Quantification of IgE antibodies simplifies the classification of allergic diseases in 4-year-old children. A report from the prospective birth cohort study - BAMSE
Quantification of IgE antibodies simplifies the classification of allergic diseases in 4-year-old children. A report from the prospective birth cohort study - BAMSE
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DOI：
10.1046/j.0905-6157.2003.00079.x
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发表时间：
2003-12-01
影响因子：
4.4
通讯作者：
Hamsten, MV
中科院分区：
文献类型：
--
作者：
Wickman, M;Ahlstedt, S;Hamsten, MV
过敏性疾病在幼儿中很常见，但目前尚不清楚针对环境过敏原的免疫球蛋白E（IgE）抗体在4岁儿童的基于人群的前瞻性材料中的分布情况。这项研究是基于75%（n = 4089）的所有符合条件的儿童从北方斯德哥尔摩，出生于1994年和1996年之间，在预先定义的地理区域。在孩子3个月和4岁时，通过父母问卷调查获得有关暴露和结局的数据。在回答4岁问卷的92%的儿童中，获得88%的这些儿童的血清，用于用Pharmacia CAP系统（TM）（Phadiatop（R）和食物混合物fx 5（R））进行IgE抗体分析。抗体水平≥ 0.35 kU（A）/l为阳性。24%的4岁儿童Phadiatop（R）或fx 5（R）阳性。两种试验之间的相关性较差（r = 0.39）。Phadiatop（R）和fx 5（R）联合使用时IgE抗体≥ 3.5 kU/l的发生率可预测任何疑似过敏性疾病[哮喘、鼻炎、特应性湿疹皮炎综合征（AEDS）和食物过敏反应]，预测率为97.4%。然而，如果Phadiatop（R）或fx 5（R）浓度大于或等于3.5 kU（A）/l，仅作为单一试验，则预测任何过敏性疾病的效率要低得多。空气和食物过敏原的两种混合物也相关，不仅在涉及器官数量方面与过敏性疾病的严重程度有关，而且与反复喘息的严重程度有关，特别是在Phadiatop阳性的男孩中（（R）），与阴性测试相比，他们表现出明显有限的峰值流量。根据Phadiatop（R）或食物混合物（fx 5（R））的评估，四分之一的儿童对过敏原过敏。IgE抗体的存在似乎不仅可以预测该年龄组的过敏性疾病，而且还与这些疾病的严重程度有关，特别是与哮喘有关。值得注意的是，Phadiatop（R）和fx 5（R）之间的相关性很差，在识别幼儿过敏性疾病时需要考虑这一点。该研究表明，血液中IgE抗体的定量可能是有益的，不仅可以诊断幼儿过敏性疾病，而且特别是可以作为哮喘严重程度的标志物。
Allergic diseases are common among small children, but it is still unclear how immunoglobulin E (IgE) antibodies to ambient allergens are distributed in a population-based prospective material of children at 4 years of age. The study is based on 75% (n = 4089) of all eligible children from northern Stockholm, born between 1994 and 1996 in pre-defined geographical areas. Data on exposure and outcome were obtained by parental questionnaires when the child was 3 months and 4 years of age. Of the 92% who responded to the 4 years of age questionnaire, serum was obtained in 88% of these children for analysis of IgE antibodies performed with Pharmacia CAP system(TM) (Phadiatop(R) and food mix fx5(R)). An antibody level greater than or equal to0.35 kU(A)/l was considered as positive. A positive Phadiatop((R)) or fx5((R)) was found in 24% of the 4 years old children. A rather poor correlation was found between the two tests (r = 0.39). Occurrence of IgE antibodies greater than or equal to3.5 kU/l for both Phadiatop(R) and fx5(R) in combination could predict any suspected allergic disease [asthma, rhinitis, atopic eczema dermatitis syndrome (AEDS) and allergic reaction to food] to 97.4%. However, the presence of greater than or equal to3.5 kU(A)/l of Phadiatop(R) or fx5(R) used as single tests only, was far less efficient to predict any allergic disease. The two mixes of airborne and food allergens were also associated, not only to the severity of the allergic disease in terms of number of organ involved, but also to the severity of recurrent wheeze, in particular in boys with a positive Phadiatop((R)) who exhibited significantly limited peak flows compared to those with a negative test.Already at the age of 4, one child in four is sensitized to an allergen as assessed by Phadiatop(R) or food mix (fx5(R)). The presence of IgE antibodies seems not only to predict allergic diseases in this age group, but also relates to severity of such diseases, in particular to asthma. Notable, there was a poor correlation between Phadiatop(R) and fx5(R) that needs to be considered when identifying allergic diseases in young children. The study demonstrates that quantification of IgE antibodies in blood may be beneficial, not only to diagnose allergic diseases in young children, but especially to serve as a marker of severity of asthma.