Introduction: Exacerbation-prone asthma subtype has been reported in studies using data-driven methodologies. However, patterns of severe exacerbations have not been studied.
Objective: To investigate longitudinal trajectories of severe wheeze exacerbations from infancy to school age.
Methods: We applied longitudinal k-means clustering to derive exacerbation trajectories among 887 participants from a population-based birth cohort with severe wheeze exacerbations confirmed in healthcare records. We examined early-life risk factors of the derived trajectories, and their asthma-related outcomes and lung function in adolescence.
Results: 498/887 children (56%) had physician-confirmed wheeze by age 8 years, of whom 160 had at least one severe exacerbation. A two-cluster model provided the optimal solution for severe exacerbation trajectories among these 160 children: "Infrequent exacerbations (IE)" (n = 150, 93.7%) and "Early-onset frequent exacerbations (FE)" (n = 10, 6.3%). Shorter duration of breastfeeding was the strongest early-life risk factor for FE (weeks, median [IQR]: FE, 0 [0-1.75] vs. IE, 6 [0-20], P < .001). Specific airway resistance (sR ) was significantly higher in FE compared with IE trajectory throughout childhood. We then compared children in the two exacerbation trajectories with those who have never wheezed (NW, n = 389) or have wheezed but had no severe exacerbations (WNE, n = 338). At age 8 years, FEV /FVC was significantly lower and FeNO significantly higher among FE children compared with all other groups. By adolescence (age 16), subjects in FE trajectory were significantly more likely to have current asthma (67% FE vs. 30% IE vs. 13% WNE, P < .001) and use inhaled corticosteroids (77% FE vs. 15% IE vs. 18% WNE, P < .001). Lung function was significantly diminished in the FE trajectory (FEV /FVC, mean [95%CI]: 89.9% [89.3-90.5] vs. 88.1% [87.3-88.8] vs. 85.1% [83.4-86.7] vs. 74.7% [61.5-87.8], NW, WNE, IE, FE respectively, P < .001).
Conclusion: We have identified two distinct trajectories of severe exacerbations during childhood with different early-life risk factors and asthma-related outcomes in adolescence.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7065181 | PMC |
| http://dx.doi.org/10.1111/cea.13553 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A machine learning framework for short-term prediction of chronic obstructive pulmonary disease exacerbations using personal air quality monitors and lifestyle data.
Sci Rep
January 2025
Department of Information Engineering, University of Padova, Padova, Italy.
Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous disease with a variety of symptoms including, persistent coughing and mucus production, shortness of breath, wheezing, and chest tightness. As the disease advances, exacerbations, i.e.
View Article and Find Full Text PDFEditorial comment on "Association between nasopharyngeal airway lipidome signatures of infants with severe bronchiolitis and risk of recurrent wheeze: A prospective multicenter cohort study".
Pediatr Allergy Immunol
January 2025
Pediatric Allergy Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
Oral administration of Limosilactobacillus reuteri VHProbi® M07 alleviates ovalbumin-induced allergic asthma in mice.
PLoS One
January 2025
Qingdao Vland Biotech Group Co., Ltd, Qingdao, China.
Aims: Asthma is characterized by chronic airway inflammation, persistent cough, wheezing, and dyspnea. This study aimed to evaluate the efficacy of Limosilactobacillus reuteri VHProbi® M07 (M07) administration in alleviate the asthma severity in a mice model.
Methods And Results: In vitro studies confirmed that M07 can survive and proliferate within the gastrointestinal tract.
Automated system for diagnosing pulmonary fibrosis using crackle analysis in recorded lung sounds based on iterative envelope mean fractal dimension filter.
Physiol Meas
January 2025
Universita Cattolica del Sacro Cuore, Rome, Italy, Largo Francesco Vito, 1, 00168 Roma RM, Italy, Rome, 00168, ITALY.
Patients with pulmonary fibrosis (PF) often experience long waits before getting a correct diagnosis, and this delay in reaching specialized care is associated with increased mortality, regardless of the severity of the disease. Early diagnosis and timely treatment of PF can potentially extend life expectancy and maintain a better quality of life. Crackles present in the recorded lung sounds may be crucial for the early diagnosis of PF.
View Article and Find Full Text PDFConsensus outcomes between health professionals and parents for oral corticosteroids in treating preschool wheeze: a multi-national survey and nominal group technique study.
Arch Dis Child
January 2025
Department of Child Life and Health, University of Edinburgh Institute for Regeneration and Repair, Edinburgh, UK.
Objective: To obtain priority consensus for outcome measures of oral corticosteroid treatment of preschool wheeze that represent stakeholder groups.
Design: (1) A systematic review to identify a set of outcome measures; (2) an international survey for healthcare professionals (HCPs) and a nominal group meeting with parents; (3) a final consensus nominal group meeting with key HCPs (trial investigators and paediatric emergency medicine clinicians) and the same parent group.
Main Outcome Measures: Consensus priority of treatment outcome measures, outcome minimal clinically important differences (MCIDs) and level of concerns about adverse effects.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!