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Cough and dyspnoea may discriminate allergic and infectious respiratory phenotypes in infancy

Fanny Rancière1, Bénédicte Clarisse, Lydia Nikasinovic

  • 1Univ Paris Descartes, Sorbonne Paris Cité, Laboratoire Santé Publique et Environnement, EA 4064, F-75006 Paris, France.

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|February 4, 2012
PubMed

Insights

Two distinct childhood respiratory phenotypes, cough (CP) and dyspnea (DP), were identified in infants. CP is linked to allergies, while DP is associated with infections and environmental factors.

Area of Science:

  • Pediatric Pulmonology
  • Environmental Health
  • Allergy and Immunology

Background:

  • Identifying distinct respiratory symptom subgroups in infants is crucial due to non-specific asthma symptoms.
  • Previous research utilized clustering to identify bronchial obstructive phenotypes in 1-year-old infants.
  • The stability and characteristics of these early phenotypes require further investigation up to preschool age.

Purpose of the Study:

  • To assess the stability of previously identified infant respiratory phenotypes at 3 years of age.
  • To investigate the comorbidities and risk factors associated with these distinct phenotypes.
  • To differentiate between potentially allergic and infectious respiratory profiles in early childhood.

Main Methods:

  • A cohort of 2084 infants from the Pollution and Asthma Risk: an Infant Study (PARIS) was analyzed.
  • Partitioning Around Medoids (PAM) clustering was applied at 1 and 3 years of age.
  • Multinomial logistic regression was used to analyze comorbidity and risk factors.

Main Results:

  • Two stable respiratory phenotypes were identified: cough phenotype (CP, 14.1%) and dyspnea phenotype (DP, 30.7%).
  • CP was associated with allergic features, parental allergy history, allergen exposure, and psychosocial factors.
  • DP was linked to respiratory infections, daycare attendance, and domestic chemical pollution exposure.

Conclusions:

  • Dry night cough and sleep-disturbing dyspnea are markers for distinct respiratory profiles in children under 3 years.
  • These phenotypes suggest a potential allergic profile (CP) and an infectious/environmental vulnerability profile (DP).
  • Understanding these early phenotypes can inform targeted interventions for childhood respiratory conditions.

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