Tesari Crnković Helena, Bendelja Krešo, Gjergja Juraški Romana, Turkalj Mirjana
Department of Pediatrics, General County Hospital Požega, Požega, Croatia -
Faculty of Medicine, J. J. Strossmayer University of Osijek, Osijek, Croatia -
Minerva Pediatr (Torino). 2025 Apr;77(2):130-138. doi: 10.23736/S2724-5276.22.06712-X. Epub 2022 Feb 15.
It has been proposed that RSV infection stimulates RSV specific IgE and IgG4 production as a hallmark of Th2 immune response, which can contribute to the development of allergic sensitization and atopic diseases. This study intends to examine the occurrence of atopic diseases in children (wheezing bronchitis, food allergy, atopic dermatitis) and their connection with RSV specific IgE and IgG4 during the first two years of life.
Prospective follow-up from the moment of birth was performed in 127 children with positive RSV specific IgG antibodies at age one and 92 children were followed-up until two years of age. The assessment included a structured interview, clinical examination, total blood eosinophils, serum total IgE and allergen specific IgE antibodies, RSV specific IgG, IgG3, IgG4 and IgE antibodies.
Significant correlation was found between positive RSV IgG4 antibodies at year one and atopic dermatitis (Tau_b=0.201, P=0.025), as well as food allergy development (Tau_b=0.205, P=0.023). RSV specific IgG4 antibodies to RSV at year one showed significant prediction of increased total and/or allergen specific IgE (odds ratio 2.73 and 95% confidence interval 1.07 - 7.00, P=0.036). In our regression model, the children who had positive RSV IgG4 antibodies had a 2.73 times higher likelihood of having increased positive total and/or allergen specific IgE during the first two years of life.
RSV specific IgG4 antibodies could be a marker of risk for the development of atopic sensitization to inhaled and food allergens, development of food allergy and atopic dermatitis in atopic children.
有人提出，呼吸道合胞病毒（RSV）感染会刺激产生RSV特异性IgE和IgG4，作为Th2免疫反应的标志，这可能有助于过敏性致敏和特应性疾病的发展。本研究旨在调查儿童在生命的前两年中特应性疾病（喘息性支气管炎、食物过敏、特应性皮炎）的发生情况及其与RSV特异性IgE和IgG4的关系。
对127名1岁时RSV特异性IgG抗体呈阳性的儿童从出生起进行前瞻性随访，92名儿童随访至2岁。评估包括结构化访谈、临床检查、全血嗜酸性粒细胞、血清总IgE和过敏原特异性IgE抗体、RSV特异性IgG、IgG3、IgG4和IgE抗体。
在1岁时，RSV IgG4抗体呈阳性与特应性皮炎（Tau_b = 0.201，P = 0.025）以及食物过敏的发生（Tau_b = 0.205，P = 0.023）之间存在显著相关性。1岁时针对RSV的特异性IgG4抗体对总IgE和/或过敏原特异性IgE升高具有显著预测作用（优势比为2.73，95%置信区间为1.07 - 7.00，P = 0.036）。在我们的回归模型中，RSV IgG4抗体呈阳性的儿童在生命的前两年中总IgE和/或过敏原特异性IgE呈阳性增加的可能性高2.73倍。
RSV特异性IgG4抗体可能是特应性儿童对吸入性和食物过敏原发生过敏性致敏、食物过敏和特应性皮炎发展风险的标志物。
