Small airway dysfunction is an independent dimension of wheezing disease in preschool children. Issue 1 (19th August 2021)

• Record Type: Journal Article
• Authors: Bokov, Plamen; Jallouli‐Masmoudi, Donies; Amat, Flore; Houdouin, Véronique; Delclaux, Christophe
• Editors: Kalayci, Ömer
• Is Part Of: Pediatric allergy and immunology. Volume 33:Issue 1(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-08-19
• Subjects: airway compliance -- airway resistance -- asthma -- impulse oscillometry -- wheezing; Allergy in children -- Periodicals; Immunologic diseases in children -- Periodicals; 617
• DOI: 10.1111/pai.13647
• Languages: English
• ISSNs: 0905-6157

Abstract

Abstract: Background: Whether small airway dysfunction (SAD), which is prevalent in asthma, helps to characterize wheezing phenotypes is undetermined. The objective was to assess whether SAD parameters obtained from impedance measurement and asthma probability are linked. Methods: One hundred and thirty‐nine preschool children (mean age 4.7 years, 68% boys) suffering from recurrent wheezing underwent impulse oscillometry that allowed calculating peripheral resistance and compliance of the respiratory system (markers of SAD) using the extended RIC model (central and peripheral resistance, inertance, and peripheral compliance). Children were classified using the probability‐based approach of GINA guidelines (few, some, and most having asthma). A principal component analysis (PCA) that determined the dimensions of wheezing disease evaluated the links between SAD and asthma probability. Results: Forty‐seven children belonged to the few, 28 to the some, and 64 to the most having asthma groups. Whereas their anthropometrics and measured parameters were similar, the most having asthma group exhibited the lowest mean value of airway inertance after bronchodilator probably due to airway inhomogeneities. PCA characterized four independent dimensions including a peripheral resistance (constituted by baseline peripheral compliance, Frs, R5Hz, R5‐20Hz, X5Hz, and AX), a central resistance (baseline central resistance, R20Hz), anthropometrics (age and height), and asthma probability (wheezing patterns and therapeutic steps). Thus, PCA showed that the SAD markers were independent from clinical dimensions and were unable to differentiate wheezing phenotypes. Conclusions: Lung function parameters obtained from impulse oscillometry and asthma probability were belonging to independent dimensions of the wheezing disease.