Allergic rhinitis phenotypes with distinct transcriptome profiles in children: A birth cohort

Youn Ho Shin; Jeong-Hyun Kim; Si-Hyeon Lee; So-Yeon Lee; Yoon Mee Park; Eum Ji Choi; Eun Young Paek; Kun-Baek Song; Min Ji Park; Sungsu Jung; Jisun Yoon; Dong In Suh; Kyung Won Kim; Kangmo Ahn; Soo-Jong Hong

doi:10.1016/j.jaci.2023.12.024

Allergic rhinitis phenotypes with distinct transcriptome profiles in children: A birth cohort

J Allergy Clin Immunol. 2024 Jan 17:S0091-6749(24)00032-0. doi: 10.1016/j.jaci.2023.12.024. Online ahead of print.

Authors

Youn Ho Shin¹, Jeong-Hyun Kim², Si-Hyeon Lee², So-Yeon Lee³, Yoon Mee Park², Eum Ji Choi⁴, Eun Young Paek³, Kun-Baek Song⁵, Min Ji Park⁶, Sungsu Jung⁷, Jisun Yoon⁸, Dong In Suh⁹, Kyung Won Kim¹⁰, Kangmo Ahn¹¹, Soo-Jong Hong¹²

Affiliations

¹ Department of Pediatrics, The Catholic University of Korea, Yeouido St Mary's Hospital, Seoul, Korea.
² Department of Medicine, University of Ulsan College of Medicine, Seoul, Korea.
³ Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea.
⁴ Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
⁵ Department of Pediatrics, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
⁶ Department of Pediatrics, Hallym Sacred Heart Hospital, Anyang, Korea.
⁷ Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea.
⁸ Department of Pediatrics, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea.
⁹ Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
¹⁰ Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
¹¹ Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
¹² Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea. Electronic address: sjhong@amc.seoul.kr.

PMID: 38242217
DOI: 10.1016/j.jaci.2023.12.024

Abstract

Background: Allergic rhinitis (AR) phenotypes in childhood are unclear.

Objectives: This study sought to determine AR phenotypes and investigate their natural course and clinical and transcriptomic characteristics.

Methods: Latent class trajectory analysis was used for phenotyping AR in 1050 children from birth through 12 years using a birth cohort study. Blood transcriptome analyses were performed to define the underlying mechanisms of each phenotype.

Results: Five AR phenotypes were identified: early onset (n = 88, 8.4%), intermediate transient (n = 110, 10.5%), late onset (n = 209, 19.9%), very late onset (n=187, 17.8%), and never/infrequent (n = 456, 43.4%). Children with early-onset AR were associated with higher AR severity and sensitizations to foods at age 1 year and inhalants at age 3 years and asthma symptoms, but not with bronchial hyperresponsiveness (BHR). Children with late-onset AR phenotype associated with sensitizations to various foods at age 1 year but not from age 3 years, and to inhalants from age 7 years and with asthma with BHR. Children with very late-onset AR phenotype associated with sensitizations to foods throughout preschool age and to inhalants at ages 7 and 9 years and with asthma with BHR. Transcriptome analysis showed that early-onset AR was associated with viral/bacterial infection-related defense response, whereas late-onset AR was associated with T cell-related immune response.

Conclusions: Early-onset AR phenotype was associated with sensitization to foods and inhalants at an early age and asthma symptoms, but not with BHR, whereas very late- and late-onset AR phenotypes were positively associated with sensitization to inhalants and asthma with BHR. Transcriptomic analyses indicated that early- and late-onset AR phenotypes had distinct underlying mechanisms related to AR as well.

Keywords: Allergic rhinitis; children; comorbidity; phenotype; trajectory; transcriptome.