{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T08:06:31Z","timestamp":1768032391520,"version":"3.49.0"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The asthma predictive index (API) predicts later asthma in preschoolers with frequent wheeze. We hypothesized that airway cytology differs between API positive (API+)\/negative (API\u2212) children with uncontrolled\/recurrent wheezing with dominance of eosinophils in API+\u00a0and neutrophils in API\u2212 groups respectively. The main objective of this study is to compare bronchoalveolar lavage (BAL) cell profiles in API+\/API\u2212 children with recurrent wheezing unresponsive to inhaled corticosteroids (ICS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective analysis of BAL in 43 children, 3\u201336 months (median: 14 months) receiving ICS (31 API+, 12 API\u2212). BAL cell differential counts, bacterial\/viral cultures, and lipid\u2010laden macrophage percentages were analyzed. Cell counts presented as median (range).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Neutrophil percentages were increased in both groups (API\u2212 16% [1%\u201376%]; API+ 42% [1%\u201395%]; <jats:italic>p<\/jats:italic>\u2009=\u2009NS). Cell percentages were similar for lymphocytes (API\u2212 12% [1%\u201330%]; API+\u00a07% [1%\u201337%]), and macrophages (API\u2212 67.5% [12%\u201397%]; API+ 41% [2%\u201394%]). Eosinophil percentages were low in both groups (API\u2212 1% [1%\u20132%]; API+ 1% [1%\u201311%]). There was no difference in cellular distributions using absolute cell counts comparing API groups. Bacterial cultures were positive in 18 (60%) API+\u00a0and 5 (41%) API\u2212 patients (<jats:italic>p<\/jats:italic>\u2009=\u20090.10).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cell profiles do not differ between API groups in children \u226436 months with recurrent wheezing unresponsive to ICS. Neutrophil percentages and total granulocyte count correlate with positive bacterial cultures independent of API status. Persistent bacterial bronchitis likely plays an important role in the persistence of symptoms unresponsive to ICS therapy regardless of API status with a trend to more positive cultures in API positive children.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.25716","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T04:11:21Z","timestamp":1633579881000},"page":"293-299","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Bronchoalveolar lavage profiles in uncontrolled wheezy children compared by asthma predictive index"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9250-5932","authenticated-orcid":false,"given":"Dima","family":"Ezmigna","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children's Hospital Colorado University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cori","family":"Daines","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The University of Arizona  Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6346-8140","authenticated-orcid":false,"given":"Wayne","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The University of Arizona  Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6705e1"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199501193320301"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115243"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/30.6.1473"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.02.041"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.162.4.9912111"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0b013e3283464c4a"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.06.032"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.3345\/kjp.2019.00640"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c4978"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.6.2005116"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.5.9805028"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.122.3.791"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.10266"},{"key":"e_1_2_6_16_1","unstructured":"National Asthma Education and Prevention Program. 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