Abstract
(1) Background: Asthma is a complex heterogeneous disease that likely comprises several distinct disease phenotypes, where the clustering approach has been used to classify the heterogeneous asthma population into distinct phenotypes; (2) Methods: For a period of 1 year, we evaluated medical history data of 71 children with asthma aged 3 to 17 years, performing pulmonary function tests, drew blood for IgE antibodies against inhalation and food allergies detection, and Asthma Control Questionnaire (ACQ); (3) Results: Five distinct phenotypes were determined. Cluster 1 (n = 10): (non-atopic) the lowest IgE level, very low ACQ, and median age of diagnosis. Cluster 2 (n = 28): (mixed) the highest Body mass index (BMI) with the latest age of diagnosis and high ACQ and bronchodilator response (BDR) levels and median and IgE levels. Cluster 3 (n = 19) (atopic) early diagnosis, highest BDR, highest ACQ score, highest total, and high specific IgE levels among the clusters. Cluster 4 (n = 9): (atopic) the highest specific IgE result, relatively high BMI, and IgE with median ACQ score among clusters. Cluster 5 (n = 5): (non-atopic) the earliest age for diagnosis, with the lowest BMI, the lowest ACQ score, and specific IgE levels, with high BDR and the median level of IgE among clusters; (4) Conclusions: We identified asthma phenotypes in Bulgarian children according to IgE levels, ACQ score, BDR, and age of diagnosis.
Highlights
Asthma is a heterogeneous disease that can be classified into several different phenotypes according to the disease’s clinical spectrum, inflammatory class, demographic characteristics, and comorbidity presence [1]
Asthma phenotypes can be the result of many factors such as age at onset of asthma symptoms, atopy, type of inflammation found in the airways, disease severity, standard therapy response, etc
Using this cluster analysis with Ward’s method, the tested population of children was divided into five clusters that differed sufficiently in their cluster center and squared width (Figures 3 and 4)
Summary
Asthma is a heterogeneous disease that can be classified into several different phenotypes according to the disease’s clinical spectrum, inflammatory class, demographic characteristics, and comorbidity presence [1]. A phenotype is a complex of observable characteristics in an organism that results from the interaction of genotype and environmental factors [2]. Asthma phenotypes can be the result of many factors such as age at onset of asthma symptoms, atopy, type of inflammation found in the airways, disease severity, standard therapy response, etc. Due to the variable clinical presentation of childhood asthma, there is a growing scientific and clinical interest in trying to uncover new asthma phenotypes and endotypes to target therapy individually [2,3]. Most of the asthma phenotypes descriptions so far are based on the time when
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