Characterization of Rhinitis According to the Asthma Status in Adults Using an Unsupervised Approach in the EGEA Study

Abstract

BackgroundThe classification of rhinitis in adults is missing in epidemiological studies.ObjectiveTo identify phenotypes of adult rhinitis using an unsupervised approach (data-driven) compared with a classical hypothesis-driven approach.Methods983 adults of the French Epidemiological Study on the Genetics and Environment of Asthma (EGEA) were studied. Self-reported symptoms related to rhinitis such as nasal symptoms, hay fever, sinusitis, conjunctivitis, and sensitivities to different triggers (dust, animals, hay/flowers, cold air…) were used. Allergic sensitization was defined by at least one positive skin prick test to 12 aeroallergens. Mixture model was used to cluster participants, independently in those without (Asthma-, n = 582) and with asthma (Asthma+, n = 401).ResultsThree clusters were identified in both groups: 1) Cluster A (55% in Asthma-, and 22% in Asthma+) mainly characterized by the absence of nasal symptoms, 2) Cluster B (23% in Asthma-, 36% in Asthma+) mainly characterized by nasal symptoms all over the year, sinusitis and a low prevalence of positive skin prick tests, and 3) Cluster C (22% in Asthma-, 42% in Asthma+) mainly characterized by a peak of nasal symptoms during spring, a high prevalence of positive skin prick tests and a high report of hay fever, allergic rhinitis and conjunctivitis. The highest rate of polysensitization (80%) was found in participants with comorbid asthma and allergic rhinitis.ConclusionThis cluster analysis highlighted three clusters of rhinitis with similar characteristics than those known by clinicians but differing according to allergic sensitization, and this whatever the asthma status. These clusters could be easily rebuilt using a small number of variables.

Self-Reported Allergic Rhinitis and/or Allergic Conjunctivitis Associate with <b><i>IL13</i></b> rs20541 Polymorphism in Finnish Adult Asthma Patients

“…Also, a significant proportion of asthmatics fail to respond to therapy [19]. Our finding of a high prevalence of AR/AC symptoms in adult asthmatics is in line with these observations [5,6,7,8]. After adjustments, the IL13 rs20541 GA or AA genotype, or a multisensitization pattern affected the risk of AR/AC in the asthma group.…”

“…The current challenge is to prevent atopy in an attempt to reduce the asthma burden [5,6,7,8]. Also, a significant proportion of asthmatics fail to respond to therapy [19].…”

“…A case-control study of French adult asthma patients showed that 92.4% of AR patients reported conjunctivitis symptoms [6]. In a Cameroonian community-based survey, 15.9% of adult asthma patients reported allergic conjunctivitis (AC) symptoms, whereas only 5.2% of nonasthmatic controls reported allergic rhinoconjunctivitis (ARC) symptoms [7].…”

The sensitization pattern differs according to rhinitis and asthma multimorbidity in adults: the EGEA study

“…In adults, using an unsupervised approach, we have previously identified three clusters of rhinitis with similar characteristics similar to those known by clinicians but differing in term of allergic sensitization, and this whatever the asthma status [13]. Furthermore, in the cluster combining asthma and allergic rhinitis, participants showed a particularly high rate of polysensitization compared to the other clusters.…”

Resumen ejecutivo de ARIA 2016: vías integradas de atención para la medicina predictiva a lo largo del ciclo de vida en Argentina

“…35,36,37,38 Estas investigaciones confirman que los sujetos polisensibilizados y multimórbidos tienen una frecuencia muy alta de síntomas alérgicos, síntomas persistentes a lo largo del tiempo, síntomas más graves de asma o rinitis y niveles más altos de IgE total y específica. Tomados en conjunto, estos resultados indican que los pacientes asmáticos no pueden ser manejados apropiadamente sin considerar la multimorbilidad de la rinitis y que los problemas nasales (rinitis o rinosinusitis) son importantes en numerosos pacientes asmáticos no controlados.…”