Eun Lee, MD
,
Pediatrics, Asan Medical Center, Seoul, South Korea
Si Hyeon Lee, BS
,
Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, South Korea
Young-Ho Kim, MD
,
Asthma/Allergy Center, Asan Medical Center, Seoul, South Korea
Hyun-Ju Cho, MD
,
Pediatrics, Asan Medical Center, Seoul, South Korea
Ho-Sung Yu, Master of Science
,
Asan Institute for Life Science, Asan Medical Center, Seoul, South Korea
Mi-Jin Kang, MS
,
Asan Institute for Life Science, Asan Medical Center, Seoul, South Korea
Song-I Yang, MD
,
Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, South Korea
Young-Ho Jung, MD
,
Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, South Korea
Hyung Young Kim, MD
,
Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, South Korea
Ju-Hee Seo, MD
,
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, South Korea
Byoung-Ju Kim, MD
,
Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH
Hyo-Bin Kim, MD
,
Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, South Korea
So-Yeon Lee, MD
,
Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, South Korea
Ho-Jang Kwon, MD
,
Preventive Medicine, Dankook University College of Medicine, Cheonan, South Korea
Soo-Jong Hong, MD, PhD
,
Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Background: Allergic rhinitis (AR) has a wide range of clinical aspects, and comorbid allergic diseases may accompany. We aimed to identify rhinitis phenotypes in school children and to predict the prognosis of developing bronchial hyperresponsiveness (BHR).
Methods: As a part of Children's HEalth and Environmental Research (CHEER) study, a prospective follow-up study for 4 years with every 2 year interval, 2,491 children aged 6 to 14 years-old were enrolled in the first survey. Among them, 512 children had current rhinitis, defined as parental-reported doctor-diagnosed rhinitis and having rhinitis symptoms in the last 12 months. Variables including age, sex, body mass index, parental allergic history, income, maternal education level, AR treatment during the last 12 months, environmental tobacco smoking exposure, total serum IgE levels, eosinophil percentage, diagnosis of atopic dermatitis and asthma, lung function tests, BHR to methacholine and skin prick tests were used in the latent class analysis.
Results: We identified 4 phenotypes of rhinitis as the best fit in this study. Cluster types were characterized as "non-atopy with low socioeconomic status" (33% of sample, Cluster 1), "atopy with normal lung function" (39%, Cluster 2), "atopy with impaired lung function" (14%, Cluster 3), and “non-atopy and high socioeconomic status" (15%, Cluster 4). Total serum IgE levels and serum eosinophil percentages were highest in cluster 3. Children in cluster 3 showed highest prevalence of new development of BHR during 4-year follow-up (P=0.039).
Conclusions: From rhinitis phenotypes, rhinitis cluster with high atopy and impaired lung function in children is associated with new development of BHR. This finding suggests that identification of distinctive rhinitis phenotype will help to prevent the progression of new development of BHR in the aspect of allergic march.
