Wheeze phenotypes in young children have different courses during the preschool period

Just, Jocelyne; Saint‐Pierre, Philippe; Gouvis-Echraghi, Rahelé; Boutin, Bernard; Panayotopoulos, Virginie; Chebahi, Nabila; Ousidhoum-Zidi, Aldjia; Khau, Cam-Anh

doi:10.1016/j.anai.2013.07.002

Cited by 36 publications

(44 citation statements)

References 26 publications

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“…In terms of the optimal number of phenotypes to describe the heterogeneity, our study found four phenotypes. This is within the range observed in other studies (between three and seven phenotypes) [6,[8][9][10][11][12]18]. In early childhood, three of the four phenotypes in our study are similar to those (asymptomatic, atopic severe and nonatopic severe) described in a cross-sectional study of children aged 18 months which used similar attributes to ours in their model [8].…”

Section: Discussionsupporting

confidence: 76%

“…To the best of our knowledge, this study is the first to simultaneously define phenotypes with multiple disease manifestations at more than two time points and examine transitions between phenotypes over time in a population-based sample of children using a data-driven approach. This approach addresses one of the basic challenges of phenotype definition: whether change of features over time should be regarded as intrinsic to a particular phenotype (as shown in earlier studies by HENDERSON et al [4] and SPYCHER et al [6]) or as evidence of different phenotypes at different ages (as shown in cross-sectional studies by JUST et al [18]), i.e. transition between phenotypes.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, the various manifestations of asthma, such as cough, wheeze, atopy, impaired lung function, airway hyperresponsiveness (AHR) and airway inflammation, are known to be associated with each other and to vary with age [16]. Two studies have examined transitions between phenotypes in preschool children that were defined based on wheeze alone [17] or with multiple clinical features including wheeze triggers [18]. Data from the Isle of Wight study have been used to describe transitions during childhood in sex-specific phenotypes that were defined based on two measures: physician-diagnosed asthma and wheeze [19].…”

Section: Introductionmentioning

confidence: 99%

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Change in the manifestations of asthma and asthma-related traits in childhood: a latent transition analysis

et al. 2015

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It is known that asthma is a heterogeneous entity whose manifestations vary with age. Our objective was to examine changes in the manifestation of asthma and asthma-related traits in childhood by defining empirically derived childhood asthma phenotypes and examining their transitions over time.To define the phenotypes we used data on respiratory symptoms, healthcare utilisation, medications, spirometry, airway hyperresponsiveness (AHR), exhaled nitric oxide concentration and atopy from a birth cohort recruited on the basis of having a first-degree relative with asthma. Data were acquired at ages 1.5-11.5 years and analysed using latent transition analysis.In a study population of 370 participants, we classified subjects into four phenotypes: 1) nonatopic, few symptoms ( prevalence range from 1.5 to 5 years: 52-60%), 2) atopic, few symptoms (3-21%), 3) nonatopic, asthma and rhinitis symptoms (13-35%), and 4) atopic, asthma and rhinitis symptoms (2-14%) in early childhood; and 1) nonatopic, no respiratory disease ( prevalence range from 8 to 11.5 years: 41-46%), 2) atopic, no respiratory disease (23-33%), 3) nonatopic, asthma symptoms, no AHR or airway inflammation (8-12%) and 4) atopic asthma (19%) in mid-childhood. Transitioning between phenotypes was common in early childhood, but less common in later childhood.This analysis represents the first attempt to incorporate longitudinal patterns of several manifestations of asthma into a single model to simultaneously define phenotypes and examine their transitions over time. It provides quantitative support for the view that asthma is a heterogeneous entity, and that some children with wheeze and other respiratory symptoms in early life progress to asthma in mid-childhood, while others become asymptomatic. @ERSpublications New objective childhood asthma phenotypes show transitioning between phenotypes is common in early not late childhood http://ow.ly/RT5qz

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Change in the manifestations of asthma and asthma-related traits in childhood: a latent transition analysis

et al. 2015

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“…Inevitably, different phenotypes will result for different age intervals (deviation from the second viewpoint) and, within the same cohort, children will not be classified into the same groups as they grow older but will be reshuffled into new groups (deviation from first viewpoint). For instance, cluster analyses in a clinical cohort from Paris identified a phenotype of "uncontrolled wheeze" at age <3 years and again at 5 years [9,10]. However, this phenotype was predominately nonatopic at younger age and predominately atopic at older age.…”

mentioning

confidence: 99%

“…In fact, clustering studies that have used cross-sectional data [9][10][11][12][13] take a middle ground between these positions. These studies seek to identify phenotypes that optimally characterise the differences between children in a given age interval.…”

mentioning

confidence: 99%