• Marie von Jagwitz, Frank Pessler, Manas Akmatov, Jialiang Li, Ursula Range, and Christian Vogelberg.
• Division of Pediatric Pulmonology and Allergology, University Children's Hospital, Dresden, Germany.
• J. Allergy Clin. Immunol. 2011 Jul 1; 128 (1): 50-5.

BackgroundEarly noninvasive detection of increased risk of asthma with exhaled breath condensate (EBC) pH measurement has not been applied to preschool children.ObjectiveWe sought to evaluate the ability of EBC pH measurement to identify young asymptomatic children at risk of asthma using the combination of recurrent wheezing and atopic sensitization as a proxy for a high risk of asthma.MethodspH values were measured in deaerated EBC from 191 children (median age, 4.4 years [interquartile range, 2.2 years]). Children were divided into one of 5 groups: asymptomatic children with recurrent wheezy bronchitis with (group 1, n = 34) or without (group 2, n = 64) allergic sensitization, acute wheezy bronchitis (group 3, n = 18), allergic rhinoconjunctivitis without recurrent wheezy bronchitis (group 4, n = 15), and healthy control subjects (group 5, n = 60). The Asthma Predictive Index score was calculated for groups 1 and 2. Statistical significance was evaluated with the appropriate nonparametric tests, and the discriminatory accuracy was evaluated with receiver operating characteristic analysis.ResultsDeaerated EBC pH values were significantly lower in groups 1 and 3 than in groups 2, 4, and 5 (median, 7.49 [interquartile range, 0.94] and 7.44 [interquartile range, 0.70] vs 7.93 [interquartile range, 0.23], 8.02 [interquartile range, 0.17], and 7.96 [interquartile range, 0.25], respectively; P < .001 and area under the receiver operating characteristic curve ≥0.80 in all comparisons). The area under the curve for the differentiation between groups 1 and 2 improved from 0.80 to 0.94 (sensitivity, 0.94; specificity, 0.84; positive predictive value, 0.76) when breath condensate pH values and Asthma Predictive Index scores were combined.ConclusionA reduced deaerated EBC pH value might help identify young asymptomatic children at high risk of asthma.Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

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