title: Sibling effect on atopy in children of patients with asthma.
abstract: BACKGROUND
  Multiple population studies have shown the presence of a sibling effect on atopic disease. However, it is unclear if the sibling effect is also of importance in subjects who are genetically at high risk for the development of atopy.
  
  
  OBJECTIVE
  To study the presence of a sibling effect on markers of atopy (serum total IgE, specific IgE, skin tests) and asthma (bronchial hyper-responsiveness to histamine) in families ascertained through a parent with asthma.
  
  
  METHODS
  First-degree offspring in 200 asthma families were studied (n = 541). Mixed effects regression models were used to account for the dependence of the observations within a family, and to adjust for possible confounding variables.
  
  
  RESULTS
  Multiple regression analysis showed that having older siblings was inversely related to atopy, defined as >/= 2, >/= 3, >/= 4, or >/= 5 skin tests (P = 0.07-0.009). In addition, family size (number of siblings) had a significant protective effect on the presence of specific IgE to common aeroallergens (P = 0.03). Exposure to cigarette smoke in the first 3 years of life significantly increased the risk of having specific IgE to common aeroallergens (P = 0.04). No sibling effect was detected for serum total IgE or bronchial hyper-responsiveness to histamine.
  
  
  CONCLUSIONS
  This study shows a protective sibling effect on the presence and severity of atopy but not on bronchial hyper-responsiveness in children who are genetically at risk. The identification of the sibling effect in high-risk families stresses the need to understand the basis of this effect, in order to design future prevention programmes.
authors.affiliation: Department of Pulmonary Rehabilitation, Beatrixoord, Haren, The Netherlands.
authors.forename: G H
authors.initials: GH
authors.lastname: Koppelman
authors.forename: D F
authors.initials: DF
authors.lastname: Jansen
authors.forename: J P
authors.initials: JP
authors.lastname: Schouten
authors.forename: S
authors.initials: S
authors.lastname: van der Heide
authors.forename: E R
authors.initials: ER
authors.lastname: Bleecker
authors.forename: D A
authors.initials: DA
authors.lastname: Meyers
authors.forename: D S
authors.initials: DS
authors.lastname: Postma
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000235:genetics / Q000276:immunology; D001722:Birth Order; D016535:Bronchial Hyperreactivity / Q000235:genetics / Q000276:immunology; D005191:Family Characteristics; D005260:Female; D006632:Histamine; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000235:genetics* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D015999:Multivariate Analysis; D012882:Skin Tests / Q000379:methods
chemical_list: D000485:Allergens; D007073:Immunoglobulin E; D006632:Histamine