Reduced breath condensate pH in asymptomatic children with prior wheezing as a risk factor for asthma

• Published in: Journal of allergy and clinical immunology Vol. 128; no. 1; pp. 50 - 55
• Main Authors: von Jagwitz, Marie, Pessler, Frank, Akmatov, Manas, Li, Jialiang, Range, Ursula, Vogelberg, Christian
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.2011; Elsevier; Elsevier Limited
• Subjects: Airway management; allergic sensitization; Allergies; Allergy and Immunology; Asthma; Asthma - complications; Asthma - diagnosis; Asthma Predictive Index; Biological and medical sciences; Biomarkers; Breath Tests - methods; bronchitis; Child, Preschool; Children & youth; Chronic illnesses; Chronic obstructive pulmonary disease, asthma; early childhood asthma; Exhalation; exhaled breath condensate pH; Families & family life; Family medical history; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Hydrogen-Ion Concentration; Hypersensitivity, Immediate - complications; Immunopathology; Infant; Male; Medical sciences; Parents & parenting; Pneumology; Preschool children; recurrent wheezy bronchitis; Respiratory Sounds - diagnosis; Risk Factors; ROC Curve; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Sensitivity and Specificity; Values; recurrent wheezy bronchitis; MEF 25; F eno; EBC; ROC; exhaled breath condensate pH; Asthma Predictive Index; Asthma; AUC; AR; allergic sensitization; dEBC pH; FAT; ICS; API; FA; early childhood asthma; RWB; Family atopy; Fraction of exhaled nitric oxide; Allergic rhinitis; Area under the curve; Deaerated exhaled breath condensate pH; Family asthma; Maximal expiratory flow at 25% of forced vital capacity; Inhaled corticosteroid; Receiver operating characteristic; Exhaled breath condensate; Allergy; Relapse; Wheezing; Asymptomatic; Index; Epidemiology; Immunology; pH; Bronchus disease; Bronchitis; Sensitization; Obstructive pulmonary disease; Child; Human; Lung disease; Expired air; Immunopathology; Respiratory disease; Risk factor; Early; Respiration
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2011.03.005

Early noninvasive detection of increased risk of asthma with exhaled breath condensate (EBC) pH measurement has not been applied to preschool children. We sought to evaluate the ability of EBC pH measurement to identify young asymptomatic children at risk of asthma using the combination of recurrent wheezing and atopic sensitization as a proxy for a high risk of asthma. pH values were measured in deaerated EBC from 191 children (median age, 4.4 years [interquartile range, 2.2 years]). Children were divided into one of 5 groups: asymptomatic children with recurrent wheezy bronchitis with (group 1, n = 34) or without (group 2, n = 64) allergic sensitization, acute wheezy bronchitis (group 3, n = 18), allergic rhinoconjunctivitis without recurrent wheezy bronchitis (group 4, n = 15), and healthy control subjects (group 5, n = 60). The Asthma Predictive Index score was calculated for groups 1 and 2. Statistical significance was evaluated with the appropriate nonparametric tests, and the discriminatory accuracy was evaluated with receiver operating characteristic analysis. Deaerated EBC pH values were significantly lower in groups 1 and 3 than in groups 2, 4, and 5 (median, 7.49 [interquartile range, 0.94] and 7.44 [interquartile range, 0.70] vs 7.93 [interquartile range, 0.23], 8.02 [interquartile range, 0.17], and 7.96 [interquartile range, 0.25], respectively; P < .001 and area under the receiver operating characteristic curve ≥0.80 in all comparisons). The area under the curve for the differentiation between groups 1 and 2 improved from 0.80 to 0.94 (sensitivity, 0.94; specificity, 0.84; positive predictive value, 0.76) when breath condensate pH values and Asthma Predictive Index scores were combined. A reduced deaerated EBC pH value might help identify young asymptomatic children at high risk of asthma.