RT Journal Article
SR Electronic
T1 Distinct clinical phenotypes of airways disease defined by cluster analysis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 812
OP 818
DO 10.1183/09031936.00174408
VO 34
IS 4
A1 M. Weatherall
A1 J. Travers
A1 P. M. Shirtcliffe
A1 S. E. Marsh
A1 M. V. Williams
A1 M. R. Nowitz
A1 S. Aldington
A1 R. Beasley
YR 2009
UL http://erj.ersjournals.com/content/34/4/812.abstract
AB Airways disease is currently classified using diagnostic labels such as asthma, chronic bronchitis and emphysema. The current definitions of these classifications may not reflect the phenotypes of airways disease in the community, which may have differing disease processes, clinical features or responses to treatment. The aim of the present study was to use cluster analysis to explore clinical phenotypes in a community population with airways disease. A random population sample of 25–75-yr-old adults underwent detailed investigation, including a clinical questionnaire, pulmonary function tests, nitric oxide measurements, blood tests and chest computed tomography. Cluster analysis was performed on the subgroup with current respiratory symptoms or obstructive spirometric results. Subjects with a complete dataset (n = 175) were included in the cluster analysis. Five clusters were identified with the following characteristics: cluster 1: severe and markedly variable airflow obstruction with features of atopic asthma, chronic bronchitis and emphysema; cluster 2: features of emphysema alone; cluster 3: atopic asthma with eosinophilic airways inflammation; cluster 4: mild airflow obstruction without other dominant phenotypic features; and cluster 5: chronic bronchitis in nonsmokers. Five distinct clinical phenotypes of airflow obstruction were identified. If confirmed in other populations, these findings may form the basis of a modified taxonomy for the disorders of airways obstruction.