Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Pediatr Allergy Immunol. 2024 Nov;35(11):e14274. doi: 10.1111/pai.14274.
Infants hospitalized for bronchiolitis are at high risk for developing recurrent wheeze in childhood. The role of airway lipids in the link between these two conditions remains unclear. This study aimed to identify the association between airway lipids in infants hospitalized for bronchiolitis and the development of recurrent wheeze, with a focus on immunoglobulin E (IgE) sensitization.
In a multicenter prospective cohort study of 919 infants (age <1 year) hospitalized for bronchiolitis, we performed lipidomic profiling of nasopharyngeal airway specimens collected at hospitalization. We first identified lipid modules composed of highly correlated lipids by performing weighted correlation network analysis. We then examined the longitudinal association of those lipid modules with the rate of recurrent wheeze by age 3 years after discharge from hospitalization for bronchiolitis. We also examined the associations of lipid modules with IgE non-sensitized (i.e., neither sensitized at admission nor at age 3 years) and IgE-sensitized (i.e., sensitized at admission and/or at age 3 years) recurrent wheeze by age 3 years, respectively.
Our analysis identified 15 distinct lipid modules in the nasopharyngeal airway lipidome data. Overall, lipid modules composed of triacylglycerols (hazard ratio [HR] 1.78, 95% confidence interval [CI] 1.26-2.51, FDR < 0.01) and sphingolipids (HR 1.74, 95% CI 1.25-2.44, FDR <0.01) had the strongest associations with recurrent wheeze development. Stratification by IgE sensitization revealed differential associations. For example, the module composed of triacylglycerols was significantly associated with IgE non-sensitized recurrent wheeze, whereas the module composed of sphingolipids was significantly associated with IgE-sensitized recurrent wheeze (both FDR <0.05).
Distinct nasopharyngeal airway lipid modules are associated with recurrent wheeze development following severe bronchiolitis, with different patterns based on IgE sensitization status.
因细支气管炎住院的婴儿在儿童时期有发生反复喘息的高风险。气道脂质在这两种情况之间的联系中的作用仍不清楚。本研究旨在确定因细支气管炎住院的婴儿的气道脂质与反复喘息的发生之间的关联，重点是免疫球蛋白 E（IgE）致敏。
在一项针对 919 名（年龄 <1 岁）因细支气管炎住院的婴儿的多中心前瞻性队列研究中，我们对住院时采集的鼻咽气道标本进行了脂质组学分析。我们首先通过进行加权相关网络分析来识别由高度相关的脂质组成的脂质模块。然后，我们检查了这些脂质模块与出院后 3 岁时反复喘息发生率之间的纵向关联。我们还分别检查了脂质模块与 IgE 非致敏（即入院时和 3 岁时均未致敏）和 IgE 致敏（即入院时和/或 3 岁时致敏）的反复喘息之间的关联。
我们的分析在鼻咽气道脂质组数据中确定了 15 个不同的脂质模块。总体而言，由三酰甘油（危险比 [HR] 1.78，95%置信区间 [CI] 1.26-2.51， FDR <0.01）和鞘脂（HR 1.74，95% CI 1.25-2.44， FDR <0.01）组成的脂质模块与反复喘息的发展有最强的关联。根据 IgE 致敏情况进行分层显示出不同的关联。例如，由三酰甘油组成的模块与 IgE 非致敏性反复喘息显著相关，而由鞘脂组成的模块与 IgE 致敏性反复喘息显著相关（均 FDR <0.05）。
不同的鼻咽气道脂质模块与严重细支气管炎后反复喘息的发展相关，根据 IgE 致敏状态存在不同的模式。
