The distinction between episodic viral wheeze (EVW) and multitrigger wheeze (MTW) is used to guide management of preschool wheeze. It has been questioned whether these phenotypes are stable over time. We examined the temporal stability of MTW and EVW in two large population-based cohorts. We classified children from the Avon Longitudinal Study of Parents and Children (n=10 970) and the Leicester Respiratory Cohorts ((LRCs), n=3263) into EVW, MTW and no wheeze at ages 2, 4 and 6 years based on parent-reported symptoms. Using multinomial regression, we estimated relative risk ratios for EVW and MTW at follow-up (no wheeze as reference category) with and without adjusting for wheeze severity. Although large proportions of children with EVW and MTW became asymptomatic, those that continued to wheeze showed a tendency to remain in the same phenotype: among children with MTW at 4 years in the LRCs, the adjusted relative risk ratio was 15.6 (95% CI 8.3–29.2) for MTW (stable phenotype) compared to 7.0 (95% CI 2.6–18.9) for EVW (phenotype switching) at 6 years. The tendency to persist was weaker for EVW and from 2–4 years. Results were similar across cohorts. This suggests that MTW, and to a lesser extent EVW, tend to persist regardless of wheeze severity. Multitrigger and episodic viral wheeze tend to persist in early childhood and may reflect distinct disease processes http://ow.ly/KQrk30fvXMj

中文翻译：

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儿童早期多触发和偶发性病毒性喘息的时间稳定性

发作性病毒性喘息 (EVW) 和多触发性喘息 (MTW)​​ 之间的区别用于指导学龄前喘息的管理。人们质疑这些表型是否会随着时间的推移而稳定。我们在两个大型人群队列中检查了 MTW 和 EVW 的时间稳定性。我们将来自雅芳父母和儿童纵向研究 (n=10970) 和莱斯特呼吸队列 ((LRCs)，n=3263) 的儿童分为 EVW、MTW 和根据父母在 2、4 和 6 岁时没有喘息-报告的症状。使用多项回归，我们估计了 EVW 和 MTW 在随访时的相对风险比（没有作为参考类别的喘息），无论是否调整了喘息的严重程度。尽管大部分患有 EVW 和 MTW 的儿童没有症状，但那些持续喘息的儿童表现出保持相同表型的趋势：在 LRC 的 4 岁 MTW 儿童中，MTW（表型稳定）的调整后相对风险比为 15.6（95% CI 8.3-29.2），而 EVW（表型转换）为 7.0（95% CI 2.6-18.9）。 6 年。EVW 和 2-4 年的持续趋势较弱。各队列的结果相似。这表明 MTW 以及较小程度的 EVW 往往会持续存在，而不管喘息的严重程度如何。多重触发和偶发性病毒性喘息往往会在儿童早期持续存在，并可能反映不同的疾病过程 http://ow.ly/KQrk30fvXMj 这表明 MTW 以及较小程度的 EVW 往往会持续存在，而不管喘息的严重程度如何。多重触发和偶发性病毒性喘息往往会在儿童早期持续存在，并可能反映不同的疾病过程 http://ow.ly/KQrk30fvXMj 这表明 MTW 以及较小程度的 EVW 往往会持续存在，而不管喘息的严重程度如何。多重触发和偶发性病毒性喘息往往会在儿童早期持续存在，并可能反映不同的疾病过程 http://ow.ly/KQrk30fvXMj