Predictive value of serum sST2 in preschool wheezers for development of asthma with high FeNO

Abstract

Wheezing is common in childhood. However, current prediction models of paediatric asthma have only modest accuracy. Novel biomarkers and definition of subphenotypes may improve asthma prediction. Interleukin-1-receptor-Like-1 is a well-replicated asthma-gene and associates with eosinophilia. We investigated whether serum sST2 predicts asthma and asthma with elevated exhaled NO (FeNO), compared to the commonly used Asthma Prediction Index (API). Using logistic regression modeling, we found that serum sST2 levels in 2-3y old wheezers do not predict doctors' diagnosed asthma at age 6y. Instead sST2 predicts a subphenotype of asthma characterized by increased levels of FeNO, a marker for eosinophilic airway inflammation. Herein, sST2 improved the predictive value of the API (AUC=0.70, 95CI 0.56-0.84), but had also significant predictive value on its own (AUC=0.65, 95CI 0.52-0.79). Our study indicates that sST2 in preschool wheezers has predictive value for the development of eosinophilic airway inflammation in asthmatic children at school age.

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