PMID- 30306745 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20201001 IS - 2092-7355 (Print) IS - 2092-7363 (Electronic) IS - 2092-7355 (Linking) VI - 10 IP - 6 DP - 2018 Nov TI - Lung Function Trajectory Types in Never-Smoking Adults With Asthma: Clinical Features and Inflammatory Patterns. PG - 614-627 LID - 10.4168/aair.2018.10.6.614 [doi] AB - PURPOSE: Asthma is a heterogeneous disease that responds to medications to varying degrees. Cluster analyses have identified several phenotypes and variables related to fixed airway obstruction; however, few longitudinal studies of lung function have been performed on adult asthmatics. We investigated clinical, demographic, and inflammatory factors related to persistent airflow limitation based on lung function trajectories over 1 year. METHODS: Serial post-bronchodilator forced expiratory volume (FEV) 1% values were obtained from 1,679 asthmatics who were followed up every 3 months for 1 year. First, a hierarchical cluster analysis was performed using Ward's method to generate a dendrogram for the optimum number of clusters using the complete post-FEV1 sets from 448 subjects. Then, a trajectory cluster analysis of serial post-FEV1 sets was performed using the k-means clustering for the longitudinal data trajectory method. Next, trajectory clustering for the serial post-FEV1 sets of a total of 1,679 asthmatics was performed after imputation of missing post-FEV1 values using regression methods. RESULTS: Trajectories 1 and 2 were associated with normal lung function during the study period, and trajectory 3 was associated with a reversal to normal of the moderately decreased baseline FEV1 within 3 months. Trajectories 4 and 5 were associated with severe asthma with a marked reduction in baseline FEV1. However, the FEV1 associated with trajectory 4 was increased at 3 months, whereas the FEV1 associated with trajectory 5 was persistently disturbed over 1 year. Compared with trajectory 4, trajectory 5 was associated with older asthmatics with less atopy, a lower immunoglobulin E (IgE) level, sputum neutrophilia and higher dosages of oral steroids. In contrast, trajectory 4 was associated with higher sputum and blood eosinophil counts and more frequent exacerbations. CONCLUSIONS: Trajectory clustering analysis of FEV1 identified 5 distinct types, representing well-preserved to severely decreased FEV1. Persistent airflow obstruction may be related to non-atopy, a low IgE level, and older age accompanied by neutrophilic inflammation and low baseline FEV1 levels. CI - Copyright (c) 2018 The Korean Academy of Asthma, Allergy and Clinical Immunology . The Korean Academy of Pediatric Allergy and Respiratory Disease. FAU - Kim, Joo Hee AU - Kim JH AUID- ORCID: 0000-0002-1572-5149 AD - Division of Pulmonology, Allergy and Critical Care, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. FAU - Chang, Hun Soo AU - Chang HS AUID- ORCID: 0000-0002-4025-4182 AD - Genome Research Center for Allergy and Respiratory Diseases, Bucheon, Korea. FAU - Shin, Seung Woo AU - Shin SW AD - Genome Research Center for Allergy and Respiratory Diseases, Bucheon, Korea. FAU - Baek, Dong Gyu AU - Baek DG AD - Department of Interdisciplinary Program in Biomedical Science Major, Soonchunhyang Graduate School, Asan, Korea. FAU - Son, Ji Hye AU - Son JH AD - Department of Interdisciplinary Program in Biomedical Science Major, Soonchunhyang Graduate School, Asan, Korea. FAU - Park, Choon Sik AU - Park CS AUID- ORCID: 0000-0003-2977-0255 AD - Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea. FAU - Park, Jong Sook AU - Park JS AUID- ORCID: 0000-0003-4128-9085 AD - Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea. js1221@schmc.ac.kr. LA - eng GR - Soonchunhyang University/ GR - 2016-ER7402-00/Ministry of Health and Welfare/ PT - Journal Article PL - Korea (South) TA - Allergy Asthma Immunol Res JT - Allergy, asthma & immunology research JID - 101518382 PMC - PMC6182203 OTO - NOTNLM OT - Adult OT - asthma OT - disease progression OT - forced expiratory volume OT - inflammation OT - phenotype EDAT- 2018/10/12 06:00 MHDA- 2018/10/12 06:01 PMCR- 2018/07/12 CRDT- 2018/10/12 06:00 PHST- 2018/03/06 00:00 [received] PHST- 2018/05/09 00:00 [revised] PHST- 2018/05/25 00:00 [accepted] PHST- 2018/10/12 06:00 [entrez] PHST- 2018/10/12 06:00 [pubmed] PHST- 2018/10/12 06:01 [medline] PHST- 2018/07/12 00:00 [pmc-release] AID - 10.614 [pii] AID - 10.4168/aair.2018.10.6.614 [doi] PST - ppublish SO - Allergy Asthma Immunol Res. 2018 Nov;10(6):614-627. doi: 10.4168/aair.2018.10.6.614.