TY - JOUR

T1 - Lung function testing and inflammation markers for wheezing preschool children

T2 - A systematic review for the EAACI Clinical Practice Recommendations on Diagnostics of Preschool Wheeze

AU - Elenius, Varpu

AU - Chawes, Bo

AU - Malmberg, Pekka L

AU - Adamiec, Aleksander

AU - Ruszczyński, Marek

AU - Feleszko, Wojciech

AU - Jartti, Tuomas

AU - EAACI Preschool Wheeze Task Force for Diagnostics of Preschool Wheeze

N1 - © 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

PY - 2021

Y1 - 2021

N2 - BACKGROUND: Preschool wheeze is highly prevalent; 30%-50% of children have wheezed at least once before age six. Wheezing is not a disorder; it is a symptom of obstruction in the airways, and it is essential to identify the correct diagnosis behind this symptom. An increasing number of studies provide evidence for novel diagnostic tools for monitoring and predicting asthma in the pediatric population. Several techniques are available to measure airway obstruction and airway inflammation, including spirometry, impulse oscillometry, whole-body plethysmography, bronchial hyperresponsiveness test, multiple breath washout test, measurements of exhaled NO, and analyses of various other biomarkers.METHODS: We systematically reviewed all the existing techniques available for measuring lung function and airway inflammation in preschool children to assess their potential and clinical value in the routine diagnostics and monitoring of airway obstruction.RESULTS: If applicable, measuring FEV1 using spirometry is considered useful. For those unable to perform spirometry, whole-body plethysmography and IOS may be useful. Bronchial reversibility to beta2-agonist and hyperresponsiveness test with running exercise challenge may improve the sensitivity of these tests.CONCLUSIONS: The difficulty of measuring lung function and the lack of large randomized controlled trials makes it difficult to establish guidelines for monitoring asthma in preschool children.

AB - BACKGROUND: Preschool wheeze is highly prevalent; 30%-50% of children have wheezed at least once before age six. Wheezing is not a disorder; it is a symptom of obstruction in the airways, and it is essential to identify the correct diagnosis behind this symptom. An increasing number of studies provide evidence for novel diagnostic tools for monitoring and predicting asthma in the pediatric population. Several techniques are available to measure airway obstruction and airway inflammation, including spirometry, impulse oscillometry, whole-body plethysmography, bronchial hyperresponsiveness test, multiple breath washout test, measurements of exhaled NO, and analyses of various other biomarkers.METHODS: We systematically reviewed all the existing techniques available for measuring lung function and airway inflammation in preschool children to assess their potential and clinical value in the routine diagnostics and monitoring of airway obstruction.RESULTS: If applicable, measuring FEV1 using spirometry is considered useful. For those unable to perform spirometry, whole-body plethysmography and IOS may be useful. Bronchial reversibility to beta2-agonist and hyperresponsiveness test with running exercise challenge may improve the sensitivity of these tests.CONCLUSIONS: The difficulty of measuring lung function and the lack of large randomized controlled trials makes it difficult to establish guidelines for monitoring asthma in preschool children.

KW - Biomarkers

KW - Bronchial Provocation Tests

KW - Child

KW - Child, Preschool

KW - Humans

KW - Inflammation

KW - Lung

KW - Respiratory Sounds/diagnosis

KW - Spirometry

U2 - 10.1111/pai.13418

DO - 10.1111/pai.13418

M3 - Review

C2 - 33222297

VL - 32

SP - 501

EP - 513

JO - Pediatric Allergy and Immunology, Supplement

JF - Pediatric Allergy and Immunology, Supplement

SN - 0906-5784

IS - 3

ER -