#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Developmental Profiles of Eczema, Wheeze, and Rhinitis: Two Population-Based Birth Cohort Studies


Background:
The term “atopic march” has been used to imply a natural progression of a cascade of symptoms from eczema to asthma and rhinitis through childhood. We hypothesize that this expression does not adequately describe the natural history of eczema, wheeze, and rhinitis during childhood. We propose that this paradigm arose from cross-sectional analyses of longitudinal studies, and may reflect a population pattern that may not predominate at the individual level.

Methods and Findings:
Data from 9,801 children in two population-based birth cohorts were used to determine individual profiles of eczema, wheeze, and rhinitis and whether the manifestations of these symptoms followed an atopic march pattern. Children were assessed at ages 1, 3, 5, 8, and 11 y. We used Bayesian machine learning methods to identify distinct latent classes based on individual profiles of eczema, wheeze, and rhinitis. This approach allowed us to identify groups of children with similar patterns of eczema, wheeze, and rhinitis over time.

Using a latent disease profile model, the data were best described by eight latent classes: no disease (51.3%), atopic march (3.1%), persistent eczema and wheeze (2.7%), persistent eczema with later-onset rhinitis (4.7%), persistent wheeze with later-onset rhinitis (5.7%), transient wheeze (7.7%), eczema only (15.3%), and rhinitis only (9.6%). When latent variable modelling was carried out separately for the two cohorts, similar results were obtained. Highly concordant patterns of sensitisation were associated with different profiles of eczema, rhinitis, and wheeze. The main limitation of this study was the difference in wording of the questions used to ascertain the presence of eczema, wheeze, and rhinitis in the two cohorts.

Conclusions:
The developmental profiles of eczema, wheeze, and rhinitis are heterogeneous; only a small proportion of children (∼7% of those with symptoms) follow trajectory profiles resembling the atopic march.

Please see later in the article for the Editors' Summary


Vyšlo v časopise: Developmental Profiles of Eczema, Wheeze, and Rhinitis: Two Population-Based Birth Cohort Studies. PLoS Med 11(10): e32767. doi:10.1371/journal.pmed.1001748
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001748

Souhrn

Background:
The term “atopic march” has been used to imply a natural progression of a cascade of symptoms from eczema to asthma and rhinitis through childhood. We hypothesize that this expression does not adequately describe the natural history of eczema, wheeze, and rhinitis during childhood. We propose that this paradigm arose from cross-sectional analyses of longitudinal studies, and may reflect a population pattern that may not predominate at the individual level.

Methods and Findings:
Data from 9,801 children in two population-based birth cohorts were used to determine individual profiles of eczema, wheeze, and rhinitis and whether the manifestations of these symptoms followed an atopic march pattern. Children were assessed at ages 1, 3, 5, 8, and 11 y. We used Bayesian machine learning methods to identify distinct latent classes based on individual profiles of eczema, wheeze, and rhinitis. This approach allowed us to identify groups of children with similar patterns of eczema, wheeze, and rhinitis over time.

Using a latent disease profile model, the data were best described by eight latent classes: no disease (51.3%), atopic march (3.1%), persistent eczema and wheeze (2.7%), persistent eczema with later-onset rhinitis (4.7%), persistent wheeze with later-onset rhinitis (5.7%), transient wheeze (7.7%), eczema only (15.3%), and rhinitis only (9.6%). When latent variable modelling was carried out separately for the two cohorts, similar results were obtained. Highly concordant patterns of sensitisation were associated with different profiles of eczema, rhinitis, and wheeze. The main limitation of this study was the difference in wording of the questions used to ascertain the presence of eczema, wheeze, and rhinitis in the two cohorts.

Conclusions:
The developmental profiles of eczema, wheeze, and rhinitis are heterogeneous; only a small proportion of children (∼7% of those with symptoms) follow trajectory profiles resembling the atopic march.

Please see later in the article for the Editors' Summary


Zdroje

1. WahnU (2000) What drives the allergic march? Allergy 55: 591–599.

2. WahnU, BergmannR, KuligM, ForsterJ, BauerCP (1997) The natural course of sensitisation and atopic disease in infancy and childhood. Pediatr Allergy Immunol 8: 16–20.

3. SaunesM, OienT, DotterudCK, RomundstadPR, StorroO, et al. (2012) Early eczema and the risk of childhood asthma: a prospective, population-based study. BMC Pediatr 12: 168.

4. DharmageSC, LoweAJ, MathesonMC, BurgessJA, AllenKJ, et al. (2014) Atopic dermatitis and the atopic march revisited. Allergy 69: 17–27.

5. BurgessJA, LoweAJ, MathesonMC, VarigosG, AbramsonMJ, et al. (2009) Does eczema lead to asthma? J Asthma 46: 429–436.

6. SpergelJM (2010) Epidemiology of atopic dermatitis and atopic march in children. Immunol Allergy Clin North Am 30: 269–280.

7. SpergelJM, PallerAS (2003) Atopic dermatitis and the atopic march. J Allergy Clin Immunol 112 (Suppl 6) S118–S127.

8. RhodesHL, ThomasP, SporikR, HolgateST, CogswellJJ (2002) A birth cohort study of subjects at risk of atopy: twenty-two-year follow-up of wheeze and atopic status. Am J Respir Crit Care Med 165: 176–180.

9. SpergelJM (2010) From atopic dermatitis to asthma: the atopic march. Ann Allergy Asthma Immunol 105: 99–106.

10. ShakerM (2014) New insights into the allergic march. Curr Opin Pediatr 26: 516–520.

11. SchneiderL, TillesS, LioP, BoguniewiczM, BeckL, et al. (2013) Atopic dermatitis: a practice parameter update 2012. J Allergy Clin Immunol 131: 295–9.e1-27.

12. National Collaborating Centre for Women's and Children's Health (2007) Atopic eczema in children: management of atopic eczema in children from birth up to the age of 12 years. London: National Collaborating Centre for Women's and Children's Health.

13. Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomised, placebo-controlled trial: first results of ETAC. Early Treatment of the Atopic Child. Pediatr Allergy Immunol 9: 116–124.

14. DiepgenTL (2002) Long-term treatment with cetirizine of infants with atopic dermatitis: a multi-country, double-blind, randomized, placebo-controlled trial (the ETAC trial) over 18 months. Pediatr Allergy Immunol 13: 278–286.

15. SaarinenUM, KajosaariM (1995) Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet 346: 1065–1069.

16. AustinJB, KaurB, AndersonHR, BurrM, HarkinsLS, et al. (1999) Hay fever, eczema, and wheeze: a nationwide UK study (ISAAC, international study of asthma and allergies in childhood). Arch Dis Child 81: 225–230.

17. KurukulaaratchyRJ, MatthewsS, ArshadSH (2005) Defining childhood atopic phenotypes to investigate the association of atopic sensitization with allergic disease. Allergy 60: 1280–1286.

18. MartinPE, MathesonMC, GurrinL, BurgessJA, OsborneN, et al. (2011) Childhood eczema and rhinitis predict atopic but not nonatopic adult asthma: a prospective cohort study over 4 decades. J Allergy Clin Immunol 127: 1473–1479.

19. von KobyletzkiLB, BornehagCG, HasselgrenM, LarssonM, LindstromCB, et al. (2012) Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort. BMC Dermatol 12: 1471–5945.

20. WuthrichB, Schmid-GrendelmeierP (2003) The atopic eczema/dermatitis syndrome. Epidemiology, natural course, and immunology of the IgE-associated (“extrinsic”) and the nonallergic (“intrinsic”) AEDS. J Investig Allergol Clin Immunol 13: 1–5.

21. KuligM, BergmannR, NiggemannB, BurowG, WahnU, et al. (1998) Prediction of sensitization to inhalant allergens in childhood: evaluating family history, atopic dermatitis and sensitization to food allergens. Clin Exp Allergy 28: 1397–1403.

22. HopperJL, BuiQM, ErbasB, MathesonMC, GurrinLC, et al. (2012) Does eczema in infancy cause hay fever, asthma, or both in childhood? Insights from a novel regression model of sibling data. J Allergy Clin Immunol 130: 1117–1122.

23. IlliS, von MutiusE, LauS, NickelR, NiggemannB, et al. (2001) The pattern of atopic sensitization is associated with the development of asthma in childhood. J Allergy Clin Immunol 108: 709–714.

24. van der HulstAE, KlipH, BrandPL (2007) Risk of developing asthma in young children with atopic eczema: a systematic review. J Allergy Clin Immunol 120: 565–569.

25. WilliamsH, FlohrC (2006) How epidemiology has challenged 3 prevailing concepts about atopic dermatitis. J Allergy Clin Immunol 118: 209–213.

26. BarberioG, PajnoGB, VitaD, CaminitiL, CanonicaGW, et al. (2008) Does a ‘reverse’ atopic march exist? Allergy 63: 1630–1632.

27. IlliS, von MutiusE, LauS, NickelR, GruberC, et al. (2004) The natural course of atopic dermatitis from birth to age 7 years and the association with asthma. J Allergy Clin Immunol 113: 925–931.

28. BishopCM (2013) Model-based machine learning. Philos Trans A Math Phys Eng Sci 371: 20120222.

29. SimpsonA, TanVY, WinnJ, SvensenM, BishopCM, et al. (2010) Beyond atopy: multiple patterns of sensitization in relation to asthma in a birth cohort study. Am J Respir Crit Care Med 181: 1200–1206.

30. LazicN, RobertsG, CustovicA, BelgraveD, BishopCM, et al. (2013) Multiple atopy phenotypes and their associations with asthma: similar findings from two birth cohorts. Allergy 68: 764–770.

31. ProsperiMC, BelgraveD, BuchanI, SimpsonA, CustovicA (2014) Challenges in interpreting allergen microarrays in relation to clinical symptoms: a machine learning approach. Pediatr Allergy Immunol 25: 71–79.

32. ProsperiMC, SahinerUM, BelgraveD, SackesenC, BuchanIE, et al. (2013) Challenges in identifying asthma subgroups using unsupervised statistical learning techniques. Am J Respir Crit Care Med 188: 1303–1312.

33. ColmanI, PloubidisGB, WadsworthME, JonesPB, CroudaceTJ (2007) A longitudinal typology of symptoms of depression and anxiety over the life course. Biol Psychiatry 62: 1265–1271.

34. PicklesA, BoltonP, MacdonaldH, BaileyA, Le CouteurA, et al. (1995) Latent-class analysis of recurrence risks for complex phenotypes with selection and measurement error: a twin and family history study of autism. Am J Hum Genet 57: 717–726.

35. BoydA, GoldingJ, MacleodJ, LawlorDA, FraserA, et al. (2013) Cohort profile: the ‘children of the 90s’—the index offspring of the Avon Longitudinal Study of Parents and Children. Int J Epidemiol 42: 111–127.

36. CustovicA, SimpsonBM, MurrayCS, LoweL, WoodcockA (2002) The National Asthma Campaign Manchester Asthma and Allergy Study. Pediatr Allergy Immunol 13 (Suppl 15) 32–37.

37. FerrisBG (1978) Epidemiology Standardization Project (American Thoracic Society). Am Rev Respir Dis 118: 1–120.

38. AsherMI, KeilU, AndersonHR, BeasleyR, CraneJ, et al. (1995) International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J 8: 483–491.

39. Minka TP (2001) Expectation propagation for approximate Bayesian inference. San Francisco (California): Morgan Kaufmann Publishers.

40. Minka T, Winn J, Guiver J, Knowles D (2010) Infer.NET, version 2.4. Cambridge: Microsoft Research Cambridge.

41. BishopCM (1997) Bayesian neural networks. J Braz Comp Soc 4 doi:10.1590/S0104-65001997000200006

42. Gelman A, Carlin JB, Stern HS, Dunson DB, Vehtari A, et al.. (2013) Bayesian data analysis, 3rd edition. Boca Raton (Florida): CRC Press.

43. Bishop CM (2006) Pattern recognition and machine learning. New York: Springer.

44. BelgraveDC, SimpsonA, Semic-JusufagicA, MurrayCS, BuchanI, et al. (2013) Joint modeling of parentally reported and physician-confirmed wheeze identifies children with persistent troublesome wheezing. J Allergy Clin Immunol 132: 575–583.e12.

Štítky
Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine


2014 Číslo 10
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Získaná hemofilie - Povědomí o nemoci a její diagnostika
nový kurz

Eozinofilní granulomatóza s polyangiitidou
Autori: doc. MUDr. Martina Doubková, Ph.D.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#