ArticleJournal of asthma and allergy2026
Early-Life Allergen Sensitization Phenotypes and Exploratory Machine-Learning Interpretation of School-Age Asthma Risk.
Article in Journal of asthma and allergy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Early-life allergen sensitization is associated with childhood asthma, but sensitization patterns are heterogeneous. This study aimed to characterize early-life sensitization phenotypes and evaluate their associations with school-age asthma, with exploratory machine-learning analyses examining model-derived allergen contributions. Methods: Electronic medical records from Renmin Hospital of Wuhan University (2014-2022) were used. Two samples were derived: a phenotype discovery sample (Sample A, n = 4989) and a nested case-control sample (Sample B, n = 435; 84 cases and 351 controls). In Sample A, latent class analysis (LCA) identified population-level sensitization phenotypes. In Sample B, pre-specified multivariable logistic regression models adjusted for age and sex evaluated associations of LCA-derived phenotypes and individual inhalant allergen sensitization with school-age asthma. Random Forest and XGBoost/SHAP were used as exploratory analyses to assess allergen feature importance and model-derived contributions to predicted asthma probability. Results: LCA identified four sensitization phenotypes: predominantly non-sensitized, food-dominant, inhalant-dominant, and pet dander-predominant. After adjustment for age and sex, The inhalant-dominant phenotype was associated with higher odds of school-age asthma (adjusted OR = 3.14, 95% CI: 1.43-6.91), whereas the pet dander-predominant phenotype showed a positive but non-significant association (adjusted OR = 1.75, 95% CI: 0.94-3.26). In the pre-specified multivariable allergen model, dust mite sensitization remained significantly associated with asthma (adjusted OR = 3.30, 95% CI: 1.94-5.62). Exploratory analyses identified consistent model-derived contribution patterns for dust mite, whereas dog dander sensitization showed more variable patterns. XGBoost AUC decreased from an apparent AUC of 0.859 to a mean internally validated AUC of 0.636. Conclusion: Early-life sensitization showed distinct population-level phenotypes, with the inhalant-dominant phenotype associated with school-age asthma. Dust mite showed the most consistent signal across association and exploratory prediction analyses. Dog dander findings were model-dependent and should be interpreted as exploratory prediction patterns. SHAP findings require external validation before clinical application.
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