Phadia AB, Uppsala, Sweden.
Allergy. 2011 Aug;66(8):1058-64. doi: 10.1111/j.1398-9995.2011.02578.x. Epub 2011 Mar 11.
Early identification of children at risk for later development of allergic disease is essential for early intervention and initiation of proper treatment and management.
To investigate the relationship between low levels (0.1-0.7 kU(A) /l) of IgE sensitization to food and inhalant allergens and symptoms of eczema, rhinitis, and asthma from birth to 5 years of age.
Children (268) were followed prospectively from birth to 5 years of age with physical examinations and measurements of s-IgE at 6, 12, 24, and 60 months of age.
Seventy-four percent of the children with low levels of s-IgE to egg and/or milk at the age of 6 months were still sensitized to one or more allergens at age 2 years. Eighty-four percent of the children with low levels of s-IgE to any of the studied allergens at 12 months of age were still sensitized at age 5. The low levels of egg and milk s-IgE also significantly increased the risk for eczema at the same age and also increased the risk for eczema at 2 years of age.
Low levels of s-IgE can be detected from the age of 6 months and are related to further IgE sensitization. The low levels seem to be of importance for both the association to present symptoms and for prediction of future allergic symptoms, especially eczema during early infancy. A detectable s-IgE level, albeit low, could be a clear signal that the immune system is alerted and should be followed.
早期识别有发展为过敏性疾病风险的儿童对于早期干预和开始适当的治疗和管理至关重要。
调查食物和吸入性过敏原的 IgE 致敏水平(0.1-0.7 kU(A)/l)与出生至 5 岁时特应性皮炎、鼻炎和哮喘症状之间的关系。
对 268 名儿童从出生到 5 岁进行前瞻性随访,分别在 6、12、24 和 60 个月龄时进行特异性 IgE(s-IgE)检测。
6 月龄时 s-IgE 对鸡蛋和/或牛奶水平较低的儿童中,74%在 2 岁时仍对一种或多种过敏原过敏。12 月龄时 s-IgE 对任何研究过敏原水平较低的儿童中,84%在 5 岁时仍过敏。鸡蛋和牛奶 s-IgE 水平较低也显著增加了相同年龄时特应性皮炎的风险,也增加了 2 岁时特应性皮炎的风险。
可在 6 月龄时检测到低水平的 s-IgE,且与进一步的 IgE 致敏相关。低水平似乎对当前症状的关联和对未来过敏症状(尤其是婴儿期特应性皮炎)的预测都很重要。尽管水平较低,但可检测到 s-IgE 可能是免疫系统受到刺激的明确信号,应进行随访。