Distinguishing wheezing phenotypes from infancy to adolescence: a pooled analysis of five birth cohorts
Distinguishing wheezing phenotypes from infancy to adolescence: a pooled analysis of five birth cohorts
RATIONALE: Pooling data from multiple cohorts and extending the time-frame across childhood should minimize study-specific effects, enabling better characterization of the childhood wheezing.
OBJECTIVE: To analyze wheezing patterns from early childhood to adolescence using combined data from five birth cohorts.
METHODS: We used latent class analysis to derive wheeze phenotypes among 7719 participants from five birth cohorts with complete report of wheeze at five time-periods. We tested the association of derived phenotypes with late asthma outcomes and lung function, and investigated the uncertainty in phenotype assignment.
RESULTS: We identified five phenotypes: Never/Infrequent wheeze (52.1%), Early-onset pre-school remitting (23.9%), Early-onset mid-childhood remitting (9%), Persistent (7.9%) and Late-onset wheeze (7.1%). Compared to the Never/infrequent wheeze, all phenotypes had higher odds of asthma and lower FEV1 and FEV1/FVC in adolescence. The association with asthma was strongest for Persistent wheeze (adjusted odds ratio 56.54, 95%CI 43.75-73.06). We observed considerable within-class heterogeneity at individual level, with 913 (12%) children having low membership probability (<0.60) of any phenotype. Class membership certainty was highest in Persistent and Never/infrequent, and lowest in Late-onset wheeze (with 51% of participants having membership probabilities<0.80). Individual wheezing patterns were particularly heterogeneous in Late-onset wheeze, while many children assigned to Early-onset pre-school remitting class reported wheezing at later time points.
CONCLUSIONS: All wheeze phenotypes had significantly diminished lung function in school-age, suggesting that the notion that early-life episodic wheeze has a benign prognosis may not be true for a proportion of transient wheezers. We observed considerable within-phenotype heterogeneity in individual wheezing patterns.
868-876
Oksel, Ceyda
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Granell, Raquel
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Haider, Sadia
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Fontanella, Sara
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Simpson, Angela
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Turner, Steve
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Devereux, Graham
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Arshad, Syed Hasan
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Murray, Clare S.
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Roberts, Graham
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Holloway, John W.
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Cullinan, Paul
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Henderson, John
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Custovic, Adnan
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STELAR and Breathing Together investigators
1 July 2019
Oksel, Ceyda
7458ddcb-eadb-471e-bf4a-e815606ee720
Granell, Raquel
06e9e006-3754-4cc9-b3fc-42024bd05123
Haider, Sadia
ed3296e0-288d-49b1-befb-fe4545a7278e
Fontanella, Sara
6c29b69f-edd6-4414-a8fd-c47241976aa5
Simpson, Angela
5591f945-0ead-46a3-a866-b7bea84a2a83
Turner, Steve
db854915-7aa0-4c38-b2f7-9ec23b1d2828
Devereux, Graham
c3123d52-d2fc-4147-938d-e9cf4ca9f821
Arshad, Syed Hasan
917e246d-2e60-472f-8d30-94b01ef28958
Murray, Clare S.
aca69df6-149c-401c-842f-5b2d8042edf1
Roberts, Graham
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Holloway, John W.
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Cullinan, Paul
b5b2eb0a-9fb9-4d4b-af18-5109de92d742
Henderson, John
dcb5516b-cca2-49b5-8a17-f4cf707daa36
Custovic, Adnan
17d8d092-73b8-44fb-bf48-5cea7b29e3fc
Oksel, Ceyda, Granell, Raquel, Haider, Sadia, Fontanella, Sara, Simpson, Angela, Turner, Steve, Devereux, Graham, Arshad, Syed Hasan, Murray, Clare S., Roberts, Graham, Holloway, John W., Cullinan, Paul, Henderson, John and Custovic, Adnan
,
STELAR and Breathing Together investigators
(2019)
Distinguishing wheezing phenotypes from infancy to adolescence: a pooled analysis of five birth cohorts.
Annals of the American Thoracic Society, 16 (7), .
(doi:10.1513/AnnalsATS.201811-837OC).
Abstract
RATIONALE: Pooling data from multiple cohorts and extending the time-frame across childhood should minimize study-specific effects, enabling better characterization of the childhood wheezing.
OBJECTIVE: To analyze wheezing patterns from early childhood to adolescence using combined data from five birth cohorts.
METHODS: We used latent class analysis to derive wheeze phenotypes among 7719 participants from five birth cohorts with complete report of wheeze at five time-periods. We tested the association of derived phenotypes with late asthma outcomes and lung function, and investigated the uncertainty in phenotype assignment.
RESULTS: We identified five phenotypes: Never/Infrequent wheeze (52.1%), Early-onset pre-school remitting (23.9%), Early-onset mid-childhood remitting (9%), Persistent (7.9%) and Late-onset wheeze (7.1%). Compared to the Never/infrequent wheeze, all phenotypes had higher odds of asthma and lower FEV1 and FEV1/FVC in adolescence. The association with asthma was strongest for Persistent wheeze (adjusted odds ratio 56.54, 95%CI 43.75-73.06). We observed considerable within-class heterogeneity at individual level, with 913 (12%) children having low membership probability (<0.60) of any phenotype. Class membership certainty was highest in Persistent and Never/infrequent, and lowest in Late-onset wheeze (with 51% of participants having membership probabilities<0.80). Individual wheezing patterns were particularly heterogeneous in Late-onset wheeze, while many children assigned to Early-onset pre-school remitting class reported wheezing at later time points.
CONCLUSIONS: All wheeze phenotypes had significantly diminished lung function in school-age, suggesting that the notion that early-life episodic wheeze has a benign prognosis may not be true for a proportion of transient wheezers. We observed considerable within-phenotype heterogeneity in individual wheezing patterns.
Text
Oksel et al 2018 Annals of the American Thoracic Society
- Accepted Manuscript
More information
Accepted/In Press date: 19 March 2019
e-pub ahead of print date: 19 March 2019
Published date: 1 July 2019
Identifiers
Local EPrints ID: 429096
URI: http://eprints.soton.ac.uk/id/eprint/429096
ISSN: 2329-6933
PURE UUID: 4586f038-76f0-44e9-b741-7c640f4ace00
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Date deposited: 21 Mar 2019 17:30
Last modified: 16 Mar 2024 07:42
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Contributors
Author:
Ceyda Oksel
Author:
Raquel Granell
Author:
Sadia Haider
Author:
Sara Fontanella
Author:
Angela Simpson
Author:
Steve Turner
Author:
Graham Devereux
Author:
Clare S. Murray
Author:
Graham Roberts
Author:
Paul Cullinan
Author:
John Henderson
Author:
Adnan Custovic
Corporate Author: STELAR and Breathing Together investigators
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