title: Asthma prediction in school children; the value of combined IgE-antibodies and obstructive airways disease severity score.
abstract: BACKGROUND
  Allergic sensitisation increases the risk for asthma development. In this prospective birth cohort (Environment and Childhood Asthma) study, we hypothesized that combining quantitative measures of IgE antibodies (Sigma-IgE) and Severity score of obstructive airways disease (OAD) at 2 years of age (Severity score) is superior to predict current asthma (CA) at 10 years than either measure alone. Secondarily, we assessed if gender modified the prediction of CA.
  
  
  METHODS
  A follow-up study at 10 years of age was performed in 371 2-year-old children with recurrent (n = 219) or no (n = 152) bronchial obstruction with available serum analysed for Sigma-IgE to common food and inhalant allergens through a panel test, Phadiatop Infant) (Phadia, Uppsala, Sweden). Clinical variables included allergic sensitisation and exercise testing to characterise children with CA vs not CA at 10 years and the Severity score (0-12, 0 indicating no OAD) was used to assess risk modification.
  
  
  RESULTS
  Severity score alone explained 24% (Nagelkerke R(2) = 0.24) of the variation in CA, whereas Sigma-IgE explained only 6% (R(2) = 0.06). Combining the two increased the explanatory capacity to R(2) = 0.30. Gender interacted significantly with Sigma-IgE; whereas Severity score predicted CA in both genders, the predictive capacity of Sigma-IgE for CA at 10 years was significant in boys only.
  
  
  CONCLUSIONS
  Combining Sigma-IgE to inhalant allergens and Severity score at 2 years was superior to predict asthma at 10 years than either alone. Severity score predicted CA in both genders, whereas Sigma-IgE significantly predicted CA in boys only.
authors.affiliation: Department of Paediatrics, Oslo University Hospital, Oslo, Norway. k.c.l.carlsen@medisin.uio.no
authors.forename: K C
authors.initials: KC
authors.lastname: Lødrup Carlsen
authors.forename: L
authors.initials: L
authors.lastname: Söderström
authors.forename: P
authors.initials: P
authors.lastname: Mowinckel
authors.forename: G
authors.initials: G
authors.lastname: Håland
authors.forename: M
authors.initials: M
authors.lastname: Pettersen
authors.forename: M C
authors.initials: MC
authors.lastname: Munthe Kaas
authors.forename: C S
authors.initials: CS
authors.lastname: Devulapalli
authors.forename: M
authors.initials: M
authors.lastname: Buchmann
authors.forename: S
authors.initials: S
authors.lastname: Ahlstedt
authors.forename: K-H
authors.initials: KH
authors.lastname: Carlsen
mesh_terms: D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000175:diagnosis* / Q000276:immunology / Q000503:physiopathology; D002648:Child; D015331:Cohort Studies; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood*; D008173:Lung Diseases, Obstructive / Q000276:immunology / Q000503:physiopathology*; D008297:Male; D011237:Predictive Value of Tests; D012720:Severity of Illness Index
chemical_list: D000485:Allergens; D007073:Immunoglobulin E