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Frequency of exacerbation and degree of required asthma medication can characterize childhood longitudinal asthma trajectories

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Authors

Lee, Eun; Rhee, Eun Hee; Kim, Kyunghoon; Kim, Hwan Soo; Kim, Woo Kyung; Song, Dae Jin; Park, Ji Soo; Yoo, Young; Suh, Dong In; Jung, Sungsu; Yoon, Ji-Sun; Lee, Seung Won; Kim, Jin Tack; Lim, Dae Hyun; Baek, Hey Sung; Shin, Meeyong; Kwon, Ji Won; Jang, Gwang Cheon; Seo, Ju Hee; Woo, Sung Il; Kim, Hyung Young; Shin, Youn Ho; Lee, Ju Suk; Yang, Hyeon-Jong; Yu, Jinho

Issue Date
2023-10
Publisher
American College of Allergy, Asthma, & Immunology
Citation
Annals of Allergy, Asthma and Immunology, Vol.131 No.4, pp.444-450
Abstract
Background: To the best of our knowledge, there have been no investigations of longitudinal asthma trajectories based on asthma exacerbation frequency and medications required for asthma control in children. Objective: To investigate longitudinal asthma trajectories based on the exacerbation frequency throughout childhood and asthma medication ranks. Methods: A total of 531 children aged 7 to 10 years were enrolled from the Korean childhood Asthma Study. Required asthma medications for control of asthma from 6 to 12 years of age and asthma exacerbation frequency from birth to 12 years of age were obtained from the Korean National Health Insurance System database. Longitudinal asthma trajectories were identified on the basis of asthma exacerbation frequency and asthma medication ranks. Results: Four asthma clusters were identified: lesser exacerbation with low-step treatment (8.1%), lesser exacerbations with middle-step treatment (30.7%), highly frequent exacerbations in early childhood with small-airway dysfunction (5.7%), and frequent exacerbations with high-step treatment (55.6%). The frequent exacerbations with high-step treatment cluster were characterized by a high prevalence of male sex, increased blood eosinophil (counts) with fractional exhaled nitric oxide, and high prevalence of comorbidities. The highly frequent exacerbation in early childhood with small-airway dysfunction cluster was characterized by recurrent wheeze in preschool age, with high prevalence of acute bronchiolitis in infancy and a greater number of family members with small-airway dysfunction at school age. Conclusion: The present study identified 4 longitudinal asthma trajectories on the basis of the frequency of asthma exacerbation and asthma medication ranks. These results would help clarify the heterogeneities and pathophysiologies of childhood asthma.
ISSN
1081-1206
URI
https://hdl.handle.net/10371/201592
DOI
https://doi.org/10.1016/j.anai.2023.05.035
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  • College of Medicine
  • Department of Medicine
Research Area 식품알레르기, 아토피피부염, 천식

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