Researchers in Sweden have identified a genetic biomarker which, when combined with clinical information at an early episode of childhood wheeze, can distinguish children who will outgrow their wheeze from those who will develop chronic asthma. The team analysed leukocyte transcriptomes from preschool children aged six months to three years (n=107) who presented with acute wheeze and again two to three months later, compared to age-matched healthy controls (n=66).In children with wheeze, they found significant enrichment of genes involved in the innate immune responses. A unique acute wheeze-specific gene module was identified which was associated with vitamin D levels (P<.005) in infancy, as well as use of asthma medication and FEV1%/FVC several years later (P<.005).The authors concluded that gene expression profiles in blood from preschool wheezers predict asthma symptoms at school age and therefore serve as biomarkers. Presenting the findings in the European Respiratory Journal , they say molecular phenotyping plus clinical information at an early episode of wheeze may help to distinguish children who will outgrow their wheeze from those who will develop chronic asthma. Based on the findings, they developed a highly accurate model that predicts leukotriene receptor antagonist (LTRA) medication use at seven years of age (AUC 0.815).
Acute wheeze-specific gene module shows correlation with vitamin D and asthma medication.