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

Hose, Alexander J. and Depner, Martin and Illi, Sabina and Lau, Susanne and Keil, Thomas and Wahn, Ulrich and Fuchs, Oliver and Pfefferle, Petra Ina and Schmaußer-Hechfellner, Elisabeth and Genuneit, Jon and Lauener, Roger and Karvonen, Anne M. and Roduit, Caroline and Dalphin, Jean-Charles and Riedler, Josef and Pekkanen, Juha and von Mutius, Erika and Ege, Markus J. and Pasture study groups, . (2017) Latent class analysis reveals clinically relevant atopy phenotypes in 2 birth cohorts. Journal Of Allergy And Clinical Immunology, 139 (6). 1935-1945.e12.

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Abstract

Phenotypes of childhood-onset asthma are characterized by distinct trajectories and functional features. For atopy, definition of phenotypes during childhood is less clear.; 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).; 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.; 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-γ 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.; 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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Environmental Exposures and Health > Physical Hazards and Health (Röösli)
UniBasel Contributors:Loss, Georg and Braun-Fahrländer, Charlotte
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Mosby
ISSN:0091-6749
e-ISSN:1097-6825
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:07 Mar 2018 12:18
Deposited On:20 Oct 2017 07:27

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