BACKGROUND: Sensitization and symptoms of allergic disease are strongly correlated, but little is known about the early clinical precursors of the development of allergen sensitization in childhood. The aim of this study was to identify these predictors, and to examine separately the effect of early sensitization on subsequent wheeze, asthma, rhinitis and eczema. METHODS: In the Childhood Asthma Prevention Study, children with a family history of asthma were assessed for allergen sensitization, total serum IgE, wheeze, asthma, eczema and rhinitis at ages 18 months and 5 years. To examine predictors, at 18 months, for subsequent sensitization, children who were non-sensitized at 18 months and had data on sensitization at 5 years were investigated, n=375. To examine the predictors, at age 18 months, of subsequent onset of symptoms, children who did not have wheeze, asthma, eczema or rhinitis at 18 months were followed-up at 5 years, n=177. RESULTS: Among children who were non-sensitized at age 18 months, the presence of eczema [adjusted relative risk (aRR), 1.67, 95% confidence interval (CI) 1.20-2.33], but not wheeze, asthma or rhinitis, was an independent predictor of the onset of sensitization by age 5 years. Among children who were asymptomatic at age 18 months, sensitization to any allergen at 18 months was an independent predictor for the presence of wheeze (aRR 2.41, 95% CI 1.28-4.55), asthma (aRR 4.66, 95% CI 1.88-11.54) and rhinitis (aRR 1.77, 95% CI 1.08-2.90), but not for the development of eczema (aRR 0.78, 95% CI 0.23-2.64) at 5 years. CONCLUSION: In non-sensitized children, eczema, but not wheeze, asthma or rhinitis is a predictor for subsequent development of sensitization. This suggests that early childhood eczema, rather than wheeze and rhinitis, may promote subsequent allergen sensitization and raises the possibility that early management of eczema may reduce the prevalence of sensitization in children.
BACKGROUND: Sensitization and symptoms of allergic disease are strongly correlated, but little is known about the early clinical precursors of the development of allergen sensitization in childhood. The aim of this study was to identify these predictors, and to examine separately the effect of early sensitization on subsequent wheeze, asthma, rhinitis and eczema. METHODS: In the Childhood Asthma Prevention Study, children with a family history of asthma were assessed for allergen sensitization, total serum IgE, wheeze, asthma, eczema and rhinitis at ages 18 months and 5 years. To examine predictors, at 18 months, for subsequent sensitization, children who were non-sensitized at 18 months and had data on sensitization at 5 years were investigated, n=375. To examine the predictors, at age 18 months, of subsequent onset of symptoms, children who did not have wheeze, asthma, eczema or rhinitis at 18 months were followed-up at 5 years, n=177. RESULTS: Among children who were non-sensitized at age 18 months, the presence of eczema [adjusted relative risk (aRR), 1.67, 95% confidence interval (CI) 1.20-2.33], but not wheeze, asthma or rhinitis, was an independent predictor of the onset of sensitization by age 5 years. Among children who were asymptomatic at age 18 months, sensitization to any allergen at 18 months was an independent predictor for the presence of wheeze (aRR 2.41, 95% CI 1.28-4.55), asthma (aRR 4.66, 95% CI 1.88-11.54) and rhinitis (aRR 1.77, 95% CI 1.08-2.90), but not for the development of eczema (aRR 0.78, 95% CI 0.23-2.64) at 5 years. CONCLUSION: In non-sensitized children, eczema, but not wheeze, asthma or rhinitis is a predictor for subsequent development of sensitization. This suggests that early childhood eczema, rather than wheeze and rhinitis, may promote subsequent allergen sensitization and raises the possibility that early management of eczema may reduce the prevalence of sensitization in children.
Authors: Caroline Roduit; Remo Frei; Martin Depner; Anne M Karvonen; Harald Renz; Charlotte Braun-Fahrländer; Elisabeth Schmausser-Hechfellner; Juha Pekkanen; Josef Riedler; Jean-Charles Dalphin; Erika von Mutius; Roger Pascal Lauener; Anne Hyvärinen; Pirkka Kirjavainen; Sami Remes; Marjut Roponen; Marie-Laure Dalphin; Vincent Kaulek; Markus Ege; Jon Genuneit; Sabina Illi; Micahel Kabesch; Bianca Schaub; Petra Ina Pfefferle; Gert Doekes Journal: JAMA Pediatr Date: 2017-07-01 Impact factor: 16.193
Authors: A G Hirsch; X S Yan; A S Sundaresan; B K Tan; R P Schleimer; R C Kern; T L Kennedy; J S Greene; B S Schwartz Journal: Allergy Date: 2015-09-25 Impact factor: 13.146
Authors: Ben D Spycher; Michael Silverman; Juerg Barben; Ernst Eber; Stéphane Guinand; Mark L Levy; Caroline Pao; Willem M van Aalderen; Onno C P van Schayck; Claudia E Kuehni Journal: PLoS One Date: 2009-12-31 Impact factor: 3.240
Authors: Jeong-Hui Park; Myong-Won Seo; Hyun Chul Jung; Jong-Kook Song; Jung-Min Lee Journal: Int J Environ Res Public Health Date: 2021-06-21 Impact factor: 3.390