Persistent asthma phenotype related with late-onset, high atopy, and low socioeconomic status in school-aged Korean children
Open Access
- 23 February 2017
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Pulmonary Medicine
- Vol. 17 (1), 1-11
- https://doi.org/10.1186/s12890-017-0387-5
Abstract
Treatment guidelines for asthma have been established based on asthma severity; there are limitations in the identification of underlying pathophysiology and prediction of prognosis in heterogeneous phenotypes of asthma. Although the complex interactions between environmental and genetic factors affect the development and progression of asthma, studies on asthma phenotypes considering environmental factors are limited. This study aimed to identify asthma phenotypes using latent class analysis including environmental factors in school-age children. We included 235 children (6–8 years) with parent-reported, physician-diagnosed asthma from the Children’s HEalth and Environmental Research (CHEER) study, which is a 4-year prospective follow-up study with 2-year intervals. At every survey, pulmonary function tests, methacholine challenge tests and blood tests with questionnaire were conducted. Four asthma phenotypes were identified. Cluster 1 (22% of children) was characterized by high prevalence of atopy and mild symptoms; subjects in cluster 2 (17%) consisted of less atopy and normal lung function, but intermittent troublesome; cluster 3 (29%) experienced late-onset atopic troublesome asthma with decreased lung function in combination with low socioeconomic status; and cluster 4 was associated with early-onset and less-atopic infrequent asthma. Late-onset, high atopy, and low socioeconomic status are associated with troublesome persistent asthma phenotype in school-age children. Environmental factors might be implicated in the clinical heterogeneity of asthma. Asthma phenotypes considering diverse factors might be more helpful in the identification of asthma pathogenesis and its prevention.Keywords
Funding Information
- Basic Science Research Program through the National Research Foundation of Korea (NRF) (NRF-2014R1A2A1A10050687)
- Korean Ministry of the Environment
This publication has 54 references indexed in Scilit:
- Joint modeling of parentally reported and physician-confirmed wheeze identifies children with persistent troublesome wheezingJournal of Allergy and Clinical Immunology, 2013
- Environmental biodiversity, human microbiota, and allergy are interrelatedProceedings of the National Academy of Sciences of the United States of America, 2012
- Comparison of childhood wheezing phenotypes in 2 birth cohorts: ALSPAC and PIAMAJournal of Allergy and Clinical Immunology, 2011
- Airway microbiota and bronchial hyperresponsiveness in patients with suboptimally controlled asthmaJournal of Allergy and Clinical Immunology, 2011
- Heterogeneity of severe asthma in childhood: Confirmation by cluster analysis of children in the National Institutes of Health/National Heart, Lung, and Blood Institute Severe Asthma Research ProgramJournal of Allergy and Clinical Immunology, 2011
- Association Between Socioeconomic Status and the Development of Asthma: Analyses of Income TrajectoriesAmerican Journal of Public Health, 2010
- Prenatal Tobacco Smoke Exposure Affects Global and Gene-specific DNA MethylationAmerican Journal of Respiratory and Critical Care Medicine, 2009
- The Urban Environment and Childhood Asthma (URECA) birth cohort study: design, methods, and study populationBMC Pulmonary Medicine, 2009
- Associations of wheezing phenotypes in the first 6 years of life with atopy, lung function and airway responsiveness in mid-childhoodThorax, 2008
- Airway hyperresponsiveness in asthma: not just a matter of airway inflammationThorax, 1998