Neutrophilic Steroid-Refractory Recurrent Wheeze and Eosinophilic Steroid-Refractory Asthma in Children.

Background: Little is known about inflammatory pathways of severe recurrent wheeze in preschool children and severe asthma in children.

Objectives: The aim of the Severe Asthma Molecular Phenotype cohort was to characterize phenotypes of severe recurrent wheeze and severe asthma during childhood in terms of triggers (allergic or not), involved cells (eosinophil or neutrophil), and corticoid responsiveness.

Methods: Children with moderate-to-severe asthma and preschool children with moderate-to-severe recurrent wheeze were enrolled prospectively.

Childhood allergic asthma is not a single phenotype.

Objective: IgE-mediated allergic asthma phenotype appears to be heterogeneous. We set out to define distinct allergic phenotypes by unsupervised cluster analysis.

Study Design: A total of 18 variables were analyzed: sex and age, eczema and food allergy, asthma duration, asthma severity and control, severe exacerbations, total IgE level, allergic sensitization, fractional exhaled nitric oxide, and functional parameters.

Wheeze phenotypes in young children have different courses during the preschool period.

Background: Rules for predicting the course of asthma in wheezy infants have low specificity.

Objective: To determine if the novel phenotypes-mild early viral wheeze (EVW), atopic multiple-trigger wheeze (MTW), and nonatopic uncontrolled wheeze (NAUW)-have different courses during the preschool period.

Methods: Part of the prospectively followed Trousseau Asthma Program cohort was phenotyped using cluster analysis with 12 parameters (sex, asthma severity and control with inhaled corticosteroid [ICS], parental asthma, allergic rhinitis, eczema, food allergy, EVW or MTW, and allergen exposure trigger).

Novel severe wheezy young children phenotypes: boys atopic multiple-trigger and girls nonatopic uncontrolled wheeze.

Background: Recurrent wheezing during infancy is a heterogeneous disorder that has been associated with early-onset asthma.

Objective: To identify phenotypes of severe recurrent wheezing and therapeutic approaches.

Methods: We performed cluster analysis with 20 variables of 551 children with active asthma, younger than 36 months old, and enrolled in the Trousseau Asthma Program.

Two novel, severe asthma phenotypes identified during childhood using a clustering approach.

Unsupervised cluster analysis has already been used to identify severe phenotypes of childhood asthma, but without taking into account inflammatory markers. The aim of this study was to define independent homogeneous phenotypic clusters of severe asthma in a cohort of asthmatic children. Cluster analysis was applied to 19 variables from 315 children enrolled in the Trousseau Asthma Program in Paris, France.