Department of Pediatric Pneumology and Immunology, Charité-Universitätsmedizin, Berlin, Germany.
Clin Exp Allergy. 2009 Oct;39(10):1551-7. doi: 10.1111/j.1365-2222.2009.03348.x. Epub 2009 Sep 10.
Allergic rhinoconjunctivitis and asthma evolve dynamically throughout childhood. Yet, data on the evolution of serum levels of IgE antibodies against airborne allergens throughout the first decade of life are scarce.
To describe the patterns of new and persistent sensitization against airborne allergens including remission from birth to 10 years of age and the long-term clinical outcomes up to the age of 13 years.
In 273 children from the Multi-Centre Allergy Study, a German birth cohort, IgE levels were determined against airborne allergens (Dermatophagoides pteronyssinus, cat and dog dander, birch and grass species pollens) at 2, 5, 7, and 10 years of age (ImmunoCAP, Phadia); allergic rhino-conjunctivitis and asthma were ascertained at the 13 years of age through a standardized questionnaire (International Study of Asthma and Allergies in Childhood).
The prevalence of sensitization to each allergen increased steadily throughout childhood, and a hierarchy of sensitization prevalence (grass>birch>mites>cat>dog) was maintained from 5 years of age onwards. A mono-sensitization state was relatively short (measurable half-life=3 years) as additional sensitizations were acquired frequently, and relatively soon after the first one. Remission of weak sensitization (UNICAP classes 1-2) was also quite frequent, especially before 5 years of age. By contrast, stronger IgE responses (>3.5 kU/L) were invariably persistent. Early sensitization was associated with a higher tendency for poly-sensitization at 10 years of age and allergic rhino-conjunctivitis and/or asthma at 13 years of age.
IgE responses against airborne allergens undergo dynamic changes throughout childhood, with a high frequency of new sensitization or remission. The long-term persistence and the clinical impact of IgE responses are affected by the intensity of IgE sensitization and the age of its onset.
变应性鼻结膜炎和哮喘在儿童期会不断发展。然而，关于儿童期前 10 年血清中针对空气传播过敏原的 IgE 抗体演变的数据却很少。
描述针对空气传播过敏原的新的和持续的致敏模式，包括从出生到 10 岁时的缓解情况，以及直至 13 岁时的长期临床结局。
在德国出生队列多中心过敏研究中的 273 名儿童中，在 2、5、7 和 10 岁时使用 ImmunoCAP（Phadia）检测针对空气传播过敏原（户尘螨、猫和狗皮屑、桦树和草花粉）的 IgE 水平；通过标准化问卷（国际儿童哮喘和过敏研究）在 13 岁时确定过敏性鼻结膜炎和哮喘。
从 5 岁起，对每种过敏原的致敏率在整个儿童期都稳步上升，并保持了致敏率的等级顺序（草花粉>桦树花粉>尘螨>猫>狗）。单一致敏状态相对较短（可测量半衰期为 3 年），因为经常会获得额外的致敏，而且是在第一次致敏后不久。弱致敏（UNICAP 等级 1-2）的缓解也相当频繁，尤其是在 5 岁之前。相比之下，更强的 IgE 反应（>3.5 kU/L）始终是持续存在的。早期致敏与 10 岁时多致敏以及 13 岁时过敏性鼻结膜炎和/或哮喘的发生趋势更高有关。
针对空气传播过敏原的 IgE 反应在整个儿童期都在不断变化，新的致敏或缓解的频率很高。IgE 反应的长期持续性及其临床影响受 IgE 致敏的强度和其起始年龄的影响。
