Imperial College London
Alternate

ProfessorSejalSaglani

Faculty of Medicine, National Heart & Lung Institute

Professor of Paediatric Respiratory Medicine
 
 
 
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Contact

 

+44 (0)20 7594 3167s.saglani

 
 
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Location

 

112Sir Alexander Fleming BuildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Oksel:2019:10.1513/AnnalsATS.201811-837OC,
author = {Oksel, C and Granell, R and Haider, S and Fontanella, S and Simpson, A and Turner, S and Devereux, G and Arshad, SH and Murray, CS and Roberts, G and Holloway, JW and Cullinan, P and Henderson, J and Custovic, A and STELAR, and Breathing Together investigators},
doi = {10.1513/AnnalsATS.201811-837OC},
journal = {Annals of the American Thoracic Society},
pages = {868--876},
title = {Distinguishing wheezing phenotypes from infancy to adolescence: a pooled analysis of five birth cohorts},
url = {http://dx.doi.org/10.1513/AnnalsATS.201811-837OC},
volume = {16},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - RATIONALE: Pooling data from multiple cohorts and extending the time-frame across childhood should minimize study-specific effects, enabling better characterization of the childhood wheezing. OBJECTIVE: To analyze wheezing patterns from early childhood to adolescence using combined data from five birth cohorts. METHODS: We used latent class analysis to derive wheeze phenotypes among 7719 participants from five birth cohorts with complete report of wheeze at five time-periods. We tested the association of derived phenotypes with late asthma outcomes and lung function, and investigated the uncertainty in phenotype assignment. RESULTS: We identified five phenotypes: Never/Infrequent wheeze (52.1%), Early-onset pre-school remitting (23.9%), Early-onset mid-childhood remitting (9%), Persistent (7.9%) and Late-onset wheeze (7.1%). Compared to the Never/infrequent wheeze, all phenotypes had higher odds of asthma and lower FEV1 and FEV1/FVC in adolescence. The association with asthma was strongest for Persistent wheeze (adjusted odds ratio 56.54, 95%CI 43.75-73.06). We observed considerable within-class heterogeneity at individual level, with 913 (12%) children having low membership probability (<0.60) of any phenotype. Class membership certainty was highest in Persistent and Never/infrequent, and lowest in Late-onset wheeze (with 51% of participants having membership probabilities<0.80). Individual wheezing patterns were particularly heterogeneous in Late-onset wheeze, while many children assigned to Early-onset pre-school remitting class reported wheezing at later time points. CONCLUSIONS: All wheeze phenotypes had significantly diminished lung function in school-age, suggesting that the notion that early-life episodic wheeze has a benign prognosis may not be true for a proportion of transient wheezers. We observed considerable within-phenotype heterogeneity in individual wheezing patterns.
AU  - Oksel,C
AU  - Granell,R
AU  - Haider,S
AU  - Fontanella,S
AU  - Simpson,A
AU  - Turner,S
AU  - Devereux,G
AU  - Arshad,SH
AU  - Murray,CS
AU  - Roberts,G
AU  - Holloway,JW
AU  - Cullinan,P
AU  - Henderson,J
AU  - Custovic,A
AU  - STELAR,and Breathing Together investigators
DO  - 10.1513/AnnalsATS.201811-837OC
EP  - 876
PY  - 2019///
SN  - 2329-6933
SP  - 868
TI  - Distinguishing wheezing phenotypes from infancy to adolescence: a pooled analysis of five birth cohorts
T2  - Annals of the American Thoracic Society
UR  - http://dx.doi.org/10.1513/AnnalsATS.201811-837OC
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30888842
UR  - http://hdl.handle.net/10044/1/67917
VL  - 16
ER  -
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