Atopic dermatitis trajectories to age 8 years in the GUSTO cohort.
Atopic dermatitis trajectories to age 8 years in the GUSTO cohort.
Background:
The heterogeneity of childhood atopic dermatitis (AD) underscores the need to understand latent phenotypes that may inform risk stratification and disease prognostication.
Objective:
To identify AD trajectories across the first 8 years of life and investigate risk factors associated with each trajectory and their relationships with other comorbidities.
Methods:
Data were collected prospectively from 1152 mother-offspring dyads in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort from ages 3 months to 8 years. AD was defined based on parent-reported doctor's diagnosis. An unsupervised machine learning technique was used to determine AD trajectories.
Results:
Three AD trajectories were identified as follows: early-onset transient (6.3%), late-onset persistent (6.3%) and early-onset persistent (2.1%), alongside a no AD/reference group (85.2%). Early-onset transient AD was positively associated with male gender, family history of atopy, house dust mite sensitization and some measures of wheezing. Early-onset persistent AD was associated with antenatal/intrapartum antibiotic use, food sensitization and some measures of wheezing. Late-onset persistent AD was associated with a family history of atopy, some measures of house dust mite sensitization and some measures of allergic rhinitis and wheezing.
Conclusion and Clinical Relevance:
Three AD trajectories were identified in this birth cohort, with different risk factors and prognostic implications. Further work is needed to understand the molecular and immunological origins of these phenotypes.
atopic dermatitis, machine learning, rhinitis, trajectories, wheezing
1195-1206
Suaini, Noor H. A.
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Yap, Gaik Chin
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Tung, Bui Do Phuong
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Loo, Evelyn X.L.
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Goh, Anne Eng Neo
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Teoh, Oon Hoe
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Tan, Kok Hian
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Godfrey, Keith
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Lee, Bee Wah
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Shek, Lynette Pei-Chi
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van Bever, Hugo
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Chong, Yap-Seng
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Tham, Elizabeth Huiwen
e22014ec-8242-478a-aafc-e4177164f814
September 2021
Suaini, Noor H. A.
8ddd1497-88c3-4840-8733-473947bbe5f9
Yap, Gaik Chin
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Tung, Bui Do Phuong
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Loo, Evelyn X.L.
c21376cb-00e3-4c16-b6e4-1a81b66a7604
Goh, Anne Eng Neo
9d869111-5368-420f-97dc-336f052bef41
Teoh, Oon Hoe
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Tan, Kok Hian
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Godfrey, Keith
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Lee, Bee Wah
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Shek, Lynette Pei-Chi
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van Bever, Hugo
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Chong, Yap-Seng
7043124b-e892-4d4b-8bb7-6d35ed94e136
Tham, Elizabeth Huiwen
e22014ec-8242-478a-aafc-e4177164f814
Suaini, Noor H. A., Yap, Gaik Chin, Tung, Bui Do Phuong, Loo, Evelyn X.L., Goh, Anne Eng Neo, Teoh, Oon Hoe, Tan, Kok Hian, Godfrey, Keith, Lee, Bee Wah, Shek, Lynette Pei-Chi, van Bever, Hugo, Chong, Yap-Seng and Tham, Elizabeth Huiwen
(2021)
Atopic dermatitis trajectories to age 8 years in the GUSTO cohort.
Clinical & Experimental Allergy, 51 (9), .
(doi:10.1111/cea.13993).
Abstract
Background:
The heterogeneity of childhood atopic dermatitis (AD) underscores the need to understand latent phenotypes that may inform risk stratification and disease prognostication.
Objective:
To identify AD trajectories across the first 8 years of life and investigate risk factors associated with each trajectory and their relationships with other comorbidities.
Methods:
Data were collected prospectively from 1152 mother-offspring dyads in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort from ages 3 months to 8 years. AD was defined based on parent-reported doctor's diagnosis. An unsupervised machine learning technique was used to determine AD trajectories.
Results:
Three AD trajectories were identified as follows: early-onset transient (6.3%), late-onset persistent (6.3%) and early-onset persistent (2.1%), alongside a no AD/reference group (85.2%). Early-onset transient AD was positively associated with male gender, family history of atopy, house dust mite sensitization and some measures of wheezing. Early-onset persistent AD was associated with antenatal/intrapartum antibiotic use, food sensitization and some measures of wheezing. Late-onset persistent AD was associated with a family history of atopy, some measures of house dust mite sensitization and some measures of allergic rhinitis and wheezing.
Conclusion and Clinical Relevance:
Three AD trajectories were identified in this birth cohort, with different risk factors and prognostic implications. Further work is needed to understand the molecular and immunological origins of these phenotypes.
Text
GUSTO_AD_Trajectories_revised_V3.7_cleaned_090721
- Accepted Manuscript
More information
Accepted/In Press date: 21 July 2021
e-pub ahead of print date: 26 July 2021
Published date: September 2021
Additional Information:
Funding Information:
This research is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Program and administered by the Singapore Ministry of Health's National Medical Research Council (NMRC), Singapore?NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/ 2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. E.H. Tham is supported by the National Medical Research Council (NMRC) Transition Award grant [MOH-TA18nov-003] from NMRC, Singapore. K.M. Godfrey is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and the NIHR Southampton Biomedical Research Centre) and by the European Union's Erasmus+Programme (ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP) The authors acknowledge the contribution of the rest of the GUSTO study group which includes Lee Yung Seng, Wei Wei Pang, Pratibha Agarwal, Dennis Bier, Arijit Biswas, Shirong Cai, Jerry Kok Yen Chan, Cornelia Yin Ing Chee, Helen Y. H Chen, Audrey Chia, Amutha Chinnadurai, Chai Kiat Chng, Shang Chee Chong, Mei Chien Chua, Chun Ming Ding, Eric Andrew Finkelstein, Doris Fok, Marielle Fortier, Yam Thiam Daniel Goh, Joshua J. Gooley, Wee Meng Han, Mark Hanson, Christiani Jeyakumar Henry, Joanna D Holbrook, Chin-Ying Hsu, Hazel Inskip, Jeevesh Kapur, Birit Leutscher-Broekman, Sok Bee Lim, Seong Feei Loh, Yen-Ling Low, Iliana Magiati, Lourdes Mary Daniel, Michael Meaney, Susan Morton, Cheryl Ngo, Krishnamoorthy Niduvaje, Anqi Qiu, Boon Long Quah, Victor Samuel Rajadurai, Mary Rauff, Jenny L. Richmond, Anne Rifkin-Graboi, Allan Sheppard, Borys Shuter, Leher Singh, Wing Chee So, Walter Stunkel, Lin Lin Su, Soek Hui Tan, Rob, M. van Dam, Sudhakar K. Venkatesh, Inez Bik Yun Wong, P. C. Wong and George Seow Heong Yeo. We would also like to thank the GUSTO Executive committee, research staff and all parents and children who participated in the GUSTO study.
Funding Information:
Chong YS has received reimbursement for speaking at conferences sponsored by Abbott Nutrition, Nestle and Danone. Godfrey KM has received reimbursement for speaking at conferences sponsored by Nestle, and Shek LP has received reimbursement for speaking at conferences sponsored by Danone and Nestle and consulting for Mead Johnson and Nestle. Godfrey KM and Chong YS are part of an academic consortium that has received research funding from Abbott Nutrition, Nestle and Danone. Shek LP has received research funding from Danone.
Funding Information:
This research is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Program and administered by the Singapore Ministry of Health's National Medical Research Council (NMRC), Singapore—NMRC/TCR/004‐NUS/2008; NMRC/TCR/012‐NUHS/ 2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. E.H. Tham is supported by the National Medical Research Council (NMRC) Transition Award grant [MOH‐TA18nov‐003] from NMRC, Singapore. K.M. Godfrey is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF‐SI‐0515‐10042) and the NIHR Southampton Biomedical Research Centre) and by the European Union's Erasmus+Programme (ImpENSA 598488‐EPP‐1‐2018‐1‐DE‐EPPKA2‐CBHE‐JP)
Publisher Copyright:
© 2021 John Wiley & Sons Ltd.
Keywords:
atopic dermatitis, machine learning, rhinitis, trajectories, wheezing
Identifiers
Local EPrints ID: 450720
URI: http://eprints.soton.ac.uk/id/eprint/450720
ISSN: 0954-7894
PURE UUID: 675cf1eb-06bf-4f41-9576-a43827829e07
Catalogue record
Date deposited: 09 Aug 2021 16:31
Last modified: 17 Mar 2024 06:45
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Contributors
Author:
Noor H. A. Suaini
Author:
Gaik Chin Yap
Author:
Bui Do Phuong Tung
Author:
Evelyn X.L. Loo
Author:
Anne Eng Neo Goh
Author:
Oon Hoe Teoh
Author:
Kok Hian Tan
Author:
Bee Wah Lee
Author:
Lynette Pei-Chi Shek
Author:
Hugo van Bever
Author:
Yap-Seng Chong
Author:
Elizabeth Huiwen Tham
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