Wheezing patterns tend to persist in children

Children, who develop asthma-like symptoms in the preschool years, establish patterns of wheezing and lung function by the age 6, which do not change by the age of 16 years. Previous studies have suggested the toddler years as the time during which important alterations in lung structure and function develop in most individuals with persistent asthma. Researchers from the University of Arizona Health Sciences Center, Tucson, 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 the age of 3 years and active wheeze at the age of 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 the age of 16 years. The increased risk of allergy, which was present in persistent and late-onset wheezers at the age of 6 years, continued through adolescence. Transient wheezers and persistent wheezers had decreased lung function at ages of 11 and 16 years. The 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. Identifying the environmental and genetic factors that influence these processes will be decisive for the prevention of asthma and chronic airway obstruction.