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Войти в исследования Allergy · 2025
Point-of-Care Blood Eosinophils to Predict Preschool Wheeze Attacks.
СтатьяНазвание и аннотация: Перевод в очереди
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Hillson Kushalinii, Fontanella Sara, Almeida Hernani, Pavlou Barbara, Lajunen Katariina, Irving Samantha, Testa Ilaria, Bingham Yvonne, Oritz Karina Mayoral, Lacbay Shane, Hay Sophie, Gore Mindy, Scotney Elizabeth, Paraskakis Emmanouil, Sonnappa Samatha, Fleming Louise, Bush Andrew, Saglani Sejal
Аннотация
BACKGROUND: Post hoc analysis of clinical trials shows blood eosinophil counts (BEC) predict future preschool wheeze attacks; however, prospective usefulness in a clinical setting is unreported. We assessed the feasibility of point-of-care (POC) eosinophil measurements in preschool wheezers and related BEC to symptoms, lung function, and utility in predicting attacks.
METHODS: Children aged 1-5 years with recurrent wheeze underwent finger-prick sampling during the outpatient clinic for POC eosinophils, forced oscillation technique (FOT) and/or spirometry, and symptom score (TRACK questionnaire). The utility of BEC and/or the other tests in predicting wheeze attacks in the subsequent 3 months was analysed by comparing those with and without an attack and using a predictive decision tree (DT) model.
RESULTS: Seventy-three children (median age 4.27 years) were recruited; BEC were higher in atopic children (median 0.5 × 109/L vs. 0.3 × 109/L non-atopic, p < 0.01). BEC moderately correlated with FOT reactance bronchodilator reversibility z-score changes (r = 0.495, p = 0.005), but no other lung function measures or TRACK score. 68/73 (93%) children were followed up at 3 months. 29/68 (43%) children had > 1 wheeze attack requiring unscheduled healthcare attendance. Absolute and %eosinophils at the baseline visit were higher in those who had an attack (median 0.5 × 109/L vs. 0.3 × 109/L, p = 0.03 and median 6% vs. 4%, p < 0.01). The DT model showed children with BEC ≥ 4% and TRACK score < 75 were more likely to have a future attack (probability 0.63).
CONCLUSION: POC blood eosinophils were feasible in a clinical setting. Our preliminary data suggest elevated BEC with a low symptom score predicts a wheeze attack within 3 months.
METHODS: Children aged 1-5 years with recurrent wheeze underwent finger-prick sampling during the outpatient clinic for POC eosinophils, forced oscillation technique (FOT) and/or spirometry, and symptom score (TRACK questionnaire). The utility of BEC and/or the other tests in predicting wheeze attacks in the subsequent 3 months was analysed by comparing those with and without an attack and using a predictive decision tree (DT) model.
RESULTS: Seventy-three children (median age 4.27 years) were recruited; BEC were higher in atopic children (median 0.5 × 109/L vs. 0.3 × 109/L non-atopic, p < 0.01). BEC moderately correlated with FOT reactance bronchodilator reversibility z-score changes (r = 0.495, p = 0.005), but no other lung function measures or TRACK score. 68/73 (93%) children were followed up at 3 months. 29/68 (43%) children had > 1 wheeze attack requiring unscheduled healthcare attendance. Absolute and %eosinophils at the baseline visit were higher in those who had an attack (median 0.5 × 109/L vs. 0.3 × 109/L, p = 0.03 and median 6% vs. 4%, p < 0.01). The DT model showed children with BEC ≥ 4% and TRACK score < 75 were more likely to have a future attack (probability 0.63).
CONCLUSION: POC blood eosinophils were feasible in a clinical setting. Our preliminary data suggest elevated BEC with a low symptom score predicts a wheeze attack within 3 months.