RT Journal Article
SR Electronic
T1 Prediction of asthma in symptomatic preschool children using exhaled nitric oxide, Rint and specific IgE
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 801
OP 807
DO 10.1136/thx.2009.126912
VO 65
IS 9
A1 Daan Caudri
A1 Alet H Wijga
A1 Maarten O Hoekstra
A1 Marjan Kerkhof
A1 Gerard H Koppelman
A1 Bert Brunekreef
A1 Henriette A Smit
A1 Johan C de Jongste
YR 2010
UL http://thorax.bmj.com/content/65/9/801.abstract
AB Rationale For clinicians it remains very difficult to predict whether preschool children with symptoms suggestive of asthma will develop asthma in later childhood.Objective To investigate whether measurement of fraction of exhaled nitric oxide (FENO), interrupter resistance (Rint) or specific immunoglobulin E (IgE) in 4-year-old children with suggestive symptoms can predict asthma symptoms up to age 8 years.Methods Children were recruited from the PIAMA birth cohort. All children with symptoms suggestive of asthma at age 3 or 4 years, who were invited for medical examination at age 4 (n=848), were eligible. Associations of FENO (n=308), Rint (n=482) and specific IgE (n=380) at 4 years with wheezing and asthma at the ages of 5–8 years were assessed using repeated measurement analyses. The added predictive value of these objective tests was then investigated by including parameters for clinical history in the model.Results FENO and specific IgE measured at 4 years were associated with wheezing and asthma at 8 years. Both tests also remained significant predictors after mutual adjustment and adjustment for clinical history: OR on wheezing at 8 years for FENO (10log-scale, per IQR) 1.6 (95% CI 1.1 to 2.2) and for specific IgE 2.8 (95% CI 1.9 to 4.1). Rint was significantly associated with wheezing at age 6, but not at 7 and 8 years.Conclusions In preschool children with symptoms suggestive of asthma, both FENO and specific IgE measured at age 4, but not Rint, improved the prediction of asthma symptoms until the age of 8 years, independent of clinical history.