Abstract:
RATIONALE:The Severe Asthma Research Program cohort includes subjects with persistent asthma who have undergone detailed phenotypic characterization. Previous univariate methods compared features of mild, moderate, and severe asthma. OBJECTIVES:To identify novel asthma phenotypes using an unsupervised hierarchical cluster analysis. METHODS:Reduction of the initial 628 variables to 34 core variables was achieved by elimination of redundant data and transformation of categorical variables into ranked ordinal composite variables. Cluster analysis was performed on 726 subjects. MEASUREMENTS AND MAIN RESULTS:Five groups were identified. Subjects in Cluster 1 (n = 110) have early onset atopic asthma with normal lung function treated with two or fewer controller medications (82%) and minimal health care utilization. Cluster 2 (n = 321) consists of subjects with early-onset atopic asthma and preserved lung function but increased medication requirements (29% on three or more medications) and health care utilization. Cluster 3 (n = 59) is a unique group of mostly older obese women with late-onset nonatopic asthma, moderate reductions in FEV(1), and frequent oral corticosteroid use to manage exacerbations. Subjects in Clusters 4 (n = 120) and 5 (n = 116) have severe airflow obstruction with bronchodilator responsiveness but differ in to their ability to attain normal lung function, age of asthma onset, atopic status, and use of oral corticosteroids. CONCLUSIONS:Five distinct clinical phenotypes of asthma have been identified using unsupervised hierarchical cluster analysis. All clusters contain subjects who meet the American Thoracic Society definition of severe asthma, which supports clinical heterogeneity in asthma and the need for new approaches for the classification of disease severity in asthma.
journal_name
Am J Respir Crit Care Medauthors
Moore WC,Meyers DA,Wenzel SE,Teague WG,Li H,Li X,D'Agostino R Jr,Castro M,Curran-Everett D,Fitzpatrick AM,Gaston B,Jarjour NN,Sorkness R,Calhoun WJ,Chung KF,Comhair SA,Dweik RA,Israel E,Peters SP,Busse WW,Erzurumdoi
10.1164/rccm.200906-0896OCsubject
Has Abstractpub_date
2010-02-15 00:00:00pages
315-23issue
4eissn
1073-449Xissn
1535-4970pii
200906-0896OCjournal_volume
181pub_type
杂志文章abstract::Nanoparticle-based drug delivery systems have considerable potential for treatment of tuberculosis (TB). The important technological advantages of nanoparticles used as drug carriers are high stability, high carrier capacity, feasibility of incorporation of both hydrophilic and hydrophobic substances, and feasibility ...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,评审
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abstract::There is a growing understanding of the effects and potential pathophysiological role of the ETs in asthma and several of the criteria required to strongly implicate ET-1 as a mediator in this disease have been fulfilled. However, some of the information is preliminary, equivocal and requires confirmation. Furthermore...
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pub_type: 杂志文章,评审
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abstract:RATIONALE:Inhaled corticosteroids are commonly prescribed to patients with chronic obstructive pulmonary disease (COPD). OBJECTIVES:To examine whether these medications might be associated with an excess risk of pneumonia. METHODS:We conducted a nested case-control study within a cohort of patients with COPD from Que...
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abstract::Patients with impaired pulmonary function are at increased risk for the development of postoperative complications. Recently exercise testing and predicted postoperative (ppo) function have gained increasing importance in the evaluation of lung resection candidates. We prospectively evaluated an algorithm for the preo...
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doi:10.1164/ajrccm.159.5.9809107
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abstract::We produced ovalbumin (OVA)-sensitized rats as an animal model of nasal allergy. Intranasal instillation of OVA induced hypertrophic and metaplastic changes of goblet cells in nasal epithelium of OVA- sensitized rats. Intraepithelial mucosubstance in nasal mucosa increased significantly at 24 h after 3 or 7 d of OVA i...
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doi:10.1164/ajrccm.161.5.9908101
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journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章
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更新日期:2000-12-01 00:00:00
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更新日期:2004-03-01 00:00:00
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更新日期:1995-01-01 00:00:00
abstract::The gender-and race-specific effects of asthma/wheeze on pulmonary function level and annual growth velocity were studied in a cohort of 10,792 white and 944 black children 6 to 18 yr of age, examined annually between 1974 and 1989 in six U.S. cities. In comparison with white boys who never reported asthma or wheeze, ...
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更新日期:1994-05-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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doi:10.1164/rccm.201711-2300OC
更新日期:2018-06-04 00:00:00
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更新日期:2014-06-01 00:00:00
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更新日期:2009-10-15 00:00:00
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abstract::Based on serial lung function measurements performed in 142 children (68 males; 74 females) with cystic fibrosis (CF), prospectively evaluated over an age range of 6 to 20 years, we attempted to determine whether the lung clearance index (LCI) as a measure of ventilation inhomogeneities could be a discriminating facto...
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2014-12-15 00:00:00
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doi:10.1164/ajrccm.154.1.8680670
更新日期:1996-07-01 00:00:00
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更新日期:2004-01-15 00:00:00
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更新日期:1996-11-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:1995-07-01 00:00:00
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更新日期:2003-05-15 00:00:00
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更新日期:2001-08-15 00:00:00