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Risk factors and characteristics of respiratory and allergic phenotypes in early childhood.
J Allergy Clin Immunol. 2012 Aug; 130(2):389-96.e4.JA

Abstract

BACKGROUND

Unsupervised approaches can be used to analyze complex respiratory and allergic disorders.

OBJECTIVE

We investigated the respiratory and allergic phenotypes of children followed in the Pollution and Asthma Risk: An Infant Study (PARIS) birth cohort.

METHODS

Information on respiratory and allergic disorders, medical visits, and medications was collected during medical examinations of children at 18 months of age; biomarker data were also collected (total and allergen-specific IgE levels and eosinophilia). Phenotypes were determined by using latent class analysis. Associated risk factors were determined based on answers to questionnaires about environmental exposures.

RESULTS

Apart from a reference group, which had a low prevalence of respiratory symptoms or allergies (n=1271 [69.4%]), 3 phenotypes were identified. On the basis of clinical signs of severity and use of health care resources, we identified a mild phenotype (n=306 [16.7%]) characterized by occasional mild wheeze and 2 severe phenotypes separated by atopic status. The atopic severe phenotype (n=59 [3.2%]) included 49 (83%) children with wheezing and was characterized by a high prevalence of atopy (61% with allergenic sensitization) and atopic dermatitis (78%). In contrast, atopy was rare among children with the nonatopic severe phenotype (n=195 [11%]); this group included 88% of the children with recurrent wheezing. Risk factors for respiratory disease included parental history of asthma, male sex, siblings, day care attendance, exposure to tobacco smoke or molds, indoor renovations, and being overweight, although these factors did not have similar affects on risk for all phenotypes.

CONCLUSION

Atopy should be taken into account when assessing the risk of severe exacerbations (that require hospital-based care) in wheezing infants; precautions should be taken against respiratory irritants and molds and to prevent children from becoming overweight.

Authors+Show Affiliations

Université Paris Descartes, Sorbonne Paris Cité, Laboratoire Santé Publique et Environnement, Paris, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22846748

Citation

Herr, Marie, et al. "Risk Factors and Characteristics of Respiratory and Allergic Phenotypes in Early Childhood." The Journal of Allergy and Clinical Immunology, vol. 130, no. 2, 2012, pp. 389-96.e4.
Herr M, Just J, Nikasinovic L, et al. Risk factors and characteristics of respiratory and allergic phenotypes in early childhood. J Allergy Clin Immunol. 2012;130(2):389-96.e4.
Herr, M., Just, J., Nikasinovic, L., Foucault, C., Le Marec, A. M., Giordanella, J. P., & Momas, I. (2012). Risk factors and characteristics of respiratory and allergic phenotypes in early childhood. The Journal of Allergy and Clinical Immunology, 130(2), 389-e4. https://doi.org/10.1016/j.jaci.2012.05.054
Herr M, et al. Risk Factors and Characteristics of Respiratory and Allergic Phenotypes in Early Childhood. J Allergy Clin Immunol. 2012;130(2):389-96.e4. PubMed PMID: 22846748.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors and characteristics of respiratory and allergic phenotypes in early childhood. AU - Herr,Marie, AU - Just,Jocelyne, AU - Nikasinovic,Lydia, AU - Foucault,Christophe, AU - Le Marec,Anne-Marie, AU - Giordanella,Jean-Pierre, AU - Momas,Isabelle, PY - 2011/12/17/received PY - 2012/05/21/revised PY - 2012/05/22/accepted PY - 2012/8/1/entrez PY - 2012/8/1/pubmed PY - 2012/10/18/medline SP - 389 EP - 96.e4 JF - The Journal of allergy and clinical immunology JO - J Allergy Clin Immunol VL - 130 IS - 2 N2 - BACKGROUND: Unsupervised approaches can be used to analyze complex respiratory and allergic disorders. OBJECTIVE: We investigated the respiratory and allergic phenotypes of children followed in the Pollution and Asthma Risk: An Infant Study (PARIS) birth cohort. METHODS: Information on respiratory and allergic disorders, medical visits, and medications was collected during medical examinations of children at 18 months of age; biomarker data were also collected (total and allergen-specific IgE levels and eosinophilia). Phenotypes were determined by using latent class analysis. Associated risk factors were determined based on answers to questionnaires about environmental exposures. RESULTS: Apart from a reference group, which had a low prevalence of respiratory symptoms or allergies (n=1271 [69.4%]), 3 phenotypes were identified. On the basis of clinical signs of severity and use of health care resources, we identified a mild phenotype (n=306 [16.7%]) characterized by occasional mild wheeze and 2 severe phenotypes separated by atopic status. The atopic severe phenotype (n=59 [3.2%]) included 49 (83%) children with wheezing and was characterized by a high prevalence of atopy (61% with allergenic sensitization) and atopic dermatitis (78%). In contrast, atopy was rare among children with the nonatopic severe phenotype (n=195 [11%]); this group included 88% of the children with recurrent wheezing. Risk factors for respiratory disease included parental history of asthma, male sex, siblings, day care attendance, exposure to tobacco smoke or molds, indoor renovations, and being overweight, although these factors did not have similar affects on risk for all phenotypes. CONCLUSION: Atopy should be taken into account when assessing the risk of severe exacerbations (that require hospital-based care) in wheezing infants; precautions should be taken against respiratory irritants and molds and to prevent children from becoming overweight. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/22846748/Risk_factors_and_characteristics_of_respiratory_and_allergic_phenotypes_in_early_childhood_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(12)00961-X DB - PRIME DP - Unbound Medicine ER -