title: Association of atopy phenotypes with new development of asthma and bronchial hyperresponsiveness in school-aged children.
abstract: Although previous studies have investigated the association between atopy phenotypes and allergic diseases, atopy characterizations in association with the development of allergic diseases remain poorly understood.
  
  
  
  To identify atopy phenotypes in school-age children and to evaluate the association between atopy phenotypes and allergic diseases.
  
  
  
  We enrolled 616 children with atopy defined as 1 or more positive allergen responses on skin prick tests and 665 children without atopy from the Children's Health and Environmental Research (CHEER) study. All children were followed up for 4 years at 2-year intervals. Atopy phenotypes were classified using latent class analysis.
  
  
  
  Four atopy phenotypes were characterized: later sensitization to indoor allergens (cluster 1); multiple early sensitization (cluster 2); early sensitization to outdoor allergens, especially Alternaria, and later sensitization to indoor allergens, including Aspergillus (cluster 3); and early sensitization to indoor allergens and later sensitization to outdoor allergens (cluster 4). New cases of asthma during follow-up were increased in clusters 2 and 3 (adjusted odds ratio [aOR], 2.76 and 4.25, respectively). The risk of new-onset bronchial hyperresponsiveness was highest in cluster 3 (aOR, 5.03). Clusters 2 and 4 had an increased risk of allergic rhinitis (aOR, 7.21 and 2.37, respectively).
  
  
  
  Identification of atopy phenotypes facilitates prediction of the development of asthma and bronchial hyperresponsiveness in school-age children. Our study suggests prevention of additional sensitization is required to modify the progression of allergic diseases.
authors.affiliation: Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Eun
authors.initials: E
authors.lastname: Lee
authors.affiliation: Asan Institute for Life Sciences, University of Ulsan College of Medicine, Sonapa-gu, Seoul, Korea.
authors.forename: Si Hyeon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea.
authors.forename: Young-Ho
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, Sonapa-gu, Seoul, Korea.
authors.forename: Hyun-Ju
authors.initials: HJ
authors.lastname: Cho
authors.affiliation: Department of Pediatrics, Childhood Asthma and Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Sonapa-gu, Seoul, Korea.
authors.forename: Jisun
authors.initials: J
authors.lastname: Yoon
authors.affiliation: Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 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, College of Medicine, Dankook University, Cheonan, Korea.
authors.forename: Ju-Hee
authors.initials: JH
authors.lastname: Seo
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, Inje University Sanggye Paik Hospital, Seoul, Korea.
authors.forename: Hyo-Bin
authors.initials: HB
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, Sonapa-gu, Seoul, 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, Sonapa-gu, Seoul, Korea. Electronic address: sjhong@amc.seoul.kr.
authors.forename: Soo-Jong
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D000367:Age Factors; D000485:Allergens / Q000145:classification / Q000276:immunology; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology*; D016535:Bronchial Hyperreactivity / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology*; D002648:Child; D015897:Comorbidity; D004804:Eosinophils; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D016017:Odds Ratio; D010641:Phenotype; D011159:Population Surveillance; D012129:Respiratory Function Tests; D012307:Risk Factors; D012882:Skin Tests; D012959:Socioeconomic Factors
chemical_list: D000485:Allergens; D007073:Immunoglobulin E