Distinct Endotypes of Pediatric Rhinitis Based on Cluster Analysis

被引:3
|
作者
Kim, Jin Youp [1 ,2 ]
Lee, Sangjun [3 ,4 ]
Suh, Dong In [5 ]
Kim, Dae Woo [6 ]
Yoon, Hyung-Jin [2 ,7 ,8 ]
Park, Sue K. [3 ]
Rhee, Chae-Seo [9 ,10 ,11 ,12 ]
Han, Doo Hee [9 ,13 ]
机构
[1] Dongguk Univ, Dept Otorhinolaryngol Head & Neck Surg, Ilsan Hosp, Goyang, South Korea
[2] Seoul Natl Univ, Interdisciplinary Program Med Informat, Coll Med, Seoul, South Korea
[3] Seoul Natl Univ, Dept Prevent Med, Coll Med, Seoul, South Korea
[4] Seoul Natl Univ, Dept Biomed Sci, Coll Med, Seoul, South Korea
[5] Seoul Natl Univ, Dept Pediat, Coll Med, Seoul, South Korea
[6] Seoul Natl Univ, Dept Otorhinolaryngol Head & Neck Surg, Seoul Metropolitan Govt, Boramae Med Ctr, Seoul, South Korea
[7] Seoul Natl Univ, Dept Biomed Engn, Coll Med, Seoul, South Korea
[8] Seoul Natl Univ, Inst Med & Biol Engn, Med Res Ctr, Seoul, South Korea
[9] Seoul Natl Univ, Dept Otorhinolaryngol, Coll Med, Seoul, South Korea
[10] Seoul Natl Univ, Grad Sch Immunol, Coll Med, Seoul, South Korea
[11] Seoul Natl Univ, Inst Allergy & Clin Immunol, Biomed Res Ctr, Seoul, South Korea
[12] Seoul Natl Univ, Sensory Organ Res Inst, Biomed Res Ctr, Seoul, South Korea
[13] Seoul Natl Univ, Dept Otorhinolaryngol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
关键词
Allergic rhinitis; asthma; bronchial hyperreactivity; child; cluster analysis; rhinitis; bronchial hyper-responsiveness; pediatric rhinitis; type; 2; inflammation; ALLERGIC RHINITIS; ASTHMA; CHILDREN;
D O I
10.4168/aair.2022.14.6.730
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Purpose: Despite the wide spectrum of pediatric rhinitis, endotyping of rhinitis based on type 2 inflammation and bronchial hyper-responsiveness (BHR) is lacking. This study aimed to investigate endotypes of pediatric rhinitis using cluster analysis.Methods: Cluster analysis was performed on data from 241 children with rhinitis by using 12 variables reflecting clinical characteristics of skin prick, laboratory, and pulmonary function tests. After extracting clusters, between-cluster differences in clinical features, such as nasal symptom scores and asthma comorbidity, were assessed to investigate the association between the endotypes and clinical features.Results: Four clusters were extracted by hierarchical cluster analysis. Cluster 1 (n = 32 [13.3%]) was the non-allergic rhinitis dominant cluster with low type 2 inflammation and the lowest rate of BHR. Patients in cluster 1 had the mildest nasal symptoms and no asthma comorbidity. Cluster 2 (n = 114 [47.3%]) was the largest cluster and exhibited intermediate type 2 inflammation and low BHR. Cluster 3 (n = 65 [27.0%]) showed high type 2 inflammation and intermediate BHR. However, the severity of nasal symptoms and asthma comorbidity in this cluster were comparable with those in cluster 2. Cluster 4 (n = 30 [12.4%]) revealed high type 2 inflammation and BHR with potential functional airway impairment. Additionally, cluster 4 displayed the most severe nasal symptoms and frequent asthma comorbidity.Conclusions: Four distinct endotypes of pediatric rhinitis based on allergen sensitization, type 2 inflammation, and BHR correlate to symptoms and asthma comorbidity. These endotypes may aid clinicians in understanding the wide spectrum of pediatric rhinitis.
引用
收藏
页码:730 / 741
页数:12
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