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Published ahead of print on October 22, 2004, doi:10.1164/rccm.200406-695OC

Am. J. Respir. Crit. Care Med., Volume 171, Number 3, February 2005, 231-237

A more recent version of this article appeared on February 1, 2005
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Submitted on June 1, 2004
Accepted on October 16, 2004

Wheeze Phenotypes Lung Function in Pre-School Children

Lesley A Lowe1, Angela Simpson1, Ashley Woodcock1, Julie Morris2, Clare S Murray1, and Adnan Custovic1*

1 North West Lung Centre, Wythenshawe Hospital, Manchester, United Kingdom, 2 Department of Medical Statistics, Wythenshawe Hospital, Manchester, United Kingdom

* To whom correspondence should be addressed. E-mail: a.custovic{at}man.ac.uk.

Distinct phenotypes can be identified in childhood wheezing illness. Within the context of a birth cohort study, we investigated the association between pre-school lung function and phenotypes of wheeze. Based on parentally-reported history of wheeze (interviewer-administered questionnaire, age 3 and 5 years), children were classified as never wheezers, transient early wheezers, late-onset wheezers or persistent wheezers. Lung function (specific airway resistance-sRaw; kiloPascal/second) was assessed at age 3 (n=463) and 5 years (n=690). Persistent wheezers had markedly poorer lung function compared to other groups. In children who had wheezed by age 3 years, the risk of persistent wheeze increased with increased sRaw (odds ratio, 95% confidence intervals: 5.2, 1.3-22.0, p=0.02). In a multivariate model, increasing sRaw (5.5, 1.2-25.9, p=0.03) and child's sensitisation (2.8, 1.3-5.8, p=0.008) were significant independent predictors of persistent wheezing. We found no association between lung function at age three and late-onset wheeze in children who had not wheezed previously (0.6, 0.07-5.3, p=0.64). In conclusion, poor lung function at age 3 years predicted the subsequent persistence of symptoms in children who had wheezed within the first 3 years, but was not associated with the onset of wheeze after age 3 years in children who had not wheezed previously.
Key words: Wheeze phenotypes, Lung function, Specific airway resistance, Dry air challenge




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