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New tool helps predict whether child with wheeze will go on to develop asthma

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A new tool has been created that can help predict whether children with wheeze will develop asthma by the age of 20, according to UK researchers.

Those behind it said the predictive tool can help forecast whether preschool children with, and without, early asthma-like symptoms actually go on to develop asthma in later childhood.

“We hope this tool will prove useful to health professionals”

Silvia Colicino

They noted that many wheezy preschool children grow out of it, while others will develop asthma symptoms that can persist throughout adolescence and into young adulthood.

Their study over 20,000 UK children has identified the main factors that may predict persistent asthma symptoms beyond school years, and one major factor that could help protect against it.

Key factors for ongoing asthma were found to be early wheezing, allergy to house dust mites and cats, asthma and hay-fever diagnosis by the age of five, eczema and a history of parental allergies.

In contrast, the presence of a dog in the house was linked to early asthma symptoms going away, said the researchers.

“It should help to inform children and their parents whether further tests may be needed”

Silvia Colicino

They said the tool had proven to be 80% accurate and, as a result, the study authors said it could be used by clinicians to help estimate the chance of asthma symptoms later in life.

However, they noted that there were exceptions, as some children with the key risk factors identified by the three-year study would not develop asthma and some without these factors will.

The study involved over 20,000 children in five different birth cohorts and considered two groups – all children recruited at birth, and those with wheezing symptoms aged two or three years old and also five.

Several studies have tried to establish tools to forecast persistent asthma but their clinical usefulness and whether they can reliably be used with the general public is still uncertain, said the researchers.

They said the new predictive tool was different from previous ones in that it was developed using information from two birth cohorts and then validated in the three remaining birth cohorts.

Results from the study will be presented today at the British Thoracic Society’s 2017 Winter Meeting in London.

“Young children prone to wheezing were less likely to develop asthma in later life if they have a dog”

Silvia Colicino

The research was carried out by Imperial College London, Brunel University, University of Aberdeen, University of Manchester, University of Southampton and University of Bristol.

Study author Silvia Colicino, a PhD student from Imperial College London, said: “Our research showed there were many factors which can predict whether children will go on to have asthma by the age of 20.

“For example, a child with wheezing symptoms and eczema in early childhood is over 75% more likely to develop asthma up to the age of 20 years compared to a wheezy child without eczema at preschool age,” she said. “Allergy to house dust-mite was also associated to an increase in risk of asthma later in life.

“Young children prone to wheezing were less likely to develop asthma in later life if they have a dog in the home in early childhood,” noted Ms Colicino.

National Heart and Lung Institute, Imperial College London

New tool helps predict if child with wheeze will develop asthma

Silvia Colicino

“We need to further understand the reasons for this; previous studies have shown that dogs may carry ‘helpful’ protective bacteria, but they also carry allergens which may cause asthma symptoms. It is a mixed picture that we need to analyse further,” she said.

“Our predictive method performed well and has an overall accuracy of around 80%,” she said. “We hope this tool will prove useful to health professionals providing more certainty in predicting which child is likely to develop asthma later in life.”

She added: “It should help to inform children and their parents whether further tests may be needed, whether their child should have a personalised treatment plan, or whether they can be reassured that the respiratory condition is unlikely to occur.”

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