University of Oulu

Elenius, V, Chawes, B, Malmberg, PL, et al; EAACI Preschool Wheeze Task Force for Diagnostics of Preschool Wheeze. Lung function testing and inflammation markers for wheezing preschool children: A systematic review for the EAACI Clinical Practice Recommendations on Diagnostics of Preschool Wheeze. Pediatr Allergy Immunol. 2021; 32: 501– 513. https://doi.org/10.1111/pai.13418

Lung function testing and inflammation markers for wheezing preschool children : a systematic review for the EAACI clinical practice recommendations on diagnostics of preschool wheeze

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Author: Elenius, Varpu1; Chawes, Bo2; Malmberg, Pekka L.3;
Organizations: 1Department of Pediatrics, Turku University Hospital and Turku University, Turku, Finland
2COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
3The Skin and Allergy Hospital, University of Helsinki, Helsinki, Finland
4Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
5Department of Pediatric Pneumology and Allergy, Medical University of Warsaw, Warsaw, Poland
6Department of Pediatrics, University of Oulu and Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2021050328481
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-11-22
Description:

Abstract

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: f 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.

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Series: Pediatric allergy and immunology
ISSN: 0905-6157
ISSN-E: 1399-3038
ISSN-L: 0905-6157
Volume: 32
Issue: 3
Pages: 501 - 513
DOI: 10.1111/pai.13418
OADOI: https://oadoi.org/10.1111/pai.13418
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3123 Gynaecology and paediatrics
Subjects:
Copyright information: © 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd. This is the peer reviewed version of the following article: Elenius, V, Chawes, B, Malmberg, PL, et al; EAACI Preschool Wheeze Task Force for Diagnostics of Preschool Wheeze. Lung function testing and inflammation markers for wheezing preschool children: A systematic review for the EAACI Clinical Practice Recommendations on Diagnostics of Preschool Wheeze. Pediatr Allergy Immunol. 2021; 32: 501– 513, which has been published in final form at https://doi.org/10.1111/pai.13418. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.