Center for Life Course Health Research, University of Oulu, Oulu, Finland.
PEDEGO Research Unit and MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Biomedicine Research Unit, Medical Microbiology and Immunology, University of Oulu, Oulu, Finland.
Ann Allergy Asthma Immunol. 2019 May;122(5):522-531.e3. doi: 10.1016/j.anai.2019.02.027. Epub 2019 Mar 8.
The temporal sequence in which allergic sensitization to different allergens emerges is not well characterized at the level of general population.
We describe the incidence patterns of atopic sensitization to different allergens from birth up to 12 years of age in an unselected Finnish population.
The study population comprised all children born between 2001 and 2006 identified from the nationwide population register as residents of the province of South Karelia, Finland (n = 5564). The results of allergy tests (22,380 results from skin prick tests, immunoglobulin E [IgE] antibodies, and open food challenges [OFCs], performed in 1827 children) were collected from patient records of all the health care units in the area.
The incidence rates of positive results for food and animal allergens as well as positive OFCs for cow's milk showed prominent peaks at 5 months of age. Positive results for pollen allergens started to emerge after 1.5 years of age. The 12-year cumulative incidence of sensitization to food, animal, pollen, and any allergens was 12%, 8%, 10%, and 18%, respectively. The cumulative incidence of sensitization to house dust mites was 1% and to molds or latex less than 1%. Firstborn boys had the highest, and those who were not firstborn girls and children born in rural municipalities had the lowest early incidence of sensitization to inhalation allergens.
In the unselected population, the atopic sensitization against food and animal allergens began before 6 months of age and was followed by sensitization to pollen allergens before 2 years of age. Primary prevention of sensitization to food and inhalation allergens should therefore occur in early infancy.
不同过敏原致敏的时间顺序在一般人群中尚未得到很好的描述。
我们描述了芬兰一个未选择人群中从出生到 12 岁时对不同过敏原的特应性致敏的发病模式。
研究人群包括 2001 年至 2006 年间出生的所有在芬兰南卡累利阿省居住的儿童（n=5564），这是从全国人口登记处确定的。该地区所有医疗保健单位的患者记录中收集了过敏测试（22380 次皮肤点刺测试、免疫球蛋白 E [IgE] 抗体和开放食物挑战 [OFC] 的结果，在 1827 名儿童中进行）的结果。
食物和动物过敏原以及牛奶的阳性 OFC 结果的阳性率在 5 个月时出现明显高峰。花粉过敏原的阳性结果在 1.5 岁后开始出现。食物、动物、花粉和任何过敏原致敏的 12 年累积发生率分别为 12%、8%、10%和 18%。对屋尘螨的致敏累积发生率为 1%，对霉菌或乳胶的致敏累积发生率低于 1%。首胎男孩的早期致敏发生率最高，而非首胎女孩和出生在农村市的儿童的早期致敏发生率最低。
在未选择的人群中，对食物和动物过敏原的特应性致敏在 6 个月之前开始，随后在 2 岁之前对花粉过敏原致敏。因此，应在婴儿早期开始预防食物和吸入性过敏原的致敏。
