RT Journal Article
SR Electronic
T1 Longitudinal data-driven definition of clinical asthma phenotypes in the pediatric arm of the All Age Asthma Cohort (ALLIANCE) of the German Center for Lung Research (DZL)
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 4021
DO 10.1183/13993003.congress-2020.4021
VO 56
IS suppl 64
A1 Alexander Hose
A1 Thomas Bahmer
A1 Klaus Rabe
A1 Erika Von Mutius
A1 Gesine Hansen
A1 Matthias Kopp
A1 Markus Ege
YR 2020
UL http://erj.ersjournals.com/content/56/suppl_64/4021.abstract
AB Background: The asthma syndrome comprises various phenotypes; its characteristics and trajectories are unclear.Objective: To define longitudinal data-driven phenotypes in the DZL cohort.Methods: Children (0-18 years, N=497) were classified by a latent class analysis (LCA) based on clinical features including frequency of asthma symptoms, GINA criteria, hospitalization and atopic symptoms. Data were collected by questionnaires at recruitment (BL) and three annual follow-ups. The classes were compared with respect to lung function and laboratory parameters, genetics, medication, comorbidities and lifestyle factors.Results: LCA revealed two atopic classes with different levels of asthma control; two non-atopic classes, one with persistently low symptoms, and a severe class characterized by higher exposure to environmental triggers such as smoking in pregnancy or traffic proximity. Besides, two classes with hospitalization at BL emerged; these differed clearly with respect to age and symptom progression vs. resolution over time.The class with high symptom progression was significantly associated with a chromosome 17q21 risk allele (OR=2.43; p=0.03). Lung function declined in the two classes with hospitalization at BL, whereas it improved in the “environmental triggers” class. The classes also differentiated for eosinophils.Conclusion: The analysis revealed a substantial heterogeneity of disease entities subsumed as asthma or wheeze cases in ALLIANCE children. The high resolution of this classification might be useful for assessing corresponding endotypes and for prediction of exacerbation and resolution of symptoms.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4021.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).