Am. J. Respir. Crit. Care Med.,
Volume 159, Number 1, January 1999, 125-129
Asthma, Wheezy Bronchitis, and Atopy across
Two Generations
G. L.
CHRISTIE,
P. J.
HELMS,
D. J.
GODDEN,
S. J.
ROSS,
J. A. R.
FRIEND,
J. S.
LEGGE,
N. E.
HAITES,
and
J. G.
DOUGLAS
Department of Thoracic Medicine, Aberdeen Royal Hospitals NHS Trust, Department of Child Health, Health Services
Research Unit, and Department of Medical Genetics, University of Aberdeen, Aberdeen, Scotland
Although the prevalence of asthma has risen significantly during the last 30 yr, it is not clear whether
this has occurred primarily in persons with a strong genetic predisposition to asthma and atopy or in
other sections of the population. We have investigated outcomes in children of nuclear families selected through probands previously characterized by studies in 1964 and 1989 as having histories of
persistent childhood onset atopic asthma, transient childhood wheezy bronchitis, and no respiratory
symptoms or atopy. Children of wheezy bronchitic probands had a significantly better symptomatic
outcome in adolescence, irrespective of the atopic status of the parent proband, than do children of
either asthmatic or asymptomatic probands, suggesting that this may be a syndrome that shows familial aggregation and is distinct from asthma. Total serum IgE levels were significantly lower in children of nonatopic asymptomatic probands, including those with wheezing symptoms. In contrast
children of nonatopic asymptomatic probands had an unexpectedly high prevalence of wheezing
(33%), positive skin prick tests (56%), and positive specific serum IgE to common allergens (48%)
that was similar to that found in children of atopic asthmatic probands. Our findings support the concept that wheezy bronchitis is a separate syndrome from atopic asthma. High total serum IgE levels
within our population appear to be an important marker of genetic predisposition to atopy. Our data
also suggest that much of the increase in asthma prevalence is associated with specific IgE sensitization and is occurring in persons previously considered to be at low risk of developing asthma or
atopy.
