Early Wheezing Patterns in Children Tend to Persist

NEW YORK (Reuters Health) - In children who develop asthma-like symptoms in the preschool years, patterns of wheezing and lung function are established by age 6 years and do not change much by age 16, according to a report in the American Journal of Respiratory and Critical Care Medicine.

Previous research implicates the toddler years as the time during which important alterations in lung structure and function develop in most individuals with persistent asthma, the authors explain.

Dr. Fernando D. Martinez from the University of Arizona Health Sciences Center, Tucson, and colleagues evaluated the effect of early life wheezing on respiratory function and continued symptoms through adolescence in a population of children who were followed from birth.

The team classified 1,200 children according to four previously described types based on the occurrence of wheezing lower respiratory illnesses before age 3 years and active wheeze at age 6 years: never wheezers, transient early wheezers, persistent wheezers, and late-onset wheezers.

Wheezing at age 6 years, regardless of whether the children wheezed previously, was associated with continued wheezing symptoms through age 16 years, the authors report.

The increased risk of allergy, which was present in persistent and late-onset tweezers at age 6 years, continued through adolescence, the results indicate.

Transient wheezers and persistent wheezers had decreased lung function at ages 11 and 16 years, the investigators observe.

"Our study strongly suggests that both lung function characteristics in early infancy and events occurring during the first 6 years of life determine the expression of asthma and the level of lung function that will be achieved during childhood and into early adult life," the authors conclude.

"Identifying the environmental and genetic factors that influence these processes will be decisive for the prevention of asthma and chronic airway obstruction," the researchers add.

SOURCE: American Journal of Respiratory Critical Care Medicine, November 15, 2005.