Serum von Willebrand Factor and Thymic Stromal Lymphopoietin Levels Are Associated With Asthma Predictive Index in Preschool Children With Recurrent Wheezing
E. Mancino, R. Nenna, L. Petrarca, F. M. Pulcinelli, M. G. Conti, Mattia Spatuzzo, E. Schiera, Rosaria Mormile, F. Midulla,ABSTRACT
Aim
Recurrent wheezing is a very common condition among preschool children. One third of these patients will develop asthma. Early risk stratification is essential. This can be done through a standardized clinical index, the Asthma Predictive Index (API), but its predictive accuracy may be improved through the integration of biological markers.
Methods
We conducted a prospective cohort study, enrolling children aged 1 to 5 years with recurrent wheezing. The API was calculated to classify participants as API‐positive (Group 1) or API‐negative (Group 0). Blood samples were collected in order to perform a complete blood count and measurement of total Immunoglobulin E, thymic stromal lymphopoietin (TSLP) and von Willebrand factor (vWF) levels.
Results
The study included 92 children. The median TSLP level was 0.473 fg/mL and the median vWF level was 107.4%. According to the API, 74 were API‐positive and 18 API‐negative. TSLP (0.48 vs. 0.39 fg/mL; p = 0.045) and vWF levels (111.6% vs. 91.7%; p = 0.012) were significantly higher in API‐positive children. In multivariable analysis, elevated TSLP and vWF levels were independently associated with API positivity.
Conclusions
These findings suggest an association between vWF, TSLP, and API status; however, longitudinal studies are required to determine their value in predicting future asthma development.