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Clinical phenotype and allergen sensitization in the first 2 years as predictors of atopic disorders at age 5 years.

ABSTRACT: INTRODUCTION:From a birth cohort of at-risk Asian infants, we prospectively investigated the role of early onset allergen sensitization and clinical phenotypes as risk factors for atopic disorders at the age of 5 years. METHODS AND MATERIALS:The study recruited 253 families with a history of allergic disease in a first degree relative from an antenatal clinic in Singapore. The children were followed prospectively to assess clinical outcomes and skin prick test was performed at 2 and 5 years of age. RESULTS:Allergen sensitization (food and/or house dust mites) alone at 2 years of age was not associated with increased risk of wheeze and eczema at 5 years. However, the clinical phenotype (eczema and wheeze) with or without the presence of concomitant allergen sensitization at 2 years increased this risk. For eczema, eczema alone at year 2 increased the risk of eczema at year 5 (adjOR?=?7.1; 95 % CI: 1.8-27.8) and this was further increased by the presence of allergen sensitization (adjOR?=?25.4; 95 % CI: 4.7-138.5) and the concomitant presence of both wheeze and allergen sensitization (adjOR?=?64.9; 95 % CI: 4.7-900.0). For wheeze, wheeze alone at 2 years (adjOR?=?4.5; 95 % CI: 1.4 -14.8), and wheeze with concomitant allergen sensitization and eczema (adjOR?=?13.9; 95 % CI: 1.2-168.5) increased the risk of wheeze at 5 years. The exception was rhinitis, where allergen sensitization alone at 2 years (adjOR?=?5.6; 95 % CI: 1.1-29.2) increased the risk of rhinitis at 5 years. Early onset of eczema at 2 years also increased the risk of rhinitis (adjOR?=?6.8; 95 % CI: 2.0-23.1). CONCLUSION:In this Asian birth cohort, the clinical phenotype (eczema and wheeze) with or without concomitant allergen sensitization in the first 2 years of life were strong predictors of atopic disorders at 5 years.

SUBMITTER: Quah PL

PROVIDER: S-EPMC4667513 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Clinical phenotype and allergen sensitization in the first 2 years as predictors of atopic disorders at age 5 years.

Quah Phaik Ling PL Loo Evelyn Xiu Ling EX Lee Gabriella Nadine Li Yuan GN Kuo I-Chun IC Gerez Irvin I Llanora Genevieve Villablanca GV Chan Yiong Huak YH Aw Marion M Shek Lynette Pei-Chi LP Lee Bee Wah BW

The World Allergy Organization journal 20151202 1

<h4>Introduction</h4>From a birth cohort of at-risk Asian infants, we prospectively investigated the role of early onset allergen sensitization and clinical phenotypes as risk factors for atopic disorders at the age of 5 years.<h4>Methods and materials</h4>The study recruited 253 families with a history of allergic disease in a first degree relative from an antenatal clinic in Singapore. The children were followed prospectively to assess clinical outcomes and skin prick test was performed at 2 a ...[more]

PMID: 26664574

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Project description:BackgroundImmune responses in allergic diseases begin with allergen sensitization, which usually occurs in childhood. Allergen sensitization involves a complex interplay of genetic and environmental factors, and sensitization patterns may change with age.ObjectiveTo determine the predictors of allergen sensitization in the first 3 years of life in the growing up in Singapore towards healthy outcomes (GUSTO) prospective birth cohort study.MethodsInterviewers collected information on demographics, family history of allergy, social and lifestyle factors, and the child's health. We analyzed data from 849 children who completed skin prick testing (SPT) to inhalant allergens (house dust mites: Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis) and food allergens (egg, peanut and cow's milk) to assess risk factors for allergen sensitization at 18 months. To ensure that clinical phenotypes preceded allergen sensitization, we also analyzed data from 649 children who had a negative skin prick test at 18 months and completed skin prick testing at 36 months.ResultsWe observed a significant association between eczema reported before 18 months and a positive SPT at 18 months [aOR 4.5 (1.9-10.7)]. Ninety-five (14.6 %) children with negative SPTs at 18 months developed positive tests at 36 months. Onset of eczema before 18 months was associated with an increased risk of new allergen sensitization at 36 months among children non-sensitized at 18 months [aOR 3.4 (1.2-9.3)]. An association was seen between wheeze reported before 18 months and new allergen sensitization at 36 months [aOR 3.2 (1.1-9.1)]. We found no significant association, however, between rhinitis reported before 18 months and new allergen sensitization at 36 months.ConclusionsEarly onset of eczema and wheeze are risk factors for later allergen sensitization, suggesting a possible increased susceptibility to allergen exposure through an impaired skin barrier or defective airway epithelium. Trial registration NCT01174875 Registered 1 July 2010, retrospectively registered.

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Clinical phenotype and allergen sensitization in the first 2 years as predictors of atopic disorders at age 5 years.

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Clinical phenotype and allergen sensitization in the first 2 years as predictors of atopic disorders at age 5 years.

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