Longitudinal Trajectories of Asthma and Allergic Comorbidities in the Korean Childhood Asthma Study
Studies on the longitudinal clinical features of asthma or allergic comorbidities in children are limited. We aimed to examine the trajectories of asthma and allergic comorbidities and determine whether these trajectories differ according to clinical asthma phenotypes from birth to adolescence. We e...
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| Published in | Allergy, asthma & immunology research Vol. 17; no. 1; pp. 47 - 59 |
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| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
Korean Academy of Asthma, Allergy and Clinical Immunology
01.01.2025
The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease 대한천식알레르기학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2092-7355 2092-7363 |
| DOI | 10.4168/aair.2025.17.1.47 |
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| Abstract | Studies on the longitudinal clinical features of asthma or allergic comorbidities in children are limited. We aimed to examine the trajectories of asthma and allergic comorbidities and determine whether these trajectories differ according to clinical asthma phenotypes from birth to adolescence.
We enrolled 958 children with physician-diagnosed asthma from the Korean childhood Asthma Study (KAS) cohort. Children with asthma were classified using hierarchical cluster analysis. Information on the diagnosis and treatment of allergic diseases before cohort entry was collected through linkage with national claims data from the Health Insurance Review and Assessment Service.
In the KAS cohort, approximately half had a history of atopic dermatitis (AD) before infancy, with its prevalence gradually decreasing during adolescence. The prevalence of allergic rhinitis (AR) increased with age. The prevalence of asthma increased during early childhood and decreased during adolescence. According to the natural progression of asthma, AD, and AR trajectories, 4 distinctive phenotypes were identified using latent class analysis: "almost controlled," "early-onset asthma with AD and late-onset AR," "early-onset asthma only," and "intermediate-onset asthma and late-onset AR." Four distinct clinical trajectory patterns of asthma, AD, and AR were identified among the 4 cluster phenotypes based on baseline characteristics. Cluster 1 comprised male-dominant, atopic asthma with early-onset AD and late-onset AR. Cluster 2 included early-onset, atopic asthma with AD" persistent into adolescence. Cluster 3 encompassed "puberty-onset, female-dominant atopic asthma" with early-onset and low remission rates. Cluster 4 comprised "early-onset asthma with less atopic features" and the lowest comorbidities of AD and AR.
The longitudinal trajectories of asthma and allergic comorbidities in Korean children can be classified into distinct clusters. Most phenotypes exhibited early-onset asthma with a varying prevalence of comorbidities. The persistence of AD, rather than its onset age, determines the phenotype. |
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| AbstractList | Purpose: Studies on the longitudinal clinical features of asthma or allergic comorbidities in children are limited. We aimed to examine the trajectories of asthma and allergic comorbidities and determine whether these trajectories differ according to clinical asthma phenotypes from birth to adolescence. Methods: We enrolled 958 children with physician-diagnosed asthma from the Korean childhood Asthma Study (KAS) cohort. Children with asthma were classified using hierarchical cluster analysis. Information on the diagnosis and treatment of allergic diseases before cohort entry was collected through linkage with national claims data from the Health Insurance Review and Assessment Service. Results: In the KAS cohort, approximately half had a history of atopic dermatitis (AD) before infancy, with its prevalence gradually decreasing during adolescence. The prevalence of allergic rhinitis (AR) increased with age. The prevalence of asthma increased during early childhood and decreased during adolescence. According to the natural progression of asthma, AD, and AR trajectories, 4 distinctive phenotypes were identified using latent class analysis: "almost controlled," "early-onset asthma with AD and late-onset AR," "early-onset asthma only," and "intermediate-onset asthma and late-onset AR." Four distinct clinical trajectory patterns of asthma, AD, and AR were identified among the 4 cluster phenotypes based on baseline characteristics. Cluster 1 comprised male-dominant, atopic asthma with early-onset AD and late-onset AR. Cluster 2 included early-onset, atopic asthma with AD" persistent into adolescence. Cluster 3 encompassed "puberty-onset, female-dominant atopic asthma" with early-onset and low remission rates. Cluster 4 comprised "early-onset asthma with less atopic features" and the lowest comorbidities of AD and AR. Conclusions: The longitudinal trajectories of asthma and allergic comorbidities in Korean children can be classified into distinct clusters. Most phenotypes exhibited early-onset asthma with a varying prevalence of comorbidities. The persistence of AD, rather than its onset age, determines the phenotype. Studies on the longitudinal clinical features of asthma or allergic comorbidities in children are limited. We aimed to examine the trajectories of asthma and allergic comorbidities and determine whether these trajectories differ according to clinical asthma phenotypes from birth to adolescence. We enrolled 958 children with physician-diagnosed asthma from the Korean childhood Asthma Study (KAS) cohort. Children with asthma were classified using hierarchical cluster analysis. Information on the diagnosis and treatment of allergic diseases before cohort entry was collected through linkage with national claims data from the Health Insurance Review and Assessment Service. In the KAS cohort, approximately half had a history of atopic dermatitis (AD) before infancy, with its prevalence gradually decreasing during adolescence. The prevalence of allergic rhinitis (AR) increased with age. The prevalence of asthma increased during early childhood and decreased during adolescence. According to the natural progression of asthma, AD, and AR trajectories, 4 distinctive phenotypes were identified using latent class analysis: "almost controlled," "early-onset asthma with AD and late-onset AR," "early-onset asthma only," and "intermediate-onset asthma and late-onset AR." Four distinct clinical trajectory patterns of asthma, AD, and AR were identified among the 4 cluster phenotypes based on baseline characteristics. Cluster 1 comprised male-dominant, atopic asthma with early-onset AD and late-onset AR. Cluster 2 included early-onset, atopic asthma with AD" persistent into adolescence. Cluster 3 encompassed "puberty-onset, female-dominant atopic asthma" with early-onset and low remission rates. Cluster 4 comprised "early-onset asthma with less atopic features" and the lowest comorbidities of AD and AR. The longitudinal trajectories of asthma and allergic comorbidities in Korean children can be classified into distinct clusters. Most phenotypes exhibited early-onset asthma with a varying prevalence of comorbidities. The persistence of AD, rather than its onset age, determines the phenotype. Purpose Studies on the longitudinal clinical features of asthma or allergic comorbidities in children are limited. We aimed to examine the trajectories of asthma and allergic comorbidities and determine whether these trajectories differ according to clinical asthma phenotypes from birth to adolescence. Methods We enrolled 958 children with physician-diagnosed asthma from the Korean childhood Asthma Study (KAS) cohort. Children with asthma were classified using hierarchical cluster analysis. Information on the diagnosis and treatment of allergic diseases before cohort entry was collected through linkage with national claims data from the Health Insurance Review and Assessment Service. Results In the KAS cohort, approximately half had a history of atopic dermatitis (AD) before infancy, with its prevalence gradually decreasing during adolescence. The prevalence of allergic rhinitis (AR) increased with age. The prevalence of asthma increased during early childhood and decreased during adolescence. According to the natural progression of asthma, AD, and AR trajectories, 4 distinctive phenotypes were identified using latent class analysis: “almost controlled,” “early-onset asthma with AD and late-onset AR,” “early-onset asthma only,” and “intermediate-onset asthma and late-onset AR.” Four distinct clinical trajectory patterns of asthma, AD, and AR were identified among the 4 cluster phenotypes based on baseline characteristics. Cluster 1 comprised male-dominant, atopic asthma with early-onset AD and late-onset AR. Cluster 2 included early-onset, atopic asthma with AD” persistent into adolescence. Cluster 3 encompassed “puberty-onset, female-dominant atopic asthma” with early-onset and low remission rates. Cluster 4 comprised “early-onset asthma with less atopic features” and the lowest comorbidities of AD and AR. Conclusions The longitudinal trajectories of asthma and allergic comorbidities in Korean children can be classified into distinct clusters. Most phenotypes exhibited early-onset asthma with a varying prevalence of comorbidities. The persistence of AD, rather than its onset age, determines the phenotype. KCI Citation Count: 0 Studies on the longitudinal clinical features of asthma or allergic comorbidities in children are limited. We aimed to examine the trajectories of asthma and allergic comorbidities and determine whether these trajectories differ according to clinical asthma phenotypes from birth to adolescence.PURPOSEStudies on the longitudinal clinical features of asthma or allergic comorbidities in children are limited. We aimed to examine the trajectories of asthma and allergic comorbidities and determine whether these trajectories differ according to clinical asthma phenotypes from birth to adolescence.We enrolled 958 children with physician-diagnosed asthma from the Korean childhood Asthma Study (KAS) cohort. Children with asthma were classified using hierarchical cluster analysis. Information on the diagnosis and treatment of allergic diseases before cohort entry was collected through linkage with national claims data from the Health Insurance Review and Assessment Service.METHODSWe enrolled 958 children with physician-diagnosed asthma from the Korean childhood Asthma Study (KAS) cohort. Children with asthma were classified using hierarchical cluster analysis. Information on the diagnosis and treatment of allergic diseases before cohort entry was collected through linkage with national claims data from the Health Insurance Review and Assessment Service.In the KAS cohort, approximately half had a history of atopic dermatitis (AD) before infancy, with its prevalence gradually decreasing during adolescence. The prevalence of allergic rhinitis (AR) increased with age. The prevalence of asthma increased during early childhood and decreased during adolescence. According to the natural progression of asthma, AD, and AR trajectories, 4 distinctive phenotypes were identified using latent class analysis: "almost controlled," "early-onset asthma with AD and late-onset AR," "early-onset asthma only," and "intermediate-onset asthma and late-onset AR." Four distinct clinical trajectory patterns of asthma, AD, and AR were identified among the 4 cluster phenotypes based on baseline characteristics. Cluster 1 comprised male-dominant, atopic asthma with early-onset AD and late-onset AR. Cluster 2 included early-onset, atopic asthma with AD" persistent into adolescence. Cluster 3 encompassed "puberty-onset, female-dominant atopic asthma" with early-onset and low remission rates. Cluster 4 comprised "early-onset asthma with less atopic features" and the lowest comorbidities of AD and AR.RESULTSIn the KAS cohort, approximately half had a history of atopic dermatitis (AD) before infancy, with its prevalence gradually decreasing during adolescence. The prevalence of allergic rhinitis (AR) increased with age. The prevalence of asthma increased during early childhood and decreased during adolescence. According to the natural progression of asthma, AD, and AR trajectories, 4 distinctive phenotypes were identified using latent class analysis: "almost controlled," "early-onset asthma with AD and late-onset AR," "early-onset asthma only," and "intermediate-onset asthma and late-onset AR." Four distinct clinical trajectory patterns of asthma, AD, and AR were identified among the 4 cluster phenotypes based on baseline characteristics. Cluster 1 comprised male-dominant, atopic asthma with early-onset AD and late-onset AR. Cluster 2 included early-onset, atopic asthma with AD" persistent into adolescence. Cluster 3 encompassed "puberty-onset, female-dominant atopic asthma" with early-onset and low remission rates. Cluster 4 comprised "early-onset asthma with less atopic features" and the lowest comorbidities of AD and AR.The longitudinal trajectories of asthma and allergic comorbidities in Korean children can be classified into distinct clusters. Most phenotypes exhibited early-onset asthma with a varying prevalence of comorbidities. The persistence of AD, rather than its onset age, determines the phenotype.CONCLUSIONSThe longitudinal trajectories of asthma and allergic comorbidities in Korean children can be classified into distinct clusters. Most phenotypes exhibited early-onset asthma with a varying prevalence of comorbidities. The persistence of AD, rather than its onset age, determines the phenotype. |
| Author | Shin, Youn Ho Suh, Dong In Jung, Sungsu Baek, Hey-Sung Lee, Seung-Won Kim, Hwan Soo Kim, Jin Tack Yoon, Jisun Kim, Kyunghoon Shin, Meeyong Park, Ji Soo Yu, Jinho Seo, Ju-Hee Song, Dae Jin Kwon, Ji Won Rhee, Eun Hee Woo, Sung Il Kim, Woo Kyung Yang, Hyeon-Jong Lee, Ju Suk Yoo, Young Kim, Hyung Young Lee, Eun Lim, Dae Hyun Jang, Gwang Cheon |
| AuthorAffiliation | 8 Department of Pediatrics, Bucheon St. Mary’s Hospital, School of Medicine, The Catholic University of Korea, Bucheon, Korea 3 Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea 2 Clinical Research Center, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea 16 Department of Pediatrics, Gangnam CHA Medical Center, CHA University School of Medicine, Seoul, Korea 5 Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea 19 Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea 9 Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea 13 Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea 7 Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea 10 Department of Pediatrics, Inje U |
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| Copyright | Copyright © 2025 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease. Copyright Korean Academy of Asthma, Allergy and Clinical Immunology Jan 2025 Copyright © 2025 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease 2025 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease |
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| Keywords | phenotype rhinitis, allergic cohort studies adolescent dermatitis, atopic cluster analysis Asthma child |
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| Publisher | Korean Academy of Asthma, Allergy and Clinical Immunology The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease 대한천식알레르기학회 |
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| References | Reddy (10.4168/aair.2025.17.1.47_ref5) 2016; 16 Illi (10.4168/aair.2025.17.1.47_ref17) 2004; 113 Strachan (10.4168/aair.2025.17.1.47_ref18) 1996; 312 In Suh (10.4168/aair.2025.17.1.47_ref8) 2019; 19 Roberts (10.4168/aair.2025.17.1.47_ref9) 2016; 19 Leffondré (10.4168/aair.2025.17.1.47_ref11) 2004; 57 Kim (10.4168/aair.2025.17.1.47_ref7) 2021; 11 Haldar (10.4168/aair.2025.17.1.47_ref2) 2008; 178 Kiley (10.4168/aair.2025.17.1.47_ref4) 2007; 13 Boyce (10.4168/aair.2025.17.1.47_ref1) 2012; 129 Grunwell (10.4168/aair.2025.17.1.47_ref12) 2020; 8 Belgrave (10.4168/aair.2025.17.1.47_ref15) 2014; 11 Kim (10.4168/aair.2025.17.1.47_ref6) 2017; 32 Garcia-Aymerich (10.4168/aair.2025.17.1.47_ref13) 2015; 70 Custovic (10.4168/aair.2025.17.1.47_ref16) 2020; 16 Ward (10.4168/aair.2025.17.1.47_ref10) 1963; 58 Bui (10.4168/aair.2025.17.1.47_ref14) 2021; 9 Yoon (10.4168/aair.2025.17.1.47_ref3) 2021; 13 Covar (10.4168/aair.2025.17.1.47_ref19) 2010; 125 Kim (10.4168/aair.2025.17.1.47_ref20) 2014; 36 |
| References_xml | – volume: 178 start-page: 218 year: 2008 ident: 10.4168/aair.2025.17.1.47_ref2 publication-title: Am J Respir Crit Care Med doi: 10.1164/rccm.200711-1754OC – volume: 125 start-page: 359 year: 2010 ident: 10.4168/aair.2025.17.1.47_ref19 publication-title: J Allergy Clin Immunol doi: 10.1016/j.jaci.2009.10.037 – volume: 58 start-page: 236 year: 1963 ident: 10.4168/aair.2025.17.1.47_ref10 publication-title: J Am Stat Assoc doi: 10.1080/01621459.1963.10500845 – volume: 57 start-page: 1049 year: 2004 ident: 10.4168/aair.2025.17.1.47_ref11 publication-title: J Clin Epidemiol doi: 10.1016/j.jclinepi.2004.02.012 – volume: 16 start-page: 873 year: 2020 ident: 10.4168/aair.2025.17.1.47_ref16 publication-title: Expert Rev Clin Immunol doi: 10.1080/1744666X.2020.1816825 – volume: 36 start-page: e2014008 year: 2014 ident: 10.4168/aair.2025.17.1.47_ref20 publication-title: Epidemiol Health doi: 10.4178/epih/e2014008 – volume: 13 start-page: 19 year: 2007 ident: 10.4168/aair.2025.17.1.47_ref4 publication-title: Curr Opin Pulm Med – volume: 19 start-page: 64 year: 2019 ident: 10.4168/aair.2025.17.1.47_ref8 publication-title: BMC Pulm Med doi: 10.1186/s12890-019-0829-3 – volume: 11 start-page: 1442 year: 2021 ident: 10.4168/aair.2025.17.1.47_ref7 publication-title: Sci Rep doi: 10.1038/s41598-021-81022-z – volume: 113 start-page: 925 year: 2004 ident: 10.4168/aair.2025.17.1.47_ref17 publication-title: J Allergy Clin Immunol doi: 10.1016/j.jaci.2004.01.778 – volume: 312 start-page: 1195 year: 1996 ident: 10.4168/aair.2025.17.1.47_ref18 publication-title: BMJ doi: 10.1136/bmj.312.7040.1195 – volume: 32 start-page: 718 year: 2017 ident: 10.4168/aair.2025.17.1.47_ref6 publication-title: J Korean Med Sci doi: 10.3346/jkms.2017.32.5.718 – volume: 16 start-page: 127 year: 2016 ident: 10.4168/aair.2025.17.1.47_ref5 publication-title: Curr Opin Allergy Clin Immunol doi: 10.1097/ACI.0000000000000252 – volume: 11 start-page: e1001748 year: 2014 ident: 10.4168/aair.2025.17.1.47_ref15 publication-title: PLoS Med doi: 10.1371/journal.pmed.1001748 – volume: 13 start-page: 42 year: 2021 ident: 10.4168/aair.2025.17.1.47_ref3 publication-title: Allergy Asthma Immunol Res doi: 10.4168/aair.2021.13.1.42 – volume: 9 start-page: 387 year: 2021 ident: 10.4168/aair.2025.17.1.47_ref14 publication-title: Lancet Respir Med doi: 10.1016/S2213-2600(20)30413-6 – volume: 19 start-page: 328 year: 2016 ident: 10.4168/aair.2025.17.1.47_ref9 publication-title: Sexualities doi: 10.1177/1363460715593477 – volume: 129 start-page: 335 year: 2012 ident: 10.4168/aair.2025.17.1.47_ref1 publication-title: J Allergy Clin Immunol doi: 10.1016/j.jaci.2011.12.968 – volume: 70 start-page: 973 year: 2015 ident: 10.4168/aair.2025.17.1.47_ref13 publication-title: Allergy doi: 10.1111/all.12640 – volume: 8 start-page: 2275 year: 2020 ident: 10.4168/aair.2025.17.1.47_ref12 publication-title: J Allergy Clin Immunol Pract doi: 10.1016/j.jaip.2020.03.005 |
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| Snippet | Studies on the longitudinal clinical features of asthma or allergic comorbidities in children are limited. We aimed to examine the trajectories of asthma and... Purpose: Studies on the longitudinal clinical features of asthma or allergic comorbidities in children are limited. We aimed to examine the trajectories of... Purpose Studies on the longitudinal clinical features of asthma or allergic comorbidities in children are limited. We aimed to examine the trajectories of... |
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| SubjectTerms | Adolescence Adolescents Age Allergic diseases Allergic rhinitis Asthma Atopic dermatitis Child development Childhood Children Childrens health Cluster analysis Comorbidity Dermatitis Original Phenotypes Puberty Remission Rhinitis 내과학 |
| Title | Longitudinal Trajectories of Asthma and Allergic Comorbidities in the Korean Childhood Asthma Study |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/39895602 https://www.proquest.com/docview/3169519020 https://www.proquest.com/docview/3162850811 https://pubmed.ncbi.nlm.nih.gov/PMC11791365 https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART003169458 |
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