Sensitization to milk, egg and peanut from birth to 18 years: A longitudinal study of a cohort at risk of allergic disease
Sensitization to milk, egg and peanut from birth to 18 years: A longitudinal study of a cohort at risk of allergic disease
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DOI：
10.1111/pai.12480
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发表时间：
2016-02-01
影响因子：
4.4
通讯作者：
Dharmage, Shyamali C.
中科院分区：
文献类型：
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作者：
Alduraywish, Shatha A.;Lodge, Caroline J.;Dharmage, Shyamali C.
背景关于儿童早期以后食物致敏的自然历史的纵向数据很少。本研究旨在调查婴儿至18岁期间牛奶、鸡蛋和花生致敏的自然历史，并评估早期食物致敏是否可以预测青少年食物过敏。方法在高危过敏出生队列(n=620)中，分别在6个月龄、1岁、2岁、12岁和18岁时用皮肤点刺试验测定牛奶、鸡蛋和花生的敏感度。广义加性模型研究了婴儿时期与性行为、湿疹和空气变应原致敏的相互作用。Logistic回归分析了早期食物致敏与青少年致敏和可能的食物过敏之间的关系。结果鸡蛋和花生致敏的患病率在12个月时达到高峰，而牛奶致敏的患病率在1岁和12岁时达到峰值。在整个随访过程中，患有早期湿疹的男孩对牛奶和鸡蛋的敏感率最高。然而，随着时间的推移，性别和湿疹都不会影响花生敏感症的流行。在7%的参与者中，观察到2岁以上的新起病食物敏感症。12个月时食物致敏与青春期食物敏化和青春期食物过敏的风险增加相关，对多种食物过敏原的敏化预测作用最强。结论食物敏化患病率在婴儿期最高，12个月后下降。患有早期湿疹的男孩对牛奶和鸡蛋的敏感率最高。12个月时的食物过敏可以预测12岁和18岁时青春期过敏和可能的食物过敏的风险更大的儿童。
BackgroundLongitudinal data on the natural history of food sensitization beyond early childhood are scarce. We aimed to investigate the natural history of milk, egg and peanut sensitization from infancy to 18 years and assess whether early food sensitization predicted adolescent food allergy.MethodsSensitization to cow's milk, hen's egg and peanut was measured by skin prick testing at ages 6 months, 1, 2, 12 and 18 years in a high-risk allergy birth cohort (n = 620). Generalized additive models investigated interactions with sex, eczema and aeroallergen sensitization in infancy. Logistic regression assessed the relationships between early food sensitization and adolescent sensitization and probable food allergy up to 18 years.ResultsThe prevalence of egg and peanut sensitization peaked at 12 months, while milk sensitization peaked at both 1 and 12 years. Boys with early eczema had the highest prevalences of milk and egg sensitization throughout follow-ups. However, neither sex nor eczema influenced the prevalence of peanut sensitization over time. New onset food sensitization beyond the age of 2 was observed in 7% of participants. Food sensitization at 12 months was associated with increased risk of adolescent food sensitization and adolescent probable food allergy, with sensitization to more than one food allergen had the strongest predictor.ConclusionsFood sensitization prevalence is highest in infancy and declines after 12 months of age. Boys with early-life eczema have the highest prevalence of milk and egg sensitization. Food sensitization at 12 months can predict children at greater risk of adolescent sensitization and probable food allergy at 12 and 18 years.