Sensitization to food and inhalant allergens in relation to age and wheeze among children with atopic dermatitis.
BACKGROUND
Atopic dermatitis (AD) is common in children; however, persistence of AD with or without asthma is less common. Longitudinal studies remain limited in their ability to characterize how IgE antibody responses evolve in AD, and their relationship with asthma.


OBJECTIVE
To use a cross-sectional study design of children with active AD to analyse age-related differences in IgE antibodies and relation to wheeze.


METHODS
IgE antibodies to food and inhalant allergens were measured in children with active AD (5 months to 15 years of age, n = 66), with and without history of wheeze.


RESULTS
Whereas IgE antibodies to foods persisted at a similar prevalence and titre throughout childhood, IgE antibodies to all aeroallergens rose sharply into adolescence. From birth, the chance of sensitization for any aeroallergen increased for each 12-month increment in age (OR ≥ 1.21, P < 0.01), with the largest effect observed for dust mite (OR = 1.56, P < 0.001). A steeper age-related rise in IgE antibody titre to dust mite, but no other allergen was associated with more severe disease. Despite this, sensitization to cat was more strongly associated with wheeze (OR = 4.5, P < 0.01), and linked to Fel d 1 and Fel d 4, but not Fel d 2. Comparison of cat allergic children with AD to those without, revealed higher IgE levels to Fel d 2 and Fel d 4 (P < 0.05), but not Fel d 1.


CONCLUSIONS
Differences in sensitization to cat and dust mite among young children with AD may aid in identifying those at increased risk for disease progression and development of asthma. Early sensitization to cat and risk for wheeze among children with AD may be linked to an increased risk for sensitization to a broader spectrum of allergen components from early life. Collectively, our findings argue for early intervention strategies designed to mitigate skin inflammation in children with AD.
Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, VA, USA.
J A
JA
Wisniewski
R
R
Agrawal
S
S
Minnicozzi
W
W
Xin
J
J
Patrie
P W
PW
Heymann
L
L
Workman
T A
TA
Platts-Mills
T W
TW
Song
M
M
Moloney
J A
JA
Woodfolk
D000293:Adolescent; D000367:Age Factors; D000485:Allergens / Q000276:immunology*; D000818:Animals; D000918:Antibody Specificity / Q000276:immunology; D002415:Cats; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000276:immunology*; D005260:Female; D005502:Food / Q000009:adverse effects*; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007223:Infant; D054834:Lipocalins; D008297:Male; D016017:Odds Ratio; D011379:Prognosis; D012135:Respiratory Sounds / Q000276:immunology*
D000485:Allergens; C499337:Fel d 4 allergen, Felis domesticus; D006023:Glycoproteins; D054834:Lipocalins; D007073:Immunoglobulin E; C059296:Fel d 1 protein, Felis domesticus
IgE antibodies; aeroallergens; age; asthma; atopic dermatitis; cat; dust mite; food allergy; wheeze