Department of Paediatric Pneumology & Immunology, Charité University Medical Centre, Berlin, Germany.
Pediatr Allergy Immunol. 2014 Jun;25(4):366-73. doi: 10.1111/pai.12248.
An early IgE response to grass or birch pollen can anticipate seasonal allergic rhinitis to pollen later in life or remain clinically silent.
To identify risk factors early in life that allow discriminating pathogenic from non-pathogenic IgE responses and contribute to the development of seasonal allergic rhinitis to grass pollen.
The German Multicentre Allergy Study examined a birth cohort born in 1990. A questionnaire was yearly administered and blood samples collected at age 1,2,3,5,6,7,10,13 yr. The definition of the primary outcome grass- and birch-pollen-related seasonal allergic rhinitis (SARg, SARb) was based on nasal symptoms in June/July and April, respectively. Serum IgE antibodies to Phleum pratense and Betula verrucosae extracts were monitored with immune-enzymatic singleplex assays.
Of the 820 examined children, 177 and 148 developed SARg and SARb, respectively. Among healthy children aged 3 or more years, IgE to grass pollen was the strongest risk factor of SARg (OR 10.39, 95%CI 6.1-17.6, p < 0.001), while parental hay fever was the only risk factor in early childhood independently associated with future SARg (1 parent: OR 2.56, 95%CI 1.4-4.5, p < 0.001; 2 parents: OR 4.17, 95%CI 1.7-10.1) and SARb (1 parent OR: 5.21, 95%CI 2.20-12.4, p < 0.001; 2 parents: OR 8.02, 95%CI 2.0-32.9, p < 0.001). Parental hay fever was associated with an increase of the concentration of pollen-specific IgE in seropositive subjects, after the age of 6 and was also a hallmark of molecularly more complex specific IgE responses to grass or birch pollen at age 6 or older.
Parental hay fever and specific IgE to grass and/or birch pollen are strong pre-clinical determinants and potentially good predictors of seasonal allergic rhinitis.
对草花粉或桦树花粉的早期 IgE 反应可预测以后生活中花粉引起的季节性过敏性鼻炎，或保持临床无症状。
确定生命早期的危险因素，以区分致病性和非致病性 IgE 反应，并有助于发展对草花粉的季节性过敏性鼻炎。
德国多中心过敏研究对 1990 年出生的队列进行了检查。每年进行问卷调查，并在 1、2、3、5、6、7、10、13 岁时采集血液样本。主要结局草花粉和桦树花粉相关季节性过敏性鼻炎（SARg、SARb）的定义基于 6 月/7 月和 4 月的鼻症状。用免疫酶单重测定法监测 Phleum pratense 和 Betula verrucosae 提取物的血清 IgE 抗体。
在 820 名接受检查的儿童中，177 名和 148 名分别发展为 SARg 和 SARb。在 3 岁或以上的健康儿童中，对草花粉的 IgE 是 SARg 的最强危险因素（比值比 10.39，95%置信区间 6.1-17.6，p<0.001），而父母的干草热是唯一与未来 SARg 独立相关的儿童早期危险因素（1 位父母：比值比 2.56，95%置信区间 1.4-4.5，p<0.001；2 位父母：比值比 4.17，95%置信区间 1.7-10.1）和 SARb（1 位父母比值比：5.21，95%置信区间 2.20-12.4，p<0.001；2 位父母比值比：8.02，95%置信区间 2.0-32.9，p<0.001）。父母的干草热与 6 岁以上血清阳性患者花粉特异性 IgE 浓度的增加有关，也是 6 岁或以上对草花粉或桦树花粉具有分子上更复杂特异性 IgE 反应的标志。
父母的干草热和对草花粉和/或桦树花粉的特异性 IgE 是季节性过敏性鼻炎的强烈临床前决定因素和潜在的良好预测指标。
