Factors predicting the development of asthma in wheezing children

Introduction: Wheeze is a common symptom in infants, but not all wheezers will develop asthma. How to predict if early wheeze will become asthma is still a matter of vivid debate. Aim: To assess the clinical and pathological factors possibly predicting the future development of asthma in children. Methods: 109 children (mean age 5.5 yrs) undergoing an indicated bronchoscopy were followed for a mean of 5 yrs. At baseline clinical characteristics with a particular focus on wheezing and its presentation (episodic, multitrigger) were collected. Structural and inflammatory changes were quantified in bronchial biopsies. Results: Children presenting with multitrigger wheeze were more likely to become asthmatics at follow-up than those with episodic or without wheeze (67% vs 29% vs 19%; p 2 ; p=0.01). Conclusion: Multitrigger wheeze, low birth-weight, reduced breast-feeding and increased IgE are predictors of asthma development. The thickening of basement membrane in early childhood is closely associated to the development of asthma, highlighting the importance of airway remodeling in early life.