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

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Marie Von Jagwitz - , Department of Child and Adolescent Psychiatry and Psychotherapy (Author)
  • Frank Pessler - , Helmholtz Centre for Infection Research, Department of Child and Adolescent Psychiatry and Psychotherapy (Author)
  • Manas Akmatov - , Helmholtz Centre for Infection Research (Author)
  • Jialiang Li - , National University of Singapore (Author)
  • Ursula Range - , Institute for Medical Informatics and Biometry (Author)
  • Christian Vogelberg - , Department of Paediatrics, University Hospital Carl Gustav Carus Dresden (Author)

Abstract

Background: Early noninvasive detection of increased risk of asthma with exhaled breath condensate (EBC) pH measurement has not been applied to preschool children. Objective: 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. Methods: 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. Results: 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. Conclusion: A reduced deaerated EBC pH value might help identify young asymptomatic children at high risk of asthma.

Details

Original languageEnglish
Pages (from-to)50-55
Number of pages6
JournalJournal of allergy and clinical immunology
Volume128
Issue number1
Publication statusPublished - Jul 2011
Peer-reviewedYes

External IDs

PubMed 21458041

Keywords

ASJC Scopus subject areas

Keywords

  • allergic sensitization, Asthma, Asthma Predictive Index, early childhood asthma, exhaled breath condensate pH, recurrent wheezy bronchitis