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Small airway dysfunction is an independent dimension of wheezing disease in preschool children
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  • Plamen Bokov,
  • Donies Masmoudi,
  • Flore Amat,
  • Véronique Houdouin,
  • Christophe Delclaux
Plamen Bokov
Hopital Universitaire Robert-Debre

Corresponding Author:plamen.bokov@aphp.fr

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Donies Masmoudi
Robert-Debré Mother-Child University Hospital
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Flore Amat
Hopital Armand-Trousseau
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Véronique Houdouin
Robert-Debré Mother-Child University Hospital
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Christophe Delclaux
Robert-Debré Mother-Child University Hospital
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Background. Whether small airway dysfunction (SAD), which is prevalent in asthma, helps to characterize wheezing phenotypes is undetermined. The objective was to assess whether SAD parameters obtained from impedance measurement and asthma probability are linked. Methods. One hundred and thirty-nine preschool children (mean age 4.7 years, 68% boys) suffering from recurrent wheeze underwent impulse oscillometry that allowed calculating peripheral resistance and compliance of the respiratory system (markers of SAD) using the extended RIC model (central and peripheral Resistance, Inertance and peripheral Compliance of the respiratory system). Children were classified using the probability-based approach of GINA guidelines (few, some, most having asthma). A principal component analysis (PCA) that determined the dimensions of wheezing disease evaluated the links between SAD and asthma probability. Results. Forty-seven children belonged to the few, 28 to the some and 64 to the most having asthma groups. Whereas their anthropometrics and measured parameters were similar, the most having asthma group exhibited the lowest mean value of airway inertance after bronchodilator probably due to airway inhomogeneities. PCA characterized nine independent dimensions including a peripheral resistance (constituted by baseline peripheral resistance, AX, R5-20Hz, X5Hz), a central resistance (baseline central resistance, R20Hz) and an airway size dimension (post-bronchodilator inertance and central resistance). PCA showed that the SAD markers were independent from clinical dimensions (control and asthma probability were two other dimensions) and did not help to define wheezing phenotypes. Conclusions. Lung function parameters obtained from impulse oscillometry and asthma probability were belonging to independent dimensions of the wheezing disease.
23 Mar 2021Submitted to Pediatric Allergy and Immunology
24 Mar 2021Reviewer(s) Assigned
19 Apr 2021Review(s) Completed, Editorial Evaluation Pending
19 Apr 2021Editorial Decision: Revise Major
24 Jun 20211st Revision Received
25 Jun 2021Review(s) Completed, Editorial Evaluation Pending
26 Jun 2021Reviewer(s) Assigned
05 Jul 2021Editorial Decision: Revise Minor
03 Aug 20212nd Revision Received
04 Aug 2021Review(s) Completed, Editorial Evaluation Pending
05 Aug 2021Editorial Decision: Accept
Jan 2022Published in Pediatric Allergy and Immunology volume 33 issue 1. 10.1111/pai.13647