Clinical predictors of wheeze trajectories and associations with allergy in Asian children

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Clinical predictors of wheeze trajectories and associations with allergy in Asian children
Title:
Clinical predictors of wheeze trajectories and associations with allergy in Asian children
Journal Title:
Annals of Allergy, Asthma & Immunology
Keywords:
Publication Date:
06 July 2023
Citation:
Lau, H. X., Chen, Z., Van Bever, H., Tham, E. H., Chan, Y. H., Yap, Q. V., Goh, A. E. N., Teoh, O. H., Tan, K. H., Yap, F. K. P., Godfrey, K. M., Eriksson, J. G., Chong, Y. S., Lee, B. W., Shek, L. P.-C., & Loo, E. X. L. (2023). Clinical predictors of wheeze trajectories and associations with allergy in Asian children. Annals of Allergy, Asthma & Immunology, 131(4), 466-473.e6. https://doi.org/10.1016/j.anai.2023.06.024
Abstract:
Background: Childhood wheezing is a highly heterogeneous condition with an incomplete understanding of the characteristics of wheeze trajectories, particularly for persistent wheeze. Objective: To characterize predictors and allergic comorbidities of distinct wheeze trajectories in a multiethnic Asian cohort. Methods: A total of 974 mother-child pairs from the prospective Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort were included in this study. Wheeze and allergic comorbidities in the first 8 years of life were assessed using the modified International Study of Asthma and Allergies in Childhood questionnaires and skin prick tests. Group-based trajectory modeling was used to derive wheeze trajectories and regression was used to assess associations with predictive risk factors and allergic comorbidities. Results: There were 4 wheeze trajectories derived, including the following: (1) early-onset with rapid remission from age 3 years (4.5%); (2) late-onset peaking at age 3 years and rapidly remitting from 4 years (8.1%); (3) persistent with a steady increase to age 5 years and high wheeze occurrence until 8 years (4.0%); and (4) no or low wheeze (83.4%). Early-onset wheezing was associated with respiratory infections during infancy and linked to subsequent nonallergic rhinitis throughout childhood. Late-onset and persistent wheeze shared similar origins characterized by parent-reported viral infections in later childhood. However, persistent wheezing was generally more strongly associated with a family history of allergy, parent-reported viral infections in later childhood, and allergic comorbidities as compared with late-onset wheezing. Conclusion: The timing of viral infection occurrence may determine the type of wheeze trajectory development in children. Children with a family history of allergy and viral infections in early life may be predisposed to persistent wheeze development and the associated comorbidities of early allergic sensitization and eczema.
License type:
Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
Funding Info:
This research / project is supported by the National Medical Research Council - Translational and Clinical Research (TCR) Flagship Program
Grant Reference no. : NMRC/TCR/004-NUS/2008

This research / project is supported by the National Medical Research Council - Translational and Clinical Research (TCR) Flagship Program
Grant Reference no. : NMRC/TCR/012-NUHS/2014

This research is supported by core funding from: Singapore Institute for Clinical Sciences
Grant Reference no. : NA

This research / project is supported by the National Medical Research Council - Transition Award grant
Grant Reference no. : MOH-TA18nov-003

Supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR) (Senior Investigator [NF-SI-0515-10042] and NIHR Southampton Bio-medical Research Centre [IS-BRC-1215-20004]), the European Union (Erasmus+ Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP), and the British Heart Foundation (RG/15/17/3174, SP/F/21/ 150013).
Description:
ISSN:
1081-1206