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Clinical and molecular analysis of longitudinal rhinitis phenotypes in an urban birth cohort

Sima K Ramratnam1, Molly Johnson2, Cynthia M Visness2

  • 1Department of Pediatrics, University of Wisconsin-Madison, Madison, Wis.

The Journal of Allergy and Clinical Immunology
|September 22, 2024
PubMed

Insights

Childhood chronic rhinitis has distinct symptom patterns linked to specific risk factors and immune responses. Identifying these phenotypes early may help prevent rhinitis and related allergic conditions.

Area of Science:

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

Background:

  • Chronic rhinitis in children presents heterogeneously, posing a significant health burden.
  • Understanding distinct phenotypes and their underlying biology is crucial for targeted interventions.

Purpose of the Study:

  • Identify longitudinal rhinitis symptom patterns in childhood.
  • Examine associations with early life factors, allergic conditions, and gene expression.

Main Methods:

  • Evaluated rhinitis symptoms in 485 urban children (ages 1-11) from the URECA birth cohort.
  • Identified longitudinal rhinitis phenotypes.
  • Assessed relationships with early exposures, atopic comorbidities, and nasal gene expression at age 11.

Main Results:

  • Four rhinitis phenotypes were identified: low/minimal, persistent, persistent decreasing, and late increasing.
  • Persistent rhinitis correlated with allergic sensitization and asthma.
  • Risk factors for persistent rhinitis included frequent colds, antibiotic use, and reduced indoor allergen exposure.
  • Rhinitis phenotypes showed distinct patterns in type 2 and immune response gene expression.

Conclusions:

  • Rhinitis symptoms in urban children often precede aeroallergen sensitization.
  • Symptom-based rhinitis phenotypes exhibit unique risk factors and nasal transcriptomes.
  • Targeting early life factors and immune mechanisms could prevent childhood chronic rhinitis.
Abstract

Keywords:
Chronic rhinitisallergic sensitizationendotypesenvironmental exposureshay feverphenotypesseasonal rhinitistranscriptomics

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