COBRAPed cohort: Do sensitization patterns differentiate children with severe asthma from those with a milder disease?

• Published in: Pediatric allergy and immunology Vol. 35; no. 3; pp. e14112 - n/a
• Main Authors: Lejeune, Stéphanie, Bouazza, Naïm, Nicaise, Pascale Roland, Jolaine, Valérie, Roditis, Léa, Marguet, Christophe, Amat, Flore, Berger, Patrick, Fayon, Michael, Dubus, Jean‐Christophe, Valois, Sophie, Reix, Philippe, Pellan, Mathieu, Brouard, Jacques, Chiron, Raphael, Giovannini‐Chami, Lisa, Blic, Jacques, Deschildre, Antoine, Lezmi, Guillaume, Abou‐Taam, Rola, Le Bourgeois, Muriel, Hadchouel‐Duvergé, Alice, Drummond, David, Delacourt, Christophe, Alyanakian, Marie‐Alexandra, Chatennoud, Lucienne, Thumerelle, Caroline, Mordacq, Clémence, Badiu‐Decleyre, Irina, Bonnel, Cécile, Delbecque, Laure, Beghin, Laurent, Mingardi, Graziella, Tournegros, Caroline, Blanchon, Sylvain, Houdoin, Véronique, Wanin, Stéphanie, Lebras, Marie Noelle, Debelleix, Stéphane, Siao, Valérie, Servat, Marine, Simon, Guillaume, El Boustany, Patricia, Bosdure, Emmanuelle, Mazenq, Julie, Cabon, Isabelle, Ohlmann, Camille, Vrielynck, Stéphanie, Jubin, Virginie, Gomez, Sylvie‐Anne André, Gallois, Marie‐Christine Werck, Biermé, Priscille, Pin, Isabelle, Chollet‐Martin, Sylvie
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-03-2024; Wiley
• Subjects: Age; Allergies; Asthma; Bacteriology; Cardiology and cardiovascular system; Children; Cluster analysis; Emerging diseases; Human health and pathology; Immune response; Immunoglobulin E; Immunoglobulins; Infectious diseases; Life Sciences; Microbiology and Parasitology; Parasitology; Pediatrics; preschool; Preschool children; Respiratory diseases; school‐age; Sensitivity analysis; sensitization; severe asthma; Virology; school‐age; severe asthma; asthma; preschool; sensitization
• ISSN: 0905-6157; 1399-3038
• DOI: 10.1111/pai.14112

Background
It is unclear whether sensitization patterns differentiate children with severe recurrent wheeze (SRW)/severe asthma (SA) from those with non‐severe recurrent wheeze (NSRW)/non‐severe asthma (NSA). Our objective was to determine whether sensitization patterns can discriminate between children from the French COBRAPed cohort with NSRW/NSA and those with SRW/SA.
Methods
IgE to 112 components (c‐sIgE) (ImmunoCAP® ISAC) were analyzed in 125 preschools (3–6 years) and 170 school‐age children (7–12 years). Supervised analyses and clustering methods were applied to identify patterns of sensitization among children with positive c‐sIgE.
Results
We observed c‐sIgE sensitization in 51% of preschool and 75% of school‐age children. Sensitization to house dust mite (HDM) components was more frequent among NSRW than SRW (53% vs. 24%, p < .01). Sensitization to non‐specific lipid transfer protein (nsLTP) components was more frequent among SA than NSA (16% vs. 4%, p < .01) and associated with an FEV1/FVC < −1.64 z‐score. Among sensitized children, seven clusters with varying patterns were identified. The two broader clusters identified in each age group were characterized by “few sensitizations, mainly to HDM.” One cluster (n = 4) with “multiple sensitizations, mainly to grass pollen, HDM, PR‐10, and nsLTP” was associated with SA in school‐age children.
Conclusions
Although children with wheeze/asthma display frequent occurrences and high levels of sensitization, sensitization patterns did not provide strong signals to discriminate children with severe disease from those with milder disease. These results suggest that the severity of wheeze/asthma may depend on both IgE‐ and non‐IgE‐mediated mechanisms.
IgE sensitization patterns in severe recurrent wheeze/school‐age asthma.