title: Tobacco smoke exposure and multiplexed immunoglobulin E sensitization in children: a population-based study.
abstract: BACKGROUND
  Although there is evidence that exposure to tobacco smoke is harmful to children's respiratory health, the effects of tobacco smoke exposure on the regulation of immunoglobulin E (IgE)-mediated immune responses to specific allergens remain unclear. This study aimed to investigate the relationship between objectively assessed tobacco smoke exposure and specific IgE profiles for a broad spectrum of allergens in a population setting.
  
  
  METHODS
  Children aged 5-18 years (N = 1315) were assessed using serum cotinine measurement and microarray-based multiplexed detection of specific IgE against 40 allergens.
  
  
  RESULTS
  Serum cotinine levels were positively associated with sensitization to foods (adjusted odds ratio [AOR] = 4.95; 95% CI: 1.59-15.34), cockroaches (AOR = 3.77; 95% CI: 1.49-9.51), and pollen (AOR = 2.84; 95% CI: 1.20-6.73) while the association was borderline significant for animals (AOR = 2.53; 95% CI: 0.92-6.93). No associations were found for sensitization against mites, mold, and latex. When considering the degree of allergic sensitization, serum cotinine levels were positively correlated to the number of sensitization to cockroaches (P = 0.004), pollen (P = 0.006), and foods (P < 0.001), with statistically significant positive dose-response relationships (all P < 0.01). Similar results were observed when summing up specific IgE concentrations for the aforementioned allergen categories.
  
  
  CONCLUSIONS
  The association between tobacco smoke exposure and IgE sensitization to environmental allergens varies for different allergens among children. This study demonstrates that elevated serum cotinine levels are significantly associated with IgE sensitization to cockroaches, grass pollen, and certain foods, with potential dose-dependent relationships.
authors.affiliation: Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.|Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
authors.forename: T-C
authors.initials: TC
authors.lastname: Yao
authors.affiliation: Clinical Informatics and Medical Statistics Research Center, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: S-W
authors.initials: SW
authors.lastname: Chang
authors.affiliation: Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.|Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
authors.forename: M-C
authors.initials: MC
authors.lastname: Hua
authors.affiliation: Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.|Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
authors.forename: S-L
authors.initials: SL
authors.lastname: Liao
authors.affiliation: Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.|Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
authors.forename: M-H
authors.initials: MH
authors.lastname: Tsai
authors.affiliation: Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.|Division of Pediatric Pulmonology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: S-H
authors.initials: SH
authors.lastname: Lai
authors.affiliation: Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.|Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
authors.forename: Y-L
authors.initials: YL
authors.lastname: Tseng
authors.affiliation: Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.|Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
authors.forename: K-W
authors.initials: KW
authors.lastname: Yeh
authors.affiliation: Division of Biostatistics and Bioinformatics, Institutes of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.|Department of Public Health, China Medical University, Taichung, Taiwan.|Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Tsai
authors.affiliation: Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.|Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
authors.forename: J-L
authors.initials: JL
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000276:immunology; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003367:Cotinine / Q000097:blood; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000209:etiology*; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D008297:Male; D016017:Odds Ratio; D011159:Population Surveillance; D012307:Risk Factors; D012906:Smoke / Q000009:adverse effects*
chemical_list: D000485:Allergens; D012906:Smoke; D007073:Immunoglobulin E; D003367:Cotinine
keywords: allergic sensitization; children; cotinine; specific IgE; tobacco smoke