Cluster Analysis Identifies 3 Phenotypes within Allergic Asthma.

Autor:	Sendín-Hernández MP; Department of Clinical Biochemistry, University Hospital of Salamanca, Salamanca, Spain., Ávila-Zarza C; Statistical Department, University of Salamanca, Salamanca, Spain; Institute for Biomedical Research, IBSAL, Salamanca, Spain., Sanz C; Institute for Biomedical Research, IBSAL, Salamanca, Spain; Department of Microbiology and Genetics, University of Salamanca, Salamanca, Spain. Electronic address: catsof@usal.es., García-Sánchez A; Institute for Biomedical Research, IBSAL, Salamanca, Spain; Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain., Marcos-Vadillo E; Institute for Biomedical Research, IBSAL, Salamanca, Spain., Muñoz-Bellido FJ; Institute for Biomedical Research, IBSAL, Salamanca, Spain; Department of Allergy, University Hospital of Salamanca, Salamanca, Spain., Laffond E; Institute for Biomedical Research, IBSAL, Salamanca, Spain; Department of Allergy, University Hospital of Salamanca, Salamanca, Spain., Domingo C; Pulmonary Service, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain., Isidoro-García M; Department of Clinical Biochemistry, University Hospital of Salamanca, Salamanca, Spain; Institute for Biomedical Research, IBSAL, Salamanca, Spain; Department of Medicine, University of Salamanca, Salamanca, Spain. Electronic address: misidoro@usal.es., Dávila I; Institute for Biomedical Research, IBSAL, Salamanca, Spain; Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain; Department of Allergy, University Hospital of Salamanca, Salamanca, Spain.
Jazyk:	angličtina
Zdroj:	The journal of allergy and clinical immunology. In practice [J Allergy Clin Immunol Pract] 2018 May - Jun; Vol. 6 (3), pp. 955-961.e1. Date of Electronic Publication: 2017 Nov 10.
DOI:	10.1016/j.jaip.2017.10.006
Abstrakt:	Background: Asthma is a heterogeneous chronic disease with different clinical expressions and responses to treatment. In recent years, several unbiased approaches based on clinical, physiological, and molecular features have described several phenotypes of asthma. Some phenotypes are allergic, but little is known about whether these phenotypes can be further subdivided. Objective: We aimed to phenotype patients with allergic asthma using an unbiased approach based on multivariate classification techniques (unsupervised hierarchical cluster analysis). Methods: From a total of 54 variables of 225 patients with well-characterized allergic asthma diagnosed following American Thoracic Society (ATS) recommendation, positive skin prick test to aeroallergens, and concordant symptoms, we finally selected 19 variables by multiple correspondence analyses. Then a cluster analysis was performed. Results: Three groups were identified. Cluster 1 was constituted by patients with intermittent or mild persistent asthma, without family antecedents of atopy, asthma, or rhinitis. This group showed the lowest total IgE levels. Cluster 2 was constituted by patients with mild asthma with a family history of atopy, asthma, or rhinitis. Total IgE levels were intermediate. Cluster 3 included patients with moderate or severe persistent asthma that needed treatment with corticosteroids and long-acting β-agonists. This group showed the highest total IgE levels. Conclusions: We identified 3 phenotypes of allergic asthma in our population. Furthermore, we described 2 phenotypes of mild atopic asthma mainly differentiated by a family history of allergy. (Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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