Wheezing and Asthma in childhood: an epidemiology approach

Wheezing/asthma in children is a complex problem due to its heterogeneous condition, with different pathogenic mechanisms, variations in duration and in severity; that make it difficult to totally understand. This relation between wheezing in infants and later development of asthma will be the result of alterations in the immune system maturation and congenital or acquired modifications of the airway. Several longitudinal studies have given us important information about the different phenotypes of wheezing/asthma that coexist in children. In this review, we analyse the recent potential mechanisms and risk factors for each of the three classic wheezing phenotypes presenting in children: transient, non-atopic and atopic; and we propose for consideration a fourth phenotype: overweight/obese girls with early menarche. A better understanding of those risk factors would be useful for the development of new strategies in wheezing/asthma management.