Early-Onset Atopic Dermatitis in Children: Which Are the Phenotypes at Risk of Asthma? Results from the ORCA Cohort

• Published in: PLOS ONE
• Main Authors: Amat, Flore, Saint-Pierre, Philippe, Bourrat, Emmanuelle, Nemni, Ariane, Couderc, Rémy, Boutmy-Deslandes, Emmanuelle, Sahraoui, Fatiha, Pansé, Isabelle, Bagot, Martine, Foueré, Sébastien, Just, Jocelyne
• Other Authors: Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Trousseau APHP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Epidemiology of Allergic and Respiratory Diseases Department iPlesp (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Laboratoire de statistiques théoriques et appliquées, Department of dermatology, Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal Paris, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Biostatistique et épidemiologie clinique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de biostatistiques et informatique médicale
• Format: Article in Journal/Newspaper
• Language: English
• Published: HAL CCSD 2015
• Subjects: [SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology; [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology; Orca
• Online Access: https://hal.sorbonne-universite.fr/hal-01230841; https://hal.sorbonne-universite.fr/hal-01230841/document; https://hal.sorbonne-universite.fr/hal-01230841/file/journal.pone.0131369.pdf; https://doi.org/10.1371/journal.pone.0131369

International audience BackgroundAtopic dermatitis (AD) is known to predate asthma and other atopic disorders described under the term “atopic march”. However, this classic sequence is not always present and only a few studies have addressed children at risk of developing asthma. The objective of this study is to define early-onset AD phenotypes leading to asthma.MethodsWe performed a cluster analysis with 9 variables of 214 infants with early-onset AD prospectively enrolled in the ORCA cohort and followed each year on the occurrence of asthma until the age of 6.ResultsWe identified 3 clusters - cluster 1 (n = 94) with low to no sensitization to food (27.7%) or aeroallergens (10.6%) and moderate AD severity (SCORAD 25.29 +/- 14.6) called “AD with low sensitization”; - cluster 2 (n = 84) characterized by a higher AD severity (SCORAD 32.66+/-16.6) and frequent sensitization to food (98.9%) or aeroallergens (26.2%), most likely multiple (96.4% for food allergens), called “AD with multiple sensitizations” - cluster 3 (n = 36) with parental history, moderate AD severity (SCORAD 24.46+/-15.7), moderate rate of sensitization to food allergens (38.9%) (exclusively single) with no sensitization to aeroallergens, called “AD with familial history of asthma”. Percentages of children suffering from asthma at the age of 6 were higher in clusters 2 and 3 (36.1% and 33.3% respectively versus 14.9% in cluster 1, p<0.01).ConclusionTwo phenotypes in infants with early-onset AD convey a higher risk of developing asthma during childhood: multiple sensitization and familial history of asthma.