Predictive value of serum sST 2 in preschool wheezers for development of asthma with high FeNO

• Published in: Allergy (Copenhagen) Vol. 72; no. 11; pp. 1811 - 1815
• Main Authors: Ketelaar, M. E., van de Kant, K. D., Dijk, F. N., Klaassen, E. M., Grotenboer, N. S., Nawijn, M. C., Dompeling, E., Koppelman, G. H.
• Format: Journal Article
• Language: English
• Published: 01.11.2017
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1111/all.13193

Abstract Wheezing is common in childhood. However, current prediction models of pediatric asthma have only modest accuracy. Novel biomarkers and definition of subphenotypes may improve asthma prediction. Interleukin‐1‐receptor‐like‐1 ( IL1RL1 or ST2 ) is a well‐replicated asthma gene and associates with eosinophilia. We investigated whether serum sST 2 predicts asthma and asthma with elevated exhaled NO (Fe NO ), compared to the commonly used Asthma Prediction Index ( API ). Using logistic regression modeling, we found that serum sST 2 levels in 2‐3 years‐old wheezers do not predict doctors’ diagnosed asthma at age 6 years. Instead, sST 2 predicts a subphenotype of asthma characterized by increased levels of Fe NO , a marker for eosinophilic airway inflammation. Herein, sST 2 improved the predictive value of the API ( AUC =0.70, 95% CI 0.56‐0.84), but had also significant predictive value on its own ( AUC =0.65, 95% CI 0.52‐0.79). Our study indicates that sST 2 in preschool wheezers has predictive value for the development of eosinophilic airway inflammation in asthmatic children at school age.