Clinical features and later prognosis of replicable early-life wheeze clusters from two birth cohorts 12 years apart
Clinical features and later prognosis of replicable early-life wheeze clusters from two birth cohorts 12 years apart
Background: clustering techniques can define the heterogeneity of asthma and wheezing. Defining early-life wheezing clusters and associated asthma risk could potentially inform patient management strategies. Clustering models that yield replicable cluster groups will have greater validity and clinical utility. This study sought to identify early-life wheezing clusters that are translatable into clinical practice and assess their stability over time in two whole-population birth cohorts established a decade apart from the same geographical location.
Methods: nonparametric K-means cluster analysis was performed separately on two birth cohorts from the Isle of Wight, UK; the Isle of Wight Birth Cohort (IOWBC) and Food Allergy and Intolerance Research Cohort (FAIR), using clinically defining variables in wheezing subjects in the first 3-4 years. Associations of resulting clusters with potential early-life risk factors and 10-year asthma outcomes were further assessed.
Results: five clusters were identified in both cohorts: (1) infantile-onset-transient-non-atopic-wheeze, (2) infantile-onset-persistent-non-atopic-wheeze, (3) infantile-onset-atopic-wheeze, (4) early-childhood-onset-non-atopic-wheeze, and (5) early-childhood-onset-atopic-wheeze. Two atopic wheezing clusters (3 and 5) were associated with greatest early-life wheeze frequency, highest wheeze persistence, and asthma prevalence at 10 years. Cluster 1 was commonest but had lowest early-life wheeze frequency and asthma prevalence at 10 years. Cluster 2, characterized by limited atopy but recurrent infantile respiratory infections and ongoing early-life wheezing, had high 10-year asthma prevalence only in IOWBC.
Conclusions: early-life wheeze comprises several disease clusters (two more severe and three mild-moderate) with differing relationships to later childhood asthma, which can be replicated over time supporting their potential validity and clinical utility.
asthma, atopy, early-life wheezing, wheezing phenotypes
Ngo, Suzanne Y.
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Venter, Carina
b865c2a4-7789-46c9-b6ef-c032c4fda66a
Anderson, William C.
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Picket, Kaci
b686b065-ccf3-486f-b64e-52d5abece7fc
Zhang, Hongmei
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Arshad, S. Hasan
795d8599-b77d-44e5-bb9c-67db78822057
Kurukulaaratchy, Ramesh J.
9c7b8105-2892-49f2-8775-54d4961e3e74
18 July 2023
Ngo, Suzanne Y.
2a2bd388-029b-40ef-aeed-2e001c01f1d9
Venter, Carina
b865c2a4-7789-46c9-b6ef-c032c4fda66a
Anderson, William C.
37b498fd-1019-472c-a88e-2572d569780c
Picket, Kaci
b686b065-ccf3-486f-b64e-52d5abece7fc
Zhang, Hongmei
9f774048-54d6-4321-a252-3887b2c76db0
Arshad, S. Hasan
795d8599-b77d-44e5-bb9c-67db78822057
Kurukulaaratchy, Ramesh J.
9c7b8105-2892-49f2-8775-54d4961e3e74
Ngo, Suzanne Y., Venter, Carina, Anderson, William C., Picket, Kaci, Zhang, Hongmei, Arshad, S. Hasan and Kurukulaaratchy, Ramesh J.
(2023)
Clinical features and later prognosis of replicable early-life wheeze clusters from two birth cohorts 12 years apart.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 34 (7), [e13999].
(doi:10.1111/pai.13999).
Abstract
Background: clustering techniques can define the heterogeneity of asthma and wheezing. Defining early-life wheezing clusters and associated asthma risk could potentially inform patient management strategies. Clustering models that yield replicable cluster groups will have greater validity and clinical utility. This study sought to identify early-life wheezing clusters that are translatable into clinical practice and assess their stability over time in two whole-population birth cohorts established a decade apart from the same geographical location.
Methods: nonparametric K-means cluster analysis was performed separately on two birth cohorts from the Isle of Wight, UK; the Isle of Wight Birth Cohort (IOWBC) and Food Allergy and Intolerance Research Cohort (FAIR), using clinically defining variables in wheezing subjects in the first 3-4 years. Associations of resulting clusters with potential early-life risk factors and 10-year asthma outcomes were further assessed.
Results: five clusters were identified in both cohorts: (1) infantile-onset-transient-non-atopic-wheeze, (2) infantile-onset-persistent-non-atopic-wheeze, (3) infantile-onset-atopic-wheeze, (4) early-childhood-onset-non-atopic-wheeze, and (5) early-childhood-onset-atopic-wheeze. Two atopic wheezing clusters (3 and 5) were associated with greatest early-life wheeze frequency, highest wheeze persistence, and asthma prevalence at 10 years. Cluster 1 was commonest but had lowest early-life wheeze frequency and asthma prevalence at 10 years. Cluster 2, characterized by limited atopy but recurrent infantile respiratory infections and ongoing early-life wheezing, had high 10-year asthma prevalence only in IOWBC.
Conclusions: early-life wheeze comprises several disease clusters (two more severe and three mild-moderate) with differing relationships to later childhood asthma, which can be replicated over time supporting their potential validity and clinical utility.
Text
IOW Wheezing Clusters Comparison PAI Final
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Pediatric Allergy Immunology - 2023 - Ngo
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e-pub ahead of print date: 18 July 2023
Published date: 18 July 2023
Additional Information:
Funding Information:
The Isle of Wight Birth Cohort assessments have been supported by the National Institutes of Health USA (Grant no. R01 HL082925 and R01 AI121226), Asthma UK (Grant no. 364) and the David Hide Asthma and Allergy Research Trust. The Food Allergy and Intolerance Research (FAIR) cohort was funded by the Food Standards Agency UK and the National Institute of Health Research (NIHR) UK.
Funding Information:
Dr. Venter reports grants from Reckitt Benckiser, Food Allergy Research and Education, National Peanut Board; personal fees from Reckitt Benckiser, Nestle Nutrition Institute, Danone, Abbott Nutrition, Else Nutrition, Sifter and Before Brands. Dr. Anderson has served as an advisory board member for Regeneron, Sanofi, and Genentech. He has grant support from the Colorado Medicaid Supplemental Funding Program and the COPIC Medical Foundation. Dr. Zhang's work was supported by R01AI121226. All other authors have no conflicts of interest to report.
Publisher Copyright:
© 2023 The Authors. Pediatric Allergy and Immunology published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.
Keywords:
asthma, atopy, early-life wheezing, wheezing phenotypes
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Local EPrints ID: 480470
URI: http://eprints.soton.ac.uk/id/eprint/480470
ISSN: 0905-6157
PURE UUID: 45cd5894-e967-4f51-9b2b-f2e69760cf00
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Date deposited: 02 Aug 2023 17:12
Last modified: 18 Mar 2024 02:51
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Contributors
Author:
Suzanne Y. Ngo
Author:
Carina Venter
Author:
William C. Anderson
Author:
Kaci Picket
Author:
Hongmei Zhang
Author:
S. Hasan Arshad
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