Airway eosinophils in older teenagers with outgrown preschool wheeze: a pilot study.

Preschool wheezing affects one-third of all children growing up in the UK [1]. It varies in clinical presentation and severity, and there is evidence to suggest the co-existence of different wheeze phenotypes [2], some of which have been associated with adult asthma and chronic obstructive pulmonary disease [3]. Using data from the Leicester Respiratory Cohort studies [4], we have previously applied objective data-driven methods to distinguish three distinct preschool wheeze phenotypes: “atopic” and “non-atopic” persistent wheeze (PW) and transient viral wheeze (TVW) [5]. In children with PW, attacks of wheeze with and without colds were observed both at preschool age (0–5 years) and when followed-up at early school-age (4–8 years). Children with TVW, triggered predominantly by colds, had symptoms at age 0–5 years but not at age 4–8 years. Prognosis 5 years later (aged 8–13 years) was markedly better in children with TVW compared to the two PW phenotypes [6].