Abstract
BACKGROUND: The endophenotypes of allergic disorders are known to vary across racial groups, underscoring the importance of studying allergic disease phenotypes in the population of Tokyo. OBJECTIVE: We sought to elucidate the developmental trajectories of wheezing among adolescents and their associations with pulmonary function and IgE sensitization in the Japanese pediatric population. METHODS: The research used data from the Tokyo Children's Health, Illness, and Development study, a comprehensive Tokyo birth cohort study, which recruited 1701 mother-infant dyads prenatally and followed the children up from birth till age 13 years. The analytical approach was conducted in 4 distinct phases: (1) delineation of trajectory groups using latent class growth analysis; (2) detailed characterization of each identified trajectory; (3) assessment of the relationships between predictors and wheezing groups through multinomial logistic regression; and (4) examination of the interrelations among trajectory groups, lung function, and IgE sensitization at age 13 years. RESULTS: A total of 5 unique wheezing phenotypes were discerned: early-onset transient wheezing (10.2%), late-onset transient wheezing (7.3%), low frequent wheezing (15.0%), persistent wheezing (11.9%), and never/infrequent wheezing (55.5%). No statistically significant deterioration in impulse oscillometry parameters and spirometry parameters except %V25 was detected across any of the phenotypes. Nonetheless, the persistent wheezing phenotype demonstrated an association with lowered %V25, elevated fractional exhaled nitric oxide levels, and an increased prevalence of sensitization to multiple allergens at age 13 years. CONCLUSIONS: The wheezing phenotypes identified in this study displayed distinct characteristics. Importantly, despite the diverse wheezing trajectories observed from birth, adolescents in Tokyo did not exhibit any discernible decline in lung function.