Childhood phenotypic origins and characterisation of wheezing at 18-years

Much debate surrounds the origins of adolescent wheeze. Using the Isle of Wight Birth Cohort (IOWBC) we assessed the origins and characteristics of wheeze at 18-years in relation to early life wheeze phenotypes. The IOWBC (n=1,456) was reviewed at 1, 2, 4, 10 and 18-years. Presence of wheeze, allergic co-morbidities and risk factors were assessed. At 10-years, 4 wheeze phenotypes were defined. Non-Wheezers (NW) had no wheeze at any point, Early-Transient-Wheezers (ETW) wheezed in the first 4 years of life but not at 10, Persistent-Wheezers (PW) wheezed in the first 4 years of life and at 10-years and Late-Onset-Wheezers (LW) demonstrated no wheeze in the first 4 years of life but had developed it by age 10. We investigated those participants still wheezing at 18-years (n = 211), comparing their original wheeze phenotype at age 10, to determine relationship of young adult disease to childhood phenotype. All phenotypes were compared to each other and p values adjusted. Of those wheezing at 18, 31% were originally NW, 17% ETW, 30% PW and 20% LW at 10 years. At 18-years significantly more atopy was seen in those originally PW (74% p=0.006) and LW (81% p These results should raise awareness that more significant airways disease at 18-years appears to originate in early life in association with smoking exposure and atopy.