Dynamic evolution of serum immunoglobulin E to airborne allergens throughout childhood: results from the Multi-Centre Allergy Study birth cohort
Dynamic evolution of serum immunoglobulin E to airborne allergens throughout childhood: results from the Multi-Centre Allergy Study birth cohort
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DOI：
10.1111/j.1365-2222.2009.03348.x
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发表时间：
2009-10-01
影响因子：
6.1
通讯作者：
Lau, S.
中科院分区：
文献类型：
--
作者：
Matricardi, P. M.;Bockelbrink, A.;Lau, S.
背景过敏性鼻结膜炎和哮喘在整个儿童时期动态演变。目的描述对空气传播变应原的新的和持续的致敏模式，包括从出生到10岁的缓解和13岁以下的长期临床结果。方法对273名来自多中心过敏研究的德国出生队列儿童在2岁、5岁、7岁和10岁时测定空气传播变应原(屋尘螨、猫和狗皮屑、桦树和草本植物花粉)的IgE水平；过敏性鼻-结膜炎和哮喘在13岁时通过标准化问卷(国际儿童哮喘和过敏症研究)确诊。结果儿童对各种过敏原的过敏性患病率在整个儿童期稳步上升，并从5岁起维持了过敏性患病率的等级(草>；桦树>；尘螨>；猫>；狗)。单敏化状态相对较短(可测量的半衰期=3年)，因为经常获得额外的敏化，并且在第一次敏化后相对较短。弱敏感度缓解(UNICAP 1-2级)也相当频繁，特别是在5岁之前。相比之下，较强的IgE反应(>；3.5kU/L)总是持久的。早期致敏与10岁多敏化倾向和13岁变态反应性鼻结膜炎和/或哮喘相关。结论儿童时期对气载变应原的IgE反应有动态变化，新致敏或缓解的频率较高。IgE反应的长期持久性和临床影响受IgE致敏强度和发病年龄的影响。
P>BackgroundAllergic rhinoconjunctivitis and asthma evolve dynamically throughout childhood. Yet, data on the evolution of serum levels of IgE antibodies against airborne allergens throughout the first decade of life are scarce.ObjectiveTo describe the patterns of new and persistent sensitization against airborne allergens including remission from birth to 10 years of age and the long-term clinical outcomes up to the age of 13 years.MethodsIn 273 children from the Multi-Centre Allergy Study, a German birth cohort, IgE levels were determined against airborne allergens (Dermatophagoides pteronyssinus, cat and dog dander, birch and grass species pollens) at 2, 5, 7, and 10 years of age (ImmunoCAP, Phadia); allergic rhino-conjunctivitis and asthma were ascertained at the 13 years of age through a standardized questionnaire (International Study of Asthma and Allergies in Childhood).ResultsThe prevalence of sensitization to each allergen increased steadily throughout childhood, and a hierarchy of sensitization prevalence (grass > birch > mites > cat > dog) was maintained from 5 years of age onwards. A mono-sensitization state was relatively short (measurable half-life=3 years) as additional sensitizations were acquired frequently, and relatively soon after the first one. Remission of weak sensitization (UNICAP classes 1-2) was also quite frequent, especially before 5 years of age. By contrast, stronger IgE responses (> 3.5 kU/L) were invariably persistent. Early sensitization was associated with a higher tendency for poly-sensitization at 10 years of age and allergic rhino-conjunctivitis and/or asthma at 13 years of age.ConclusionsIgE responses against airborne allergens undergo dynamic changes throughout childhood, with a high frequency of new sensitization or remission. The long-term persistence and the clinical impact of IgE responses are affected by the intensity of IgE sensitization and the age of its onset.