Author:
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Wickman, Magnus; Lupinek, Christian; Andersson, Niklas; Belgrave, Danielle; Asarnoj, Anna; Benet, Marta; Pinart Gilberga, Mariona; Wieser, Sandra; García Aymerich, Judith; Baar, Alexandra; Pershagen, Göran; Simpson, Angela; Kull, Inger; Bergstrom, Anna; Melén, Erik; Hamsten, Carl; Antó i Boqué, Josep Maria; Bousquet, Jean; Custovic, Adnan; Valenta, Rudolf; Hage, Marianne van
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Abstract:
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BACKGROUND: Sensitization in early childhood may precede
respiratory allergy in adolescence. METHODS: IgE reactivity
against 132 allergen molecules was evaluated using the MeDALL
microarray in sera obtained from a random sample of 786 children
at the age of 4, 8 and 16years in a population based birth
cohort (BAMSE). Symptoms were analyzed by questionnaire at ages
4, 8 and 16years. Clinically and independent relevant allergen
molecules accounting for >/=90% of IgE reactivities in
sensitized individuals and at all time-points were identified as
risk molecules and used to predict respiratory allergy. The data
was replicated in the Manchester Asthma and Allergy Study (MAAS)
birth cohort by studying IgE reactivity with the use of a
commercial IgE microarray. Sera were obtained from children at
the ages of 3, 5, 8 and 11years (N=248) and the outcome was
studied at 11years. FINDINGS: In the BAMSE cohort 4 risk
molecules could be identified, i.e.: Ara h 1 (peanut), Bet v 1
(birch), Fel d 1 (cat), Phl p 1 (grass). For MAAS the
corresponding number of molecules was 5: Der p 1 (dust mite),
Der f 2 (dust mite), Phl p 1 (grass), Phl p 5 (grass), Fel d 1
(cat). In BAMSE, early IgE reactivity to >/=3 of 4 allergen
molecules at four years predicted incident and persistent asthma
and/or rhinitis at 16years (87% and 95%, respectively). The
corresponding proportions in the MAAS cohort at 16years were
100% and 100%, respectively, for IgE reactivity to >/=3 of 5
risk molecules. INTERPRETATIONS: IgE reactivity to a few
allergen molecules early in life identifies children with a high
risk of asthma and/or rhinitis at 16years. These findings will
be of importance for developing preventive strategies for asthma
and rhinitis in children. |