Asthma in children is difficult to predict. However, a new risk score gives hope. Prof. Bianca Schaub from the German Centre for Lung Research (DZL) led a study combining molecular markers, epidemiological factors and allergic symptoms to provide a more precise prognosis.
Around a third of preschool children show asthma-like symptoms such as wheezing. Asthma develops later in 30 to 40 percent of these children. Early identification of children at risk is important to provide timely and personalised treatment and prevent serious chronic secondary diseases. Existing risk scores are often based on current symptoms such as early wheezing or allergic sensitisation and are poor at predicting childhood asthma.
Even at birth, genetic variants associated with an increased susceptibility to asthma can be identified in the umbilical cord blood. Epigenetic markers, such as chemical changes in the DNA, can also play a role in the development of asthma. Prof Schaub's team at the DZL site in Munich (CPC-M) developed a new risk score that combines these genetic markers with epidemiological markers such as gender and family history of asthma. They also included symptoms and diagnoses such as wheezing, atopic dermatitis and food allergies, significantly improving the predictive power. Researchers from the DZL site network BREATH also took part in the project. The results could be of great importance for clinical practice and future studies. Nevertheless, even this risk score is currently not sufficient to be used in practice.
Future studies could further analyse other factors, such as the composition of intestinal bacteria, metabolic products, and proteins in the body, to improve the accuracy of the predictions.
Original publication: Böck A, Urner K, Eckert JK, et al. An integrated molecular risk score early in life for subsequent childhood asthma risk. Clin Exp Allergy. 2024;54(5):314-328. doi: 10.1111/cea.14475