Advanced Search
Korean J Pediatr 2012 August;55(8) :259-264.
Published online 2012 June 16.        doi:
Early childhood wheezing: various natural courses and their relationship to later asthma
Dong In Suh (Suh DI), Young Yull Koh (Koh YY)
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
Corresponding Author: Young Yull Koh ,Tel: +82-2-2072-3631, Fax: +82-2-747-5130, Email:
Copyright © 2012 by The Korean Pediatric Society
Wheezing is one of the most frequent complaints that lead to the use of medical resources in younger children. Generally, wheezing is caused by bronchiolitis and resolves spontaneously without recurrence, but sometimes, wheezing can progress into asthma. Early data on the natural history of childhood wheezing was mostly obtained from retrospective reviews of medical records or from questionnaires, which made it difficult to exclude biases. Now that many cohort studies are available, reviewing the results of birth cohort studies makes it possible to understand the natural course of early childhood wheezing and the risk factors for asthma. In this study, we have reviewed the various phenotypes of early childhood wheezing and their natural courses to help select the most appropriate management modalities for the different types of early childhood wheezing.
Keywords: Asthma | Preschool child | Cohort studies | Infant | Wheezing
1. Taussig LM, Wright AL, Holberg CJ, Halonen M, Morgan WJ, Martinez FD. Tucson Children's Respiratory Study: 1980 to present. J Allergy Clin Immunol 2003;111:661–675.
2. Morgan WJ, Stern DA, Sherrill DL, Guerra S, Holberg CJ, Guilbert TW, et al. Outcome of asthma and wheezing in the first 6 years of life: follow-up through adolescence. Am J Respir Crit Care Med 2005;172:1253–1258.
3. Kurukulaaratchy RJ, Fenn MH, Waterhouse LM, Matthews SM, Holgate ST, Arshad SH. Characterization of wheezing phenotypes in the first 10 years of life. Clin Exp Allergy 2003;33:573–578.
4. Kurukulaaratchy RJ, Karmaus W, Raza A, Matthews S, Roberts G, Arshad SH. The influence of gender and atopy on the natural history of rhinitis in the first 18 years of life. Clin Exp Allergy 2011;41:851–859.
5. Lau S, Nickel R, Niggemann B, Gruber C, Sommerfeld C, Illi S, et al. The development of childhood asthma: lessons from the German Multicentre Allergy Study (MAS). Paediatr Respir Rev 2002;3:265–272.
6. Lowe LA, Simpson A, Woodcock A, Morris J, Murray CS, Custovic A, et al. Wheeze phenotypes and lung function in preschool children. Am J Respir Crit Care Med 2005;171:231–237.
7. Simpson A, Tan VY, Winn J, Svensen M, Bishop CM, Heckerman DE, et al. Beyond atopy: multiple patterns of sensitization in relation to asthma in a birth cohort study. Am J Respir Crit Care Med 2010;181:1200–1206.
8. Henderson J, Granell R, Heron J, Sherriff A, Simpson A, Woodcock A, et al. Associations of wheezing phenotypes in the first 6 years of life with atopy, lung function and airway responsiveness in mid-childhood. Thorax 2008;63:974–980.
9. Savenije OE, Granell R, Caudri D, Koppelman GH, Smit HA, Wijga A, et al. Comparison of childhood wheezing phenotypes in 2 birth cohorts: ALSPAC and PIAMA. J Allergy Clin Immunol 2011;127:1505–1512.e14.
10. von Mutius E. Trajectories of childhood wheeze. J Allergy Clin Immunol 2011;127:1513–1514.
11. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med 1995;332:133–138.
12. Stein RT, Holberg CJ, Morgan WJ, Wright AL, Lombardi E, Taussig L, et al. Peak flow variability, methacholine responsiveness and atopy as markers for detecting different wheezing phenotypes in childhood. Thorax 1997;52:946–952.
13. Kurukulaaratchy RJ, Fenn M, Matthews S, Arshad SH. Characterisation of atopic and non-atopic wheeze in 10 year old children. Thorax 2004;59:563–568.
14. Lau S, Illi S, Sommerfeld C, Niggemann B, Volkel K, Madloch C, et al. Transient early wheeze is not associated with impaired lung function in 7-yr-old children. Eur Respir J 2003;21:834–841.
15. Matricardi PM, Illi S, Gruber C, Keil T, Nickel R, Wahn U, et al. Wheezing in childhood: incidence, longitudinal patterns and factors predicting persistence. Eur Respir J 2008;32:585–592.
16. Burrows B, Knudson RJ, Lebowitz MD. The relationship of childhood respiratory illness to adult obstructive airway disease. Am Rev Respir Dis 1977;115:751–760.
17. Martinez FD, Morgan WJ, Wright AL, Holberg CJ, Taussig LM. Diminished lung function as a predisposing factor for wheezing respiratory illness in infants. N Engl J Med 1988;319:1112–11
18. Tepper RS, Morgan WJ, Cota K, Wright A, Taussig LM. Physiologic growth and development of the lung during the first year of life. Am Rev Respir Dis 1986;134:513–519.
19. Lombardi E, Morgan WJ, Wright AL, Stein RT, Holberg CJ, Martinez FD. Cold air challenge at age 6 and subsequent incidence of asthma. A longitudinal study. Am J Respir Crit Care Med 1997;156:1863–1869.
20. Martinez FD. Recognizing early asthma. Allergy 1999;54 Suppl 49:24–28.
21. Palmer LJ, Rye PJ, Gibson NA, Burton PR, Landau LI, Lesouef PN. Airway responsiveness in early infancy predicts asthma, lung function, and respiratory symptoms by school age. Am J Respir Crit Care Med 2001;163:37–42.
22. Delacourt C, Benoist MR, Le Bourgeois M, Waernessyckle S, Rufin P, Brouard JJ, et al. Relationship between bronchial hyperresponsiveness and impaired lung function after infantile asthma. PLoS One 2007;2:e1180.
23. van de Kant KD, Klaassen EM, Jobsis Q, Nijhuis AJ, van Schayck OC, Dompeling E. Early diagnosis of asthma in young children by using non-invasive biomarkers of airway inflammation and early lung function measurements: study protocol of a case-control study. BMC Public Health 2009;9:210.
24. Castro-Rodriguez JA, Holberg CJ, Wright AL, Martinez FD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med 2000;162(4 Pt 1):1403–1406.
25. Castro-Rodriguez JA. The Asthma Predictive Index: a very useful tool for predicting asthma in young children. J Allergy Clin Immunol 2010;126:212–216.
26. Guilbert TW, Morgan WJ, Zeiger RS, Bacharier LB, Boehmer SJ, Krawiec M, et al. Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma. J Allergy Clin Immunol 2004;114:1282–1287.
27. Kurukulaaratchy RJ, Matthews S, Holgate ST, Arshad SH. Predicting persistent disease among children who wheeze during early life. Eur Respir J 2003;22:767–771.
28. Caudri D, Wijga A, A Schipper CM, Hoekstra M, Postma DS, Koppelman GH, et al. Predicting the long-term prognosis of children with symptoms suggestive of asthma at preschool age. J Allergy Clin Immunol 2009;124:903–910.e1-7.
29. Castro-Rodriguez JA, Cifuentes L, Rodriguez-Martinez CE. The asthma predictive index remains a useful tool to predict asthma in young children with recurrent wheeze in clinical practice. J Allergy Clin Immunol 2011;127:1082–1083.
30. Pedersen SE, Hurd SS, Lemanske RF Jr, Becker A, Zar HJ, Sly PD, et al. Global strategy for the diagnosis and management of asthma in children 5 years and younger. Pediatr Pulmonol 2011;46:1–17.
31. Hong SJ. Childhood asthma and allergic diseases cohort study. Public Health Wkly Rep 2010;3:721–726.
PDF Links  PDF Links
Full text via DOI  Full text via DOI
  via Pubmed
Full text via PMC  Full text via PMC
via Pubreader  via PubReader
Download Citation  Download Citation
Supplementary Material  Supplementary Material
Register for e-submission
Register here to access the e-submission system of Korean J Pediatr for authors and reviewers.
Manuscript Submission
To submit a manuscript, please visit the Korean J Pediatr e-submission management system at, read the Instructions for Authors, and log into the Korean J Pediatr e-submission system. For assistance with manuscript submission, please contact:
Free archive
Anyone may access any past or current articles without logging in.
Korean Pediatric Society Office
#1606, Seocho World Officetel, 19 Seoun-ro, Seocho-gu, Seoul 137-070, Korea
TEL : +82-2-3473-7305    FAX : +82-2-3473-7307   E-mail:
BrowseCurrent IssueFor Authors and ReviewersAbout
Copyright© The Korean Pediatric Society. All right reserved.