Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
Clin Exp Allergy. 2019 Mar;49(3):308-316. doi: 10.1111/cea.13273. Epub 2018 Oct 12.
IgE sensitization is usually associated with allergy-related diseases, but may also occur in asymptomatic individuals. The clinical importance of IgE antibody concentrations in the interval 0.1-0.34 kU/L in early life in relation to allergy development is poorly evaluated.
To assess the relevance of low specific IgE (s-IgE) to hen's egg, cow's milk and peanut at 6 months of age for development of sensitization and allergy-related disease during early childhood.
s-IgE concentrations to relevant allergens from blood samples taken at 6 months and 1, 2 and 5 years from children in the prospective ALADDIN cohort were divided into three categories: non-sensitized (<0.1 kU/L), low sensitized (0.1-0.34 kU/L) and sensitized (≥0.35 kU/L) and allergy-related disease assessed.
A total of 372 children were included in this study. Compared with non-sensitized children at 6 months of age, children with low levels of allergen specific IgE (0.1-0.34 kU/L) to food allergens, especially to egg, at 6 months of age were associated with development of sensitization to aeroallergens at 5 years of age (10/14 [71%] vs 39/250 [15%]). In addition, children with low levels to egg or milk at 6 months were more often sensitized to the respective allergen at 1 year of age and, regarding low levels to egg, also to the development of eczema (6/18 [33%] vs 29/292 [10%]).
CONCLUSION & CLINICAL RELEVANCE: IgE antibody concentrations in the interval 0.1-0.34 kU/L to food allergens in infancy seem to increase the probability of sensitization to aeroallergens and, regarding low levels to egg, also of eczema during early childhood. Thus, IgE levels during the first year of life, although below 0.35 kU/L, can provide additional allergy-related prognostic information.
IgE 致敏通常与过敏相关疾病相关，但也可能发生在无症状个体中。在生命早期 IgE 抗体浓度处于 0.1-0.34 kU/L 区间与过敏发展相关的临床重要性尚未得到充分评估。
评估 6 个月时低特异性 IgE（s-IgE）对鸡卵、牛奶和花生的水平对于儿童早期致敏和过敏相关疾病发展的相关性。
前瞻性 ALADDIN 队列中，6 个月及 1、2 和 5 岁时采集的血液样本中 s-IgE 浓度对相关过敏原进行分类：非致敏（<0.1 kU/L）、低致敏（0.1-0.34 kU/L）和致敏（≥0.35 kU/L），并评估过敏相关疾病。
共有 372 名儿童纳入本研究。与 6 个月时非致敏儿童相比，6 个月时对食物过敏原（尤其是鸡蛋）具有低水平 s-IgE（0.1-0.34 kU/L）的儿童，5 岁时更容易对空气过敏原致敏（10/14 [71%] vs 39/250 [15%]）。此外，6 个月时对鸡蛋或牛奶水平较低的儿童更易在 1 岁时对相应过敏原致敏，且对鸡蛋水平较低的儿童也更易发展为湿疹（6/18 [33%] vs 29/292 [10%]）。
婴儿期食物过敏原 IgE 抗体浓度处于 0.1-0.34 kU/L 区间似乎会增加对空气过敏原致敏的可能性，且对于鸡蛋水平较低的儿童，也会增加湿疹的可能性。因此，虽然生命第一年的 IgE 水平低于 0.35 kU/L，但仍可提供额外的过敏相关预后信息。
