Multiple atopy phenotypes and their associations with asthma: similar findings from two birth cohorts
Multiple atopy phenotypes and their associations with asthma: similar findings from two birth cohorts
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DOI：
10.1111/all.12134
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发表时间：
2013-06-01
期刊：
影响因子：
12.4
通讯作者：
Simpson, A.
中科院分区：
文献类型：
--
作者：
Lazic, N.;Roberts, G.;Simpson, A.
背景虽然特应性致敏是哮喘最严重的危险因素之一，但其与哮喘的关系却知之甚少。我们假设“特应性”包含以不同方式与哮喘相关的多种亚表型。方法 在两个基于人口的出生队列（爱荷华州曼彻斯特和怀特岛）中，我们根据整个童年和青春期进行的皮肤点刺和 sIgE 测试，使用机器学习方法以无人监督的方式独立地将儿童分为不同的特应性过敏类别。我们检查了定性聚类特性及其与哮喘和肺功能的关系。结果五类解决方案最好地描述了两个队列中的数据，两个群体的类别之间具有惊人的相似性。与非致敏类别相比，对多种过敏原敏感的类别中的儿童（类似于传统定义中 1/3 的特应性儿童）患哮喘的可能性要高得多（曼彻斯特的 aOR [95% CI0；曼彻斯特为 20.1 [10.940.2]，爱荷华州为 11.9 [7.319.4]）。哮喘与传统特应性之间的关系要弱得多（曼彻斯特为 5.5 [3.48.8]，爱荷华州为 5.8 [4.18.3]）。在这两个队列中，该类别的儿童的肺功能明显较差（曼彻斯特的 FEV1/FVC 降低了 4.4%，爱荷华州的 FEV1/FVC 降低了 2.6%；P
Background Although atopic sensitization is one of the strongest risk factors for asthma, its relationship with asthma is poorly understood. We hypothesize that atopy' encompasses multiple sub-phenotypes that relate to asthma in different ways. Methods In two population-based birth cohorts (Manchester and Isle of Wight IoW), we used a machine learning approach to independently cluster children into different classes of atopic sensitization in an unsupervised manner, based on skin prick and sIgE tests taken throughout childhood and adolescence. We examined the qualitative cluster properties and their relationship to asthma and lung function. Results A five-class solution best described the data in both cohorts, with striking similarity between the classes across the two populations. Compared with nonsensitized class, children in the class with sensitivity to a wide variety of allergens (similar to 1/3 of children atopic by conventional definition) were much more likely to have asthma (aOR [95% CI0; 20.1 [10.940.2] in Manchester and 11.9 [7.319.4] in IoW). The relationship between asthma and conventional atopy was much weaker (5.5 [3.48.8] in Manchester and 5.8 [4.18.3] in IoW). In both cohorts, children in this class had significantly poorer lung function (FEV1/FVC lower by 4.4% in Manchester and 2.6% in IoW; P