Clustering lung function and symptom profiles for asthma risk stratification
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Asthma is a heterogeneous condition often studied through wheeze alone, yet the interplay between lung function and reported symptoms remains underexplored. To capture this heterogeneity, we applied Bayesian Profile Regression to data from school-age children in two prospective birth cohorts, integrating airway hyperresponsiveness, lung function, bronchodilator reversibility, allergic sensitisation, reported symptoms, and physician diagnosis.
In the Manchester Allergy and Asthma Study (discovery cohort), five reproducible clusters were identified: HA-LLF (high asthma-low lung function), HA-NLF (high asthma-near-normal lung function), LA-LLF (low asthma-low lung function), LA-NLF (low asthma-normal lung function), and INT-SYM (intermediate asthma with prominent symptoms). The HA-LLF and HA-NLF clusters had very high asthma prevalence (80–100%), but differed markedly in lung function, airway responsiveness, bronchodilator reversibility, sensitisation, and symptom burden. The LA-HLF and LA-NLF clusters with low asthma prevalence (<5%) displayed contrasting lung function profiles, while INT-SYM (~50% asthma prevalence) was largely defined by prominent symptoms such as chest tightness and shortness of breath. These subtypes were replicated in an independent cohort, Isle of Wight. Our findings demonstrate that integrating physiological, immunological, and symptom-based measures yields clinically meaningful asthma subtypes beyond wheeze-based definitions and may support more precise disease classification.
In the Manchester Allergy and Asthma Study (discovery cohort), five reproducible clusters were identified: HA-LLF (high asthma-low lung function), HA-NLF (high asthma-near-normal lung function), LA-LLF (low asthma-low lung function), LA-NLF (low asthma-normal lung function), and INT-SYM (intermediate asthma with prominent symptoms). The HA-LLF and HA-NLF clusters had very high asthma prevalence (80–100%), but differed markedly in lung function, airway responsiveness, bronchodilator reversibility, sensitisation, and symptom burden. The LA-HLF and LA-NLF clusters with low asthma prevalence (<5%) displayed contrasting lung function profiles, while INT-SYM (~50% asthma prevalence) was largely defined by prominent symptoms such as chest tightness and shortness of breath. These subtypes were replicated in an independent cohort, Isle of Wight. Our findings demonstrate that integrating physiological, immunological, and symptom-based measures yields clinically meaningful asthma subtypes beyond wheeze-based definitions and may support more precise disease classification.
Date Issued
2026-01-23
Date Acceptance
2025-12-15
Citation
Scientific Reports, 2026, 16
ISSN
2045-2322
Publisher
Nature Portfolio
Journal / Book Title
Scientific Reports
Volume
16
Copyright Statement
© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
10.1038/s41598-025-32977-w
Subjects
Asthma
Childhood
Bayesian profile regression
Birth cohorts
Disease subtyping
Publication Status
Published
Article Number
3110
Date Publish Online
2025-12-24