title: Early-onset atopic dermatitis in children: which are the phenotypes at risk of asthma? Results from the ORCA cohort.
abstract: BACKGROUND
  Atopic dermatitis (AD) is known to predate asthma and other atopic disorders described under the term "atopic march". However, this classic sequence is not always present and only a few studies have addressed children at risk of developing asthma. The objective of this study is to define early-onset AD phenotypes leading to asthma.
  
  
  METHODS
  We performed a cluster analysis with 9 variables of 214 infants with early-onset AD prospectively enrolled in the ORCA cohort and followed each year on the occurrence of asthma until the age of 6.
  
  
  RESULTS
  We identified 3 clusters - cluster 1 (n = 94) with low to no sensitization to food (27.7%) or aeroallergens (10.6%) and moderate AD severity (SCORAD 25.29 +/- 14.6) called "AD with low sensitization"; - cluster 2 (n = 84) characterized by a higher AD severity (SCORAD 32.66+/-16.6) and frequent sensitization to food (98.9%) or aeroallergens (26.2%), most likely multiple (96.4% for food allergens), called "AD with multiple sensitizations" - cluster 3 (n = 36) with parental history, moderate AD severity (SCORAD 24.46+/-15.7), moderate rate of sensitization to food allergens (38.9%) (exclusively single) with no sensitization to aeroallergens, called "AD with familial history of asthma". Percentages of children suffering from asthma at the age of 6 were higher in clusters 2 and 3 (36.1% and 33.3% respectively versus 14.9% in cluster 1, p<0.01).
  
  
  CONCLUSIONS
  Two phenotypes in infants with early-onset AD convey a higher risk of developing asthma during childhood: multiple sensitization and familial history of asthma.
authors.affiliation: Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France; Equipe EPAR, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR_S1136, INSERM, Paris, France; UPMC Univ Paris 06, Sorbonne Universités, Paris, France.
authors.forename: Flore
authors.initials: F
authors.lastname: Amat
authors.affiliation: Equipe EPAR, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR_S1136, INSERM, Paris, France; UPMC Univ Paris 06, Sorbonne Universités, Paris, France; Laboratory of Theoretical and Applied Statistics-Laboratoire de Statistiques Théoriques et Appliquées, UPMC Univ Paris 06, Sorbonne Universités, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Saint-Pierre
authors.affiliation: Department of Dermatology, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Bourrat
authors.affiliation: Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Ariane
authors.initials: A
authors.lastname: Nemni
authors.affiliation: Laboratory of Biochemistry and Molecular Biology- Laboratoire de Biochimie et Biologie Moléculaire, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Rémy
authors.initials: R
authors.lastname: Couderc
authors.affiliation: Department of Biostatistics and Medical Informatics-Service de Biostatistiques et informatique médicale, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France; U717, INSERM, Université Paris 7, Paris, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Boutmy-Deslandes
authors.affiliation: Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Fatiha
authors.initials: F
authors.lastname: Sahraoui
authors.affiliation: Department of Dermatology, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Pansé
authors.affiliation: Department of Dermatology, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Bagot
authors.affiliation: Department of Dermatology, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Foueré
authors.affiliation: Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France; Equipe EPAR, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR_S1136, INSERM, Paris, France; UPMC Univ Paris 06, Sorbonne Universités, Paris, France.
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Just
mesh_terms: D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000175:diagnosis* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003876:Dermatitis, Atopic / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D005512:Food Hypersensitivity / Q000276:immunology; D005602:France; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007223:Infant; D008297:Male; D010641:Phenotype; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
chemical_list: D000485:Allergens; D007073:Immunoglobulin E