Association of urinary eosinophilic protein X at age 3 years and subsequent persistence of wheezing and asthma diagnosis in adolescence
Author(s)
Type
Journal Article
Abstract
Background
Wheezing is common in early life, but most children stop wheezing by school age. However, the prediction of course of wheezing through childhood is difficult.
Objective
To investigate whether urinary EPX (a marker of eosinophil activation) in children at age 3 years may be useful for the prediction of wheeze persistence and future asthma diagnosis.
Methods
U-EPX was measured at age 3 years (radioimmunoassay) in 906 participants in the population-based birth cohort. Children attended follow-ups to age 16 years. We investigate the discriminative ability of u-EPX and other factors in predicting asthma diagnosis at age 16 using receiver operating characteristic [ROC] curves.
Results
Of 613 children with follow-up information at age 16, 511 had data on u-EPX at age 3 and asthma diagnosis at age 16 years; of those; 133 (21.7%) had asthma. Based on longitudinal data, children were assigned to wheeze clusters: No wheeze (NWZ), early transient (ETW), late-onset (LOW), intermittent (INT) and persistent wheeze (PEW). U-EPX levels differed significantly between different wheeze clusters (p = .003), with clusters characterised with persistent symptoms having higher u-EPX. In the whole cohort, the best performing classification model for asthma diagnosis at age 16 years included sex, u-EPX, sensitisation and wheeze (area under the curve (AUC) = 0.82, 95% CI: 0.76–0.88). u-EPX and allergic sensitisation alone had similar predictive power (AUC [95%CI]: 0.64 [0.58–0.71] and 0.65 [0.60–0.71]). The best performing classification model for asthma prediction among children with doctor-confirmed wheeze in the first 3 years included child's u-EPX and sensitisation at age 3 years, sex, gestational age and maternal atopy (AUC: 0.76, 95%CI: 0.67–0.85).
Conclusions
Early-life u-EPX may be a useful non-invasive marker for asthma prediction in adolescence.
Wheezing is common in early life, but most children stop wheezing by school age. However, the prediction of course of wheezing through childhood is difficult.
Objective
To investigate whether urinary EPX (a marker of eosinophil activation) in children at age 3 years may be useful for the prediction of wheeze persistence and future asthma diagnosis.
Methods
U-EPX was measured at age 3 years (radioimmunoassay) in 906 participants in the population-based birth cohort. Children attended follow-ups to age 16 years. We investigate the discriminative ability of u-EPX and other factors in predicting asthma diagnosis at age 16 using receiver operating characteristic [ROC] curves.
Results
Of 613 children with follow-up information at age 16, 511 had data on u-EPX at age 3 and asthma diagnosis at age 16 years; of those; 133 (21.7%) had asthma. Based on longitudinal data, children were assigned to wheeze clusters: No wheeze (NWZ), early transient (ETW), late-onset (LOW), intermittent (INT) and persistent wheeze (PEW). U-EPX levels differed significantly between different wheeze clusters (p = .003), with clusters characterised with persistent symptoms having higher u-EPX. In the whole cohort, the best performing classification model for asthma diagnosis at age 16 years included sex, u-EPX, sensitisation and wheeze (area under the curve (AUC) = 0.82, 95% CI: 0.76–0.88). u-EPX and allergic sensitisation alone had similar predictive power (AUC [95%CI]: 0.64 [0.58–0.71] and 0.65 [0.60–0.71]). The best performing classification model for asthma prediction among children with doctor-confirmed wheeze in the first 3 years included child's u-EPX and sensitisation at age 3 years, sex, gestational age and maternal atopy (AUC: 0.76, 95%CI: 0.67–0.85).
Conclusions
Early-life u-EPX may be a useful non-invasive marker for asthma prediction in adolescence.
Date Issued
2024-12-01
Date Acceptance
2024-11-26
Citation
Pediatric Allergy and Immunology, 2024, 35 (12)
ISSN
0905-6157
Publisher
Wiley
Journal / Book Title
Pediatric Allergy and Immunology
Volume
35
Issue
12
Copyright Statement
© 2024 The Author(s). Pediatric Allergy and Immunology published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
10.1111/pai.70013
Subjects
Allergy
asthma prediction
ATOPY
BIOMARKERS
DISEASE
EXACERBATIONS
Immunology
LIFE
Life Sciences & Biomedicine
LUNG-FUNCTION
Pediatrics
PHENOTYPES
PREDICTION
preschool wheeze
Science & Technology
SENSITIZATION
urinary eosinophilic protein X
wheeze phenotypes
YOUNG-CHILDREN
Publication Status
Published
Article Number
e70013
Date Publish Online
2024-12-04