Preschool children with wheezing disorders pose diagnostic and therapeutic challenges and consume substantial healthcare resources. Peripheral eosinophil blood count (EBC) has been proposed as a potential indicator for future asthma development. This review by the European Academy of Allergy and Clinical Immunology (EAACI) Preschool Wheeze Task Force aimed to provide systematic evidence for the association between increased EBC and the risk of future asthma, as well as to identify potential cutoff values. In February 2023, a search of PubMed, EMBASE, and Cochrane Library databases was conducted to identify studies comparing EBCs in preschool children with wheezing who continued to wheeze later in life and those who did not. Included observational studies focused on children aged <6 years with a wheezing disorder, assessment of their EBCs, and subsequent asthma status. No language or publication date restrictions were applied. Among the initial 3394 studies screened, 10 were included in the final analysis, involving 1225 patients. The data from these studies demonstrated that high EBC in preschool children with wheezing is associated with future asthma development, with odds ratios of 1.90 (95% CI: 0.45–7.98, p = .38), 2.87 (95% CI: 1.38–5.95, p < .05), and 3.38 (95% CI: 1.72–6.64, p < .05) for cutoff values in the <300, 300–449, and ≥450 cells/μL ranges, respectively. Defining a specific cutoff point for an elevated EBC lacks consistency, but children with EBC >300 cells/μL are at increased risk of asthma. However, further research is needed due to the limitations of the included studies. Future investigations are necessary to fully elucidate the discussed association.

中文翻译：

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对学龄前喘息儿童绝对嗜酸性粒细胞计数和哮喘风险的系统回顾和荟萃分析：EAACI 工作组报告

患有喘息性疾病的学龄前儿童给诊断和治疗带来了挑战，并消耗了大量的医疗资源。外周嗜酸性粒细胞计数（EBC）已被提议作为未来哮喘发展的潜在指标。欧洲过敏和临床免疫学学会 (EAACI) 学前哮鸣音工作组进行的这项审查旨在为 EBC 增加与未来哮喘风险之间的关联提供系统证据，并确定潜在的临界值。 2023 年 2 月，对 PubMed、EMBASE 和 Cochrane 图书馆数据库进行了检索，以找出比较学龄前儿童中患有喘息的儿童的 EBC 的研究，这些儿童在以后的生活中继续喘息和没有喘息。包括针对患有喘息障碍的 6 岁以下儿童的观察性研究、对其 EBC 的评估以及随后的哮喘状况。没有语言或出版日期限制。在最初筛选的 3394 项研究中，最终分析纳入 10 项研究，涉及 1225 名患者。这些研究的数据表明，患有喘息的学龄前儿童的高 EBC 与未来哮喘的发展相关，比值比为 1.90 (95% CI: 0.45–7.98, p  = 0.38)、2.87 (95% CI: 1.38–5.95) ，p  < .05）和 3.38（95% CI：1.72-6.64，p  < .05），截断值分别在 <300、300-449 和 ≥ 450 个细胞/μL 范围内。为 EBC 升高定义特定的临界点缺乏一致性，但 EBC > 300 个细胞/μL 的儿童患哮喘的风险增加。然而，由于纳入研究的局限性，还需要进一步研究。未来的调查有必要充分阐明所讨论的关联。