Brockow I, Zutavern A, Hoffmann U, Grübl A, von Berg A, Koletzko S, Filipiak B, Bauer C P, Wichmann H E, Reinhardt D, Berdel D, Krämer U, Heinrich J
Department of Pediatrics, Technical University of Munich, Munich, Germany.
J Investig Allergol Clin Immunol. 2009;19(3):180-7.
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.
To investigate the relevance of sensitization in 12-month-old children in the development of atopic disease by the age of 6 years.
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.
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.
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.
仅有少数研究分析了早期致敏在预测特应性疾病发生方面的价值。低免疫球蛋白（Ig）E抗体水平在这方面的相关性也仍不明确。
探讨12月龄儿童致敏与6岁时特应性疾病发生之间的相关性。
我们分析了来自前瞻性多中心德国婴儿营养干预（GINIplus）研究的1290名有特应性家族史儿童的数据，调查了12月龄时可检测到的特异性IgE抗体的存在与6岁时特应性疾病发生之间的关系。
总计，所分析的儿童中有10.9%发生了致敏。在6岁时，早期致敏儿童中有20.6%患有湿疹，而未致敏儿童中这一比例为9.4%（比值比[OR]，2.31；95%置信区间[CI]，1.42 - 3.74）。过敏性鼻炎的相应数字分别为15.4%和7.3%（OR，2.22；CI，1.31 - 3.78），哮喘为10.2%和2.6%（OR，3.93；95% CI，1.98 - 7.76）。早期对气传变应原致敏的儿童发生后续特应性疾病的风险最高。早期致敏在1岁内无湿疹的儿童中并未增加风险。极低的特异性IgE水平（0.18 - 0.34 kU/L）与所分析的任何结局均无显著关联。
对于有特应性家族史的儿童，发现1岁内尤其是对常见食物变应原和气传变应原的致敏是6岁时特应性疾病发生的有力预测因素。
