Keywords: preschool wheezing, asthma, exhaled breath, gut microbiome

"Non-Invasive Biomarkers In Paediatric Asthma"

Asthma is the most common chronic respiratory disease in children and adults. However, asthma is a heterogeneous disease, which makes an adequate and timely diagnosis challenging, particularly in preschool children. Wheezing is one of the most common respiratory symptoms in preschool children: 40% of young children suffer from these symptoms. However, in the majority of wheezing preschool children (70%) these symptoms are transient. It is currently hardly possible to adequately predict which wheezing children will eventually develop asthma. This results in both underdiagnosis and overdiagnosis of true asthma. Moreover, it is unclear which wheezing children will benefit from asthma treatment, which results in both undertreatment and overtreatment with (anti-inflammatory) asthma medication.

This thesis investigated the usefulness of non-invasive biomarkers in the prediction of asthma and the prediction of a clinical treatment response in wheezing preschool children. For this purpose, this thesis focused on exhaled breath analysis and assessment of the gut microbiome. The findings from this thesis will improve the applicability of these newly developed non-invasive biomarkers, which might lead to improved diagnostic algorithms, better monitoring of disease, and improved treatment decision making.

Language: Dutch

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