Deakin University

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Childhood wheeze phenotypes show less than expected growth in FEV 1 across adolescence

journal contribution
posted on 2014-06-01, 00:00 authored by C J Lodge, A J Lowe, K J Allen, S Zaloumis, L C Gurrin, M C Matheson, C Axelrad, L Welsh, Catherine BennettCatherine Bennett, J Hopper, P S Thomas, D J Hill, C S Hosking, C Svanes, M J Abramson, S C Dharmage
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. Copyright © 2014 by the American Thoracic Society.



American Journal of Respiratory and Critical Care Medicine






1351 - 1358





Publication classification

C Journal article; C1 Refereed article in a scholarly journal

Copyright notice

2014, American Thoracic Society