Phenotypes of atopic dermatitis up to 36 months of age by latent class analysis and associated factors in Japan

Takayasu Arima; Yuki Shiko; Yohei Kawasaki; Minako Tomiita; Kenichi Yamaguchi; Shuichi Suzuki; Yuzaburo Inoue; Yoshinori Morita; Takeshi Kambara; Zenro Ikezawa; Yoichi Kohno; Naoki Shimojo

doi:10.5415/apallergy.2022.12.e2

Phenotypes of atopic dermatitis up to 36 months of age by latent class analysis and associated factors in Japan

Asia Pac Allergy. 2022 Jan 12;12(1):e2. doi: 10.5415/apallergy.2022.12.e2. eCollection 2022 Jan.

Authors

Takayasu Arima¹, Yuki Shiko^{2

3}, Yohei Kawasaki^{2

4}, Minako Tomiita⁵, Kenichi Yamaguchi⁶, Shuichi Suzuki⁵, Yuzaburo Inoue⁷, Yoshinori Morita⁸, Takeshi Kambara⁹, Zenro Ikezawa¹⁰, Yoichi Kohno¹¹, Naoki Shimojo¹²

Affiliations

¹ Department of Pediatrics, Kimitsu Chuo Hospital, Chiba, Japan.
² Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan.
³ Applied Cognitive Neuroscience Laboratory, Faculty of Science and Engineering, Chuo University, Tokyo, Japan.
⁴ Faculty of Nursing, Japanese Red Cross College of Nursing, Tokyo, Japan.
⁵ Department of Pediatrics, National Shimoshizu Hospital, Chiba, Japan.
⁶ Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo, Japan.
⁷ Department of Allergy and Rheumatology, Chiba Children's Hospital, Chiba, Japan.
⁸ Department of Pediatrics, IMS Memorial Hospital, Tokyo, Japan.
⁹ Department of Dermatology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
¹⁰ Ai Dermatology Clinic, Yokohama, Japan.
¹¹ Chiba Rosai Hospital, Chiba, Japan.
¹² Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.

Abstract

Background: Atopic dermatitis (AD) in early childhood is the first allergic manifestation in the atopic march. Recently, latent class analysis (LCA) has revealed the presence of AD subgroups in childhood.

Objective: This study aimed to elucidate different AD phenotypes up to 36 months of age and identify factors associated with a particular AD phenotype in early childhood.

Methods: Pediatric allergists or dermatologists examined children who visited local public health centers in Chiba or Yokohama city at 4, 18, and 36 months of age for regular health checkups between 2003 and 2005. LCA was used to identify AD subtypes on the basis of the course of skin symptoms and comorbidity of other allergic diseases. After LCA, the association between genetic and environmental factors and AD phenotypes was assessed.

Results: A total of 1,378 children who underwent the 3 checkups were included. Complete data were available for 515 children up to 36 months of age. Of 515 children, 183 were diagnosed with AD at least at one out of the 3 time points. The LCA model of these children with AD separated 4 AD phenotypes: early-persistent (EP), early-transient (ET), late-onset (LO), and variable (V). Antibiotic use by 4 months of age was significantly higher in EP group than in other 3 groups. Mother's allergy was significantly higher in EP and LO groups than in other 2 groups. Passive smoking at 18 months of age was higher in LO group than in other groups. Furthermore, >80% of V group was born in spring-summer.

Conclusion: We identified 4 AD phenotypes using LCA on the basis of the onset/course of AD and comorbidity of other allergic diseases and also identified several factors related to the particular phenotypes, which may be useful markers for the prediction of prognosis of AD in early childhood.

Keywords: Child; Cohort study; Dermatitis, Atopic; Latent class analysis; Phenotype.