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Atopic endotype in childhood

Background The term atopic disorder is an early attempt to define specific endotypes of children with asthma, eczema, or both and increased IgE levels. Objective We performed a longitudinal analysis of the relevance of the atopic endotype from birth to age 13 years. Methods Allergic sensitization ag...

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Published in:	Journal of allergy and clinical immunology 2016-03, Vol.137 (3), p.844-851.e4
Main Authors:	Schoos, Ann-Marie Malby, MD, PhD, Chawes, Bo Lund, MD, PhD, Rasmussen, Morten Arendt, PhD, Bloch, Joakim, MS, Bønnelykke, Klaus, MD, PhD, Bisgaard, Hans, MD, DMSc
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Language:	English
Subjects:	Adolescent Age Age Factors Algorithms Allergens - immunology Allergies Allergy and Immunology Asthma Asthma - diagnosis Asthma - immunology Child Child, Preschool children Children & youth Clinical outcomes eczema Eczema - diagnosis Eczema - immunology Endotype Female Food Humans Hypersensitivity, Immediate - diagnosis Hypersensitivity, Immediate - epidemiology Hypersensitivity, Immediate - immunology Immunization Immunoglobulin E - immunology Infant Male Prevalence Prospective Studies sensitization skin prick test Skin Tests Socioeconomic Factors specific IgE
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creator	Schoos, Ann-Marie Malby, MD, PhD Chawes, Bo Lund, MD, PhD Rasmussen, Morten Arendt, PhD Bloch, Joakim, MS Bønnelykke, Klaus, MD, PhD Bisgaard, Hans, MD, DMSc
description	Background The term atopic disorder is an early attempt to define specific endotypes of children with asthma, eczema, or both and increased IgE levels. Objective We performed a longitudinal analysis of the relevance of the atopic endotype from birth to age 13 years. Methods Allergic sensitization against 28 inhalant and food allergens was assessed at ½, 1½, 4, 6, and 13 years of age in 399 children from the Copenhagen Prospective Study on Asthma in Childhood2000 birth cohort by using both skin prick test responses and specific IgE levels. Asthma and eczema were diagnosed longitudinally by strictly adhering to predefined algorithms. Associations between allergic sensitization, asthma, and eczema were estimated by means of logistic regression, and a machine learning approach was used to identify temporal phenotype clusters of these traits. Results Allergic sensitization showed no association with asthma through early childhood (0-6 years) when analyzed as any sensitization (odds ratio [OR] range, 0.78-1.29; P ≥ .48). However, at 13 years of age, any sensitization was associated with asthma (OR range, 4.02-5.94; all P
doi_str_mv	10.1016/j.jaci.2015.10.004
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Objective We performed a longitudinal analysis of the relevance of the atopic endotype from birth to age 13 years. Methods Allergic sensitization against 28 inhalant and food allergens was assessed at ½, 1½, 4, 6, and 13 years of age in 399 children from the Copenhagen Prospective Study on Asthma in Childhood2000 birth cohort by using both skin prick test responses and specific IgE levels. Asthma and eczema were diagnosed longitudinally by strictly adhering to predefined algorithms. Associations between allergic sensitization, asthma, and eczema were estimated by means of logistic regression, and a machine learning approach was used to identify temporal phenotype clusters of these traits. Results Allergic sensitization showed no association with asthma through early childhood (0-6 years) when analyzed as any sensitization (odds ratio [OR] range, 0.78-1.29; P ≥ .48). However, at 13 years of age, any sensitization was associated with asthma (OR range, 4.02-5.94; all P < .001). In contrast, any sensitization was associated with eczema at ½, 1½, and 6 years of age (OR range, 2.06-6.02; P ≤ .01) and borderline associated at 4 years of age (OR, 1.61 [95% CI, 0.96-2.69]; P = .07) but not at 13 years of age (OR, 1.57 [95% CI, 0.78-3.16]; P = .21). We identified 4 latent patterns of disease development that were either dominated by sensitization (37%), eczema (26%), asthma (14%), or healthy status (24%). Conclusion We found very little interdependency between asthma, eczema, and allergic sensitization through childhood. The associations between those entities were strongly dependent on age, type of allergens, and method of testing for sensitization. Therefore, atopy in children is unlikely to represent a true endotype.</description><identifier>ISSN: 0091-6749</identifier><identifier>EISSN: 1097-6825</identifier><identifier>DOI: 10.1016/j.jaci.2015.10.004</identifier><identifier>PMID: 26597163</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Age ; Age Factors ; Algorithms ; Allergens - immunology ; Allergies ; Allergy and Immunology ; Asthma ; Asthma - diagnosis ; Asthma - immunology ; Child ; Child, Preschool ; children ; Children & youth ; Clinical outcomes ; eczema ; Eczema - diagnosis ; Eczema - immunology ; Endotype ; Female ; Food ; Humans ; Hypersensitivity, Immediate - diagnosis ; Hypersensitivity, Immediate - epidemiology ; Hypersensitivity, Immediate - immunology ; Immunization ; Immunoglobulin E - immunology ; Infant ; Male ; Prevalence ; Prospective Studies ; sensitization ; skin prick test ; Skin Tests ; Socioeconomic Factors ; specific IgE</subject><ispartof>Journal of allergy and clinical immunology, 2016-03, Vol.137 (3), p.844-851.e4</ispartof><rights>American Academy of Allergy, Asthma & Immunology</rights><rights>2015 American Academy of Allergy, Asthma & Immunology</rights><rights>Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Mar 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c516t-3f1631bcb92db98f941be3e9a12bf04ef272b7a36a69de0da9336b6b6b3677da3</citedby><cites>FETCH-LOGICAL-c516t-3f1631bcb92db98f941be3e9a12bf04ef272b7a36a69de0da9336b6b6b3677da3</cites><orcidid>0000-0003-4131-7592</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26597163$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schoos, Ann-Marie Malby, MD, PhD</creatorcontrib><creatorcontrib>Chawes, Bo Lund, MD, PhD</creatorcontrib><creatorcontrib>Rasmussen, Morten Arendt, PhD</creatorcontrib><creatorcontrib>Bloch, Joakim, MS</creatorcontrib><creatorcontrib>Bønnelykke, Klaus, MD, PhD</creatorcontrib><creatorcontrib>Bisgaard, Hans, MD, DMSc</creatorcontrib><title>Atopic endotype in childhood</title><title>Journal of allergy and clinical immunology</title><addtitle>J Allergy Clin Immunol</addtitle><description>Background The term atopic disorder is an early attempt to define specific endotypes of children with asthma, eczema, or both and increased IgE levels. Objective We performed a longitudinal analysis of the relevance of the atopic endotype from birth to age 13 years. Methods Allergic sensitization against 28 inhalant and food allergens was assessed at ½, 1½, 4, 6, and 13 years of age in 399 children from the Copenhagen Prospective Study on Asthma in Childhood2000 birth cohort by using both skin prick test responses and specific IgE levels. Asthma and eczema were diagnosed longitudinally by strictly adhering to predefined algorithms. Associations between allergic sensitization, asthma, and eczema were estimated by means of logistic regression, and a machine learning approach was used to identify temporal phenotype clusters of these traits. Results Allergic sensitization showed no association with asthma through early childhood (0-6 years) when analyzed as any sensitization (odds ratio [OR] range, 0.78-1.29; P ≥ .48). However, at 13 years of age, any sensitization was associated with asthma (OR range, 4.02-5.94; all P < .001). In contrast, any sensitization was associated with eczema at ½, 1½, and 6 years of age (OR range, 2.06-6.02; P ≤ .01) and borderline associated at 4 years of age (OR, 1.61 [95% CI, 0.96-2.69]; P = .07) but not at 13 years of age (OR, 1.57 [95% CI, 0.78-3.16]; P = .21). We identified 4 latent patterns of disease development that were either dominated by sensitization (37%), eczema (26%), asthma (14%), or healthy status (24%). Conclusion We found very little interdependency between asthma, eczema, and allergic sensitization through childhood. The associations between those entities were strongly dependent on age, type of allergens, and method of testing for sensitization. Therefore, atopy in children is unlikely to represent a true endotype.</description><subject>Adolescent</subject><subject>Age</subject><subject>Age Factors</subject><subject>Algorithms</subject><subject>Allergens - immunology</subject><subject>Allergies</subject><subject>Allergy and Immunology</subject><subject>Asthma</subject><subject>Asthma - diagnosis</subject><subject>Asthma - immunology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>children</subject><subject>Children & youth</subject><subject>Clinical outcomes</subject><subject>eczema</subject><subject>Eczema - diagnosis</subject><subject>Eczema - immunology</subject><subject>Endotype</subject><subject>Female</subject><subject>Food</subject><subject>Humans</subject><subject>Hypersensitivity, Immediate - diagnosis</subject><subject>Hypersensitivity, Immediate - epidemiology</subject><subject>Hypersensitivity, Immediate - immunology</subject><subject>Immunization</subject><subject>Immunoglobulin E - immunology</subject><subject>Infant</subject><subject>Male</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>sensitization</subject><subject>skin prick test</subject><subject>Skin Tests</subject><subject>Socioeconomic Factors</subject><subject>specific IgE</subject><issn>0091-6749</issn><issn>1097-6825</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqNkU1LxDAQhoMoun78ARFZ8OKla76aNCDCIn7Bggf1HNJkiqndZm26wv57U3ZV8CCSw5DhmRfmGYSOCZ4QTMRFPamN9ROKSZ4aE4z5FhoRrGQmCppvoxHGimRCcrWH9mOscfqzQu2iPSpyJYlgI3Qy7cPC2zG0LvSrBYx9O7avvnGvIbhDtFOZJsLRph6gl9ub5-v7bPZ493A9nWU2J6LPWJWiSGlLRV2pikpxUgIDZQgtK8yhopKW0jBhhHKAnVGMiXJ4TEjpDDtA5-vcRRfelxB7PffRQtOYFsIyaiIlKxjnef4flHBeYCYTevYLrcOya9MiiSqwoFKqIlF0TdkuxNhBpRedn5tupQnWg2Zd60GzHjQPvaQ5DZ1uopflHNz3yJfXBFyuAUjaPjx0OloPrQXnO7C9dsH_nX_1a9w2vvXWNG-wgvizh45UY_00HHq4M8kx4TTp_QSi25-9</recordid><startdate>20160301</startdate><enddate>20160301</enddate><creator>Schoos, Ann-Marie Malby, MD, PhD</creator><creator>Chawes, Bo Lund, MD, PhD</creator><creator>Rasmussen, Morten Arendt, PhD</creator><creator>Bloch, Joakim, MS</creator><creator>Bønnelykke, Klaus, MD, PhD</creator><creator>Bisgaard, Hans, MD, DMSc</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7SS</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4131-7592</orcidid></search><sort><creationdate>20160301</creationdate><title>Atopic endotype in childhood</title><author>Schoos, Ann-Marie Malby, MD, PhD ; Chawes, Bo Lund, MD, PhD ; Rasmussen, Morten Arendt, PhD ; Bloch, Joakim, MS ; Bønnelykke, Klaus, MD, PhD ; Bisgaard, Hans, MD, DMSc</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c516t-3f1631bcb92db98f941be3e9a12bf04ef272b7a36a69de0da9336b6b6b3677da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Age</topic><topic>Age Factors</topic><topic>Algorithms</topic><topic>Allergens - immunology</topic><topic>Allergies</topic><topic>Allergy and Immunology</topic><topic>Asthma</topic><topic>Asthma - diagnosis</topic><topic>Asthma - immunology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>children</topic><topic>Children & youth</topic><topic>Clinical outcomes</topic><topic>eczema</topic><topic>Eczema - diagnosis</topic><topic>Eczema - immunology</topic><topic>Endotype</topic><topic>Female</topic><topic>Food</topic><topic>Humans</topic><topic>Hypersensitivity, Immediate - diagnosis</topic><topic>Hypersensitivity, Immediate - epidemiology</topic><topic>Hypersensitivity, Immediate - immunology</topic><topic>Immunization</topic><topic>Immunoglobulin E - immunology</topic><topic>Infant</topic><topic>Male</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>sensitization</topic><topic>skin prick test</topic><topic>Skin Tests</topic><topic>Socioeconomic Factors</topic><topic>specific IgE</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schoos, Ann-Marie Malby, MD, PhD</creatorcontrib><creatorcontrib>Chawes, Bo Lund, MD, PhD</creatorcontrib><creatorcontrib>Rasmussen, Morten Arendt, PhD</creatorcontrib><creatorcontrib>Bloch, Joakim, MS</creatorcontrib><creatorcontrib>Bønnelykke, Klaus, MD, PhD</creatorcontrib><creatorcontrib>Bisgaard, Hans, MD, DMSc</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of allergy and clinical immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schoos, Ann-Marie Malby, MD, PhD</au><au>Chawes, Bo Lund, MD, PhD</au><au>Rasmussen, Morten Arendt, PhD</au><au>Bloch, Joakim, MS</au><au>Bønnelykke, Klaus, MD, PhD</au><au>Bisgaard, Hans, MD, DMSc</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Atopic endotype in childhood</atitle><jtitle>Journal of allergy and clinical immunology</jtitle><addtitle>J Allergy Clin Immunol</addtitle><date>2016-03-01</date><risdate>2016</risdate><volume>137</volume><issue>3</issue><spage>844</spage><epage>851.e4</epage><pages>844-851.e4</pages><issn>0091-6749</issn><eissn>1097-6825</eissn><abstract>Background The term atopic disorder is an early attempt to define specific endotypes of children with asthma, eczema, or both and increased IgE levels. Objective We performed a longitudinal analysis of the relevance of the atopic endotype from birth to age 13 years. Methods Allergic sensitization against 28 inhalant and food allergens was assessed at ½, 1½, 4, 6, and 13 years of age in 399 children from the Copenhagen Prospective Study on Asthma in Childhood2000 birth cohort by using both skin prick test responses and specific IgE levels. Asthma and eczema were diagnosed longitudinally by strictly adhering to predefined algorithms. Associations between allergic sensitization, asthma, and eczema were estimated by means of logistic regression, and a machine learning approach was used to identify temporal phenotype clusters of these traits. Results Allergic sensitization showed no association with asthma through early childhood (0-6 years) when analyzed as any sensitization (odds ratio [OR] range, 0.78-1.29; P ≥ .48). However, at 13 years of age, any sensitization was associated with asthma (OR range, 4.02-5.94; all P < .001). In contrast, any sensitization was associated with eczema at ½, 1½, and 6 years of age (OR range, 2.06-6.02; P ≤ .01) and borderline associated at 4 years of age (OR, 1.61 [95% CI, 0.96-2.69]; P = .07) but not at 13 years of age (OR, 1.57 [95% CI, 0.78-3.16]; P = .21). We identified 4 latent patterns of disease development that were either dominated by sensitization (37%), eczema (26%), asthma (14%), or healthy status (24%). Conclusion We found very little interdependency between asthma, eczema, and allergic sensitization through childhood. The associations between those entities were strongly dependent on age, type of allergens, and method of testing for sensitization. Therefore, atopy in children is unlikely to represent a true endotype.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26597163</pmid><doi>10.1016/j.jaci.2015.10.004</doi><orcidid>https://orcid.org/0000-0003-4131-7592</orcidid><oa>free_for_read</oa></addata></record>
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subjects	Adolescent Age Age Factors Algorithms Allergens - immunology Allergies Allergy and Immunology Asthma Asthma - diagnosis Asthma - immunology Child Child, Preschool children Children & youth Clinical outcomes eczema Eczema - diagnosis Eczema - immunology Endotype Female Food Humans Hypersensitivity, Immediate - diagnosis Hypersensitivity, Immediate - epidemiology Hypersensitivity, Immediate - immunology Immunization Immunoglobulin E - immunology Infant Male Prevalence Prospective Studies sensitization skin prick test Skin Tests Socioeconomic Factors specific IgE
title	Atopic endotype in childhood
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