. Conversely, early transient wheeze was a benign condition with no sequelae for respiratory health by age 18. SN - 1535-4970 UR - https://www.unboundmedicine.com/medline/citation/24796409/Childhood_wheeze_phenotypes_show_less_than_expected_growth_in_FEV1_across_adolescence_ L2 - https://www.atsjournals.org/doi/10.1164/rccm.201308-1487OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -