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

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Hose , A J , Depner , M , Illi , S , Lau , S , Keil , T , Wahn , U , Fuchs , O , Pfefferle , P I , Schmausser-Hechfellner , E , Genuneit , J , Lauener , R , Karvonen , A M , Roduit , C , Dalphin , J-C , Riedler , J , Pekkanen , J , von Mutius , E , Ege , M J , Bauer , C P , Forster , J , Zepp , F , Wahn , V , Schuster , A , Bergmann , R L , Bergmann , K E , Reich , A , Grabenhenrich , L , Schaub , B , Loss , G J , Renz , H , Kabesch , M , Roponen , M , Hyvarinen , A , Tiittanen , P , Remes , S , Braun-Fahrlander , C , Frei , R , Kaulek , V , Dalphin , M-L , Doekes , G , Blumer , N , Frey , U , MAS Study Grp & PASTURE Study Grp 2017 , ' Latent class analysis reveals clinically relevant atopy phenotypes in 2 birth cohorts ' , Journal of Allergy and Clinical Immunology , vol. 139 , no. 6 , pp. 1935-+ . https://doi.org/10.1016/j.jaci.2016.08.046

Title: Latent class analysis reveals clinically relevant atopy phenotypes in 2 birth cohorts
Author: Hose, Alexander J.; 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; von Mutius, Erika; Ege, Markus J.; Bauer, Carl Peter; Forster, Johannes; Zepp, Fred; Wahn, Volker; Schuster, Antje; Bergmann, Renate L.; Bergmann, Karl E.; Reich, Andreas; Grabenhenrich, Linus; Schaub, Bianca; Loss, Georg J.; Renz, Harald; Kabesch, Michael; Roponen, Marjut; Hyvarinen, Anne; Tiittanen, Pekka; Remes, Sami; Braun-Fahrlander, Charlotte; Frei, Remo; Kaulek, Vincent; Dalphin, Marie-Laure; Doekes, Gert; Blumer, Nicole; Frey, Urs; MAS Study Grp; PASTURE Study Grp
Other contributor: University of Helsinki, Clinicum


Date: 2017-06
Language: eng
Number of pages: 23
Belongs to series: Journal of Allergy and Clinical Immunology
ISSN: 0091-6749
DOI: https://doi.org/10.1016/j.jaci.2016.08.046
URI: http://hdl.handle.net/10138/237010
Abstract: Background: Phenotypes of childhood-onset asthma are characterized by distinct trajectories and functional features. For atopy, definition of phenotypes during childhood is less clear. Objective: We sought to define phenotypes of atopic sensitization over the first 6 years of life using a latent class analysis (LCA) integrating 3 dimensions of atopy: allergen specificity, time course, and levels of specific IgE (sIgE). Methods: Phenotypes were defined by means of LCA in 680 children of the Multizentrische Allergiestudie (MAS) and 766 children of the Protection against allergy: Study in Rural Environments (PASTURE) birth cohorts and compared with classical nondisjunctive definitions of seasonal, perennial, and food sensitization with respect to atopic diseases and lung function. Cytokine levels were measured in the PASTURE cohort. Results: The LCA classified predominantly by type and multiplicity of sensitization (food vs inhalant), allergen combinations, and sIgE levels. Latent classes were related to atopic disease manifestations with higher sensitivity and specificity than the classical definitions. LCA detected consistently in both cohorts a distinct group of children with severe atopy characterized by high seasonal sIgE levels and a strong propensity for asthma; hay fever; eczema; and impaired lung function, also in children without an established asthma diagnosis. Severe atopy was associated with an increased IL-5/IFN-gamma ratio. A path analysis among sensitized children revealed that among all features of severe atopy, only excessive sIgE production early in life affected asthma risk. Conclusions: 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.
Subject: Atopy
IgE
sensitization
asthma
lung function
cytokines
severe atopy
atopic diseases
latent class analysis
unsupervised clustering
path analysis
epidemiology
RESPIRATORY SYMPTOMS
INHALANT ALLERGENS
SKIN-TEST
SENSITIZATION
ASTHMA
CHILDHOOD
RISK
IGE
CHILDREN
LIFE
3142 Public health care science, environmental and occupational health
3121 General medicine, internal medicine and other clinical medicine
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