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These factors include complex cellular interactions among different immune cell subsets, induction of pro\u2010inflammatory mediators and the molecular impact of environmental factors like allergens or viral infections on the developing immune system. Furthermore, the activation of specific genes and signalling pathways during this early phase plays a pivotal role in the manifestation of symptoms and subsequent development of asthma. Early identification of the propensity or risk for asthma development, for example by allergen sensitisation and viral infections during this critical period, is crucial for understanding the transition from wheeze to asthma. Favourable immune regulation during a critical \u2018window of opportunity\u2019 in early childhood can induce persistent changes in immune cell behaviour. In this context, trained immunity, including memory function of innate immune cells, has significant implications for understanding immune responses, potentially shaping long\u2010term immunological outcomes based on early\u2010life environmental exposures. Exploration of these underlying immune mechanisms that drive disease progression will provide valuable insights to understand childhood asthma development. This will be instrumental to develop preventive strategies at different stages of disease development for (i) inhibiting progression from wheeze to asthma or (ii) reducing disease severity and (iii) uncovering novel therapeutic strategies and contributing to more tailored and effective treatments for childhood asthma. In the long term, this shall empower healthcare professionals to develop evidence\u2010based interventions that reduce the burden of asthma for children, families and society overall.<\/jats:p>","DOI":"10.1111\/pai.14038","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T04:09:22Z","timestamp":1698206962000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["From preschool wheezing to asthma: Immunological determinants"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0785-9964","authenticated-orcid":false,"given":"Kristina","family":"Laubhahn","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Allergy Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich  Munich Germany"},{"name":"Member of German Centre for Lung Research \u2013 DZL, LMU Munich  Munich 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