Comparison of phenotypes of childhood wheeze and cough in 2 independent cohorts

Spycher, Ben D.; Silverman, Michael; Pescatore, Anina M.; Beardsmore, Caroline S.; Kühni, Claudia E. (2013). Comparison of phenotypes of childhood wheeze and cough in 2 independent cohorts. Journal of allergy and clinical immunology, 132(5), pp. 1058-1067. St. Louis, Mo.: Mosby 10.1016/j.jaci.2013.08.002

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BACKGROUND Among children with wheeze and recurrent cough there is great variation in clinical presentation and time course of the disease. We previously distinguished 5 phenotypes of wheeze and cough in early childhood by applying latent class analysis to longitudinal data from a population-based cohort (original cohort). OBJECTIVE To validate previously identified phenotypes of childhood cough and wheeze in an independent cohort. METHODS We included 903 children reporting wheeze or recurrent cough from an independent population-based cohort (validation cohort). As in the original cohort, we used latent class analysis to identify phenotypes on the basis of symptoms of wheeze and cough at 2 time points (preschool and school age) and objective measurements of atopy, lung function, and airway responsiveness (school age). Prognostic outcomes (wheeze, bronchodilator use, cough apart from colds) 5 years later were compared across phenotypes. RESULTS When using a 5-phenotype model, the analysis distinguished 3 phenotypes of wheeze and 2 of cough as in the original cohort. Two phenotypes were closely similar in both cohorts: Atopic persistent wheeze (persistent multiple trigger wheeze and chronic cough, atopy and reduced lung function, poor prognosis) and transient viral wheeze (early-onset transient wheeze with viral triggers, favorable prognosis). The other phenotypes differed more between cohorts. These differences might be explained by differences in age at measurements. CONCLUSIONS Applying the same method to 2 different cohorts, we consistently identified 2 phenotypes of wheeze (atopic persistent wheeze, transient viral wheeze), suggesting that these represent distinct disease processes. Differences found in other phenotypes suggest that the age when features are assessed is critical and should be considered carefully when defining phenotypes.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Spycher, Ben; Pescatore, Anina and Kühni, Claudia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0091-6749

Publisher:

Mosby

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

17 Jan 2014 10:31

Last Modified:

23 Dec 2014 09:35

Publisher DOI:

10.1016/j.jaci.2013.08.002

PubMed ID:

24075230

Uncontrolled Keywords:

Wheeze, cough, asthma, children, phenotypes, latent class analysis, cluster analysis, cohort study, allergy, bronchial responsiveness

BORIS DOI:

10.7892/boris.39139

URI:

https://boris.unibe.ch/id/eprint/39139

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