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Metabolomics to predict asthma in preschool children

Schultz, A., Hall, G., Trengove, R., Ang, S., Lethbridge, R., Laing, I., Broadhurst, D. and Reinke, S. (2021) Metabolomics to predict asthma in preschool children. Respirology, 26 (S2). p. 23.

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Introduction/Aim: Differentiation of preschool wheeze into asthma and non‐asthma would allow targeted treatment for those more likely to benefit. We aimed to use metabolic biochemical profiling to discover novel urinary biomarkers of asthma in school‐age children (6‐10y) and investigate the potential to predict future development of asthma in preschool children (2‐4y).

Methods: 211 children were recruited. Healthy preschool(n=25); preschool wheeze (n=87); school‐aged healthy(n=43) and school‐aged asthma(n=56). Urinary metabolic profiles at baseline and during exacerbations were characterized using liquid chromatography mass spectrometry.

The utility of each individual metabolite as a biomarker of asthma at school‐age was tested using one‐way ANOVA. Canonical Variate Analysis (CVA), followed by multivariate regression, was performed to identify a specific urinary profile for effectively discriminating school‐age asthma from healthy controls. This model was then mapped to the urinary profiles of the preschool‐wheeze children, collected under identical analytical and data processing protocols.

Results: 162 putatively identified metabolites were measured within approved levels of analytical repeatability. There was a significant (p<0.05) disease effect for 34 metabolites. CVA uncovered a strong exacerbation profile correlated to the preschool‐wheeze exacerbation sample. Baseline and exacerbation regression models showed strong discrimination (AUROC=0.91&0.98 respectively). When preschool urinary profiles were projected through these models the proportion of preschool wheeze participants classified as “asthma”(~40%) was in‐line with clinical expectations(~30%).

Conclusion: A putative multifactorial urinary biomarker of asthma has shown promise of predicting the onset of childhood asthma. Longitudinal follow‐up is ongoing to determine predictive accuracy of the model. Targeted chemical assay development is underway.

Grant Support: Telethon Perth Children's Hospital Research Funds.

Item Type: Journal Article
Publisher: Wiley-Blackwell
Copyright: © 2021 Asian Pacific Society of Respirology.
Other Information: Oral abstract: TSANZSRS 2021 The Australia & New Zealand Society of Respiratory Science and The Thoracic Society of Australia and New Zealand (ANZSRS/TSANZ) Annual Scientific Meeting for Leaders in Lung Health & Respiratory Science, 1–2 May 2021
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