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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.* ; Hyvärinen, A.* ; Tiittanen, P.* ; Remes, S.* ; Braun-Fahrländer, C.* ; Frei, R.* ; Kaulek, V.* ; Dalphin, M.* ; Doekes, G.* ; Blümer, N.* ; Frey, U.H.*

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

J. Allergy Clin. Immunol. 139, 1935-1945.e12 (2017)
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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.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords 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
ISSN (print) / ISBN 0091-6749
e-ISSN 1097-6825
Journal The journal of allergy and clinical immunology
Quellenangaben Volume: 139, Issue: 6, Pages: 1935-1945.e12 Article Number: , Supplement: ,
Publisher Elsevier
Publishing Place Amsterdam [u.a.]
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Lung Health and Immunity (LHI)
Institute of Asthma and Allergy Prevention (IAP)