Patterns of sensitization to food and aeroallergens in the first 3 years of life

Dean, Taraneh, Venter, Carina, Pereira, Brett, Arshad, S. Hasan, Grundy, Jane, Clayton, C. Bernie and Higgins, Bernie (2007) Patterns of sensitization to food and aeroallergens in the first 3 years of life. Journal of Allergy and Clinical Immunology, 120 (5), 1166-1171. (doi:10.1016/j.jaci.2007.06.042).

Abstract

BACKGROUND: There is a paucity of longitudinal studies of allergen sensitization in childhood. OBJECTIVE: To investigate the pattern of sensitization in early childhood. METHODS: A nested cohort of children (n = 543) were followed up from birth and given a skin prick test (SPT) at 1, 2, and 3 years of age. A detailed clinical history was obtained. RESULTS: The prevalences of sensitization to aeroallergens were 1.3%, 6.4%, and 10.7% at 1, 2, and 3 years of age. The figures for food allergens were 2.8%, 3.9%, and 3.7%. There was a statistically significant increase in the prevalence of sensitization to >or=1 allergen between years 1 and 2 (P < .001) and years 2 and 3 (P = .032). Among those with a positive SPT at 1 year, 29% tested positive to additional allergens at 2 years (P = .0054). Sensitization to milk or egg at 1 year was a predictor for increased sensitization to peanut at 3 years (odds ratio, 34.8; P < .0001). Sensitization to egg at 1 year was associated with increased sensitization to aeroallergens at 3 years (odds ratios, house dust mite, 27.1, P < .001; cat, 8.9, P < .01; grass, 11.8, P = .005). For peanut and cat allergens, wheal size increases with the age of the child (P = .009 and P = .017, respectively). CONCLUSION: Sensitization to allergens as demonstrated by positive SPT tends to increase with age, and this change can be detected in the first 3 years of life. CLINICAL IMPLICATIONS: The high predictive value for early sensitization and a linear increase in SPT reactivity provide an opportunity for early intervention.

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