Phenotypes of Preschool Wheezing Among Children Attending Sohag University Hospital

Wheezing in preschool children is very common, with a wide differential diagnosis. It is essential to be sure of the exact sound that parents are describing; the term 'wheeze' is often applied to non-specific sound.Approximately one-third of children are diagnosed with wheeze in the first 3 years of life, making wheeze one of the commonest respiratory symptoms.The differential diagnosis of wheeze is wide, and different management strategies are needed depending on the underlying phenotype. The word 'wheeze' is used to describe many different sounds. That can be heard by both clincians and parent. Even if true wheeze is heard, this should not be automatically assumed to be due to bronchospasm. Airway narrowing by mucus will produce true wheeze but does not respond to bronchodilators. Similarly, airway malacia, either related to intrinsic airway wall defects or loss of alveolar tethering points, are also causes of bronchodilatorunresponsive wheeze; indeed, bronchodilators, by reducing airway smooth muscle tone, may actually worsen airway narrowing.

Study Overview

• Status: Recruiting
• Conditions: Wheezing
• Intervention / Treatment: Radiation: Chest x- Rays

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

• Study Contact: Name: Amr A Farghal, resident; Phone Number: 01020479524; Email: amrahmed@med.sohag.edu.eg
• Study Contact Backup: Name: Mostfa A Mohammed, assistant professor

Study Locations

• Egypt
  • Sohag, Egypt
    • Recruiting
    • Sohag University Hospital
    • Contact: Magdy M Amin, professor

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

- patients from the age of one to five years with recurrent wheezing

Description

Inclusion Criteria:

• patients from the age of one to five years with recurrent wheezing

Exclusion Criteria:

• Children above 5 years and below one year old.
• Failure to obtain informed consent.
• Children below 6 years with chest diseases other than wheezing

Study Plan

How is the study designed?

Number of groups / cohorts

4

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
group A; Bronchial Asthma	Radiation: Chest x- Rays; prebronchial Thicknening - Right upper lobe Patches suggesting Aspiration -Collapsing lobe
group B; Chronic Aspiration	Radiation: Chest x- Rays; prebronchial Thicknening - Right upper lobe Patches suggesting Aspiration -Collapsing lobe
group C; Primary Ciliary Dyskinesia	Radiation: Chest x- Rays; prebronchial Thicknening - Right upper lobe Patches suggesting Aspiration -Collapsing lobe
group D; Cystic Fibrosis	Radiation: Chest x- Rays; prebronchial Thicknening - Right upper lobe Patches suggesting Aspiration -Collapsing lobe

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Forced Expiratory Volume	Changes in Forced Expiratory Volume in bronchial Asthmatic Patient	6 months

Collaborators and Investigators

• Sponsor: Sohag University

Publications and helpful links

General Publications

• Fitzpatrick AM, Bacharier LB, Guilbert TW, Jackson DJ, Szefler SJ, Beigelman A, Cabana MD, Covar R, Holguin F, Lemanske RF Jr, Martinez FD, Morgan W, Phipatanakul W, Pongracic JA, Zeiger RS, Mauger DT; NIH/NHLBI AsthmaNet. Phenotypes of Recurrent Wheezing in Preschool Children: Identification by Latent Class Analysis and Utility in Prediction of Future Exacerbation. J Allergy Clin Immunol Pract. 2019 Mar;7(3):915-924.e7. doi: 10.1016/j.jaip.2018.09.016. Epub 2018 Sep 26.
• Lowe LA, Simpson A, Woodcock A, Morris J, Murray CS, Custovic A; NAC Manchester Asthma and Allergy Study Group. Wheeze phenotypes and lung function in preschool children. Am J Respir Crit Care Med. 2005 Feb 1;171(3):231-7. doi: 10.1164/rccm.200406-695OC. Epub 2004 Oct 22.
• Salehian S, Fleming L, Saglani S, Custovic A. Phenotype and endotype based treatment of preschool wheeze. Expert Rev Respir Med. 2023 Jul-Dec;17(10):853-864. doi: 10.1080/17476348.2023.2271832. Epub 2023 Nov 24.
• Kwong CG, Bacharier LB. Phenotypes of wheezing and asthma in preschool children. Curr Opin Allergy Clin Immunol. 2019 Apr;19(2):148-153. doi: 10.1097/ACI.0000000000000516.

Study record dates

Study Major Dates

• Study Start (Actual): June 4, 2024
• Primary Completion (Estimated): April 4, 2025
• Study Completion (Estimated): April 4, 2025

Study Registration Dates

• First Submitted: September 17, 2024
• First Submitted That Met QC Criteria: September 17, 2024
• First Posted (Estimated): September 19, 2024

Study Record Updates

• Last Update Posted (Estimated): September 19, 2024
• Last Update Submitted That Met QC Criteria: September 17, 2024
• Last Verified: September 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Signs and Symptoms, Respiratory; Respiratory Sounds
• Other Study ID Numbers: soh-Med-24-06-20MS

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No