CONCLUSION
This study highlights the importance of BSM remodelling in the
susceptibility of severe preschool wheezers to present subsequent
exacerbations. The combination of the level of BSM remodelling with
atopic dermatitis, age at first wheeze and the presence ofHaemophilus in the BALF allows to differentiate preschool
wheezers from the three groups of exacerbation frequency (i.e .,
No-Ex, Low-Ex and High-Ex). Mechanistic studies are required to better
understand the pathophysiological mechanisms leading to BSM remodelling
in this specific population as well as longitudinal studies to assess
the long-term stability of such exacerbation groups and its consequences
over time.