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.

中文翻译：

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对多种过敏原敏感的儿童在 10 岁时患哮喘的风险增加

背景

先前已发现儿童致敏模式与几个出生队列中的早期过敏性疾病的可变风险有关。

客观的

以确定这些风险是否会持续到儿童后期。

方法

在韦恩县健康、环境、过敏和哮喘纵向研究的出生队列中，先前基于对 10 种过敏原致敏的潜在类别分析发现，在 2 岁时有以下 4 种早期生活致敏模式：“高度致敏”、“牛奶/鸡蛋”主导”、“花生和吸入剂”和“低至无致敏性”。在 10 岁的特定研究访问中，过敏症专家通过身体检查和与儿童和父母或监护人的面谈，评估儿童当前的哮喘和特应性皮炎。还完成了总和特异性免疫球蛋白 E (IgE)、肺活量测定和乙酰甲胆碱激发试验。

结果

与对无过敏原或对 1 种过敏原过敏的儿童相比，2 岁时对 4 种或更多食物和吸入过敏原过敏的儿童目前患哮喘的风险最高（相对风险 [RR]，4.42；95% 置信区间 [CI]，2.58-7.59 ; P < .001) 和支气管高反应性 (RR, 1.77; 95% CI, 1.29-2.42; P < .001)。此外，在 4 组中，他们的总 IgE 水平最高（几何平均值，800 IU/mL；95% CI，416-1536）。当前特应性皮炎的风险不取决于致敏模式，但对于任何致敏的儿童来说仍然增加（RR，2.23；95% CI，1.40-3.55；P< .001)。在肺活量测定（1 秒用力呼气量、25% 和 75% 之间的用力呼气流量和 1 秒用力呼气量/用力肺活量）方面没有发现差异。

结论

先前报道的生命早期特定致敏模式（对≥4 种吸入和食物过敏原致敏）的重要性继续与 10 岁时哮喘、支气管高反应性和高总 IgE 风险增加相关。