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Predictive value of serum sST 2 in preschool wheezers for development of asthma with high FeNO
Author(s) -
Ketelaar M. E.,
Kant K. D.,
Dijk F. N.,
Klaassen E. M.,
Grotenboer N. S.,
Nawijn M. C.,
Dompeling E.,
Koppelman G. H.
Publication year - 2017
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.13193
Subject(s) - asthma , eosinophilia , medicine , logistic regression , predictive value , exhaled nitric oxide , eosinophilic , immunology , pediatrics , pathology , spirometry
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.