title: Atopic dermatitis phenotype with early onset and high serum IL-13 is linked to the new development of bronchial hyperresponsiveness in school children.
abstract: Atopic dermatitis (AD) is characterized by a heterogeneous clinical spectrum, and some forms of AD are associated with the initial steps of allergic march. The aims of this study were to determine AD phenotypes in school-age children and investigate their associations with the allergic march in each cluster.
  
  
  
  We included 242 children (6-8 years) with current AD from the Children's HEalth and Environmental Research study, a 4-year prospective follow-up study with 2-year survey intervals. Latent class analysis was used. Serum IL-13 and thymic stromal lymphopoietin (TSLP) levels at the time of enrollment were measured using ELISA.
  
  
  
  We identified four current AD phenotypes in children, characterized as 'early onset with low atopy' (26.4% of the sample; group 1), 'early onset with high atopy and high eosinophil percentages' (48.3%; group 2), 'late onset with low atopy' (9.9%; group 3), and 'late onset with high atopy and normal eosinophils' (15.3%; group 4). Although groups 2 and 4 demonstrated high atopic burden, children in group 2 showed the persistence of AD and eosinophilia associated with a high prevalence of new cases of bronchial hyper-responsiveness and asthma symptoms during follow-up. The serum IL-13 level was significantly increased in the early-onset AD groups, but there was no significant difference in the serum TSLP levels across all four groups.
  
  
  
  An allergic march-associated AD phenotype exists that is characterized by early onset of AD with its persistence, increased serum IL-13 levels, high atopy, and a persistently increased blood eosinophil percentage.
authors.affiliation: Department of Pediatrics, Childhood Asthma and Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: E
authors.initials: E
authors.lastname: Lee
authors.affiliation: Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Kwon
authors.affiliation: Department of Pediatrics, Childhood Asthma and Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Y H
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Childhood Asthma and Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Cho
authors.affiliation: Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: S I
authors.initials: SI
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea.
authors.forename: Y H
authors.initials: YH
authors.lastname: Jung
authors.affiliation: Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Seoul, Korea.
authors.forename: H Y
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Seo
authors.affiliation: Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: H B
authors.initials: HB
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Kwon
authors.affiliation: Department of Pediatrics, Childhood Asthma and Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: S J
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D000367:Age Factors; D015415:Biomarkers; D016535:Bronchial Hyperreactivity / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D016000:Cluster Analysis; D015897:Comorbidity; D016207:Cytokines / Q000097:blood; D003876:Dermatitis, Atopic / Q000097:blood* / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D018793:Interleukin-13 / Q000097:blood*; D008297:Male; D010641:Phenotype; D011379:Prognosis; D012129:Respiratory Function Tests; D012307:Risk Factors; D011795:Surveys and Questionnaires; D000094632:Thymic Stromal Lymphopoietin
chemical_list: D015415:Biomarkers; D016207:Cytokines; D018793:Interleukin-13; D007073:Immunoglobulin E; D000094632:Thymic Stromal Lymphopoietin
keywords: IL-13; allergic march; atopic dermatitis; bronchial; hyperresponsiveness; phenotype