Developmental profiles of eczema, wheeze, and rhinitis: two population-based birth cohort studies.
<h4>Background</h4>The term "atopic march" has been used to imply a natural progression of a cascade of symptoms from eczema to asthma and rhinitis through childhood. We hypothesize that this expression does not adequately describe the natural history of eczema, wheeze, and rhi...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2014-10-01
|
| Series: | PLoS Medicine |
| Online Access: | https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1001748&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850134615537221632 |
|---|---|
| author | Danielle C M Belgrave Raquel Granell Angela Simpson John Guiver Christopher Bishop Iain Buchan A John Henderson Adnan Custovic |
| author_facet | Danielle C M Belgrave Raquel Granell Angela Simpson John Guiver Christopher Bishop Iain Buchan A John Henderson Adnan Custovic |
| author_sort | Danielle C M Belgrave |
| collection | DOAJ |
| description | <h4>Background</h4>The term "atopic march" has been used to imply a natural progression of a cascade of symptoms from eczema to asthma and rhinitis through childhood. We hypothesize that this expression does not adequately describe the natural history of eczema, wheeze, and rhinitis during childhood. We propose that this paradigm arose from cross-sectional analyses of longitudinal studies, and may reflect a population pattern that may not predominate at the individual level.<h4>Methods and findings</h4>Data from 9,801 children in two population-based birth cohorts were used to determine individual profiles of eczema, wheeze, and rhinitis and whether the manifestations of these symptoms followed an atopic march pattern. Children were assessed at ages 1, 3, 5, 8, and 11 y. We used Bayesian machine learning methods to identify distinct latent classes based on individual profiles of eczema, wheeze, and rhinitis. This approach allowed us to identify groups of children with similar patterns of eczema, wheeze, and rhinitis over time. Using a latent disease profile model, the data were best described by eight latent classes: no disease (51.3%), atopic march (3.1%), persistent eczema and wheeze (2.7%), persistent eczema with later-onset rhinitis (4.7%), persistent wheeze with later-onset rhinitis (5.7%), transient wheeze (7.7%), eczema only (15.3%), and rhinitis only (9.6%). When latent variable modelling was carried out separately for the two cohorts, similar results were obtained. Highly concordant patterns of sensitisation were associated with different profiles of eczema, rhinitis, and wheeze. The main limitation of this study was the difference in wording of the questions used to ascertain the presence of eczema, wheeze, and rhinitis in the two cohorts.<h4>Conclusions</h4>The developmental profiles of eczema, wheeze, and rhinitis are heterogeneous; only a small proportion of children (∼ 7% of those with symptoms) follow trajectory profiles resembling the atopic march. Please see later in the article for the Editors' Summary. |
| format | Article |
| id | doaj-art-e2889a7a2bcc48f1829bfdf10cde08ff |
| institution | OA Journals |
| issn | 1549-1277 1549-1676 |
| language | English |
| publishDate | 2014-10-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Medicine |
| spelling | doaj-art-e2889a7a2bcc48f1829bfdf10cde08ff2025-08-20T02:31:40ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762014-10-011110e100174810.1371/journal.pmed.1001748Developmental profiles of eczema, wheeze, and rhinitis: two population-based birth cohort studies.Danielle C M BelgraveRaquel GranellAngela SimpsonJohn GuiverChristopher BishopIain BuchanA John HendersonAdnan Custovic<h4>Background</h4>The term "atopic march" has been used to imply a natural progression of a cascade of symptoms from eczema to asthma and rhinitis through childhood. We hypothesize that this expression does not adequately describe the natural history of eczema, wheeze, and rhinitis during childhood. We propose that this paradigm arose from cross-sectional analyses of longitudinal studies, and may reflect a population pattern that may not predominate at the individual level.<h4>Methods and findings</h4>Data from 9,801 children in two population-based birth cohorts were used to determine individual profiles of eczema, wheeze, and rhinitis and whether the manifestations of these symptoms followed an atopic march pattern. Children were assessed at ages 1, 3, 5, 8, and 11 y. We used Bayesian machine learning methods to identify distinct latent classes based on individual profiles of eczema, wheeze, and rhinitis. This approach allowed us to identify groups of children with similar patterns of eczema, wheeze, and rhinitis over time. Using a latent disease profile model, the data were best described by eight latent classes: no disease (51.3%), atopic march (3.1%), persistent eczema and wheeze (2.7%), persistent eczema with later-onset rhinitis (4.7%), persistent wheeze with later-onset rhinitis (5.7%), transient wheeze (7.7%), eczema only (15.3%), and rhinitis only (9.6%). When latent variable modelling was carried out separately for the two cohorts, similar results were obtained. Highly concordant patterns of sensitisation were associated with different profiles of eczema, rhinitis, and wheeze. The main limitation of this study was the difference in wording of the questions used to ascertain the presence of eczema, wheeze, and rhinitis in the two cohorts.<h4>Conclusions</h4>The developmental profiles of eczema, wheeze, and rhinitis are heterogeneous; only a small proportion of children (∼ 7% of those with symptoms) follow trajectory profiles resembling the atopic march. Please see later in the article for the Editors' Summary.https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1001748&type=printable |
| spellingShingle | Danielle C M Belgrave Raquel Granell Angela Simpson John Guiver Christopher Bishop Iain Buchan A John Henderson Adnan Custovic Developmental profiles of eczema, wheeze, and rhinitis: two population-based birth cohort studies. PLoS Medicine |
| title | Developmental profiles of eczema, wheeze, and rhinitis: two population-based birth cohort studies. |
| title_full | Developmental profiles of eczema, wheeze, and rhinitis: two population-based birth cohort studies. |
| title_fullStr | Developmental profiles of eczema, wheeze, and rhinitis: two population-based birth cohort studies. |
| title_full_unstemmed | Developmental profiles of eczema, wheeze, and rhinitis: two population-based birth cohort studies. |
| title_short | Developmental profiles of eczema, wheeze, and rhinitis: two population-based birth cohort studies. |
| title_sort | developmental profiles of eczema wheeze and rhinitis two population based birth cohort studies |
| url | https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1001748&type=printable |
| work_keys_str_mv | AT daniellecmbelgrave developmentalprofilesofeczemawheezeandrhinitistwopopulationbasedbirthcohortstudies AT raquelgranell developmentalprofilesofeczemawheezeandrhinitistwopopulationbasedbirthcohortstudies AT angelasimpson developmentalprofilesofeczemawheezeandrhinitistwopopulationbasedbirthcohortstudies AT johnguiver developmentalprofilesofeczemawheezeandrhinitistwopopulationbasedbirthcohortstudies AT christopherbishop developmentalprofilesofeczemawheezeandrhinitistwopopulationbasedbirthcohortstudies AT iainbuchan developmentalprofilesofeczemawheezeandrhinitistwopopulationbasedbirthcohortstudies AT ajohnhenderson developmentalprofilesofeczemawheezeandrhinitistwopopulationbasedbirthcohortstudies AT adnancustovic developmentalprofilesofeczemawheezeandrhinitistwopopulationbasedbirthcohortstudies |