Abstract:
Dividing preschool wheezing infants into episodic
wheezers or multitrigger wheezers, or into groups
used in longitudinal cohorts may only be clinically
useful if temporal factors such as severity and frequency,
and clinical parameters such as age of onset,
pattern and severity, atopy and eczema are taken
into account. There is little evidence to suggest that
phenotypes described are related to pathobiological
processes. The challenge is to identify phenotypes
associated with a pathobiological process and longitudinal
outcome and response to a specific therapy.
In clinical practice therapy should be decided by
identifying the preschool infant as an episodic viral
wheezer or a multitrigger wheezer and by determining
the association with the child’s asthma predictive
index (API), age of onset of wheeze and degree
of atopic sensitisation. The wheezy preschool child
with a positive API and evidence of multiple atopic
sensitisation is more likely to respond to therapy.
