Asthma: predicting which pre-school children with wheezing will go on to develop the condition later in childhood

Around 1.1 million children in the UK are currently receiving treatment for asthma.[1] Childhood asthma causes a reduction in lung function, which persists into adulthood – affecting their long-term quality of life. Although most pre-school children who wheeze will outgrow their symptoms, some will develop asthma at school age. Professor Sejal Saglani of Imperial College London is aiming to design a new computer-based tool that can predict which young children who wheeze will go on to develop asthma. The long-term goal is to help prevent the condition from developing in children most at risk, reducing the lifelong impact on their lung health.

How are children’s lives affected now?

Asthma is the most common chronic medical condition in children in the UK, affecting one in every 11 children.¹ Childhood asthma has a lifelong impact on lung health.

“A child with asthma will cough, wheeze and have breathing difficulties – which can seriously impact on their long-term quality of life,” says Professor Saglani.

Up to half of all children aged between one and five years will suffer from wheezing attacks² – where they will make a high-pitched whistling noise, mostly when breathing out. Although many will outgrow these symptoms, approximately one in three young children who wheeze will develop asthma by school age.³  

“It is important to predict which pre-school children will go on to develop asthma as this could enable early interventions to help prevent the condition from developing,” says Professor Saglani. “But this is challenging as there are several different potential causes for wheezing attacks in young children, including allergies or lung infections.”

How could this research help?

“Our goal is to develop a computer-based tool that can predict which pre-school children who wheeze will continue to have reduced lung function and develop asthma,” says Professor Saglani.

The researchers will assess children who had severe wheezing at pre-school age to find out if they have reduced lung function or asthma at school age. They will also carry out experiments to explore how lung cells from young children who wheeze and school-age children with asthma react to stimuli that can trigger wheezing attacks, such as bacterial infections and allergens.

“We will combine these clinical and biological data and use mathematical modelling to develop a computer-based tool that can predict which young children with wheezing are most likely to develop asthma,” says Professor Saglani.

If successful, their next step would be to design a larger national study to evaluate the accuracy of the new predictive tool.

References

1. Asthma UK. Asthma facts and statistics. https://www.asthma.org.uk/about/media/facts-and-statistics/ [website accessed 23 February 2021]
2. Lowe LA et al. Wheeze phenotypes and lung function in preschool children. Am J Respir Crit Care Med 2005;171(3):231-7.
3. Bloom CT et al. Burden of preschool wheeze and progression to asthma in the UK: Population-based cohort 2007 to 2017. Allergy Clin Immunol 2021;147(5):1949–1958.

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