title: A rhinitis phenotype associated with increased development of bronchial hyperresponsiveness and asthma in children.
abstract: Allergic rhinitis (AR) has a wide range of clinical features and may be accompanied by comorbid allergic diseases.
  
  
  
  To identify rhinitis phenotypes in school aged children and to predict the prognosis for developing bronchial hyperresponsiveness (BHR) and asthma.
  
  
  
  This prospective follow-up study involved schoolchildren from the Children's Health and Environment Research cohort with current rhinitis, which was defined based on parental-reported, physician-diagnosed rhinitis and symptoms of rhinitis in the previous 12 months. All participants were followed up at 2 and 4 years later. Rhinitis clusters were identified by latent class analysis that used demographic, clinical, and environmental variables.
  
  
  
  In 512 eligible children (age range, 6-8 years), 4 rhinitis phenotypes were identified: cluster 1 (25% of children) was associated with nonatopy and a low socioeconomic status; cluster 2 (36%) was associated with a high-atopic burden but normal lung function; cluster 3 (22%) was associated with a high-atopic burden and impaired lung function; and cluster 4 (17%) was associated with low atopy and a high socioeconomic status. Cluster 3 was associated with the highest total serum IgE levels and blood eosinophil percentages at enrollment and the highest incidence of new cases of BHR (P = .04) and asthma symptoms (P = .005) during follow-up.
  
  
  
  The rhinitis cluster of schoolchildren with atopy and impaired lung function is associated with allergic march. This identification of distinct rhinitis phenotypes in affected children may help to prevent allergic march in children with rhinitis.
authors.affiliation: Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea.
authors.forename: Eun
authors.initials: E
authors.lastname: Lee
authors.affiliation: Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Si Hyeon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ji-Won
authors.initials: JW
authors.lastname: Kwon
authors.affiliation: Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea.
authors.forename: Yeongho
authors.initials: Y
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: Hyun-Ju
authors.initials: HJ
authors.lastname: Cho
authors.affiliation: Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Song-I
authors.initials: SI
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea.
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Jung
authors.affiliation: Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Hyung Young
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Dankook University College of Medicine, Seoul, Korea.
authors.forename: Ju-Hee
authors.initials: JH
authors.lastname: Seo
authors.affiliation: Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio.
authors.forename: Byoung-Ju
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: Hyo Bin
authors.initials: HB
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Ho-Jang
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. Electronic address: sjhong@amc.seoul.kr.
authors.forename: Soo-Jong
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D001249:Asthma / Q000453:epidemiology* / Q000209:etiology*; D016535:Bronchial Hyperreactivity / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D008297:Male; D010641:Phenotype; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D062486:Public Health Surveillance; D056910:Republic of Korea / Q000453:epidemiology; D012129:Respiratory Function Tests; D012220:Rhinitis / Q000150:complications* / Q000175:diagnosis*; D012307:Risk Factors
chemical_list: D007073:Immunoglobulin E