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Our objective was to examine changes in the manifestation of asthma and asthma-related traits in childhood by defining empirically derived childhood asthma phenotypes and examining their transitions over time.<\/jats:p><jats:p>To define the phenotypes we used data on respiratory symptoms, healthcare utilisation, medications, spirometry, airway hyperresponsiveness (AHR), exhaled nitric oxide concentration and atopy from a birth cohort recruited on the basis of having a first-degree relative with asthma. Data were acquired at ages 1.5\u201311.5\u2005years and analysed using latent transition analysis.<\/jats:p><jats:p>In a study population of 370 participants, we classified subjects into four phenotypes: 1) nonatopic, few symptoms (prevalence range from 1.5 to 5\u2005years: 52\u201360%), 2) atopic, few symptoms (3\u201321%), 3) nonatopic, asthma and rhinitis symptoms (13\u201335%), and 4) atopic, asthma and rhinitis symptoms (2\u201314%) in early childhood; and 1) nonatopic, no respiratory disease (prevalence range from 8 to 11.5\u2005years: 41\u201346%), 2) atopic, no respiratory disease (23\u201333%), 3) nonatopic, asthma symptoms, no AHR or airway inflammation (8\u201312%) and 4) atopic asthma (19%) in mid-childhood. Transitioning between phenotypes was common in early childhood, but less common in later childhood.<\/jats:p><jats:p>This analysis represents the first attempt to incorporate longitudinal patterns of several manifestations of asthma into a single model to simultaneously define phenotypes and examine their transitions over time. It provides quantitative support for the view that asthma is a heterogeneous entity, and that some children with wheeze and other respiratory symptoms in early life progress to asthma in mid-childhood, while others become asymptomatic.<\/jats:p>","DOI":"10.1183\/13993003.00284-2015","type":"journal-article","created":{"date-parts":[[2015,10,26]],"date-time":"2015-10-26T18:42:18Z","timestamp":1445884938000},"page":"499-509","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":46,"title":["Change in the manifestations of asthma and asthma-related traits in childhood: a latent transition analysis"],"prefix":"10.1183","volume":"47","author":[{"given":"Frances L.","family":"Garden","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy M.","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig 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