Allergic rhinitis phenotypes with distinct transcriptome profiles in children: A birth cohort

Area of Science:

• Pediatric Allergy and Immunology
• Genetics and Genomics
• Respiratory Medicine

Background:

• Childhood allergic rhinitis (AR) phenotypes lack clear definition.
• Understanding these phenotypes is crucial for targeted interventions.

Purpose of the Study:

• To identify distinct allergic rhinitis (AR) phenotypes in children.
• To investigate the natural course, clinical features, and transcriptomic characteristics of each AR phenotype.

Main Methods:

• Utilized latent class trajectory analysis on a birth cohort of 1050 children from birth to 12 years.
• Conducted blood transcriptome analyses to elucidate the molecular mechanisms of identified AR phenotypes.

Main Results:

• Identified five AR phenotypes: early onset (8.4%), intermediate transient (10.5%), late onset (19.9%), very late onset (17.8%), and never/infrequent (43.4%).
• Early-onset AR associated with higher severity, early food/inhalant sensitization, and asthma symptoms (without BHR).
• Late- and very late-onset AR phenotypes linked to inhalant sensitization, asthma, and bronchial hyperresponsiveness (BHR), with distinct temporal sensitization patterns.

Conclusions:

• Early-onset AR is characterized by early sensitization and asthma symptoms, distinct from later-onset phenotypes associated with BHR.
• Transcriptomic data revealed unique immune response pathways for early- and late-onset AR, highlighting distinct underlying mechanisms.