Comparison of phenotypes of childhood wheeze and cough in 2 independent cohorts
| Autor: | Anina M. Pescatore, Caroline Beardsmore, Michael Silverman, Claudia E. Kuehni, Ben D. Spycher |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Immunology Population Disease Atopy Cohort Studies 03 medical and health sciences 0302 clinical medicine Wheeze Surveys and Questionnaires medicine Immunology and Allergy Humans 030212 general & internal medicine education Child Asthma Respiratory Sounds education.field_of_study business.industry Infant medicine.disease Prognosis 3. Good health Patient Outcome Assessment Chronic cough Phenotype 030228 respiratory system Cough Child Preschool Cohort Female medicine.symptom business Cohort study |
| Zdroj: | Journal of Allergy and Clinical Immunology The Journal of allergy and clinical immunology |
| DOI: | 10.1016/j.jaci.2013.08.002 |
| Popis: | Background Among children with wheeze and recurrent cough there is great variation in clinical presentation and time course of the disease. We previously distinguished 5 phenotypes of wheeze and cough in early childhood by applying latent class analysis to longitudinal data from a population-based cohort (original cohort). Objective To validate previously identified phenotypes of childhood cough and wheeze in an independent cohort. Methods We included 903 children reporting wheeze or recurrent cough from an independent population-based cohort (validation cohort). As in the original cohort, we used latent class analysis to identify phenotypes on the basis of symptoms of wheeze and cough at 2 time points (preschool and school age) and objective measurements of atopy, lung function, and airway responsiveness (school age). Prognostic outcomes (wheeze, bronchodilator use, cough apart from colds) 5 years later were compared across phenotypes. Results When using a 5-phenotype model, the analysis distinguished 3 phenotypes of wheeze and 2 of cough as in the original cohort. Two phenotypes were closely similar in both cohorts: Atopic persistent wheeze (persistent multiple trigger wheeze and chronic cough, atopy and reduced lung function, poor prognosis) and transient viral wheeze (early-onset transient wheeze with viral triggers, favorable prognosis). The other phenotypes differed more between cohorts. These differences might be explained by differences in age at measurements. Conclusions Applying the same method to 2 different cohorts, we consistently identified 2 phenotypes of wheeze (atopic persistent wheeze, transient viral wheeze), suggesting that these represent distinct disease processes. Differences found in other phenotypes suggest that the age when features are assessed is critical and should be considered carefully when defining phenotypes. |
| Databáze: | OpenAIRE |
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