Distinct Endotypes of Pediatric Rhinitis Based on Cluster Analysis

Area of Science:

• Pediatric Allergy and Immunology
• Respiratory Medicine
• Clinical Data Science

Background:

• Pediatric rhinitis exhibits a wide clinical spectrum, yet lacks detailed endotyping based on type 2 inflammation and bronchial hyper-responsiveness (BHR).
• Understanding distinct rhinitis phenotypes is crucial for targeted management and predicting comorbidities like asthma.

Purpose of the Study:

• To investigate and define endotypes of pediatric rhinitis.
• To utilize cluster analysis for classifying rhinitis based on key inflammatory and pulmonary markers.

Main Methods:

• Hierarchical cluster analysis was applied to data from 241 children with rhinitis.
• Twelve variables including skin prick tests, laboratory markers, and pulmonary function tests were analyzed.
• Clinical features, symptom scores, and asthma comorbidity were assessed across identified clusters.

Main Results:

• Four distinct pediatric rhinitis clusters emerged.
• Cluster 1: Non-allergic, low type 2 inflammation, low BHR, mild symptoms, no asthma.
• Cluster 4: High type 2 inflammation, high BHR, severe symptoms, frequent asthma comorbidity.

Conclusions:

• Four endotypes of pediatric rhinitis were identified, correlating with allergen sensitization, type 2 inflammation, and BHR.
• These endotypes are associated with specific symptom severity and asthma comorbidity patterns.
• The findings provide a framework for better understanding and potentially managing diverse pediatric rhinitis cases.