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Original Article

 

Early Allergic Sensitizations and Their Relevance to Atopic Diseases in Children Aged 6 Years: Results of the GINI Study

 

I Brockow,1,4 A Zutavern,3,4 U Hoffmann,1 A Grübl,1 A von Berg,2 S Koletzko,3 B Filipiak,4 CP Bauer,1 HE Wichmann,4  Reinhardt,3 D Berdel,2 U Krämer,5 J Heinrich4 for the GINIplus Study Group

1 Department of Pediatrics, Technical University of Munich, Munich, Germany
2 Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
3 Department of Pediatrics, Ludwig Maximilians University, Munich, Germany
4 Helmholtz Zentrum München, Germany, Institute of Epidemiology, Munich, Germany
5 IUF-Institut für Umweltmedizinische Forschung, Düsseldorf, Germany

J Investig Allergol Clin Immunol 2009; Vol. 19(3): 180-187

 

 Abstract


Background: Only a few studies have analyzed the value of early sensitization in predicting the development of atopic disease. The relevance of low immunoglobulin (Ig)E antibody levels in this respect also remains unclear.

Objective: To investigate the relevance of sensitization in 12-month-old children in the development of atopic disease by the age of 6 years.

Methods: We analyzed data for 1290 children with a positive family history of atopy from the prospective, multicenter German Infant Nutritional Intervention (GINIplus) study and investigated the relationship between the presence of detectable specific IgE antibodies at the age of 12 months and the development of atopic disease by the age of 6 years.
Results: In all, 10.9 % of children analyzed developed sensitization. At the age of 6 years, 20.6% of children with early sensitization had eczema compared to 9.4% of those without (odds ratio [OR], 2.31; 95% confidence interval [CI], 1.42-3.74). The corresponding figures
were 15.4% vs 7.3% for allergic rhinitis (OR, 2.22; CI, 1.31-3.78) and 10.2% vs 2.6% (OR, 3.93; 95% CI, 1.98-7.76) for asthma. Children with early sensitization to aeroallergens had the greatest risk of subsequent atopic disease. Early sensitization did not increase risk in children without eczema within the first year of life. Very low specific IgE levels (0.18-0.34 kU/L) were not significantly associated with any of the outcomes analyzed.

Conclusion: Sensitization to common food allergens and to aeroallergens in particular during the first year of life was found to be a strong predictor for the development of atopic disease by the age of 6 years in children with a positive family history of atopy.

Key words: Atopic disease. Children. GINI study. Low immunoglobulin E (IgE) levels. Sensitization.