{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:42:00Z","timestamp":1770291720491,"version":"3.49.0"},"reference-count":85,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T00:00:00Z","timestamp":1654819200000},"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":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Numerous publications on wheezing disorders in children younger than 6 years have appeared in the medical literature over the last decades with the aim of shedding light on the mechanistic pathways (endotypes) and treatment. Nevertheless, there is yet no consensus as to the appropriate way to manage preschool wheeze mainly because of the lack of a clear definition of \u201cpreschool asthma\u201d and the paucity of scientific evidence concerning its underlying endotypes. A symptom\u2010based approach is inadequate since the human airway can respond to external stimuli with a limited range of symptoms and signs, including cough and wheeze, and these manifestations represent the final expression of many clinical entities with potentially different pathophysiologies requiring different individualized treatments. Hence, new studies challenge the symptom\u2010based approach and promote the importance of managing the wheezy child based on the \u201cairway phenotype.\u201d This will enable the clinician to identify not only the child with a serious underlying pathology (e.g., a structural airway disorder or immunodeficiency) who is in need of prompt and specific treatment but also increase the specificity of treatment for the child with symptoms suggestive of an \u201casthma\u201d syndrome. In the latter case, focus should be given to the identification of treatable traits. This review summarizes the current understanding in management of preschool wheezing and highlights the unmet need for further research.<\/jats:p>","DOI":"10.1002\/ppul.26027","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T07:29:34Z","timestamp":1654154974000},"page":"1990-1997","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Enigma variations: The multi\u2010faceted problems of pre\u2010school wheeze"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4308-4710","authenticated-orcid":false,"given":"Grigorios","family":"Chatziparasidis","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Metropolitan Hospital, Athens, and Primary Cilia Dyskinesia Unit University of Thessaly  Volos Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Bush","sequence":"additional","affiliation":[{"name":"Departments of Paediatrics and Paediatric Respiratory Medicine Royal Brompton Harefield NHS Foundation Trust and Imperial College  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.12.643"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199501193320301"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.115188"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.4086"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00780-2015"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2017.1257940"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-015-0542-0"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201810-1956CI"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.10.059"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.02.002"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202009-3696OC"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.12.985"},{"key":"e_1_2_10_14_1","first-page":"8","article-title":"Preschool wheezing: trajectories and Long\u2010Term treatment","volume":"12","author":"Fainardi V","year":"2020","journal-title":"Front Pediatr"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.02.003"},{"key":"e_1_2_10_16_1","first-page":"7","article-title":"Pathophysiological mechanisms of asthma","volume":"19","author":"Bush A","year":"2019","journal-title":"Front Pediatr"},{"key":"e_1_2_10_17_1","unstructured":"Global Initiative for Asthma. Global Strategy for Asthma Mangement and Prevention. 2019. Available fromwww.ginaasthma.orgAccessed December 3 2020."},{"key":"e_1_2_10_18_1","first-page":"8","article-title":"Asthma: a loss of post\u2010natal homeostatic control of airways smooth muscle with regression toward a pre\u2010natal state","volume":"16","author":"Anthracopoulos MB","year":"2020","journal-title":"Front Pediatr"},{"key":"e_1_2_10_19_1","first-page":"8","article-title":"Time to say goodbye to bronchiolitis, viral wheeze, reactive airways disease, wheeze bronchitis and all that","volume":"5","author":"Douros K","year":"2020","journal-title":"Front Pediatr"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2019.05.025"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aller.2018.05.002"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/101572"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2008.02966.x"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)61398-1"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201309-1700OC"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2003.162"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7386.422"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2002.120951"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00080312"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411532"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.12.1033"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(18)30100-0"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.05.043"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2021.05.006"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa054692"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69285-4"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051378"},{"key":"e_1_2_10_38_1","first-page":"207","volume-title":"Wheezing as a respiratory sound","author":"Chatziparasidis G","year":"2018"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00008406"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2018.10.003"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.02.045"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.04.025"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpam.2019.02.003"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00002108"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g15"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2004.029934"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-207961"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-1875"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.2332\/allergolint.12-RAI-0440"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aller.2018.03.003"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(58)91385-0"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200702-212OC"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200712-1818OC"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2016.09.028"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20159"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200603-352OC"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.08.031"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1804092"},{"key":"e_1_2_10_59_1","doi-asserted-by":"publisher","DOI":"10.1186\/1824-7288-35-21"},{"key":"e_1_2_10_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.22782"},{"key":"e_1_2_10_61_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2006.00473.x"},{"key":"e_1_2_10_62_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.22705"},{"key":"e_1_2_10_63_1","unstructured":"TangHH TeoSM BelgraveDC et al.Trajectories of childhood immune development and respiratory health relevant to asthma and allergy.eLife.2018;7:1\u201031."},{"key":"e_1_2_10_64_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201801-0190OC"},{"key":"e_1_2_10_65_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0027913"},{"key":"e_1_2_10_66_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c4978"},{"key":"e_1_2_10_67_1","first-page":"30","article-title":"Question 4: is there a role for antibiotics in infantile wheeze?","volume":"33","author":"Benedictis FM","year":"2020","journal-title":"Paediatr Respir Rev"},{"key":"e_1_2_10_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.10.001"},{"key":"e_1_2_10_69_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.13896"},{"key":"e_1_2_10_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00520-2"},{"key":"e_1_2_10_71_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00160412"},{"key":"e_1_2_10_72_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23636"},{"key":"e_1_2_10_73_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-2259"},{"key":"e_1_2_10_74_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23366"},{"key":"e_1_2_10_75_1","doi-asserted-by":"publisher","DOI":"10.1159\/000245899"},{"key":"e_1_2_10_76_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2011-201064"},{"key":"e_1_2_10_77_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.156836"},{"key":"e_1_2_10_78_1","doi-asserted-by":"publisher","DOI":"10.3390\/children8060428"},{"key":"e_1_2_10_79_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00092908"},{"key":"e_1_2_10_80_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjp.2008.232"},{"key":"e_1_2_10_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.steroids.2005.09.019"},{"key":"e_1_2_10_82_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajplung.00269.2006"},{"key":"e_1_2_10_83_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2014-205572"},{"key":"e_1_2_10_84_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1110226108"},{"key":"e_1_2_10_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsbmb.2013.05.009"},{"key":"e_1_2_10_86_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(16)00023-0"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26027","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.26027","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T12:40:14Z","timestamp":1731933614000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.26027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,10]]},"references-count":85,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1002\/ppul.26027"],"URL":"https:\/\/doi.org\/10.1002\/ppul.26027","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,10]]},"assertion":[{"value":"2022-02-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}