BACKGROUND: There has been significant progress recently in the clinical investigation of atopic dermatitis (AD), especially in the recognition of aeroallergens as aggravating factors in AD. However, sensitization to food allergens and aeroallergens in children with AD has not been fully studied. OBJECTIVE: To evaluate the correlation between age and allergens in children with AD. METHODS: A retrospective cross-sectional study was performed between January 1, 1999, and December 31, 2002, on 262 children with a definitive diagnosis of AD aged 0 to 16 years. Comparison of 3 age groups (<2 years, 2-5 years, and >5 years) with the correlation of food allergens and aeroallergens using the CAP-FEIA test was made using linear regression and logistic regression analyses. RESULTS: In children younger than 2 years, AD was associated with food allergens. In children aged 2 to 5 years, both food allergens and aeroallergens played an important role. In children older than 5 years, only elevated aeroallergen specific IgE levels were noted (P < .02). Age correlated negatively with food allergens and positively with aeroallergens after adjusting for sex (P < .04). Sensitization to aeroallergens may correlate with acquisition of the respiratory symptoms of the atopic state. CONCLUSIONS: Food allergens may be the major trigger of AD in early life, after which the role of environmental aeroallergens become more important and may be associated with respiratory sensitization.
BACKGROUND: There has been significant progress recently in the clinical investigation of atopic dermatitis (AD), especially in the recognition of aeroallergens as aggravating factors in AD. However, sensitization to food allergens and aeroallergens in children with AD has not been fully studied. OBJECTIVE: To evaluate the correlation between age and allergens in children with AD. METHODS: A retrospective cross-sectional study was performed between January 1, 1999, and December 31, 2002, on 262 children with a definitive diagnosis of AD aged 0 to 16 years. Comparison of 3 age groups (<2 years, 2-5 years, and >5 years) with the correlation of food allergens and aeroallergens using the CAP-FEIA test was made using linear regression and logistic regression analyses. RESULTS: In children younger than 2 years, AD was associated with food allergens. In children aged 2 to 5 years, both food allergens and aeroallergens played an important role. In children older than 5 years, only elevated aeroallergen specific IgE levels were noted (P < .02). Age correlated negatively with food allergens and positively with aeroallergens after adjusting for sex (P < .04). Sensitization to aeroallergens may correlate with acquisition of the respiratory symptoms of the atopic state. CONCLUSIONS:Food allergens may be the major trigger of AD in early life, after which the role of environmental aeroallergens become more important and may be associated with respiratory sensitization.
Authors: Robert S Tepper; Conrado J Llapur; Marcus H Jones; Christina Tiller; Cathy Coates; Risa Kimmel; Jeffrey Kisling; Barry Katz; Yan Ding; Nancy Swigonski Journal: J Allergy Clin Immunol Date: 2008-08-28 Impact factor: 10.793