Identifying the heterogeneity of young adult rhinitis through cluster analysis in the Isle of Wight birth cohort

被引:29
作者
Kurukulaaratchy, Ramesh J. [1 ]
Zhang, Hongmei [3 ]
Patil, Veeresh [1 ]
Raza, Abid [1 ]
Karmaus, Wilfried [3 ]
Ewart, Susan [4 ]
Arshad, S. Hasan [1 ,2 ]
机构
[1] St Marys Hosp, David Hide Asthma & Allergy Res Ctr, Newport, Wight, England
[2] Univ Southampton, Fac Med, Clin & Expt Med, Southampton SO9 5NH, Hants, England
[3] Univ Memphis, Sch Publ Hlth, Div Epidemiol Biostat & Environm Hlth, Memphis, TN 38152 USA
[4] Michigan State Univ, Large Anim Clin Sci, E Lansing, MI 48824 USA
基金
美国国家卫生研究院;
关键词
Asthma; cluster analysis; morbidity; rhinitis; wheezing; CHRONIC RHINOSINUSITIS; ASTHMA PHENOTYPES; ALLERGIC RHINITIS; CLINICAL IMMUNOLOGY; EUROPEAN ACADEMY; RISK-FACTOR; CHILDHOOD; ATOPY; PREVALENCE; ENDOTYPES;
D O I
10.1016/j.jaci.2014.06.017
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: Rhinitis affects many young adults and often shows comorbidity with asthma. Objective: We hypothesized that young adult rhinitis, like asthma, exhibits clinical heterogeneity identifiable by means of cluster analysis. Methods: Participants in the Isle of Wight birth cohort (n = 1456) were assessed at 1, 2, 4, 10, and 18 years of age. Cluster analysis was performed on those with rhinitis at age 18 years (n 5 468) by using 13 variables defining clinical characteristics. Results: Four clusters were identified. Patients in cluster 1 (n = 128 [27.4%]; ie, moderate childhood-onset rhinitis) had high atopy and eczema prevalence and high total IgE levels but low asthma prevalence. They showed the best lung function at 18 years of age, with normal fraction of exhaled nitric oxide (FENO), low bronchial hyperresponsiveness (BHR), and low bronchodilator reversibility (BDR) but high rhinitis symptoms and treatment. Patients in cluster 2 (n = 199 [42.5%]; ie, mild-adolescence-onset female rhinitis) had the lowest prevalence of comorbid atopy, asthma, and eczema. They had normal lung function and low BHR, BDR, FENO values, and total IgE levels plus low rhinitis symptoms, severity, and treatment. Patients in cluster 3 (n = 59 [12.6%]; ie, severe earliest-onset rhinitis with asthma) had the youngest rhinitis onset plus the highest comorbid asthma (of simultaneous onset) and atopy. They showed the most obstructed lung function with high BHR, BDR, and FENO values plus high rhinitis symptoms, severity, and treatment. Patient 4 in cluster 4 (n = 82 [17.5%]; ie, moderate childhood-onset male rhinitis with asthma) had high atopy, intermediate asthma, and low eczema. They had impaired lung function with high FENO values and total IgE levels but intermediate BHR and BDR. They had moderate rhinitis symptoms. Conclusion: Clinically distinctive adolescent rhinitis clusters are apparent with varying sex and asthma associations plus differing rhinitis severity and treatment needs.
引用
收藏
页码:143 / U225
页数:15
相关论文
共 28 条
  • [1] Endotypes and phenotypes of chronic rhinosinusitis: A PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology
    Akdis, Cezmi A.
    Bachert, Claus
    Cingi, Cemal
    Dykewicz, Mark S.
    Hellings, Peter W.
    Naclerio, Robert M.
    Schleimer, Robert P.
    Ledford, Dennis
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2013, 131 (06) : 1479 - 1490
  • [2] Impact of gender on asthma in childhood and adolescence:: a GA2LEN review
    Almqvist, C.
    Worm, M.
    Leynaert, B.
    [J]. ALLERGY, 2008, 63 (01) : 47 - 57
  • [3] [Anonymous], 1983, SAS Technical Report A-108
  • [4] EFFECT OF ENVIRONMENTAL-FACTORS ON THE DEVELOPMENT OF ALLERGIC DISORDERS IN INFANCY
    ARSHAD, SH
    HIDE, DW
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1992, 90 (02) : 235 - 241
  • [5] INTERNATIONAL STUDY OF ASTHMA AND ALLERGIES IN CHILDHOOD (ISAAC) - RATIONALE AND METHODS
    ASHER, MI
    KEIL, U
    ANDERSON, HR
    BEASLEY, R
    CRANE, J
    MARTINEZ, F
    MITCHELL, EA
    PEARCE, N
    SIBBALD, B
    STEWART, AW
    STRACHAN, D
    WEILAND, SK
    WILLIAMS, HC
    [J]. EUROPEAN RESPIRATORY JOURNAL, 1995, 8 (03) : 483 - 491
  • [6] Chronic rhinosinusitis: From one disease to different phenotypes
    Bachert, Claus
    Zhang, Nan
    van Zele, Thibaut
    Gevaert, Philippe
    [J]. PEDIATRIC ALLERGY AND IMMUNOLOGY, 2012, 23 : 2 - 4
  • [7] Allergic Rhinitis and its Impact on Asthma (ARIA): Achievements in 10 years and future needs
    Bousquet, J.
    Schuenemann, H. J.
    Samolinski, B.
    Demoly, P.
    Baena-Cagnani, C. E.
    Bachert, C.
    Bonini, S.
    Boulet, L. P.
    Bousquet, P. J.
    Brozek, J. L.
    Canonica, G. W.
    Casale, T. B.
    Cruz, A. A.
    Fokkens, W. J.
    Fonseca, J. A.
    van Wijk, R. Gerth
    Grouse, L.
    Haahtela, T.
    Khaltaev, N.
    Kuna, P.
    Lockey, R. F.
    Carlsen, K. C. Lodrup
    Mullol, J.
    Naclerio, R.
    O'Hehir, R. E.
    Ohta, K.
    Palkonen, S.
    Papadopoulos, N. G.
    Passalacqua, G.
    Pawankar, R.
    Price, D.
    Ryan, D.
    Simons, F. E. R.
    Togias, A.
    Williams, D.
    Yorgancioglu, A.
    Yusuf, O. M.
    Aberer, W.
    Adachi, M.
    Agache, I.
    Ait-Khaled, N.
    Akdis, C. A.
    Andrianarisoa, A.
    Annesi-Maesano, I.
    Ansotegui, I. J.
    Baiardini, I.
    Bateman, E. D.
    Bedbrook, A.
    Beghe, B.
    Beji, M.
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2012, 130 (05) : 1049 - 1062
  • [8] Calinski T., 1974, Communications in Statistics-theory and Methods, V3, P1, DOI [10.1080/03610927408827101, DOI 10.1080/03610927408827101]
  • [9] Allergic rhinitis is associated with poor asthma control in children with asthma
    de Groot, Eric P.
    Nijkamp, Anke
    Duiverman, Eric J.
    Brand, Paul L. P.
    [J]. THORAX, 2012, 67 (07) : 582 - 587
  • [10] Rhinitis phenotypes correlate with different symptom presentation and risk factor patterns of asthma
    Eriksson, Jonas
    Bjerg, Anders
    Lotvall, Jan
    Wennergren, Goran
    Ronmark, Eva
    Toren, Kjell
    Lundback, Bo
    [J]. RESPIRATORY MEDICINE, 2011, 105 (11) : 1611 - 1621