Serum von Willebrand Factor and Thymic Stromal Lymphopoietin Levels Are Associated With Asthma Predictive Index in Preschool Children With Recurrent Wheezing

Aim: Recurrent wheezing is a very common condition among preschool children. One third of these patients will develop asthma. Early risk stratification is essential. This can be done through a standardized clinical index, the Asthma Predictive Index (API), but its predictive accuracy may be improved through the integration of biological markers. Methods: We conducted a prospective cohort study, enrolling children aged 1 to 5 years with recurrent wheezing. The API was calculated to classify participants as API-positive (Group 1) or API-negative (Group 0). Blood samples were collected in order to perform a complete blood count and measurement of total Immunoglobulin E, thymic stromal lymphopoietin (TSLP) and von Willebrand factor (vWF) levels. Results: The study included 92 children. The median TSLP level was 0.473 fg/mL and the median vWF level was 107.4%. According to the API, 74 were API-positive and 18 API-negative. TSLP (0.48 vs. 0.39 fg/mL; p = 0.045) and vWF levels (111.6% vs. 91.7%; p = 0.012) were significantly higher in API-positive children. In multivariable analysis, elevated TSLP and vWF levels were independently associated with API positivity. Conclusions: These findings suggest an association between vWF, TSLP, and API status; however, longitudinal studies are required to determine their value in predicting future asthma development.