Endotyping Seasonal Allergic Rhinitis in Children: A Cluster Analysis.
allergic rhinitis
children
cluster analysis
cytokines
endotypes
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2021
2021
Historique:
received:
01
11
2021
accepted:
24
12
2021
entrez:
14
2
2022
pubmed:
15
2
2022
medline:
15
2
2022
Statut:
epublish
Résumé
Seasonal Allergic Rhinitis (SAR) is a heterogeneous inflammatory disease. We hypothesized that a cluster analysis based on the evaluation of cytokines in nasal lavage (NL) could characterize distinctive SAR endotypes in children. This cross-sectional study enrolled 88 children with SAR. Detailed medical history was obtained by well-trained physicians. Quality of life and sleep quality were assessed through standardized questionnaires [Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and Pittsburgh Sleep Quality Index (PSQI) respectively]. Children were grouped through K-means clustering using Interleukin (IL)-5, IL-17, IL-23, and Interferon (INF)-γ in NL. Out of the 88 patients enrolled, 80 were included in the cluster analysis, which revealed three SAR endotypes. Cluster 1 showed lower levels of IL-5 and IL-17 and intermediate levels of IL-23 and IFN-γ; Cluster 2 had higher levels of IL-5 and intermediate levels of IL-17, IL-23, and IFN-γ; Cluster 3 showed higher levels of IL-17, IL-23, and IFN-γ and intermediate levels of IL-5. Cluster 1 showed intermediate values of nasal pH and nasal nitric oxide (nNO), and a lower percentage of neutrophils at nasal cytology than Clusters 2 and 3. Cluster 2 had a lower level of nasal pH, a higher nNO, higher scores in the ocular domain of PRQLQ, and worse sleep quality than Clusters 1 and 3. Cluster 3 showed a higher percentage of neutrophils at nasal cytology than Clusters 1 and 2. Our study identified three endotypes based on the evaluation of cytokines in NL, highlighting that childhood SAR is characterized by heterogeneous inflammatory cytokines.
Sections du résumé
BACKGROUND
BACKGROUND
Seasonal Allergic Rhinitis (SAR) is a heterogeneous inflammatory disease. We hypothesized that a cluster analysis based on the evaluation of cytokines in nasal lavage (NL) could characterize distinctive SAR endotypes in children.
METHODS
METHODS
This cross-sectional study enrolled 88 children with SAR. Detailed medical history was obtained by well-trained physicians. Quality of life and sleep quality were assessed through standardized questionnaires [Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and Pittsburgh Sleep Quality Index (PSQI) respectively]. Children were grouped through K-means clustering using Interleukin (IL)-5, IL-17, IL-23, and Interferon (INF)-γ in NL.
RESULTS
RESULTS
Out of the 88 patients enrolled, 80 were included in the cluster analysis, which revealed three SAR endotypes. Cluster 1 showed lower levels of IL-5 and IL-17 and intermediate levels of IL-23 and IFN-γ; Cluster 2 had higher levels of IL-5 and intermediate levels of IL-17, IL-23, and IFN-γ; Cluster 3 showed higher levels of IL-17, IL-23, and IFN-γ and intermediate levels of IL-5. Cluster 1 showed intermediate values of nasal pH and nasal nitric oxide (nNO), and a lower percentage of neutrophils at nasal cytology than Clusters 2 and 3. Cluster 2 had a lower level of nasal pH, a higher nNO, higher scores in the ocular domain of PRQLQ, and worse sleep quality than Clusters 1 and 3. Cluster 3 showed a higher percentage of neutrophils at nasal cytology than Clusters 1 and 2.
CONCLUSIONS
CONCLUSIONS
Our study identified three endotypes based on the evaluation of cytokines in NL, highlighting that childhood SAR is characterized by heterogeneous inflammatory cytokines.
Identifiants
pubmed: 35155483
doi: 10.3389/fmed.2021.806911
pmc: PMC8825866
doi:
Types de publication
Journal Article
Langues
eng
Pagination
806911Informations de copyright
Copyright © 2022 Malizia, Ferrante, Cilluffo, Gagliardo, Landi, Montalbano, Fasola, Profita, Licari, Marseglia and La Grutta.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer RC declared past collaborations with the authors AL and GLM to the handling editor.
Références
Int Arch Allergy Immunol. 2012;157(4):349-53
pubmed: 22123238
Pediatr Allergy Immunol. 2010 Feb;21(1 Pt 2):e174-84
pubmed: 19566585
Arch Immunol Ther Exp (Warsz). 2006 Jan-Feb;54(1):15-24
pubmed: 16642253
J Immunol Methods. 2014 Feb;404:41-51
pubmed: 24370751
Clin Exp Allergy. 2011 Mar;41(3):417-23
pubmed: 21121983
PLoS One. 2018 Jul 26;13(7):e0200366
pubmed: 30048449
PLoS One. 2013;8(4):e58892
pubmed: 23573194
Pediatr Allergy Immunol. 2017 Jun;28(4):393-397
pubmed: 28218956
J Allergy Clin Immunol. 2006 Nov;118(5):1068-74
pubmed: 17088131
Occup Environ Med. 2005 Sep;62(9):616-22
pubmed: 16109818
Allergy Asthma Immunol Res. 2015 Jan;7(1):44-50
pubmed: 25553262
Ann Allergy Asthma Immunol. 2005 Feb;94(2):258-61
pubmed: 15765742
J Investig Allergol Clin Immunol. 2017;27(4):261-263
pubmed: 28731413
J Exp Med. 1999 Nov 1;190(9):1309-18
pubmed: 10544202
Psychiatry Res. 1989 May;28(2):193-213
pubmed: 2748771
Ital J Pediatr. 2012 Oct 25;38:60
pubmed: 23098057
J Allergy Clin Immunol. 2015 Jan;135(1):143-50
pubmed: 25085342
Clin Exp Allergy. 2013 Aug;43(8):956-66
pubmed: 23889249
J Immunol. 1998 Jun 1;160(11):5300-8
pubmed: 9605128
Int Arch Allergy Immunol. 2009;149 Suppl 1:108-12
pubmed: 19494515
Allergy. 2008 Apr;63 Suppl 86:8-160
pubmed: 18331513
Rhinology. 2009 Jun;47(2):115-20
pubmed: 19593964
J Allergy Clin Immunol. 2002 May;109(5):803-9
pubmed: 11994704
J Allergy Clin Immunol. 1998 Feb;101(2 Pt 1):163-70
pubmed: 9500748
Proc Natl Acad Sci U S A. 2004 Feb 17;101(7):1987-92
pubmed: 14769916
Int J Immunopathol Pharmacol. 2010 Oct-Dec;23(4):1211-9
pubmed: 21244770
Am J Respir Crit Care Med. 2011 Sep 1;184(5):602-15
pubmed: 21885636
Curr Opin Allergy Clin Immunol. 2018 Feb;18(1):1-9
pubmed: 29135513
Pediatr Allergy Immunol. 2011 Feb;22(1 Pt 1):60-8
pubmed: 20825572
Allergy Asthma Clin Immunol. 2015 Sep 22;11(1):26
pubmed: 26401140
Annu Rev Immunol. 1997;15:749-95
pubmed: 9143706
Int Arch Allergy Immunol. 2015;166(3):231-40
pubmed: 25924687
Allergy. 2019 Apr;74(4):720-730
pubmed: 30353934
Pediatr Allergy Immunol. 2010 Mar;21(2 Pt 1):268-76
pubmed: 20444167
PLoS One. 2020 Feb 13;15(2):e0228533
pubmed: 32053609
Am J Respir Crit Care Med. 2002 May 15;165(10):1364-70
pubmed: 12016097
Int Arch Allergy Immunol. 2017;174(2):97-103
pubmed: 29059673
Ann Allergy Asthma Immunol. 2020 Oct;125(4):447-459.e5
pubmed: 32663599
Clin Exp Allergy. 2018 Sep;48(9):1092-1106
pubmed: 29904978
Am J Respir Crit Care Med. 1996 Aug;154(2 Pt 1):308-17
pubmed: 8756799
Clin Mol Allergy. 2007 Oct 29;5:4
pubmed: 17967188
Allergy. 2016 Aug;71(8):1181-91
pubmed: 26999633