Abstract
Background: Evidence suggests that a raised level of cord serum IgE (CS-IgE) is a risk factor for allergic sensitisation. However, whether CS-IgE is a risk for asthma is controversial. A study was undertaken to investigate the association between CS-IgE levels and allergic sensitisation at 4 and 10 years of age and asthma at ages 1–2, 4 and 10.
Methods: CS-IgE was available for 1358 of 1456 children born between 1989 and 1990. The cohort was evaluated for allergic diseases at ages 1, 2, 4 and 10 years. Skin prick tests for six allergens were performed on 981 children at age 4 and 1036 at age 10. Asthma was defined based on a physician's diagnosis. Using logistic regression analysis, the risk of asthma and allergic sensitisation for raised levels of CS-IgE (⩾0.5 kU/l) was estimated.
Results: At ages 4 and 10 years 20.2% and 27.0% of children, respectively, had allergic sensitisation. The risk of allergic sensitisation was significantly associated with raised CS-IgE levels at ages 4 (OR 2.29) and 10 years (OR 1.73). The prevalence of asthma was 10.3% at age 1–2, 15.2% at age 4, and 12.8% at age 10. CS-IgE was not associated with asthma at age 1–2 and 4 but showed an increased relative risk at age 10 (OR 1.66, 95% CI 1.05 to 2.62). The association was stronger in children who did not develop allergic sensitisation at age 4 or 10 (OR 3.35, 95% CI 1.41 to 7.93).
Conclusions: Raised cord serum IgE is a risk factor for allergic sensitisation at ages 4 and 10 years. This is the second study suggesting that CS-IgE is also a risk factor for asthma at age 10, probably related to the late onset of asthma. This association is not necessarily mediated by allergic sensitisation.
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Selected References
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- Arshad S. H., Stevens M., Hide D. W. The effect of genetic and environmental factors on the prevalence of allergic disorders at the age of two years. Clin Exp Allergy. 1993 Jun;23(6):504–511. doi: 10.1111/j.1365-2222.1993.tb03238.x. [DOI] [PubMed] [Google Scholar]
- Arshad S. H., Tariq S. M., Matthews S., Hakim E. Sensitization to common allergens and its association with allergic disorders at age 4 years: a whole population birth cohort study. Pediatrics. 2001 Aug;108(2):E33–E33. doi: 10.1542/peds.108.2.e33. [DOI] [PubMed] [Google Scholar]
- Bergmann R. L., Edenharter G., Bergmann K. E., Guggenmoos-Holzmann I., Forster J., Bauer C. P., Wahn V., Zepp F., Wahn U. Predictability of early atopy by cord blood-IgE and parental history. Clin Exp Allergy. 1997 Jul;27(7):752–760. [PubMed] [Google Scholar]
- Bodtger U., Jacobsen C. R., Poulsen L. K., Malling H-J. Long-term repeatability of the skin prick test is high when supported by history or allergen-sensitivity tests: a prospective clinical study. Allergy. 2003 Nov;58(11):1180–1186. doi: 10.1046/j.1398-9995.2003.00323.x. [DOI] [PubMed] [Google Scholar]
- Croner S., Kjellman N. I., Eriksson B., Roth A. IgE screening in 1701 newborn infants and the development of atopic disease during infancy. Arch Dis Child. 1982 May;57(5):364–368. doi: 10.1136/adc.57.5.364. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Edenharter G., Bergmann R. L., Bergmann K. E., Wahn V., Forster J., Zepp F., Wahn U. Cord blood-IgE as risk factor and predictor for atopic diseases. Clin Exp Allergy. 1998 Jun;28(6):671–678. doi: 10.1046/j.1365-2222.1998.00241.x. [DOI] [PubMed] [Google Scholar]
- Eiríksson T. H., Sigurgeirsson B., Ardal B., Sigfússon A., Valdimarsson H. Cord blood IgE levels are influenced by gestational age but do not predict allergic manifestations in infants. Pediatr Allergy Immunol. 1994 Feb;5(1):5–10. doi: 10.1111/j.1399-3038.1994.tb00211.x. [DOI] [PubMed] [Google Scholar]
- Gaunt G., Ramin K. Immunological tolerance of the human fetus. Am J Perinatol. 2001 Sep;18(6):299–312. doi: 10.1055/s-2001-17861. [DOI] [PubMed] [Google Scholar]
- Halonen M., Stern D., Taussig L. M., Wright A., Ray C. G., Martinez F. D. The predictive relationship between serum IgE levels at birth and subsequent incidences of lower respiratory illnesses and eczema in infants. Am Rev Respir Dis. 1992 Oct;146(4):866–870. doi: 10.1164/ajrccm/146.4.866. [DOI] [PubMed] [Google Scholar]
- Hansen L. G., Høst A., Halken S., Holmskov A., Husby S., Lassen L. B., Storm K., Osterballe O. Cord blood IgE. II. Prediction of atopic disease. A follow-up at the age of 18 months. Allergy. 1992 Aug;47(4 Pt 2):397–403. doi: 10.1111/j.1398-9995.1992.tb02079.x. [DOI] [PubMed] [Google Scholar]
- Hattevig G., Kjellman B., Björkstén B. Clinical symptoms and IgE responses to common food proteins and inhalants in the first 7 years of life. Clin Allergy. 1987 Nov;17(6):571–578. doi: 10.1111/j.1365-2222.1987.tb02053.x. [DOI] [PubMed] [Google Scholar]
- Haus M., Heese H. D., Weinberg E. G., Potter P. C., Malherbe D., Hall J. M. Genetic and environmental influences on cord blood serum IgE and on atopic sensitisation in infancy. S Afr Med J. 1990 Jan 6;77(1):7–13. [PubMed] [Google Scholar]
- Hide D. W., Arshad S. H., Twiselton R., Stevens M. Cord serum IgE: an insensitive method for prediction of atopy. Clin Exp Allergy. 1991 Nov;21(6):739–743. doi: 10.1111/j.1365-2222.1991.tb03204.x. [DOI] [PubMed] [Google Scholar]
- Illi S., von Mutius E., Lau S., Nickel R., Niggemann B., Sommerfeld C., Wahn U., Multicenter Allergy Study Group The pattern of atopic sensitization is associated with the development of asthma in childhood. J Allergy Clin Immunol. 2001 Nov;108(5):709–714. doi: 10.1067/mai.2001.118786. [DOI] [PubMed] [Google Scholar]
- Johnson C. C., Ownby D. R., Peterson E. L. Parental history of atopic disease and concentration of cord blood IgE. Clin Exp Allergy. 1996 Jun;26(6):624–629. [PubMed] [Google Scholar]
- Jones A. C., Miles E. A., Warner J. O., Colwell B. M., Bryant T. N., Warner J. A. Fetal peripheral blood mononuclear cell proliferative responses to mitogenic and allergenic stimuli during gestation. Pediatr Allergy Immunol. 1996 Aug;7(3):109–116. doi: 10.1111/j.1399-3038.1996.tb00117.x. [DOI] [PubMed] [Google Scholar]
- Kaan A., Dimich-Ward H., Manfreda J., Becker A., Watson W., Ferguson A., Chan H., Chan-Yeung M. Cord blood IgE: its determinants and prediction of development of asthma and other allergic disorders at 12 months. Ann Allergy Asthma Immunol. 2000 Jan;84(1):37–42. doi: 10.1016/S1081-1206(10)62738-X. [DOI] [PubMed] [Google Scholar]
- Karmaus W., Arshad H., Mattes J. Does the sibling effect have its origin in utero? Investigating birth order, cord blood immunoglobulin E concentration, and allergic sensitization at age 4 years. Am J Epidemiol. 2001 Nov 15;154(10):909–915. doi: 10.1093/aje/154.10.909. [DOI] [PubMed] [Google Scholar]
- Kjellman N. I., Croner S. Cord blood IgE determination for allergy prediction--a follow-up to seven years of age in 1,651 children. Ann Allergy. 1984 Aug;53(2):167–171. [PubMed] [Google Scholar]
- Kuehr J., Karmaus W., Forster J., Frischer T., Hendel-Kramer A., Moseler M., Stephan V., Urbanek R., Weiss K. Sensitization to four common inhalant allergens within 302 nuclear families. Clin Exp Allergy. 1993 Jul;23(7):600–605. doi: 10.1111/j.1365-2222.1993.tb00900.x. [DOI] [PubMed] [Google Scholar]
- Kuehr J., Karmaus W., Frischer T., Hendel-Kramer A., Weiss K., Moseler M., Stephan V., Forster J., Urbanek R. Longitudinal variability of skin prick test results. Clin Exp Allergy. 1992 Sep;22(9):839–844. doi: 10.1111/j.1365-2222.1992.tb02829.x. [DOI] [PubMed] [Google Scholar]
- Kurukulaaratchy R. J., Fenn M. H., Waterhouse L. M., Matthews S. M., Holgate S. T., Arshad S. H. Characterization of wheezing phenotypes in the first 10 years of life. Clin Exp Allergy. 2003 May;33(5):573–578. doi: 10.1046/j.1365-2222.2003.01657.x. [DOI] [PubMed] [Google Scholar]
- Kurukulaaratchy R. J., Fenn M., Twiselton R., Matthews S., Arshad S. H. The prevalence of asthma and wheezing illnesses amongst 10-year-old schoolchildren. Respir Med. 2002 Mar;96(3):163–169. doi: 10.1053/rmed.2001.1236. [DOI] [PubMed] [Google Scholar]
- Magnusson C. G. Cord serum IgE in relation to family history and as predictor of atopic disease in early infancy. Allergy. 1988 May;43(4):241–251. doi: 10.1111/j.1398-9995.1988.tb00896.x. [DOI] [PubMed] [Google Scholar]
- Magnusson C. G. Maternal smoking influences cord serum IgE and IgD levels and increases the risk for subsequent infant allergy. J Allergy Clin Immunol. 1986 Nov;78(5 Pt 1):898–904. doi: 10.1016/0091-6749(86)90237-x. [DOI] [PubMed] [Google Scholar]
- Margni R. A., Zenclussen A. C. During pregnancy, in the context of a Th2-type cytokine profile, serum IL-6 levels might condition the quality of the synthesized antibodies. Am J Reprod Immunol. 2001 Sep;46(3):181–187. doi: 10.1034/j.1600-0897.2001.d01-1.x. [DOI] [PubMed] [Google Scholar]
- Michel F. B., Bousquet J., Greillier P., Robinet-Levy M., Coulomb Y. Comparison of cord blood immunoglobulin E concentrations and maternal allergy for the prediction of atopic diseases in infancy. J Allergy Clin Immunol. 1980 Jun;65(6):422–430. doi: 10.1016/0091-6749(80)90234-1. [DOI] [PubMed] [Google Scholar]
- Murphy E., Shibuya K., Hosken N., Openshaw P., Maino V., Davis K., Murphy K., O'Garra A. Reversibility of T helper 1 and 2 populations is lost after long-term stimulation. J Exp Med. 1996 Mar 1;183(3):901–913. doi: 10.1084/jem.183.3.901. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nambu Mitsuhiko, Shintaku Noriaki, Ohta Shigeru. Relationship between cord blood level of IgE specific for Dermatophagoides pteronyssinus and allergic manifestations in infancy. Biol Neonate. 2003;83(2):102–106. doi: 10.1159/000067961. [DOI] [PubMed] [Google Scholar]
- Nishiwaki Tetsu, Yoneyama Hiroyuki, Eishi Yoshinobu, Matsuo Naoki, Tatsumi Koichiro, Kimura Hiroshi, Kuriyama Takayuki, Matsushima Kouji. Indigenous pulmonary Propionibacterium acnes primes the host in the development of sarcoid-like pulmonary granulomatosis in mice. Am J Pathol. 2004 Aug;165(2):631–639. doi: 10.1016/S0002-9440(10)63327-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Orgel H. A., Hamburger R. N., Bazaral M., Gorrin H., Groshong T., Lenoir M., Miller J. R., Wallace W. Development of IgE and allergy in infancy. J Allergy Clin Immunol. 1975 Oct;56(4):296–307. doi: 10.1016/0091-6749(75)90104-9. [DOI] [PubMed] [Google Scholar]
- Perez V. L., Lederer J. A., Lichtman A. H., Abbas A. K. Stability of Th1 and Th2 populations. Int Immunol. 1995 May;7(5):869–875. doi: 10.1093/intimm/7.5.869. [DOI] [PubMed] [Google Scholar]
- Ruiz R. G., Richards D., Kemeny D. M., Price J. F. Neonatal IgE: a poor screen for atopic disease. Clin Exp Allergy. 1991 Jul;21(4):467–472. doi: 10.1111/j.1365-2222.1991.tb01687.x. [DOI] [PubMed] [Google Scholar]
- Stazi Maria-Antonietta, Sampogna Francesca, Montagano Giuseppe, Grandolfo Michele E., Couilliot Marie-France, Annesi-Maesano Isabella. Early life factors related to clinical manifestations of atopic disease but not to skin-prick test positivity in young children. Pediatr Allergy Immunol. 2002 Apr;13(2):105–112. doi: 10.1034/j.1399-3038.2002.00070.x. [DOI] [PubMed] [Google Scholar]
- Strimas J. H., Chi D. S. Significance of IgE level in amniotic fluid and cord blood for the prediction of allergy. Ann Allergy. 1988 Aug;61(2):133–136. [PubMed] [Google Scholar]
- Szabo S. J., Jacobson N. G., Dighe A. S., Gubler U., Murphy K. M. Developmental commitment to the Th2 lineage by extinction of IL-12 signaling. Immunity. 1995 Jun;2(6):665–675. doi: 10.1016/1074-7613(95)90011-x. [DOI] [PubMed] [Google Scholar]
- Tariq S. M., Arshad S. H., Matthews S. M., Hakim E. A. Elevated cord serum IgE increases the risk of aeroallergen sensitization without increasing respiratory allergic symptoms in early childhood. Clin Exp Allergy. 1999 Aug;29(8):1042–1048. doi: 10.1046/j.1365-2222.1999.00594.x. [DOI] [PubMed] [Google Scholar]
- Taussig Lynn M., Wright Anne L., Holberg Catharine J., Halonen Marilyn, Morgan Wayne J., Martinez Fernando D. Tucson Children's Respiratory Study: 1980 to present. J Allergy Clin Immunol. 2003 Apr;111(4):661–676. doi: 10.1067/mai.2003.162. [DOI] [PubMed] [Google Scholar]
