Heterogeneity of Childhood Asthma in Korea: Cluster Analysis of the Korean Childhood Asthma Study Cohort
Year: 2020
Type: article
Abstract: PURPOSE: Asthma is a heterogeneous airway disease occurring in children, and it has various clinical phenotypes. A clear differentiation of the clinical phenotypes can provide better asthma management and prediction of asthma prognosis. Little is currently known about asthma phenotypes in Korean children. This study was designed to identify asthma phenotypes in school-aged Korean children. METHODS: This study enrolled 674 children with physician-diagnosed asthma from the Korean childhood Asthma Study (KAS) cohort. The physicians verified the relevant histories of asthma and comorbid diseases, as well as airway lability and hyper-responsiveness from the results of pulmonary function tests and bronchial provocation tests. Questionnaires regarding the participants' baseline characteristics, their environment and self-rating of asthma control were collected at the time of enrollment. Laboratory tests were performed to assess allergy and airway inflammation. Children with asthma were classified by hierarchical cluster analysis. RESULTS: Of the 674 patients enrolled from the KAS cohort, 447 were included in the cluster analysis. Cluster analysis of these 447 children revealed 4 asthma phenotypes: cluster 1 (n = 216, 48.3%) which was characterized by male-dominant atopic asthma; cluster 2 (n = 79, 17.7%) which was characterized by early-onset atopic asthma with atopic dermatitis; cluster 3 (n = 47, 10.5%) which was characterized by puberty-onset, female-dominant atopic asthma with the low lung function; and cluster 4 (n = 105, 23.5%) which was characterized by early-onset, non-atopic dominant asthma. CONCLUSIONS: The asthma phenotypes among Korean children can be classified into 4 distinct clusters. Long-term follow-up with these phenotypes will be needed to define their prognosis and response to treatment.
Authors: Jisun Yoon, Eun Jin Eom, Jin Tack Kim, Dae Hyun Lim, Woo Kyung Kim, Dae Jin Song, Young Yoo, Dong In Suh, Hey-Sung Baek, Meeyong Shin, Ji-Won Kwon, Gwang Cheon Jang, Hyeon-Jong Yang, Eun Lee, Hwan Soo Kim, Ju-Hee Seo, Sung-Il Woo, Hyung Young Kim, Youn Ho Shin, Ju Suk Lee, Sungsu Jung, Minkyu Han, Jinho Yu
Institutions: University of Ulsan, The Catholic University of Korea Uijeongbu St. Mary's Hospital, Inha University, Inha University Hospital, Inje University Seoul Paik Hospital, Korea University Guro Hospital, Korea University Anam Hospital, Seoul National University, Hallym University, Kangdong Sacred Heart Hospital, Soonchunhyang University, Soonchunhyang University Hospital Bucheon, Seoul National University Bundang Hospital, National Health Insurance Service Ilsan Hospital, Chonnam National University, Chonnam National University Hospital, The Catholic University of Korea Bucheon St. Mary's Hospital, Pusan National University Yangsan Hospital, Dankook University Hospital, Chungbuk National University, CHA University, CHA University Gangnam Medical Center, Samsung Changwon Hospital, Sungkyunkwan University, Asan Medical Center
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Awards: G2987293047, G816347289
OpenAlex ID: W3090777794