COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Sachs Children's Hospital, Södersjukhuset, Stockholm, Sweden.
J Allergy Clin Immunol. 2017 Dec;140(6):1693-1699. doi: 10.1016/j.jaci.2017.01.041. Epub 2017 Mar 25.
Assessment of sensitization at a single time point during childhood provides limited clinical information. We hypothesized that sensitization develops as specific patterns with respect to age at debut, development over time, and involved allergens and that such patterns might be more biologically and clinically relevant.
We sought to explore latent patterns of sensitization during the first 6 years of life and investigate whether such patterns associate with the development of asthma, rhinitis, and eczema.
We investigated 398 children from the at-risk Copenhagen Prospective Studies on Asthma in Childhood 2000 (COPSAC) birth cohort with specific IgE against 13 common food and inhalant allergens at the ages of ½, 1½, 4, and 6 years. An unsupervised cluster analysis for 3-dimensional data (nonnegative sparse parallel factor analysis) was used to extract latent patterns explicitly characterizing temporal development of sensitization while clustering allergens and children. Subsequently, these patterns were investigated in relation to asthma, rhinitis, and eczema. Verification was sought in an independent unselected birth cohort (BAMSE) constituting 3051 children with specific IgE against the same allergens at 4 and 8 years of age.
The nonnegative sparse parallel factor analysis indicated a complex latent structure involving 7 age- and allergen-specific patterns in the COPSAC birth cohort data: (1) dog/cat/horse, (2) timothy grass/birch, (3) molds, (4) house dust mites, (5) peanut/wheat flour/mugwort, (6) peanut/soybean, and (7) egg/milk/wheat flour. Asthma was solely associated with pattern 1 (odds ratio [OR], 3.3; 95% CI, 1.5-7.2), rhinitis with patterns 1 to 4 and 6 (OR, 2.2-4.3), and eczema with patterns 1 to 3 and 5 to 7 (OR, 1.6-2.5). All 7 patterns were verified in the independent BAMSE cohort (R > 0.89).
This study suggests the presence of specific sensitization patterns in early childhood differentially associated with development of clinical outcomes. Using such patterns in future research might provide more robust and clinically relevant results.
在儿童时期仅评估一个时间点的致敏情况提供的临床信息有限。我们假设致敏是按照特定的模式发展的，与首次出现的年龄、随时间的发展以及涉及的过敏原有关，并且这些模式可能在生物学和临床上更有意义。
我们试图在儿童生命的前 6 年中探索致敏的潜在模式，并研究这些模式是否与哮喘、鼻炎和湿疹的发生有关。
我们对来自哥本哈根前瞻性儿童哮喘研究 2000（COPSAC）出生队列的 398 名儿童进行了研究，这些儿童在半岁、1 岁半、4 岁和 6 岁时接受了 13 种常见食物和吸入性过敏原的特异性 IgE 检测。使用 3 维数据的无监督聚类分析（非负稀疏并行因子分析）来提取明确描述致敏随时间发展的潜在模式，同时对过敏原和儿童进行聚类。随后，研究了这些模式与哮喘、鼻炎和湿疹的关系。在由 3051 名儿童组成的另一个独立的未选择的出生队列（BAMSE）中，使用针对相同过敏原的特异性 IgE 在 4 岁和 8 岁时进行了验证。
非负稀疏并行因子分析表明，在 COPSAC 出生队列数据中存在一个复杂的潜在结构，涉及 7 种与年龄和过敏原特异性相关的模式：（1）狗/猫/马，（2）梯牧草/桦木，（3）霉菌，（4）尘螨，（5）花生/小麦粉/艾蒿，（6）花生/大豆，和（7）鸡蛋/牛奶/小麦粉。哮喘仅与模式 1 相关（比值比[OR]，3.3；95%CI，1.5-7.2），鼻炎与模式 1 至 4 和 6 相关（OR，2.2-4.3），湿疹与模式 1 至 3 和 5 至 7 相关（OR，1.6-2.5）。在独立的 BAMSE 队列中验证了所有 7 种模式（R>0.89）。
本研究表明，在儿童早期存在特定的致敏模式，与临床结局的发展相关。在未来的研究中使用这些模式可能会提供更稳健和更有临床意义的结果。
