Childhood wheeze phenotypes show less than expected growth in FEV1 across adolescence

Caroline J Lodge, Adrian J Lowe, Katrina J Allen, Sophie Zaloumis, Lyle C Gurrin, Melanie C Matheson, Christine Axelrad, Liam Welsh, Catherine Bennett, John L Hopper, Paul S Thomas, David J Hill, Clifford S Hosking, Cecilie Svanes, Michael John Abramson, Shyamali C Dharmage

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Abstract

Abstract. 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 ; Late Onset ) and: lung function, change in lung function (12-18yrs), respiratory symptoms, and asthma. Baseline : Never/Infrequent wheeze. Measurements and Main Results: Deficits in expected growth of lung function, measured by change in pre-bronchodilator Forced Expiratory Volume over 1 second (FEV1) between 12 and 18 years were found for: Early Persistent (reduced 290mls; 95 CI 82,498); Intermediate Onset (reduced 210mls; 62,359); and Late Onset wheeze; (reduced 255mls; 69,442 ). Intermediate Onset wheezers had persistent FEV1 deficit post bronchodilator at 18 years (reduced 198mls; 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 pre-bronchodilator 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.
Original languageEnglish
Pages (from-to)1351 - 1358
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume189
Issue number11
DOIs
Publication statusPublished - 2014

Cite this

Lodge, C. J., Lowe, A. J., Allen, K. J., Zaloumis, S., Gurrin, L. C., Matheson, M. C., Axelrad, C., Welsh, L., Bennett, C., Hopper, J. L., Thomas, P. S., Hill, D. J., Hosking, C. S., Svanes, C., Abramson, M. J., & Dharmage, S. C. (2014). Childhood wheeze phenotypes show less than expected growth in FEV1 across adolescence. American Journal of Respiratory and Critical Care Medicine, 189(11), 1351 - 1358. https://doi.org/10.1164/rccm.201308-1487OC