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

Identifying the heterogeneity of young adult rhinitis through cluster analysis in the Isle of Wight birth cohort
Identifying the heterogeneity of young adult rhinitis through cluster analysis in the Isle of Wight birth cohort
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 = 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.
asthma, cluster analysis, morbidity, rhinitis, wheezing
0091-6749
143-150
Kurukulaaratchy, R.
9c7b8105-2892-49f2-8775-54d4961e3e74
zhang, H.
49b0dd51-9e3e-4c73-ac6f-af1bd3a9bcd0
Patil, V.
b898b9a7-db31-4c1c-b0f0-4165b3e4d29c
raza, A.
28cf549d-f7e9-4f43-b60e-8c7866cb1d1d
Karmaus, W.
d78616d6-bc9c-4664-a461-7c0d0be5e39e
Ewart, S.
9da730b1-7e8a-4889-8dc5-2703de288a34
Arshad, S.H.
917e246d-2e60-472f-8d30-94b01ef28958
Kurukulaaratchy, R.
9c7b8105-2892-49f2-8775-54d4961e3e74
zhang, H.
49b0dd51-9e3e-4c73-ac6f-af1bd3a9bcd0
Patil, V.
b898b9a7-db31-4c1c-b0f0-4165b3e4d29c
raza, A.
28cf549d-f7e9-4f43-b60e-8c7866cb1d1d
Karmaus, W.
d78616d6-bc9c-4664-a461-7c0d0be5e39e
Ewart, S.
9da730b1-7e8a-4889-8dc5-2703de288a34
Arshad, S.H.
917e246d-2e60-472f-8d30-94b01ef28958

Kurukulaaratchy, R., zhang, H., Patil, V., raza, A., Karmaus, W., Ewart, S. and Arshad, S.H. (2015) Identifying the heterogeneity of young adult rhinitis through cluster analysis in the Isle of Wight birth cohort. Journal of Allergy and Clinical Immunology, 135 (1), 143-150. (doi:10.1016/j.jaci.2014.06.017). (PMID:25085342)

Record type: Article

Abstract

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 = 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.

Full text not available from this repository.

More information

Accepted/In Press date: 14 June 2014
e-pub ahead of print date: 29 July 2014
Published date: January 2015
Keywords: asthma, cluster analysis, morbidity, rhinitis, wheezing
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 394642
URI: https://eprints.soton.ac.uk/id/eprint/394642
ISSN: 0091-6749
PURE UUID: 244b3d14-a43d-492e-bdc9-9ce69ebd2799

Catalogue record

Date deposited: 18 May 2016 09:10
Last modified: 17 Jul 2017 18:58

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