杭州浙大迪迅生物基因工程有限公司

背景：各种过敏性疾病通常在儿童早期共同发展，但在发病、缓解和进展的时间上有所不同。随着时间的推移，他们的病程往往很难预测，而且决定因素也不太清楚。
目的：本研究旨在确定过敏性疾病直到青春期的发展轨迹，并研究它们与早期生活、遗传决定因素和临床特征的关系。
方法：使用纵向k均值聚类推导两个德国出生队列（GINIplus/LISA）中过敏性疾病（哮喘、特应性皮炎和鼻炎）的轨迹。通过多项模型估计了与早期生活决定因素、多基因风险评分、食物和空气过敏原致敏以及肺功能的相关性。这些结果在独立的瑞典BAMSE队列中得到了重复。
结果：确定了七种过敏性疾病轨迹：“间歇性过敏”、“鼻炎”、“早期消退性皮炎”、“中期持续性皮炎”，“多发性过敏”、“持续性皮炎加鼻炎”和“早期短暂性哮喘”。与非过敏对照组相比，过敏家族史在所有过敏性疾病轨迹中更为普遍，对包括一种以上过敏性疾病的集群的影响更大（例如，在RRR=5.0的情况下，多发性过敏组的95%置信区间=[3.1-8.0]，而轻度间歇性过敏的集群为1.8[1.4-2.4]）。单一过敏性疾病的特定多基因风险评分与其相关轨迹显著相关。得出的轨迹及其与遗传效应和临床特征的关联在BAMSE中显示出类似的结果。
结论：本研究确定了7个强烈的过敏性集群，并显示出与早期生活、遗传因素以及临床特征有关。


延伸阅读
Allergy
Allergic disease trajectories up to adolescence: Characteristics,early-life, and genetic determinants
DOI: 10.1111/all.15511
Abstract:
Background: Allergic diseases often develop jointly during early childhood but differ in timing of onset, remission, and progression. Their disease course over time is often difficult to predict and determinants are not well understood.
Objectives: We aimed to identify trajectories of allergic diseases up to adolescence and to investigate their association with early-life and genetic determinants and clinical characteristics.
Methods: Longitudinal k-means clustering was used to derive trajectories of allergic diseases (asthma, atopic dermatitis, and rhinitis) in two German birth cohorts (GINIplus/LISA). Associations with early-life determinants, polygenic risk scores, food and aeroallergen sensitization, and lung function were estimated by multinomial models.The results were replicated in the independent Swedish BAMSE cohort.
Results: Seven allergic disease trajectories were identified: “Intermittently allergic,” “rhinitis,” “early-resolving dermatitis,” “mid-persisting dermatitis,” “multimorbid,” “persisting dermatitis plus rhinitis,” and “early-transient asthma.” Family history of allergies was more prevalent in all allergic disease trajectories compared the non-allergic controls with stronger effect sizes for clusters comprising more than one allergic disease(e.g., RRR = 5.0, 95% CI = [3.1–8.0] in the multimorbid versus 1.8 [1.4–2.4] in the mild intermittently allergic cluster). Specific polygenic risk scores for single allergic diseases were significantly associated with their relevant trajectories. The derived trajectories and their association with genetic effects and clinical characteristics showed similar results in BAMSE.
Conclusion: Seven robust allergic clusters were identified and showed associations with early life and genetic factors as well as clinical characteristics.
First Author:
Anna Kilanowski
Corresponding author:
Marie Standl
Correspondence:
Marie Standl, Helmholtz Zentrum München –Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH),Institute of Epidemiology, Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany.
Email: marie.standl@helmholtz-muenchen.de