Predicting onset and persistence of wheeze in children

Summary

To identify the risk factors for the development, persistence and remission of child asthma.

Study description

Wheezing disorders are the most common chronic health problem in childhood and place a large burden on children, their families and society. Wheezing disorders in adults, including asthma and chronic obstructive pulmonary disease (COPD), appear to have their origins in early childhood. In order to prevent these diseases it is important to understand what causes young children to begin wheezing and what causes wheezing to become a problem persisting throughout childhood and into adulthood. Many previous studies have tried to determine the factors in early life that cause children to wheeze. However, these studies differ in the groups of children studied (children from hospitals and clinics or from the general population), and in the particular early life events and influences considered. Also, few studies have examined whether different types of wheezing have different causes. The Leicester childhood cohorts represent a rich data resource for studying the effects of early life influences on later respiratory health.

This project aims to develop models to predict whether or not a child will develop wheeze, and if yes, whether the child will continue to suffer from the disease in later life. Specific objectives are: 1) to perform a systematic review of the published literature on factors affecting the development and persistence of wheeze and asthma in children; 2) to find out, using a variety of statistical techniques on original datasets, which factors predict the development and persistence of wheeze in children. A multitude of information from early childhood, including environmental exposures, hereditary factors, and childhood illnesses will be considered as potential predictors. For these analyses we will use data from the Leicester respiratory cohorts, 8700 children followed up since their first years of life. To validate the results, we will compare them with data from other cohort studies; 3) To translate the findings into simple decision rules, which help doctors predict how a particular child might be affected by wheezing disorders.

By increasing our understanding of the causes of wheezing disorders this project should help designing ways to prevent and treat these diseases. The project will also provide simple tools for prediction that should be useful for informed counselling of parents and clinical management.

Publications

Pescatore AM, Spycher BD, Jurca M, Gaillard EA, Kuehni CE.  
Environmental and socioeconomic data do not improve the Predicting Asthma Risk in Children (PARC) tool
J Allergy Clin Immunol. 2014 Dec 26. pii: S0091-6749(14)01604-2. doi: 10.1016/j.jaci.2014.10.053. 

Goutaki M, Pescatore AM, Singh P, Beardsmore CS, Kuehni CE.  
Increased prevalence of pre-school wheeze is not explained by time trends in body mass index
Eur Respir J. 2014 Oct;44(4):1078-82. doi: 10.1183/09031936.00011514. Epub 2014 Jun 25. 

Pescatore AM, Dogaru CM, Duembgen L, Silverman M, Gaillard EA, Spycher BD, Kuehni CE.
A simple asthma prediction tool for preschool children with wheeze or cough
J Allergy Clin Immunol. 2014 Jan;133(1):111-8.e1-13. doi: 10.1016 /j.jaci. 2013.06. 002. Epub 2013 Jul 24. 

Kuehni CE. 
Do migrant studies help to identify causes of asthma (editorial)? 
Clin Exp Allergy 2011;41:1054-8.

Leonardi NA, Spycher BD, Strippoli MPF, Frey U, Silverman M, Kuehni CE.
Validation of the asthma predictive index and comparison with simpler clinical prediction rules.
J Allergy Clin Immunol 2011; 127:1466-1472 

Conference abstracts

Pescatore AM, Spycher BD, Dogaru C, Baeuml, J, Goutaki M, Gaillard E, Kuehni CE. 
Predicting later asthma in toddlers: do enviromental exposure data improve a clinical tool?
European Respiratory Society annual congress, Barcelona, 2013.

Goutaki M, Singh P, Spycher BD, Dogaru C, Pescatore AM, Baeuml, J, Beardsmore CS, Kuehni CE. 
Do changes in body mass index explain temporal trends in prevalence of wheeze and asthma?
European Respiratory Society annual congress, Barcelona, 2013.

Pescatore AM, Spycher BD, Duembgen L, Strippoli MPF, Dogaru C, Silverman M, Kuehni CE. 
Robust prediction of later asthma in symptomatic toddlers: a novel approach.
European Respiratory Society annual congress, Amsterdam, 2011.

Pescatore AM, Strippoli MPF, Spycher BD, Beardsmore CS, Gaillard E, Kuehni CE.
How do patterns of wheeze change over first 14 years of life?
European Respiratory Society annual congress, Vienna, 2012.

Leonardi NA, Spycher BD, Beardsmore CS, Silverman M, Kuehni CE.
Validation of the Tucson asthma predictive index in an independent cohort.
European Respiratory Society annual congress, Barcelona, 2010.

Spycher BD, Strippoli MPF, Silverman M, Kuehni CE.
Predicting persistence of childhood wheeze using a symptom based severity score?
European Respiratory Society annual congress, Berlin, 2008.