Clinical and bronchial parameters associated with the exacerbation frequency of severe preschool wheezers
Recurrent preschool wheezers represent approximately 10% of children under 5 years of age.1 Among them, those who report frequent exacerbations (ie, 3 or more per year), mainly due to viral and/or bacterial infections, have an increased risk of persistent asthma and poor lung function throughout life.1,2 The risk of exacerbation has been previously associated with several clinical and/or biological parameters, including those of bronchial remodeling. The latter corresponds to a poorly reversible structural abnormality of the bronchial tissue (ie, altered epithelial integrity, increased mass of mucus gland and/or bronchial smooth muscle [BSM], increased density of blood vessels, and an increased collagen deposition leading to reticular basement membrane [RBM] thickening and increased submucosal fibrosis).