Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, VA, USA.
Clin Exp Allergy. 2013 Oct;43(10):1160-70. doi: 10.1111/cea.12169.
Atopic dermatitis (AD) is common in children; however, persistence of AD with or without asthma is less common. Longitudinal studies remain limited in their ability to characterize how IgE antibody responses evolve in AD, and their relationship with asthma.
To use a cross-sectional study design of children with active AD to analyse age-related differences in IgE antibodies and relation to wheeze.
IgE antibodies to food and inhalant allergens were measured in children with active AD (5 months to 15 years of age, n = 66), with and without history of wheeze.
Whereas IgE antibodies to foods persisted at a similar prevalence and titre throughout childhood, IgE antibodies to all aeroallergens rose sharply into adolescence. From birth, the chance of sensitization for any aeroallergen increased for each 12-month increment in age (OR ≥ 1.21, P < 0.01), with the largest effect observed for dust mite (OR = 1.56, P < 0.001). A steeper age-related rise in IgE antibody titre to dust mite, but no other allergen was associated with more severe disease. Despite this, sensitization to cat was more strongly associated with wheeze (OR = 4.5, P < 0.01), and linked to Fel d 1 and Fel d 4, but not Fel d 2. Comparison of cat allergic children with AD to those without, revealed higher IgE levels to Fel d 2 and Fel d 4 (P < 0.05), but not Fel d 1.
Differences in sensitization to cat and dust mite among young children with AD may aid in identifying those at increased risk for disease progression and development of asthma. Early sensitization to cat and risk for wheeze among children with AD may be linked to an increased risk for sensitization to a broader spectrum of allergen components from early life. Collectively, our findings argue for early intervention strategies designed to mitigate skin inflammation in children with AD.
特应性皮炎（AD）在儿童中很常见；然而，AD 持续存在，无论是否伴有哮喘，这种情况都比较少见。纵向研究在描述 AD 中 IgE 抗体的演变及其与哮喘的关系方面仍然存在局限性。
通过对患有活动性 AD 的儿童进行横断面研究设计，分析 IgE 抗体与年龄相关的差异及其与喘息的关系。
对 66 例患有活动性 AD（5 个月至 15 岁）的儿童进行了食物和吸入性过敏原 IgE 抗体的检测，其中包括有喘息史和无喘息史的儿童。
虽然食物 IgE 抗体在整个儿童期保持相似的流行率和滴度，但所有吸入性过敏原的 IgE 抗体在青春期急剧上升。从出生开始，每个 12 个月龄的增加，都会增加对任何吸入性过敏原的致敏机会（OR≥1.21，P<0.01），其中尘螨的影响最大（OR=1.56，P<0.001）。与尘螨相比，IgE 抗体对尘螨的年龄相关性上升更为陡峭，但与其他过敏原无关。尽管如此，对猫的过敏与喘息（OR=4.5，P<0.01）更为相关，并且与 Fel d 1 和 Fel d 4 相关，但与 Fel d 2 无关。对患有 AD 的猫过敏的儿童与无过敏的儿童进行比较，发现对 Fel d 2 和 Fel d 4 的 IgE 水平更高（P<0.05），但对 Fel d 1 则不然。
患有 AD 的幼儿对猫和尘螨的致敏差异可能有助于识别那些疾病进展和哮喘发展风险增加的患者。患有 AD 的儿童早期对猫的致敏和喘息风险可能与生命早期对更广泛的过敏原成分的致敏风险增加有关。总的来说，我们的研究结果表明，需要制定早期干预策略，以减轻患有 AD 的儿童的皮肤炎症。
