Distinct Clinical and Cytokine Features of Moderate-Severe Persistent AR Phenotype by ARIA Classification: COCOA.

IF 4.3 2区医学 Q2 ALLERGY

Allergy, Asthma & Immunology Research Pub Date : 2025-09-01 DOI:10.4168/aair.2025.17.5.563

Da Kyeong Lee, Jisun Yoon, Hyo-Won Lee, Seung-Hwa Lee, Eun Young Baek, Eom Ji Choi, Kun Baek Song, Min Jee Park, Kangmo Ahn, Jihyun Kim, Kyung Won Kim, Youn Ho Shin, Dong In Suh, Ji Soo Park, So-Yeon Lee, Soo-Jong Hong

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Abstract

Purpose: The prevalence of allergic rhinitis (AR) has increased rapidly. However, the AR phenotype in the general population remains poorly explored. In this study, we aimed to determine the distinct features of AR phenotypes according to Allergic Rhinitis and its Impact on Asthma (ARIA) classification in Korean children.

Methods: We enrolled 1,113 children aged 7 years from the COhort for Childhood Origin of Asthma and allergic diseases (COCOA) study. AR was diagnosed by a physician at each scheduled visit, and the AR phenotype was defined according to the ARIA classification. We analyzed the results of skin prick tests and performed cytokine assays using blood samples collected at ages 3 and 7.

Results: The prevalence of AR at age 7 was 48.9%, while that of moderate-to-severe persistent AR phenotype was 4.4%. Cesarean delivery was associated with the mild-intermittent AR phenotype, while prenatal antibiotic use was linked to the moderate-to-severe persistent phenotype. Sensitization to Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), birch, and Japanese hop at age 3 and sensitization to Der p, Der f, birch, oak, and cat at age 7 increased the risk of moderate-to-severe persistent AR phenotype. Upon cytokine analysis, interleukin (IL)-4 tended to be elevated at age 3 in children with moderate-to-severe persistent AR. By age 7, concentrations of IL-5 and IL-17A were significantly higher in children with moderate-to-severe persistent AR phenotype.

Conclusions: These findings suggest that 4.4% of Korean children had a moderate-to-severe persistent AR phenotype, as defined by ARIA. Early sensitization to Der p, Der f, birch, and Japanese hop at age 3 and prenatal antibiotic use are risk factors. Furthermore, this phenotype may involve both T helper 2 and T helper 17-related immune responses, reflecting a potential shift toward more complex or mixed patterns of inflammation.

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中重度持续性AR表型的独特临床和细胞因子特征：ARIA分类：COCOA

目的：变应性鼻炎（AR）的患病率迅速上升。然而，在一般人群中，AR表型的研究仍然很少。在这项研究中，我们旨在根据韩国儿童变应性鼻炎及其对哮喘（ARIA）分类的影响来确定AR表型的独特特征。方法：我们从儿童哮喘和过敏性疾病起源队列（COCOA）研究中招募了1113名7岁儿童。AR由医生在每次预约就诊时诊断，并根据ARIA分类定义AR表型。我们分析了皮肤点刺试验的结果，并使用3岁和7岁时收集的血液样本进行了细胞因子分析。结果：7岁AR患病率为48.9%，中重度持续性AR患病率为4.4%。剖宫产与轻度间歇性AR表型相关，而产前抗生素使用与中度至重度持续性表型相关。3岁时对翼状棘球绦虫（Der p）、粉状棘球绦虫（Der f）、桦树和日本酒花致敏，7岁时对Der p、Der f、桦树、橡树和猫致敏，增加了中度至重度持续性AR表型的风险。细胞因子分析显示，在中度至重度持续性AR患儿中，白细胞介素(IL)-4倾向于在3岁时升高。到7岁时，IL-5和IL- 17a浓度在中度至重度持续性AR患儿中显著升高。结论：这些研究结果表明，4.4%的韩国儿童具有ARIA定义的中度至重度持续性AR表型。3岁时早期对Der p、Der f、桦树和日本啤酒花过敏以及产前使用抗生素是危险因素。此外，这种表型可能涉及辅助性T 2和辅助性T 17相关的免疫反应，反映了向更复杂或混合的炎症模式的潜在转变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Allergy, Asthma & Immunology Research ALLERGY-IMMUNOLOGY

CiteScore

6.10

自引率

6.80%

发文量

审稿时长

>12 weeks

期刊介绍： The journal features cutting-edge original research, brief communications, and state-of-the-art reviews in the specialties of allergy, asthma, and immunology, including clinical and experimental studies and instructive case reports. Contemporary reviews summarize information on topics for researchers and physicians in the fields of allergy and immunology. As of January 2017, AAIR do not accept case reports. However, if it is a clinically important case, authors can submit it in the form of letter to the Editor. Editorials and letters to the Editor explore controversial issues and encourage further discussion among physicians dealing with allergy, immunology, pediatric respirology, and related medical fields. AAIR also features topics in practice and management and recent advances in equipment and techniques for clinicians concerned with clinical manifestations of allergies and pediatric respiratory diseases.