Identifying and predicting severe bronchiolitis profiles at high risk for developing asthma: Analysis of three prospective cohorts.
Identifying and predicting severe bronchiolitis profiles at high risk for developing asthma: Analysis of three prospective cohorts.
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DOI：
10.1016/j.eclinm.2021.101257
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发表时间：
2022-01
影响因子：
15.1
通讯作者：
Camargo CA
中科院分区：
文献类型：
--
作者：
Fujiogi M;Dumas O;Hasegawa K;Jartti T;Camargo CA
细支气管炎是美国和欧洲婴儿住院的主要原因。此外，细支气管炎是儿童哮喘发生的主要危险因素。越来越多的证据表明细支气管炎存在异质性。我们试图识别独特的、可重复的细支气管炎亚组（概况），并制定决策规则，准确预测患哮喘风险最高的概况。在 2007 年至 2014 年在美国和芬兰（总计 n = 3081）因细支气管炎住院的三个多中心前瞻性婴儿队列（年龄 < 12 个月）中，我们通过潜在类别分析确定了临床上不同的细支气管炎特征。我们检查了这些特征与 6-7 岁时患哮喘风险的关联。通过执行递归分区分析，我们制定了一个决策规则来预测哮喘最高风险的情况，并在两个不同的队列中测量其预测性能。我们确定了四种细支气管炎特征（特征 A-D）。 A 型（n = 388；13%）的特点是有呼吸问题/湿疹和非呼吸道合胞病毒 (non-RSV) 感染史。相比之下，B 型（n = 1064；34%）类似于典型的 RSV 诱发的细支气管炎。 C 组（n = 993；32%）由病情最严重的组组成。配置 D（n = 636；21%）是病情最轻的组。与 B 型婴儿相比，A 型婴儿患哮喘的风险显着较高（38% 与 23%，调整后优势比 [adjOR] 2⋅57，95% 置信区间 [CI] 1⋅63–4⋅06）。导出的 4 预测因子（RSV 感染、呼吸问题史、湿疹史和父母哮喘病史）决策规则强烈预测曲线 A，例如，曲线下面积 [AUC] 为 0⋅98 (95%CI 0⋅97–0⋅99)、灵敏度为 1⋅00 (95%CI 0⋅96–1⋅00) 和特异性为 0⋅90 (95%CI) 0⋅89–0⋅93）在验证队列中。在三个患有细支气管炎的婴儿的前瞻性队列中，我们确定了临床上不同的特征及其与哮喘风险的纵向关系。我们还导出并验证了准确的预测规则，以确定最高风险的情况。目前的结果应该会推动针对哮喘的特定预防策略的开发研究。
Bronchiolitis is the leading cause of infants hospitalization in the U.S. and Europe. Additionally, bronchiolitis is a major risk factor for the development of childhood asthma. Growing evidence suggests heterogeneity within bronchiolitis. We sought to identify distinct, reproducible bronchiolitis subgroups (profiles) and to develop a decision rule accurately predicting the profile at the highest risk for developing asthma. In three multicenter prospective cohorts of infants (age < 12 months) hospitalized for bronchiolitis in the U.S. and Finland (combined n = 3081) in 2007–2014, we identified clinically distinct bronchiolitis profiles by using latent class analysis. We examined the association of the profiles with the risk for developing asthma by age 6–7 years. By performing recursive partitioning analyses, we developed a decision rule predicting the profile at highest risk for asthma, and measured its predictive performance in two separate cohorts. We identified four bronchiolitis profiles (profiles A–D). Profile A (n = 388; 13%) was characterized by a history of breathing problems/eczema and non–respiratory syncytial virus (non-RSV) infection. In contrast, profile B (n = 1064; 34%) resembled classic RSV-induced bronchiolitis. Profile C (n = 993; 32%) was comprised of the most severely ill group. Profile D (n = 636; 21%) was the least-ill group. Profile A infants had a significantly higher risk for asthma, compared to profile B infants (38% vs. 23%, adjusted odds ratio [adjOR] 2⋅57, 95%confidence interval [CI] 1⋅63–4⋅06). The derived 4-predictor (RSV infection, history of breathing problems, history of eczema, and parental history of asthma) decision rule strongly predicted profile A—e.g., area under the curve [AUC] of 0⋅98 (95%CI 0⋅97–0⋅99), sensitivity of 1⋅00 (95%CI 0⋅96–1⋅00), and specificity of 0⋅90 (95%CI 0⋅89–0⋅93) in a validation cohort. In three prospective cohorts of infants with bronchiolitis, we identified clinically distinct profiles and their longitudinal relationship with asthma risk. We also derived and validated an accurate prediction rule to determine the profile at highest risk. The current results should advance research into the development of profile-specific preventive strategies for asthma.
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呼吸道合胞病毒基因组载荷和疾病的严重程度患有细支气管炎的儿童：美国和芬兰的多中心队列研究。
DOI：
10.1093/infdis/jiu658
发表时间：
2015-05-15
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Hasegawa K;Jartti T;Mansbach JM;Laham FR;Jewell AM;Espinola JA;Piedra PA;Camargo CA Jr
通讯作者：
Camargo CA Jr
DOI：
10.1111/pai.13296
发表时间：
2020-10
期刊：
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
影响因子：
--
作者：
Fujiogi M;Camargo CA Jr;Raita Y;Bochkov YA;Gern JE;Mansbach JM;Piedra PA;Hasegawa K
通讯作者：
Hasegawa K
影响因子：
10
作者：
Dumas O;Mansbach JM;Jartti T;Hasegawa K;Sullivan AF;Piedra PA;Camargo CA Jr
通讯作者：
Camargo CA Jr
影响因子：
8
作者：
Ralston, Shawn L.;Lieberthal, Allan S.;Hernandez-Cancio, Sinsi
通讯作者：
Hernandez-Cancio, Sinsi
DOI：
10.1016/j.jaci.2018.08.043
发表时间：
2019-04
期刊：
The Journal of allergy and clinical immunology
影响因子：
--
作者：
Dumas O;Hasegawa K;Mansbach JM;Sullivan AF;Piedra PA;Camargo CA Jr
通讯作者：
Camargo CA Jr