D1.172 - Parallel Trajectories of Lung Function and Allergic Sensitization in Childhood Asthma: A 7-Year Prospective Study

 While diverse phenotypes of childhood asthma are well-recognized, their long-term trajectories during the transition to adolescence require comprehensive long-term follow-up. This study aimed to investigate the parallel trajectories of lung function and allergic sensitization patterns during the transition from childhood to late adolescence.

 We prospectively followed 344 children with asthma from the Korean Childhood Asthma Study (KAS) cohort for seven years. Standardized spirometry (Forced Expiratory Volume in 1 second, FEV₁; Forced Vital Capacity, FVC; Maximal Mid-Expiratory Flow, MMEF) and skin prick tests (SPT) were performed at baseline (mean age 9.1) and at the 7-year follow-up (mean age 16.0). We analyzed the concurrent changes in lung function growth and longitudinal changes of allergen sensitization based on SPT results.

 Over the 7-year period, there was a significant decrease in asthma severity (P < 0.001). However, we identified parallel trajectories where persistent high-level sensitization to house dust mites (HDM) and elevated total IgE were closely coupled with suboptimal FEV₁ growth. Notably, children with early polysensitization showed a synchronous progression toward seasonal allergen sensitization (tree and grass pollens) by late adolescence. These linked pathways suggest that allergic inflammation remains a dominant driver of lung function development throughout the second decade of life.

 The parallel development of allergic sensitization and lung function underlines the necessity of early, integrated management. Targeted interventions for high-risk allergic phenotypes in early childhood may be critical for preserving long-term respiratory health and preventing permanent airway deficits in adulthood.