Bruno G, Cantani A, Ragno V, Milita O, Ziruolo G, Businco L
Department of Pediatrics, University of Roma La Sapienza, Italy.
Ann Allergy Asthma Immunol. 1995 May;74(5):431-6.
The relationship between atopic diseases and high serum IgE levels has been emphasized since the mid-sixties, when IgE antibodies were discovered. A number of environmental factors, such as the type of feeding, passive smoking, viral infections, early mold, house dust mite and pet fur exposure modulate IgE synthesis and affect the development of atopic diseases.
The aim of the present study was to investigate the natural history of total and specific IgE antibodies in babies at risk for atopy, enrolled in a prospective study for the prevention of atopic disease, and follow-up from birth to 4 years of age.
One hundred seventy-four babies (90 boys and 84 girls) at risk for atopy were enrolled in this study. At the last follow-up the children had a median age of 52 months (range 43 to 74 months), dietary and environmental manipulations for the prevention of atopic diseases were recommended. All the infants were examined at the ages of 1, 3, 6, 9, and 12 months and twice each year subsequently when detailed histories were taken and signs and symptoms of atopic disease were sought. Total and specific IgE to cow milk, egg, soy, wheat, and Dermatophagoides pteronyssinus (Dpt) were measured at 6 and 12 months of life and then every year.
During the first 24 months of life, the number of children with specific IgE to foods (n = 30) was significantly higher in comparison to the number of children with specific IgE to Dpt (n = 12) (P = .0006). Cow milk and egg were the most common offending foods. The number of children with IgE to cow milk (n = 14) was significantly higher than that with IgE to soy (n = 9) (P = .0011). Total serum IgE levels were significantly higher in the group of children who developed atopic disease in comparison with the group that did not (P < .01).
Dietary and environmental measures may influence the IgE response in atopy-prone children, thus confirming the role of environmental factors in the modulation of the phenotypic expression of atopy.
自20世纪60年代中期发现IgE抗体以来，特应性疾病与高血清IgE水平之间的关系就受到了关注。许多环境因素，如喂养方式、被动吸烟、病毒感染、早期接触霉菌、屋尘螨和宠物毛发等，会调节IgE的合成并影响特应性疾病的发展。
本研究旨在调查参与特应性疾病预防前瞻性研究的、有患特应性疾病风险的婴儿从出生到4岁期间总IgE抗体和特异性IgE抗体的自然病程。
本研究纳入了174名有患特应性疾病风险的婴儿（90名男孩和84名女孩）。在最后一次随访时，这些儿童的中位年龄为52个月（范围43至74个月），研究建议采取饮食和环境干预措施来预防特应性疾病。所有婴儿在1、3、6、9和12个月龄时接受检查，随后每年检查两次，期间详细记录病史并查找特应性疾病的体征和症状。在婴儿6个月和12个月龄时以及之后每年检测其针对牛奶、鸡蛋、大豆、小麦和尘螨（Dpt）的总IgE和特异性IgE。
在生命的前24个月中，对食物有特异性IgE的儿童数量（n = 30）显著高于对Dpt有特异性IgE的儿童数量（n = 12）（P = .0006）。牛奶和鸡蛋是最常见的致敏食物。对牛奶有IgE的儿童数量（n = 14）显著高于对大豆有IgE的儿童数量（n = 9）（P = .0011）。与未患特应性疾病的儿童组相比，患特应性疾病的儿童组总血清IgE水平显著更高（P < .01）。
饮食和环境措施可能会影响易患特应性疾病儿童的IgE反应，从而证实环境因素在调节特应性疾病表型表达中的作用。
