• Jocelyne Just, Philippe Saint-Pierre, Rahele Gouvis-Echraghi, Bernard Boutin, Virginie Panayotopoulos, Nabila Chebahi, Aldjia Ousidhoum-Zidi, and Cam-Anh Khau.
• Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau, Université Pierre et Marie Curie, Paris, France. Electronic address: jocelyne.just@trs.aphp.fr.
• Ann. Allergy Asthma Immunol. 2013 Oct 1; 111 (4): 256-261.e1.

BackgroundRules for predicting the course of asthma in wheezy infants have low specificity.ObjectiveTo determine if the novel phenotypes-mild early viral wheeze (EVW), atopic multiple-trigger wheeze (MTW), and nonatopic uncontrolled wheeze (NAUW)-have different courses during the preschool period.MethodsPart of the prospectively followed Trousseau Asthma Program cohort was phenotyped using cluster analysis with 12 parameters (sex, asthma severity and control with inhaled corticosteroid [ICS], parental asthma, allergic rhinitis, eczema, food allergy, EVW or MTW, and allergen exposure trigger). Wheezing trajectories were assessed by crossing the original phenotypes with the phenotypes obtained at 5 years.ResultsFour clusters were identified at 5 years of age: asymptomatic children (n = 47) with no wheezing (98%), children with mild EVW (n = 40, 87% with EVW, 50% with EVW controlled with low-dose ICS), those with atopic MTW (n = 30, 100% with MTW, only 17% with MTW controlled with low-dose ICS, more significant for pollen asthmatic trigger), and those with atopic severe UW (n = 33, 63% with UW uncontrolled despite high doses of ICS, more significant for allergic rhinitis and dust as asthmatic trigger). Those with mild EVW became asymptomatic or remained with mild EVW. Those with atopic MTW remained with atopic MTW and those with NAUW developed severe UW in most cases.ConclusionThese results show that remission is most frequently observed in mild EVW and that no remission is observed in atopic MTW.Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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