Prospective association between food sensitization and food allergy: results of the LISA birth cohort study.
BACKGROUND
Food allergy is common, especially in childhood, where 6-8% of children are affected. Identification of early and efficient markers for later development of food allergy is very important.


OBJECTIVE
We examined the ability of repeated measurements of food sensitization in early childhood to predict doctor-diagnosed food allergy (DDFA) at the age of 6 years.


METHODS
The analysis was based on data from a prospective birth cohort study. Information was collected by parental questionnaires, and blood samples were obtained at 2 and 6 years of age. Children with repeated determination of sensitization to food allergens at 2 and 6 years of age were categorized into the sensitization phenotypes: no, early onset, late onset and persistent sensitization. The association between sensitization phenotypes and DDFA was prospectively investigated using multiple logistic regression analyses.


RESULTS
Of 3097 children recruited at birth, a complete follow-up of IgE measurements and questionnaires at 1.5, 2 and 6 years were available for 1082 children. Early food allergen sensitization (fx5) was a strong risk for DDFA at 6 years [odds ratio (OR)=4.7; 95% confidence intervals (95% CI) 2.0-11.2] and for a new onset of DDFA at 6 years (OR=4.1; 95% CI 1.5-11.3). Additionally, persistent food allergen sensitization increased the risk of DDFA at 6 years (OR=6.1; 95% CI 2.7-13.7). Early sensitized children with a history of parental atopy showed the highest risk for DDFA at 6 years.


CONCLUSIONS
Food-sensitized children during the first 2 years of life, especially with a family history of atopy, might be considered as a susceptible subgroup that requires specific attention concerning the development of food allergy-related symptoms.
Schnabel
E
E
Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany. Schnabel@helmholtz-muenchen.de
Sausenthaler
S
S
Schaaf
B
B
Schäfer
T
T
Lehmann
I
I
Behrendt
H
H
Herbarth
O
O
Borte
M
M
Krämer
U
U
von Berg
A
A
Wichmann
H-E
HE
Heinrich
J
J
D000818:Animals; D002417:Cattle; D002642:Chick Embryo; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005512:Food Hypersensitivity / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007231:Infant, Newborn; D008016:Life Change Events; D008297:Male; D016017:Odds Ratio; D010641:Phenotype; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
D007073:Immunoglobulin E