Early-life wheeze: "the Child is father of the Man"

Abstract

To the Editor: We applaud the recent article by Hovland et al. [1] from the Environment and Childhood Asthma (ECA) study, which provides intriguing insight into the longer-term consequences of early-life wheezing. Employing a different classification of early wheeze (recurrent bronchial obstruction (RBO)) to previous studies, including our own Isle of Wight Birth Cohort (IOWBC), their findings suggest that a not-insubstantial proportion of such disease is associated with wheezing at the end of childhood. We note their comparison of findings with those reported from the 10-year follow-up of our IOWBC, highlighting both similarities and differences between the two studies. They also query what a later follow-up of the IOWBC would show in relation to young adult outcome of early-life wheezing. The ECA report followed up patients at 16 years of age, whereas the corresponding follow-up of our cohort was at 18 years. Using data from that follow-up, we can both corroborate the findings of Hovland et al. [1] and shed further light on their understanding by returning to our earlier classification of wheeze phenotypes in the first decade of life. Hovland et al. [1] used a very stringent definition of “early life” confined to wheezing events in the first 2 years of life. By contrast, the IOWBC papers they compare their findings against use a broader definition of “early life” encompassing the first 4 years of life [2, 3]. Interest is growing in the influence of early life as a period of vulnerability for disease development and an argument …