Suaini, N. H. A., Yap, G. C., Bui, D. P. T., Loo, E. X. L., Goh, A. E. N., Teoh, O. H., … Tham, E. H. (2021). Atopic dermatitis trajectories to age 8 years in the GUSTO cohort. Clinical & Experimental Allergy. doi:10.1111/cea.13993
Abstract:
Background: The heterogeneity of childhood atopic dermatitis (AD) underscores the need to understand latent phenotypes that may inform risk stratification and disease prognostication.
Objective: To identify AD trajectories across the first 8 years of life, investigate risk factors associated with each trajectory and their relationships with other comorbidities.
Methods: Data were collected prospectively from 1152 mother-offspring dyads in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort from ages 3 months to 8 years. AD was defined based on parent-reported doctor's diagnosis. An unsupervised machine learning technique was used to determine AD trajectories.
Results: Three AD trajectories were identified: early onset transient (6.3%), late onset persistent (6.3%) and early onset persistent (2.1%), alongside a no AD/reference group (85.2%). Early onset transient AD was positively associated with male gender, family history of atopy, house dust mite sensitization and some measures of wheezing. Early onset persistent AD was associated with antenatal/intrapartum antibiotic use, food sensitization and some measures of wheezing. Late onset persistent AD was associated with a family history of atopy, some measures of house dust mite sensitization and some measures of allergic rhinitis and wheezing.
Conclusion and clinical relevance: Three AD trajectories were identified in this birth cohort, with different risk factors and prognostic implications. Further work is needed to understand the molecular and immunological origins of these phenotypes.
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Publisher Copyright
Funding Info:
This research / project is supported by the National Medical Research Council - Translational and Clinical Research (TCR) Flagship Program
Grant Reference no. : NMRC/TCR/004-NUS/2008
This research / project is supported by the National Medical Research Council - Translational and Clinical Research (TCR) Flagship Program
Grant Reference no. : NMRC/TCR/012-NUHS/ 2014
This research is supported by core funding from: Singapore Institute for Clinical Sciences
Grant Reference no. : -
Description:
This is the peer reviewed version of the following article: Suaini NHA, Yap GC, Bui DPT, Loo EXL, Goh AEN, Teoh OH, Tan KH, Godfrey KM, Lee BW, Shek LP, Van Bever H, Chong YS, Tham EH. Atopic dermatitis trajectories to age 8 years in the GUSTO cohort. Clin Exp Allergy. 2021 Jul 26. doi: 10.1111/cea.13993. Epub ahead of print. PMID: 34310791., which has been published in final form at 10.1111/cea.13993. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.