Prediction of sensitization to inhalant allergens in childhood: evaluating family history, atopic dermatitis and sensitization to food allergens
Prediction of sensitization to inhalant allergens in childhood: evaluating family history, atopic dermatitis and sensitization to food allergens
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DOI：
10.1046/j.1365-2222.1998.00439.x
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发表时间：
1998-11-01
影响因子：
6.1
通讯作者：
Wahn, U
中科院分区：
文献类型：
--
作者：
Kulig, M;Bergmann, R;Wahn, U
特应性家族史是儿童期吸入性过敏原致敏和过敏性疾病的不良预测因素。我们最近确定了早期致敏的食物过敏原，特别是鸡蛋，作为一个有价值的预测随后致敏吸入性allergens.Objective（1）是否预测将提高体外过敏试验在1岁的家庭史和病史数据相结合。(2)与体外试验预测致敏aeroallergens.Methods的观察性出生队列研究（MAS）的能力比较49名儿童谁是致敏吸入性过敏原在5岁和116个非致敏对照被列入本研究。为预测吸入性过敏原致敏的预后因素进行了评估：特应性家族史（FH），特应性皮炎（AD）在第一年的生活，两个IR？体外过敏试验的特定IEE常见的食物过敏原在1岁（fx 5 [Pharmacia]和单一过敏原特异性试验（sIgE）的四个过敏原）和“高”总血清IgE，定义由三个不同的cut-cutpoints.Results的组合的病史数据和实验室检查导致最好的预测歧视。如果通过单一过敏原特异性试验检测到食物致敏（PPV：66%/75%/100%，对应于三个评价的风险组），则阳性预测值（PPV）高于定性fx 5（PPV：46%/65%/100%）。两种检测的阴性预测值相等（两个低风险组分别为69%和92%）。结论婴儿期吸入性过敏原致敏的预测应以病史资料和食物过敏原致敏试验为依据。体外试验提高了预测的区分度，但必须考虑儿童的个体风险状况，以进行可靠和有效的预测。
Background A family history of atopy is a poor predictor of sensitization to inhalant allergens and allergic disease during childhood. We recently identified early sensitization to food allergens, especially hen's egg, as a valuable predictor of subsequent sensitization to inhalant allergens.Objective (1) Whether prediction will be improved by in vitro allergy tests at 1 year of age in combination with family history and medical history data. (2) Comparison with the capacities of in vitro tests to predict sensitization to aeroallergens.Methods Of an observational birth cohort study (MAS) 49 children who were sensitized to inhalant allergens at 5 years of age and 116 non-sensitized controls were included in the present study. For the prediction of sensitization to inhalant allergens the following prognostic factors were evaluated: atopic family history (FH), atopic dermatitis (AD) during the first year of life, two ir? vitro allergy tests for specific IEE to common food allergens at I year of age (fx5 [Pharmacia] and single allergen specific tests (sIgE) for four allergens) and 'high' total serum IgE, defined by three different cut off points.Results The combination of medical history data and laboratory tests resulted in the best predictive discrimination. The positive predictive values (PPV) were higher if sensitization to food was detected by single allergen specific tests (PPV: 66%/75%/100% corresponding to the three evaluated risk groups) than by the qualitative fx5 (PPV: 46%/65%/100%). The negative predictive values were equal for both tests (69 and 92% for the two low risk groups). High total serum IgE had low predictive capacity.Conclusion During infancy the prediction of sensitization to inhalant allergens should be based on medical history data and allergy tests determining sensitization to food allergens. The in vitro tests improve the predictive discrimination, but the individual risk profile of the child must be considered for a reliable and valid prediction.