Back to Search
Start Over
Four childhood atopic dermatitis subtypes identified from trajectory and severity of disease and internally validated in a large UK birth cohort
Four childhood atopic dermatitis subtypes identified from trajectory and severity of disease and internally validated in a large UK birth cohort
- Source :
- The British journal of dermatology, vol 185, iss 3, British Journal of Dermatology
- Publication Year :
- 2021
- Publisher :
- Oxford University Press (OUP), 2021.
-
Abstract
- BACKGROUND: Atopic dermatitis (AD) disease activity and severity is highly variable during childhood. Early attempts to identify subtypes based on disease trajectory have assessed AD presence over time without incorporating severity. OBJECTIVES: To identify childhood AD subtypes from symptom severity and trajectories, and determine associations with genetic risk factors, comorbidities and demographic and environmental variables. METHODS: We split data from children in the Avon Longitudinal Study of Parents and Children birth cohort into development and validation sets. To identify subtypes, we ran latent class analyses in the development set on AD symptom reports up to age 14 years. We regressed identified subtypes on nongenetic variables in mutually adjusted, multiply imputed (genetic: unadjusted, complete case) multinomial regression analyses. We repeated analyses in the validation set and report confirmed results. RESULTS: There were 11 866 children who contributed to analyses. We identified one Unaffected/Rare class (66% of children) and four AD subtypes: Severe-Frequent (4%), Moderate-Frequent (7%), Moderate-Declining (11%) and Mild-Intermittent (12%). Symptom patterns within the first two subtypes appeared more homogeneous than the last two. Filaggrin (FLG) null mutations, an AD polygenic risk score (PRS), being female, parental AD and comorbid asthma were associated with higher risk for some or all subtypes; FLG, AD-PRS and asthma associations were stronger along a subtype gradient arranged by increasing severity and frequency; FLG and AD-PRS further differentiated some phenotypes from each other. CONCLUSIONS: Considering severity and AD trajectories leads to four well-defined and recognizable subtypes. The differential associations of risk factors among and between subtypes is novel and requires further research.
- Subjects :
- Male
Longitudinal study
medicine.medical_specialty
Adolescent
Clinical Sciences
Oncology and Carcinogenesis
Eczema
Dermatitis
Dermatology
Disease
Filaggrin Proteins
Severity of Illness Index
Atopic
Dermatitis, Atopic
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
Intermediate Filament Proteins
Internal medicine
Genetics
medicine
2.1 Biological and endogenous factors
Humans
Longitudinal Studies
Aetiology
Preschool
Child
Multinomial logistic regression
Asthma
Pediatric
business.industry
Dermatology & Venereal Diseases
Infant
Atopic dermatitis
medicine.disease
United Kingdom
3. Good health
Child, Preschool
Mutation
Female
business
Birth cohort
Childhood atopic dermatitis
Filaggrin
Subjects
Details
- ISSN :
- 13652133 and 00070963
- Volume :
- 185
- Database :
- OpenAIRE
- Journal :
- British Journal of Dermatology
- Accession number :
- edsair.doi.dedup.....ab0c5f81993749267590c04346382f25
- Full Text :
- https://doi.org/10.1111/bjd.19885