Increased risk of asthma at age 10 years for children sensitized to multiple allergens

Document Type

Article

Publication Date

5-8-2021

Publication Title

Annals of allergy, asthma & immunology

Abstract

BACKGROUND: Childhood sensitization patterns have been previously found to be related to variable risk of early life allergic disease in several birth cohorts.

OBJECTIVE: To determine whether these risks persist into later childhood.

METHODS: In the birth cohort of the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study, previous latent class analysis based on sensitization to 10 allergens found the following 4 early life sensitization patterns at age 2 years: "highly sensitized," "milk/egg dominated," "peanut and inhalant(s)," and "low to no sensitization." At an age 10 study-specific visit, children were evaluated by an allergist for current asthma and atopic dermatitis through a physical examination and interviews with the child and parent or guardian. Total and specific immunoglobulin E (IgE), spirometry, and methacholine challenge were also completed.

RESULTS: Compared with children sensitized to none or 1 allergen, children sensitized to 4 or more food and inhalant allergens at age 2 had the highest risk of current asthma (relative risk [RR], 4.42; 95% confidence interval [CI], 2.58-7.59; P < .001) and bronchial hyperresponsiveness (RR, 1.77; 95% CI, 1.29-2.42; P < .001). In addition, they had the highest levels of total IgE (geometric mean, 800 IU/mL; 95% CI, 416-1536) among the 4 groups. Risk of current atopic dermatitis did not depend on pattern of sensitization but remained increased for children with any sensitization (RR, 2.23; 95% CI, 1.40-3.55; P < .001). No differences in spirometry (forced expiratory volume in 1 second, forced expiratory flow between 25% and 75%, and forced expiratory volume in 1 second/forced vital capacity) were identified.

CONCLUSION: The previously reported importance of a specific pattern of sensitization in early life (sensitization to ≥4 inhalant and food allergens) continues to be associated with an increased risk of asthma, bronchial hyperresponsiveness, and high total IgE at age 10 years.

Medical Subject Headings

Adult; Allergens/immunology; Asthma/diagnosis/epidemiology; Bronchial Hyperreactivity/diagnosis/immunology; Child; Egg Hypersensitivity/immunology; Female; Food Hypersensitivity/epidemiology/immunology; Forced Expiratory Volume/physiology; Humans; Immunoglobulin E/blood; Longitudinal Studies; Male; Middle Aged; Milk Hypersensitivity; Peanut Hypersensitivity/immunology; Spirometry; Vital Capacity/physiology; Young Adult

PubMed ID

33971358

ePublication

ePub ahead of print

Volume

127

Issue

4

First Page

441

Last Page

445.e1

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