Identification of asthma phenotypes in children

Carlsen, Karin C. Lødrup; Pijnenburg, Mariëlle

doi:10.1183/20734735.004611

Cited by 7 publications

(3 citation statements)

References 54 publications

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“…Fourthly, our findings may lack external validity as generalization of our observations may not be valid in different age groups. It is also well established that exposure to risk factors at specific time-points may influence the development of asthma, which means that this pathology may change with time [36]. Moreover, given the possibility of remission and relapse it is unclear over how long a period a phenotype should be stable [13].…”

Section: Discussionmentioning

confidence: 99%

Development and validation of exhaled breath condensate microRNAs to identify and endotype asthma in children

et al. 2019

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Detection and quantification of microRNAs (miRNAs) in exhaled breath condensate (EBC) has been poorly explored. Therefore we aimed to assess miRNAs in EBC as potential biomarkers to diagnose and endotype asthma in school aged children. In a cross sectional, nested case control study, all the asthmatic children (n = 71) and a random sample of controls (n = 115), aged 7 to 12 years, attending 71 classrooms from 20 local schools were selected and arbitrarily allocated to the development or validation set. Participants underwent skin-prick testing, spirometry with bronchodilation, had exhaled level of nitric oxide determined and EBC collected. Based on previous studies eleven miRNAs were chosen and analyzed in EBC by reverse transcription-quantitative real-time PCR. Principal component analysis was applied to identify miRNAs profiles and associations were estimated using regression models. In the development set (n = 89) two clusters of miRNAs were identified. After adjustments, cluster 1 and three of its clustered miRNAs, miR-126-3p, miR-133a-3p and miR-145-5p were positively associated with asthma. Moreover miR-21-5p was negatively associated with symptomatic asthma and positively associated with positive bronchodilation without symptoms. An association was also found between miR-126-3p, cluster 2 and one of its clustered miRNA, miR-146-5p, with higher FEF25-75 reversibility. These findings were confirmed in the validation set (n = 97) where two identical clusters of miRNAs were identified. Additional significant associations were observed between miR-155-5p with symptomatic asthma, negative bronchodilation with symptoms and positive bronchodilation without symptoms. We showed that microRNAs can be measured in EBC of children and may be used as potential biomarkers of asthma, assisting asthma endotype establishment.

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Section: Discussionmentioning

confidence: 99%

Development and validation of exhaled breath condensate microRNAs to identify and endotype asthma in children

et al. 2019

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“…However, several studies have disproved this notion and demonstrated that asthma is a heterogeneous disease with different clinical phenotypes and multiple inflammatory endotypes. 28,[35][36][37][38] Allergic asthma is the most prevalent phenotype of childhood asthma that develops earlier in life and is associated with other atopic comorbid disorders. 29,31,39,40 Meanwhile, other asthma endotypes, such as eosinophilic and neutrophilic asthma, have been identified.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Allergic, Eosinophilic, and Overlapping Asthma Phenotypes Among Pediatric Patients with Current Asthma: A Cross-Sectional Study from Saudi Arabia

Asseri

2023

JAA

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Purpose Asthma is one of the most common chronic diseases affecting 10%–30% of children in Saudi Arabia. Although data exist on adult asthma phenotyping and endotyping in Saudi Arabia, little is known about asthma phenotypes in Saudi children. Patients and Methods This cross-sectional study enrolled pediatric patients diagnosed with bronchial asthma and followed in the pediatric pulmonology clinic of the Abha Maternity and Children Hospital between August 2021 and May 2023. Results A total of 321 children (aged 5–14 years) were analyzed. The population was classified into allergic [169 (52.6%)], eosinophilic [144 (44.9%)], and overlapping allergic and eosinophilic asthma [97 (30.2%)] phenotypes. Regarding asthma severity, 35.5%, 50.2%, and 14.3% were classified as mild, moderate, and severe, respectively. Of the 321 patients in the study, 124 (38.6%) had at least one asthma exacerbation that required hospitalization. The number of reported missed school days in the previous year was 1571 days [190 (59.2%) patients reported at least one missed school day]. The factors associated with the likelihood of uncontrolled asthma for all study participants included: emergency room (ER) visit last year (OR = 3.7, 95% CI:0.6–15.9]), overlapping eosinophilic and allergic (OR = 3.2, 95% CI = 1.8–5.9), and allergic phenotype (OR = 2.7, 95% CI = 1.3–5.4). The level of asthma control differed significantly among the three asthma phenotypes (p = 0.037). Conclusion Allergic asthma is the most prevalent asthma phenotype in this study, followed by the eosinophilic phenotype. The research has also shown that several factors predict uncontrolled asthma, including a family history of asthma, previous admission to the PICU, and previous hospitalization ever. There is, therefore, a definite need for multicenter cohort studies to better understand the phenotypes and endotypes of childhood asthma, as it could offer therapeutic and prognostic relevance.

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“…Asthma is not one disease but many, and we have earlier suggested an approach to assess problematic severe asthma [6]. Here, the different phenotypes of asthma are discussed and the complexity of this common disease and the problems perceived when we characterise (or phenotype) childhood asthma are described [7].…”

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confidence: 99%