Club cell protein-16, periostin, galectin and YKL-40 as potential predictors of recurrent wheeze in children

ABSTRACT
The aim of this research is to determine the serum levels of club cell protein (CC)-16, periostin, galectin and YKL-40 in children with first episode of wheezing who do or do not have recurrent wheezing in six months of follow up.
In this cohort study, we enrolled 152 subjects younger than three years of age who presented with first-time wheezing. Age, sex, previous history of wheezing and family history were recorded at enrollment as well as the wheezing severity score at presentation. Blood samples were obtained from all the subjects at enrollment for measurement of the levels of CC-16, periostin, galectin and YKL-40. Subjects enrolled were followed up for six months and history of wheezing was questioned by face-to-face interviews and physical examination performed at intervals of three months.
Among the 152 children enrolled 22 had recurrent wheezing during follow up. Mean age at presentation was not significantly different between recurrent wheezers and one-time wheezers [9.2(7.8) vs. 9.9(7.4) respectively, p = 0.55, 95% CI (-1.7-3.2)]. CC-16, periostin and galectine-3 levels were not significantly different between recurrent and one-time wheezers (p = 0.44, p = 0.31, p = 0.59). YKL-40 levels were higher in the recurrent wheezing group [89.2(75.2)] compared to one-time wheezers [59.3(43.3)], but the difference did not reach statistical significance (p = 0.06, 95% CI = -60.9-0.9).
In conclusion, YKL-40 may be a promising biomarker to predict recurrent wheezing children who present with first episode of wheezing. Further cohort studies with higher number of subjects may provide valuable data if different phenotypes of wheezing are considered.