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COBRAPed cohort: Sensitization patterns do not differentiate children with severe asthma from those with a milder disease
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  • Stephanie Lejeune,
  • Naïm Bouazza,
  • Pascale Nicaise,
  • Valérie Jolaine,
  • Lea Roditis,
  • Christophe Marguet,
  • Flore Amat,
  • Patrick Berger,
  • Michael Fayon,
  • Jean-Christophe Dubus,
  • Sophie Valois,
  • Philippe Reix,
  • Mathieu Pellan,
  • Brouard Jacques,
  • Raphaël Chiron,
  • Lisa Giovannini-Chami,
  • Jacques de Blic,
  • A. Deschildre,
  • Guillaume LEZMI
Stephanie Lejeune
Centre d'Infection et d'Immunite de Lille

Corresponding Author:stephanie.lejeune@chru-lille.fr

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Naïm Bouazza
Hopital universitaire Necker-Enfants malades
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Pascale Nicaise
Hopital Bichat - Claude-Bernard
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Valérie Jolaine
Hopital universitaire Necker-Enfants malades
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Lea Roditis
Centre Hospitalier Universitaire de Toulouse
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Christophe Marguet
Centre Hospitalier Universitaire de Rouen
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Flore Amat
Hopital Universitaire Mere-enfant Robert-Debre
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Patrick Berger
INSERM U1045
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Michael Fayon
Centre Hospitalier Universitaire de Bordeaux
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Jean-Christophe Dubus
Assistance Publique Hopitaux de Marseille
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Sophie Valois
Centre Hospitalier Universitaire Grenoble Alpes Hopital Couple Enfant
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Philippe Reix
Hospices Civils de Lyon
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Mathieu Pellan
Hopital Jean Verdier
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Brouard Jacques
Centre Hospitalier Universitaire de Caen
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Raphaël Chiron
Centre Hospitalier Regional Universitaire de Montpellier
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Lisa Giovannini-Chami
Hopitaux Pediatriques de Nice CHU-LENVAL
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Jacques de Blic
Hopital universitaire Necker-Enfants malades
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A. Deschildre
Centre d'Infection et d'Immunite de Lille
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Guillaume LEZMI
Hopital universitaire Necker-Enfants malades
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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 compare the sensitization patterns between children with SRW/SA and NSRW/NSA from the French COBRAPed cohort. Methods: IgE to 112 components (c-sIgE) (ImmunoCAP® ISAC) were analyzed in 125 preschool (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<0.01). Sensitization to non-specific lipid transfer protein (nsLTP) components was more frequent among SA than NSA (16% vs 4%, p<0.01) and associated with a 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, the sensitization patterns did not clearly 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.
04 Sep 2023Submitted to Pediatric Allergy and Immunology
05 Sep 2023Submission Checks Completed
05 Sep 2023Assigned to Editor
05 Sep 2023Review(s) Completed, Editorial Evaluation Pending
07 Sep 2023Reviewer(s) Assigned
26 Sep 2023Editorial Decision: Revise Major
05 Mar 20242nd Revision Received
06 Mar 2024Review(s) Completed, Editorial Evaluation Pending
06 Mar 2024Submission Checks Completed
06 Mar 2024Assigned to Editor
07 Mar 2024Editorial Decision: Accept