Asthma and allergic rhinitis risk depends on house dust mite specific IgE levels in PARIS birth cohort children
Asthma and allergic rhinitis risk depends on house dust mite specific IgE levels in PARIS birth cohort children
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DOI：
10.1016/j.waojou.2019.100057
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发表时间：
2019-09-01
影响因子：
5.1
通讯作者：
Momas, Isabelle
中科院分区：
文献类型：
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作者：
Gabet, Stephan;Ranciere, Fanny;Momas, Isabelle
背景：儿童期过敏性致敏的自然史及其对过敏性疾病发展的影响需要澄清。本研究的目的是确定过敏的致敏性和发病率模式在第一个8 years of life.Methods：这项研究是在正在进行的人口为基础的前瞻性污染和哮喘风险：婴儿研究（巴黎）出生队列。根据18个月和8/9年时测得的过敏原特异性IgE水平，通过k均值聚类确定致敏特征。过敏性疾病的发病率的基础上确定的症状，症状严重程度，治疗和终身医生诊断的哮喘，过敏性鼻炎，特应性皮炎和下呼吸道infections前2 years.Results：五个致敏和5过敏性发病模式建立在714名儿童的潜在类分析。未致敏或孤立和低过敏原特异性致敏的儿童被分组在一起（76.8%）。早期和短暂的过敏性食物，增加了哮喘的风险，在儿童期以后被确定（4.9%）。在8/9岁时对屋尘螨高度致敏（>= 3.5kU（A）/L）的儿童（9.0%）发生哮喘和变应性鼻炎的风险最高。最后，梯牧草花粉在8/9年的致敏特性（5.3%）与呼吸道过敏性疾病有关，早发性和持续性致敏性也是如此（4.1%），后者也与特应性皮炎密切相关。结论和临床意义：我们表明，准确评估过敏性疾病的风险应依赖于早期和多重致敏，涉及过敏原，和过敏原特异性IgE水平，而不是像通常那样仅将过敏性致敏性视为二分变量（过敏原特异性IgE >= 0.35 kU（A）/L）。这对屋尘螨来说尤其明显。我们希望，在其他人群中得到进一步证实之前，我们的研究结果将改善临床实践，作为预防过敏性疾病方法的一部分。
Background: The natural history of allergic sensitization in childhood, and its impact on allergic disease development, needs to be clarified. This study aims to identify allergic sensitization and morbidity patterns during the first 8 years of life.Methods: The study was conducted in the on-going population-based prospective Pollution and Asthma Risk: an Infant Study (PARIS) birth cohort. Sensitization profiles were identified by k-means clustering based upon allergen-specific IgE levels measured at 18 months and 8/9 years. Allergic morbidity profiles were identified by latent class analysis based on symptoms, symptom severity, treatments, and lifetime doctor-diagnoses of asthma, allergic rhinitis, and atopic dermatitis and on lower respiratory infections before 2 years.Results: Five sensitization and 5 allergic morbidity patterns were established in 714 children. Children not sensitized or with isolated and low allergen-specific sensitization were grouped together (76.8%). A profile of early and transient sensitization to foods that increased the risk of asthma later in childhood was identified (4.9%). Children strongly sensitized (>= 3.5 kU(A)/L) to house dust mite at 8/9 years (9.0%) had the highest risk of asthma and allergic rhinitis. Finally, timothy grass pollen at 8/9 years sensitization profile (5.3%) was related to respiratory allergic diseases, as was early onset and persistent sensitization profile (4.1%), this latter being also strongly associated with atopic dermatitis.Conclusions & Clinical Relevance: We show that accurate assessment of the risk of allergic disease should rely on earliness and multiplicity of sensitization, involved allergens, and allergen-specific IgE levels, and not considering solely allergic sensitization as a dichotomous variable (allergen-specific IgE >= 0.35 kU(A)/L), as usually done. This is particularly striking for house dust mite. We are hopeful that, pending further confirmation in other populations, our findings will improve clinical practice as part of an approach to allergic disease prevention.