Latent class analysis reveals clinically relevant atopy phenotypes in 2 birth cohorts

Hose, Alexander; Depner, Martin; Illi, Sabina; Lau, Susanne; Keil, Thomas; Wahn, Ulrich; Fuchs, Oliver; Pfefferle, Petra Ina; Schmaußer‐Hechfellner, Elisabeth; Genuneit, Jon; Lauener, Roger; Karvonen, Anne M.; Roduit, Caroline; Dalphin, Jean‐Charles; Riedler, Josef; Pekkanen, Juha; Mutius, Erika von; Ege, Markus; Bauer, Carl Peter; Förster, Johannes; Zepp, Fred; Wahn, V.; Schuster, Antje; Bergmann, Renate L.; Bergmann, Karl E.; Reich, Andreas; Grabenhenrich, Linus; Schaub, Bianca; Loss, Georg; Renz, Harald; Kabesch, Michael; Roponen, Marjut; Hyvärinen, Anne; Tiittanen, Pekka; Remes, Sami; Braun‐Fahrländer, Charlotte; Frei, Remo; Kaulek, Vincent; Dalphin, Marie‐Laure; Doekes, Gert; Blümer, Nicole; Frey, Urs

doi:10.1016/j.jaci.2016.08.046

Cited by 86 publications

(106 citation statements)

References 32 publications

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“…Similar quantitative relationship has also been reported in relation to asthma severity and severe asthma exacerbations in children (23, 24). Notably, a recent report suggested that in severe pediatric asthma both allergen-specific IgE antibodies and skin prick tests should be carried out and quantified, as these tests are not always concordant in this specific population of patients (25).…”

Section: The Burden Of Atopy In Pediatric Asthmasupporting

confidence: 84%

“…Increasing data also show that the level of allergen-specific IgE antibodies and the size of skin test wheal to aeroallergens can better help identifying children at risk of preschool wheezing and subsequent asthma than a simple positive allergy test (21–23). Similar quantitative relationship has also been reported in relation to asthma severity and severe asthma exacerbations in children (23, 24).…”

Section: The Burden Of Atopy In Pediatric Asthmamentioning

confidence: 99%

“…Longitudinal follow-up of different birth cohorts across the globe showed that the combination of early and multiple AS represents a strong risk factor for persistent and severe asthma (18, 23, 38). …”

Section: Heterogeneity Of Atopy and Pediatric Asthmamentioning

confidence: 99%

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How Much Asthma Is Atopic in Children?

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Section: The Burden Of Atopy In Pediatric Asthmasupporting

confidence: 84%

Section: The Burden Of Atopy In Pediatric Asthmamentioning

confidence: 99%

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How Much Asthma Is Atopic in Children?

et al. 2017

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“…26 intensive care is also more frequently associated with food allergy 29 and food sensitization presents an increased risk of admission related to pollen exposure in girls. 26 intensive care is also more frequently associated with food allergy 29 and food sensitization presents an increased risk of admission related to pollen exposure in girls.…”

Section: And the Manchester Asthma And Allergy Studymentioning

confidence: 99%

Clinical phenotypes in asthma during childhood

Just

Bourgoin‐Heck

Amat

2017

Clin Experimental Allergy

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Asthma is a heterogeneous disease characterized by numerous phenotypes relating to age of onset, triggers, comorbidities, severity (assessed by multiple exacerbations, lung function pattern) and finally the inflammatory cells involved in the pathophysiologic pathway. These phenotypes can vary over time in relation to changes in the principal triggers involved in the aetiology of the disease. Nevertheless, in a patient with multiple allergies and early-onset disease (defined as multiple sensitizations and allergic comorbidities), the prognosis of asthma is poor with a high risk of persistence and severity of the disease during childhood. Future research will focus on classifying phenotypes into groups based on pathophysiologic mechanisms (endotypes) and the biomarkers attached to these endotypes, which could predict prognosis and lead to targeted therapy. Currently, these biomarkers are related to inflammatory cells associated with the asthma endotype, essentially eosinophils and neutrophils (and related cytokines) attached to Th-2 and non Th-1 pathways, respectively. The most severe asthma (refractory asthma) is linked to neutrophil-derived inflammation (frequently associated with female sex, obesity and possibly disorganized airway microbiota) encountered in very young children or teenagers. Severe asthma is also linked to or a marked eosinophil inflammatory process (frequently associated with multiple atopy and, more rarely, with non-atopic hypereosinophilic asthma in children) and frequently encountered in teenagers. Severe phenotypes of asthma could also play a role in the origin of chronic obstructive pulmonary disease in adult life.

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“…Because clinical manifestations of transient wheeze and asthma (persistent wheeze) are indistinguishable in early life, childhood asthma cannot be diagnosed with certainty before the age of 5, even though most childhood asthma likely begins in the first 3 years of life [4]. The development of atopic sensitization to food and inhalant allergens in the first years of life significantly contributes to the development of asthma [5–7], but epidemiologic patterns of asthma and atopy differ: the prevalence of atopy rises from infancy to preschool age and then it reaches a plateau [7]. Infections with rhinovirus (RV) and respiratory syncytial virus (RSV) early in life are likewise strong determinants of subsequent asthma development [8,9].…”

Section: Introductionmentioning

confidence: 99%

Immune development and environment: lessons from Amish and Hutterite children

Ober

Sperling

Mutius

et al. 2017

Current Opinion in Immunology

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Children who grow up in traditional farm environments are protected from developing asthma and allergy. This “farm effect” can be largely explained by the child’s early life contact with farm animals, in particular cows, and their microbes. Our studies in Amish and Hutterite school children living on farms in the U.S. have further demonstrated that this protection is mediated through innate immune pathways. Although very similar with respect to ancestry and many lifestyle factors that are associated with asthma risk, Amish and Hutterites follow farming practices that are associated with profound differences in the levels of house dust endotoxin, in the prevalence of asthma and atopy among school children, and in the proportions, phenotypes, and functions of immune cells from these children. In this review, we will consider our studies in Amish and Hutterites children in the context of the many previous studies in European farm children and discuss how these studies have advanced our understanding of the asthma-protective “farm effect”.

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Latent class analysis reveals clinically relevant atopy phenotypes in 2 birth cohorts

Abstract: LCA revealed a set of benign, symptomatic, and severe atopy phenotypes. The severe phenotype emerged as a latent condition with signs of a dysbalanced immune response. It determined high asthma risk through excessive sIgE production and directly affected impaired lung function.

Cited by 86 publications

References 32 publications

How Much Asthma Is Atopic in Children?

How Much Asthma Is Atopic in Children?

Clinical phenotypes in asthma during childhood

Immune development and environment: lessons from Amish and Hutterite children

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