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Early predictors for developing allergic disease and asthma: examining separate steps in the 'allergic march'.
Clin Exp Allergy. 2007 Sep; 37(9):1296-302.CE

Abstract

BACKGROUND

Sensitization and symptoms of allergic disease are strongly correlated, but little is known about the early clinical precursors of the development of allergen sensitization in childhood. The aim of this study was to identify these predictors, and to examine separately the effect of early sensitization on subsequent wheeze, asthma, rhinitis and eczema.

METHODS

In the Childhood Asthma Prevention Study, children with a family history of asthma were assessed for allergen sensitization, total serum IgE, wheeze, asthma, eczema and rhinitis at ages 18 months and 5 years. To examine predictors, at 18 months, for subsequent sensitization, children who were non-sensitized at 18 months and had data on sensitization at 5 years were investigated, n=375. To examine the predictors, at age 18 months, of subsequent onset of symptoms, children who did not have wheeze, asthma, eczema or rhinitis at 18 months were followed-up at 5 years, n=177.

RESULTS

Among children who were non-sensitized at age 18 months, the presence of eczema [adjusted relative risk (aRR), 1.67, 95% confidence interval (CI) 1.20-2.33], but not wheeze, asthma or rhinitis, was an independent predictor of the onset of sensitization by age 5 years. Among children who were asymptomatic at age 18 months, sensitization to any allergen at 18 months was an independent predictor for the presence of wheeze (aRR 2.41, 95% CI 1.28-4.55), asthma (aRR 4.66, 95% CI 1.88-11.54) and rhinitis (aRR 1.77, 95% CI 1.08-2.90), but not for the development of eczema (aRR 0.78, 95% CI 0.23-2.64) at 5 years.

CONCLUSION

In non-sensitized children, eczema, but not wheeze, asthma or rhinitis is a predictor for subsequent development of sensitization. This suggests that early childhood eczema, rather than wheeze and rhinitis, may promote subsequent allergen sensitization and raises the possibility that early management of eczema may reduce the prevalence of sensitization in children.

Authors+Show Affiliations

Woolcock Institute of Medical Research, Camperdown, NSW, Australia; University of Sydney, Sydney, NSW, Australia. catarina.almqvist@ki.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17845409

Citation

Almqvist, C, et al. "Early Predictors for Developing Allergic Disease and Asthma: Examining Separate Steps in the 'allergic March'." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 37, no. 9, 2007, pp. 1296-302.
Almqvist C, Li Q, Britton WJ, et al. Early predictors for developing allergic disease and asthma: examining separate steps in the 'allergic march'. Clin Exp Allergy. 2007;37(9):1296-302.
Almqvist, C., Li, Q., Britton, W. J., Kemp, A. S., Xuan, W., Tovey, E. R., & Marks, G. B. (2007). Early predictors for developing allergic disease and asthma: examining separate steps in the 'allergic march'. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 37(9), 1296-302.
Almqvist C, et al. Early Predictors for Developing Allergic Disease and Asthma: Examining Separate Steps in the 'allergic March'. Clin Exp Allergy. 2007;37(9):1296-302. PubMed PMID: 17845409.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early predictors for developing allergic disease and asthma: examining separate steps in the 'allergic march'. AU - Almqvist,C, AU - Li,Q, AU - Britton,W J, AU - Kemp,A S, AU - Xuan,W, AU - Tovey,E R, AU - Marks,G B, AU - ,, PY - 2007/9/12/pubmed PY - 2007/10/17/medline PY - 2007/9/12/entrez SP - 1296 EP - 302 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin Exp Allergy VL - 37 IS - 9 N2 - BACKGROUND: Sensitization and symptoms of allergic disease are strongly correlated, but little is known about the early clinical precursors of the development of allergen sensitization in childhood. The aim of this study was to identify these predictors, and to examine separately the effect of early sensitization on subsequent wheeze, asthma, rhinitis and eczema. METHODS: In the Childhood Asthma Prevention Study, children with a family history of asthma were assessed for allergen sensitization, total serum IgE, wheeze, asthma, eczema and rhinitis at ages 18 months and 5 years. To examine predictors, at 18 months, for subsequent sensitization, children who were non-sensitized at 18 months and had data on sensitization at 5 years were investigated, n=375. To examine the predictors, at age 18 months, of subsequent onset of symptoms, children who did not have wheeze, asthma, eczema or rhinitis at 18 months were followed-up at 5 years, n=177. RESULTS: Among children who were non-sensitized at age 18 months, the presence of eczema [adjusted relative risk (aRR), 1.67, 95% confidence interval (CI) 1.20-2.33], but not wheeze, asthma or rhinitis, was an independent predictor of the onset of sensitization by age 5 years. Among children who were asymptomatic at age 18 months, sensitization to any allergen at 18 months was an independent predictor for the presence of wheeze (aRR 2.41, 95% CI 1.28-4.55), asthma (aRR 4.66, 95% CI 1.88-11.54) and rhinitis (aRR 1.77, 95% CI 1.08-2.90), but not for the development of eczema (aRR 0.78, 95% CI 0.23-2.64) at 5 years. CONCLUSION: In non-sensitized children, eczema, but not wheeze, asthma or rhinitis is a predictor for subsequent development of sensitization. This suggests that early childhood eczema, rather than wheeze and rhinitis, may promote subsequent allergen sensitization and raises the possibility that early management of eczema may reduce the prevalence of sensitization in children. SN - 0954-7894 UR - https://www.unboundmedicine.com/medline/citation/17845409/Early_predictors_for_developing_allergic_disease_and_asthma:_examining_separate_steps_in_the_'allergic_march'_ L2 - https://doi.org/10.1111/j.1365-2222.2007.02796.x DB - PRIME DP - Unbound Medicine ER -