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