Original article
Longitudinal changes in atopy during a 4-year period: Relation to bronchial hyperresponsiveness and respiratory symptoms in a population sample of Australian schoolchildren

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Abstract

A total of 380 schoolchildren living in Belmont, New South Wales, a coastal town where the predominant aeroallergens are house dust mites, were studied on three occasions at 2-year intervals. At each study, atopy was measured by skin prick tests to 13 allergens, bronchial responsiveness was measured by histamine inhalation test, and respiratory illness history was assessed by a self-administered questionnaire to parents. The age of the group was 8 to 10 years at enrollment. We found that skin wheals <4 mm were not associated with respiratory or allergic illness, and therefore, we defined atopy as the presence of a skin wheal of ≥4 mm. In the sample, 24% of the children were atopic at 8 to 10 years (early-onset atopy), and an additional 15% became atopic during the study (late-onset atopy). Both early- and late-onset atopy had a close association with hay fever. Late-onset atopy was strongly associated with inconsistent reporting of symptoms. Early-onset atopy was an important risk factor for bronchial hyperresponsiveness (BHR), diagnosed asthma, and continuing symptoms of wheeze, and was a particularly important risk factor for BHR with current wheeze in late childhood years. We conclude that atopy acquired at an early age is an important predictive factor for respiratory symptoms occurring with BHR and continuing into late childhood.

References (37)

  • RA Barbee et al.

    Longitudinal changes in allergen skin test reactivity in a community population sample

    J Allergy Clin Immunol

    (1987)
  • LP Boulet et al.

    Asthma and increases in nonallergic bronchial responsiveness from seasonal pollen exposure

    J Allergy Clin Immunol

    (1983)
  • CS Witt et al.

    Positive allergy prick tests associated with bronchial histamine responsiveness in an unselected population

    J Allergy Clin Immunol

    (1986)
  • B Stenius

    Skin and provocation tests with Dermotophagoides pteronyssinus in allergic rhinitis: comparison of prick and intracutaneous skin test methods and correlation with specific IgE

    Allergy

    (1973)
  • DH Bryant et al.

    The correlation between skin tests, bronchial provocation tests, and the serum level of IgE specific for common allergens in patients with asthma

    Clin Allergy

    (1975)
  • FA Herbert et al.

    RAST and skin test screening in the investigation of asthma

    Ann Allergy

    (1982)
  • S Krilis et al.

    Analysis of allergen-specific IgE responses in 341 allergic patients: associations between allergens and between allergen groups and clinical diagnoses

    Aust NZ J Med

    (1985)
  • RC Godfrey et al.

    The prevalence of immediate positive skin tests to Dermatophagoides pteronyssinus and grass pollen in schoolchildren

    Clin Allergy

    (1976)
  • AJ Woolcock et al.

    Atopy and bronchial reactivity in Australian and Melanesian populations

    Clin Allergy

    (1978)
  • TMK Haahtella

    The prevalence of allergic conditions and immediate skin test reactions among Finnish adolescents

    Clin Allergy

    (1979)
  • RA Barbee et al.

    Immediate skin-test reactivity in a general population sample

    Ann Intern Med

    (1976)
  • LR Friedhoff et al.

    A genetic-epidemiological study of human immune responsiveness to allergens in an industrial population. 1. Epidemiology of reported allergy and skin test positivity

    Am J Med Genet

    (1981)
  • M Chan-Yeung et al.

    Immediate skin reactivity and its relationship to age, sex, smoking, and occupational exposure

    Arch Environ Health

    (1985)
  • G Hattevig et al.

    The prevalence of allergy and IgE antibodies to inhalant allergens in Swedish schoolchildren

    Acta Paediatr Scand

    (1987)
  • A Barbato et al.

    Modification of bronchial hyperreactivity during pollen season in children allergic to grass

    Ann Allergy

    (1987)
  • DW Cockcroft et al.

    Allergen-induced increase in nonaliergic bronchial reactivity

    Clin Allergy

    (1977)
  • B Burrows et al.

    Respiratory disorders and allergy skin-test reactions

    Ann Intern Med

    (1976)
  • KN McNicol et al.

    Spectrum of asthma in children. II. Allergic components

    Br Med J

    (1973)
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    Supported by the Asthma Foundation of New South Wales and National Health and Medical Research Council of Australia.

    Senior Research Assistant.

    ∗∗

    Professor of Respiratory Medicine.

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