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. 2024 Mar;35(3):e14112.
doi: 10.1111/pai.14112.

COBRAPed cohort: Do sensitization patterns differentiate children with severe asthma from those with a milder disease?

Stéphanie Lejeune  1   2 , Naïm Bouazza  3 , Pascale Roland Nicaise  4   5 , Valérie Jolaine  3 , Léa Roditis  6 , Christophe Marguet  7 , Flore Amat  8 , Patrick Berger  9 , Michael Fayon  10 , Jean-Christophe Dubus  11 , Sophie Valois  12 , Philippe Reix  13   14 , Mathieu Pellan  15 , Jacques Brouard  16   17 , Raphael Chiron  18 , Lisa Giovannini-Chami  19 , Jacques de Blic  20 , Antoine Deschildre  1   2 , Guillaume Lezmi  20 ; COBRAPed Study Group
Collaborators, Affiliations

COBRAPed cohort: Do sensitization patterns differentiate children with severe asthma from those with a milder disease?

Stéphanie Lejeune et al. Pediatr Allergy Immunol. 2024 Mar.

Abstract

Background: It is unclear whether sensitization patterns differentiate children with severe recurrent wheeze (SRW)/severe asthma (SA) from those with non-severe recurrent wheeze (NSRW)/non-severe asthma (NSA). Our objective was to determine whether sensitization patterns can discriminate between children from the French COBRAPed cohort with NSRW/NSA and those with SRW/SA.

Methods: IgE to 112 components (c-sIgE) (ImmunoCAP® ISAC) were analyzed in 125 preschools (3-6 years) and 170 school-age children (7-12 years). Supervised analyses and clustering methods were applied to identify patterns of sensitization among children with positive c-sIgE.

Results: We observed c-sIgE sensitization in 51% of preschool and 75% of school-age children. Sensitization to house dust mite (HDM) components was more frequent among NSRW than SRW (53% vs. 24%, p < .01). Sensitization to non-specific lipid transfer protein (nsLTP) components was more frequent among SA than NSA (16% vs. 4%, p < .01) and associated with an FEV1/FVC < -1.64 z-score. Among sensitized children, seven clusters with varying patterns were identified. The two broader clusters identified in each age group were characterized by "few sensitizations, mainly to HDM." One cluster (n = 4) with "multiple sensitizations, mainly to grass pollen, HDM, PR-10, and nsLTP" was associated with SA in school-age children.

Conclusions: Although children with wheeze/asthma display frequent occurrences and high levels of sensitization, sensitization patterns did not provide strong signals to discriminate children with severe disease from those with milder disease. These results suggest that the severity of wheeze/asthma may depend on both IgE- and non-IgE-mediated mechanisms.

Keywords: asthma; preschool; school‐age; sensitization; severe asthma.

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