Abstract
Background: It is unclear whether sensitization patterns
differentiate children with severe recurrent wheeze (SRW) / severe
asthma (SA) from those with non-severe recurrent wheeze (NSRW) /
non-severe asthma (NSA). Our objective was to compare the sensitization
patterns between children with SRW/SA and NSRW/NSA from the French
COBRAPed cohort.
Methods: IgE to 112 components (c-sIgE) (ImmunoCAP® ISAC) were
analyzed in 125 preschool (3-6 years) and 170 school-age children (7-12
years). Supervised analyses and clustering methods were applied to
identify patterns of sensitization among children with positive c-sIgE.
Results: We observed c-sIgE sensitization in 51% of preschool
and 75% of school-age children. Sensitization to house dust mite (HDM)
components was more frequent among NSRW than SRW (53% vs 24%,
p<0.01). Sensitization
to non-specific lipid transfer protein (nsLTP) components was more
frequent among SA than NSA (16% vs 4%, p<0.01) and
associated with a FEV1/FVC <-1.64 z-score. Among sensitized
children, seven clusters with varying patterns were identified. The two
broader clusters identified in each age group were characterized by
“few sensitizations, mainly to HDM”. One cluster (n=4) with “multiple
sensitizations, mainly to grass pollen, HDM, PR-10, and nsLTP” was
associated with SA in school-age children.
Conclusions: Although children with wheeze/asthma display
frequent occurrences and high levels of
sensitization, the sensitization
patterns did not clearly discriminate children with severe disease from
those with milder disease. These results suggest that the severity of
wheeze/asthma may depend on both IgE- and non-IgE-mediated mechanisms.