Analysis of the predicting factors of recurrent wheezing in infants

Abstract

BackgroundClinically, asthma in children under 5 years old is under estimated because lack of diagnostic criteria. The current study was, therefore, designed to identify the predicting factors for recurrent wheezing in infants.MethodsOne hundred forty-five infants under 3-year old hospitalized with respiratory diseases were enrolled into this study. Patients were followed up for one-year period after being discharged from the hospital and were, then, divided into recurrent wheezing group and non-recurrent wheezing group based on whether there was recurrent wheezing or not. Wheezing or recurrent wheezing was specifically monitored in addition to blood tests for allergic and respiratory diseases.ResultsThe prevalence of eczema and respiratory syncytial virus (RSV) infection were significantly higher in recurrent wheezing group than in control group (74.2% vs 45.8%; 32.3% vs. 13.3%, respectively, both P < 0.05); the percentage of blood eosinophil and serum eosinophil-derived neurotoxin (EDN) concentration at admission were also higher in recurrent wheezing group than in control group (3.10 ± 2.54% vs. 1.31 ± 1.15%; 68.67 ± 55.05 ng/mL vs. 27. 36 ± 19.51 ng/mL; respectively, both P < 0.001). Multivariate logistic regression analysis on eosinophil count and serum EDN concentration in predicting recurrent wheezing revealed that the eosinophil count showed the lowest sensitivity (51.6%) and highest specificity (90.4%), with the area under the ROC curve (AUC) of 0.752 ± 0.041; and that, in contrast, the serum EDN showed the highest sensitivity (88.7%) and lowest specificity (56.6%), with AUC of 0.795 ± 0.037.ConclusionCombination of eosinophil count and serum EDN measurement may be better to predict the risk of recurrent wheezing in early life of childhood.

Longitudinal eosinophil‐derived neurotoxin measurements and asthma development in preschool wheezers

“…Previously, in the same cohort, we have shown that preschool wheezers that develop asthma were hospitalized more often and for more extended periods during their first year after inclusion, indicating more severe symptoms than preschool wheezers that do not develop asthma 6 . This is in line with previous studies that showed higher EDN levels in children with more severe asthma symptoms and where infants hospitalized with recurrent wheezing showed higher EDN levels than infants hospitalized with nonrecurrent wheezing 7 . In adults, higher EDN levels have been associated with current asthma, poor asthma control and asthma treatment during the last year 8 .…”

Disrupting Bordetella Immunosuppression Reveals a Role for Eosinophils in Coordinating the Adaptive Immune Response in the Respiratory Tract

“…However, how eosinophils modulate adaptive immune responses during bacterial respiratory infections remains not fully understood [ 48 ]. Intriguingly, there is a correlation between respiratory infections and increasing risk of asthma and allergies [ 49 , 50 , 51 , 52 , 53 , 54 ], suggesting that eosinophils might be involved in the immune responses to these infections, and infection-induced dysregulation may contribute to this hyper-responsiveness. However, if the role(s) of eosinophils in the immune response to infection involves complex interactions and communication with multiple other immune cells, it/they might be difficult to detect and/or study in crude models of human pathogens infecting mice.…”

Recurrent wheezing after bronchiolitis caused by respiratory syncytial virus in children younger than 3 years: A 1-year follow-up study

“…18 RSV infection prevalence, eosinophil percentage, and serum eosinophil-derived neurotoxin levels are the predominant risk factors of wheezing and could therefore be used to predict recurrent wheezing in infants. 1 The risk factors for developing asthma by 6 years of age in children hospitalized for wheezing before 2 years of age are eosinophils in the blood, atopic dermatitis, elevated serum IgE levels, and wheezing onset in early life. It has been suggested that the defining factor of childhood asthma is atopy.…”

“…About half of children experience at least one wheeze before school age, and some of the infants with acute bronchiolitis can develop into recurrent wheezing. 1 Viral infection is the most common cause of wheezing in infants and young children, with human respiratory syncytial virus (RSV) being the most common cause. 2,3 RSV infection can cause irreversible lung damage and increase the incidence of chronic lung disease in adulthood.…”