Natural course of sensitization to food and inhalant allergens during the first 6 years of life

doi:10.1016/S0091-6749(99)70195-8

Journal of Allergy and Clinical Immunology

Volume 103, Issue 6, June 1999, Pages 1173-1179

https://doi.org/10.1016/S0091-6749(99)70195-8 Get rights and content

Abstract

Background: Specific IgE antibody responses to alimentary and environmental allergens are one of the hallmarks of atopic diseases. The knowledge of the time course of allergic sensitization during early life may facilitate measures for preventive interventions. Objective: In a prospective birth cohort study (the Multicenter Allergy Study [MAS]) we investigated annual incidence and prevalence rates of sensitization to food and inhalant allergens during the first 6 years of life. Methods: For 216 children of a prospective birth cohort (MAS), a complete follow-up of specific IgE measurements to 9 food and inhalant allergens was available at 1, 2, 3, 5, and 6 years of age. On the basis of these measurements, sensitization rates were estimated for the reference population of 4082 children by weighted analysis. Results: Annual incidence rates of sensitization to food allergens decreased from 10% at 1 year of age to 3% at the 6 years of age. Incidences of sensitization to inhalant allergen, however, increased with age (from 1.5% at 1 year to 8% at 6 years). Point prevalences of allergic sensitization to at least 1 of the 9 tested allergens increased from 11% at 1 year up to 30% at 6 years. This increase was due to markedly increasing sensitization rates to inhalant allergens (1.5% to at least 1 inhalant allergen at 1 year and 26% at 6 years of age), whereas sensitization rates to food allergens remained stable during the first 6 years of life (10%). Conclusion: The earliest serologic marker for atopic immunoreactivity in infancy is the presence of IgE antibodies to egg, followed by milk. The development of sensitization to inhalant allergens occurs mostly after infancy. Beyond the third birthday annual incidence and prevalence increase markedly with age. Rates for outdoor allergens are twice those for indoor allergens. (J Allergy Clin Immunol 1999;103:1173-9.)

Section snippets

Study population

Subjects in this study were participants of the MAS. A detailed description of the 1314 study subjects and methods is presented elsewhere.¹⁶ Briefly, in 1990 all 7609 newborns were enrolled in 6 obstetric departments in 5 German cities. For 5051 children, data about atopic family history and cord blood IgE (CB-IgE) was available. There were no significant differences between the total sample and the 5051 children with respect to the main characteristics given in Table I.Of these subjects, 499

RESULTS

A description of the population-based sample and the analyzed subcohort with regard to the weighting factors and other perinatal characteristics available for both samples are given in Table I. The differences in respect to the 2 atopic risk factors (atopic family history and elevated CB-IgE level) were due to the study design but were adjusted for in the analysis. The subsample corresponded to the population-based sample with regard to the other characteristics.

We were unable to detect sIgE to

DISCUSSION

To our knowledge, this is the first study with a complete and consecutive follow-up of sIgE measurements of over 200 children from birth to 6 years of age that allows estimates for a large population-based sample. Previous reports regarding specific allergic sensitization often relied on small sample sizes in the respective age groups, on selected groups of subjects (eg, children at risk for atopy), or both.1, 3, 4, 5, 6, 7, 18, 19, 20 Reports of prevalence rates were mostly based on

Acknowledgements

We thank C. P. Bauer, F. Bieber, G. Edenharter, J. Forster, C. Genzel, M. Goetz, M. Groeger, B. Hampel, G. Leskosek, R. Mayrl, C. Sommerfeld, and P. Wagner for their contributions to the MAS-90 study.

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^☆: Supported by the German Ministry of Research and Technology (BMFT), grant no. 01EE9406.

^☆☆: Reprint requests: Michael Kulig, MD, MPH, c/o Prof Ulrich Wahn, Department of Pediatric Pneumology and Immunology, Humboldt University Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.

^★: 0091-6749/99 $8.00 + 0 1/1/96778

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Natural course of sensitization to food and inhalant allergens during the first 6 years of life☆,☆☆,★

Abstract

Section snippets

Study population

RESULTS

DISCUSSION

Acknowledgements

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

Development of IgE and IgG antibodies to food and inhalant allergens in children at risk of allergic disease

Arch Dis Child

Natural history of IgE antibodies in children at risk for atopy

Ann Allergy

Dietary manipulations in infants and their mothers and the natural course of atopic disease

Pediatr Allergy Immunol

Clinical symptoms and IgE responses to common food proteins and inhalants in the first 7 years of life

Clin Allergy