Yamamoto-Hanada Kiwako, Yang Limin, Saito-Abe Mayako, Ishikawa Fumi, Sato Miori, Miyaji Yumiko, Mitsui-Iwama Motoko, Inazuka Yusuke, Nishimura Koji, Toyokuni Kenji, Ogita Hiroya, Kiguchi Tomoyuki, Miyagi Yoshitsune, Inagaki Shinichiro, Kabashima Shigenori, Fukuie Tatsuki, Narita Masami, Tham Elizabeth Huiwen, Ohya Yukihiro
Allergy Center, National Center for Child Health and Development, Tokyo, Japan.
Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan.
J Allergy Clin Immunol Glob. 2025 Apr 19;4(3):100480. doi: 10.1016/j.jacig.2025.100480. eCollection 2025 Aug.
The endophenotypes of allergic disorders are known to vary across racial groups, underscoring the importance of studying allergic disease phenotypes in the population of Tokyo.
We sought to elucidate the developmental trajectories of wheezing among adolescents and their associations with pulmonary function and IgE sensitization in the Japanese pediatric population.
The research used data from the Tokyo Children's Health, Illness, and Development study, a comprehensive Tokyo birth cohort study, which recruited 1701 mother-infant dyads prenatally and followed the children up from birth till age 13 years. The analytical approach was conducted in 4 distinct phases: (1) delineation of trajectory groups using latent class growth analysis; (2) detailed characterization of each identified trajectory; (3) assessment of the relationships between predictors and wheezing groups through multinomial logistic regression; and (4) examination of the interrelations among trajectory groups, lung function, and IgE sensitization at age 13 years.
A total of 5 unique wheezing phenotypes were discerned: early-onset transient wheezing (10.2%), late-onset transient wheezing (7.3%), low frequent wheezing (15.0%), persistent wheezing (11.9%), and never/infrequent wheezing (55.5%). No statistically significant deterioration in impulse oscillometry parameters and spirometry parameters except %V25 was detected across any of the phenotypes. Nonetheless, the persistent wheezing phenotype demonstrated an association with lowered %V25, elevated fractional exhaled nitric oxide levels, and an increased prevalence of sensitization to multiple allergens at age 13 years.
The wheezing phenotypes identified in this study displayed distinct characteristics. Importantly, despite the diverse wheezing trajectories observed from birth, adolescents in Tokyo did not exhibit any discernible decline in lung function.
已知过敏性疾病的内表型在不同种族群体中存在差异，这凸显了在东京人群中研究过敏性疾病表型的重要性。
我们试图阐明日本儿童群体中青少年喘息的发展轨迹及其与肺功能和IgE致敏的关联。
该研究使用了来自东京儿童健康、疾病与发育研究的数据，这是一项全面的东京出生队列研究，产前招募了1701对母婴，并对儿童从出生一直随访到13岁。分析方法分4个不同阶段进行：（1）使用潜在类别增长分析来划分轨迹组；（2）对每个确定的轨迹进行详细特征描述；（3）通过多项逻辑回归评估预测因素与喘息组之间的关系；（4）检查13岁时轨迹组、肺功能和IgE致敏之间的相互关系。
共识别出5种独特的喘息表型：早发型短暂性喘息（10.2%）、晚发型短暂性喘息（7.3%）、低频率喘息（15.0%）、持续性喘息（11.9%）和从不/极少喘息（55.5%）。在任何一种表型中，除了%V25外，未检测到脉冲振荡法参数和肺量计参数有统计学意义的恶化。尽管如此，持续性喘息表型在13岁时表现出与%V25降低、呼出一氧化氮分数水平升高以及对多种过敏原致敏患病率增加有关。
本研究中确定的喘息表型表现出不同的特征。重要的是，尽管从出生起观察到多种喘息轨迹，但东京的青少年肺功能并未出现任何明显下降。
