Zhang Jiale, Luo Wenting, Li Guoping, Ren Huali, Su Jie, Sun Jianxin, Zhong Ruifen, Wang Siqin, Li Zhen'an, Zhao Yan, Ke Huashou, Chen Ting, Xv Chun, Chang Zhenglin, Wu Liting, Zheng Xianhui, Xv Miaoyuan, Ye Qingyuan, Hao Chuangli, Sun Baoqing
Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Laboratory of Allergy and Precision Medicine, Department of Pulmonary and Critical Care Medicine, Chengdu Institute of Respiratory Health, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Chengdu, China.
Clin Transl Allergy. 2023 Jul;13(7):e12271. doi: 10.1002/clt2.12271.
This cross-sectional study aimed to identify latent sensitization profiles of asthma patients in mainland China, unveiling the association between regional differences and sensitization patterns.
1056 asthma participants from 10 medical centers divided into eastern and western cohorts were clustered into four individual sensitization patterns, respectively, by using an unsupervised statistical modeling method, latent class analysis (LCA), based on the levels of 12 aeroallergens specific IgE reactivities. Moreover, differences in clinical characteristics and environmental exposures were compared in different sensitization patterns.
Four distinct sensitization patterns in the two cohorts were defined as follows, respectively. Eastern cohort: Class 1: "High weed pollen and house dust mites (HDMs) sensitization" (8.87%), Class 2: "HDMs dominated sensitization" (38.38%), Class 3: "High HDMs and animal dander sensitization" (6.95%), Class 4: "Low/no aeroallergen sensitization" (45.80%). Western cohort: Class 1: "High weed pollen sensitization" (26.14%), Class 2: "High multi-pollen sensitization" (15.02%), Class 3: "HDMs-dominated sensitization" (10.33%), Class 4: "Low/no aeroallergen sensitization" (48.51%). Of note, the significant statistical difference in age, asthma control test score (ACT) and comorbidities were observed within or between different sensitization patterns. Exposure factors in different sensitization patterns were pointed out.
Asthmatic patients with distinct sensitization patterns were clustered and identified through the LCA method, disclosing the relationship between sensitization profiles of multiple aeroallergens and geographical differences, providing novel insights and potential strategies for atopic disease monitoring, management and prevention in clinical practice.
本横断面研究旨在识别中国大陆哮喘患者的潜在致敏模式，揭示地区差异与致敏模式之间的关联。
来自10个医疗中心的1056名哮喘参与者被分为东部和西部队列，分别使用无监督统计建模方法——潜在类别分析（LCA），根据12种空气变应原特异性IgE反应水平，聚类为四种个体致敏模式。此外，还比较了不同致敏模式下临床特征和环境暴露的差异。
两个队列中四种不同的致敏模式分别定义如下。东部队列：第1类：“高杂草花粉和屋尘螨（HDM）致敏”（8.87%），第2类：“以HDM为主的致敏”（38.38%），第3类：“高HDM和动物皮屑致敏”（6.95%），第4类：“低/无空气变应原致敏”（45.80%）。西部队列：第1类：“高杂草花粉致敏”（26.14%），第2类：“高多种花粉致敏”（15.02%），第3类：“以HDM为主的致敏”（10.33%），第4类：“低/无空气变应原致敏”（48.51%）。值得注意的是，在不同致敏模式内或之间观察到年龄、哮喘控制测试评分（ACT）和合并症存在显著统计学差异。指出了不同致敏模式下的暴露因素。
通过LCA方法聚类并识别出具有不同致敏模式的哮喘患者，揭示了多种空气变应原致敏模式与地理差异之间的关系，为临床实践中特应性疾病的监测、管理和预防提供了新的见解和潜在策略。
