Allergic disease trajectories up to adolescence: Characteristics, early‐life, and genetic determinants

Abstract

Background Allergic diseases often develop jointly during early childhood but differ in timing of onset, remission, and progression. Their disease course over time is often difficult to predict and determinants are not well understood. Objectives We aimed to identify trajectories of allergic diseases up to adolescence and to investigate their association with early‐life and genetic determinants and clinical characteristics. Methods Longitudinal k‐means clustering was used to derive trajectories of allergic diseases (asthma, atopic dermatitis, and rhinitis) in two German birth cohorts (GINIplus/LISA). Associations with early‐life determinants, polygenic risk scores, food and aeroallergen sensitization, and lung function were estimated by multinomial models. The results were replicated in the independent Swedish BAMSE cohort. Results Seven allergic disease trajectories were identified: “Intermittently allergic,” “rhinitis,” “early‐resolving dermatitis,” “mid‐persisting dermatitis,” “multimorbid,” “persisting dermatitis plus rhinitis,” and “early‐transient asthma.” Family history of allergies was more prevalent in all allergic disease trajectories compared the non‐allergic controls with stronger effect sizes for clusters comprising more than one allergic disease (e.g., RRR = 5.0, 95% CI = [3.1–8.0] in the multimorbid versus 1.8 [1.4–2.4] in the mild intermittently allergic cluster). Specific polygenic risk scores for single allergic diseases were significantly associated with their relevant trajectories. The derived trajectories and their association with genetic effects and clinical characteristics showed similar results in BAMSE. Conclusion Seven robust allergic clusters were identified and showed associations with early life and genetic factors as well as clinical characteristics.

Siblings and risk of allergic rhinitis: A systematic review and meta‐analysis

“…Subgroup analyses were performed in the case of ≥4 comparable studies in ≥2 subgroups, 41 to evaluate the consistency of the associations based on: (a) overall rating; (b) study design; (c) exposure cardinality (e.g., birth order 3); (d) year(s) of data collection, divided into <2000 and ≥2000; (e) classification of country into “high‐income,” “upper‐middle income,” “lower‐middle income,” and “low income” economy, according to the definition by the World Bank at the year the article was published 42 ; (f) age of subjects, divided into ≤12 and ≥13 years 43 …”

“…Subgroup analyses were performed in the case of ≥4 comparable studies in ≥2 subgroups, 41 to evaluate the consistency of the associations based on: (a) overall rating; (b) study design; (c) exposure cardinality (e.g., birth order 3); (d) year(s) of data collection, divided into <2000 and ≥2000; (e) classification of country into "high-income," "uppermiddle income," "lower-middle income," and "low income" economy, according to the definition by the World Bank at the year the article was published 42 ; (f) age of subjects, divided into ≤12 and ≥13 years. 43 Furthermore, we performed a sensitivity analysis to evaluate the robustness of our findings by re-running the meta-analyses after excluding: (a) studies where the outcome was not confirmed clinically (either by medical records or clinical assessment); (b) studies of "low" overall rating. We also performed sensitivity analysis based on the rho value used in the meta-analyses, re-running the meta-analysis with rho ranging from 0 to 1 with 0.2 increments.…”

A Web-Based Instrument for Infantile Atopic Dermatitis Identification (Electronic Version of the Modified Child Eczema Questionnaire): Development and Implementation

“…Children with AD younger than 2 years are clinically defined as having “infantile AD,” which is characterized by chronic eczema, itching, and dry skin [ 1 ]. Children with infantile AD, especially severe early-onset AD, may develop food allergies, aeroallergen sensitizations, and other airway allergic diseases later in life [ 3 - 5 ]. Thus, the importance of infantile AD is that its management may help reduce the incidence of subsequent allergic diseases [ 6 ].…”

Association between lipid-lowering drugs and allergic diseases: A Mendelian randomization study

“…Frequently coexisting, these disorders substantially reduce the quality of life for those affected. 4 , 5 , 6 Driven by societal, environmental, and lifestyle changes, the prevalence and morbidity of allergic diseases continue to rise, positioning them as a prominent health issue. 7 , 8 Therefore, understanding the relationship between allergic diseases and other risk factors is crucial for developing effective disease prevention and treatment strategies to minimize their societal burden and impact.…”