Early-life allergen exposure and atopy, asthma, and wheeze up to 6 years of age.
BACKGROUND
Although it is widely assumed that the incidence of childhood respiratory allergies to common aeroallergens is directly related to allergen exposure in early life, few longitudinal studies have investigated this issue, and available data are scarce and mainly limited to high-risk groups.


OBJECTIVE
To assess, in a prospective manner and in a general population, the role of early life exposures to Der p1 and Fel d1 on the inception of sensitization and asthma.


METHODS
Pregnant women and their children were recruited for the Asthma Multicentre Infant Cohort Study. Overall, 1,611 newborns were initially enrolled in three cohorts in the United Kingdom and Spain. Der p1 and Fel d1 allergens were measured in household dust samples at 3 months of age for 1,474 (91.5%) participants, and skin prick tests were performed at 6 years of age on 1,182 (80.2%) participants. Wheeze and diagnosed asthma were reported in yearly questionnaires.


RESULTS
Exposure to Der p1 early in life was not related to a positive specific prick test or to asthma or persistent wheeze at 6 years of age. Fel d1 showed an association with all these outcomes (third vs. first tertile; odds ratio, 4.43 for positive specific prick test and 2.6 for diagnosed asthma).


CONCLUSIONS
Dose-response relationships between allergen exposure and sensitization or asthma may be allergen specific and nonlinear; a minimum threshold level is needed to induce sensitization, but no dose-response relationship exists above this level. The effect of a particular allergen seems to be similar on atopy and asthma inception.
Torrent
Matias
M
Menorca Health Area, ib-salut Menorca, Institute Universitary d'Investigacio en Ciencies de la Salut, Menorca, Spain. mtorrent@smen.es
Sunyer
Jordi
J
Garcia
Raquel
R
Harris
Jessica
J
Iturriaga
Maria V
MV
Puig
Carme
C
Vall
Oriol
O
Anto
Josep M
JM
Newman Taylor
Anthony J
AJ
Cullinan
Paul
P
D039741:Antigens, Dermatophagoides / Q000009:adverse effects* / Q000276:immunology; D060829:Arthropod Proteins; D001249:Asthma / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D002648:Child; D003546:Cysteine Endopeptidases; D004306:Dose-Response Relationship, Immunologic; D004391:Dust / Q000276:immunology*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006023:Glycoproteins / Q000009:adverse effects* / Q000276:immunology; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012135:Respiratory Sounds / Q000209:etiology* / Q000276:immunology; D012307:Risk Factors; D012882:Skin Tests; D013030:Spain / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology
D039741:Antigens, Dermatophagoides; D060829:Arthropod Proteins; D004391:Dust; D006023:Glycoproteins; D003546:Cysteine Endopeptidases; C451162:Dermatophagoides pteronyssinus antigen p 1; C059296:Fel d 1 protein, Felis domesticus