Assessment of Wheezing Frequency and Viral Etiology on Childhood and Adolescent Asthma Risk
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Halie M. Anderson, MD, Robert F. Lemanske Jr., MD FAAAAI, Michael D. Evans, MS, Ronald E. Gangnon, PhD, James E. Gern, MD FAAAAI, Daniel J. Jackson, MD
Rationale: We have previously reported that early rhinovirus (RV) wheezing illnesses are the most robust predictor of asthma development at age 6 years in high-risk children in the Childhood Origins of ASThma (COAST) birth cohort study. We sought to assess the role of etiology and frequency of wheezing illnesses in asthma risk from ages 6 to 13 years.

Methods: A total of 259 children were followed prospectively to age 6 years, and 217 were followed to age 13 years. A generalized additive logistic regression model (GAM) of asthma was fit for asthma diagnosed at ages 6, 8, 11, 13 years; with smooth terms for number of RV wheezing illnesses, number of non-RV wheezing illnesses, and their interaction.  In the absence of significant interaction the main effect p-values are reported.

Results: The number of RV wheezing episodes in early childhood was significantly associated with asthma at all ages (6 years: p<0.0001; 8 years: p<0.0001; 11 years: p=0.0006; 13 years: p=0.002).  The number of non-RV wheezing episodes was not significantly associated with asthma (6 years: p=0.06; 8 years: p=0.09; 11 years: p=0.06; 13 years: p=0.33).

Conclusions: RV wheezing illnesses remain an important predictor of asthma development in high-risk children and continued research efforts should focus on defining host and viral factors that promote wheezing RV illnesses in early childhood.