Development of atopic sensitization in Finnish and Estonian children: A latent class analysis in a multicenter cohort

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:143

Article

Schmidt, Felicitas¹  Hose, Alexander J.²  Mueller-Rompa, Susanne¹  Brick, Tabea¹  Hamalainen, Anu-Maaria³  Peet, Aleksandr^4,5  Tillmann, Vallo^4,5  Niemela, Onni^6,7,8  Siljander, Heli^9,10,11  Knip, Mikael^{9,10,11,12,13}  Weber, Juliane¹⁴  von Mutius, Erika^1,15  Ege, Markus J.^1,15 

[1] Ludwig Maximilians Univ Munchen, Dr von Hauner Childrens Hosp, Munich, Germany

[2] German Res Ctr Environm Hlth, Inst Asthma & Allergy Prevent IAP, Helmholtz Zentrum Munchen, Neuherberg, Germany

[3] Jorvi Hosp, Dept Pediat, Espoo, Finland

[4] Univ Tartu, Dept Pediat, Tartu, Estonia

[5] Tartu Univ Hosp, Tartu, Estonia

[6] Seinajoki Cent Hosp, Dept Lab Med, Helsinki, Finland

[7] Seinajoki Cent Hosp, Med Res Unit, Helsinki, Finland

[8] Univ Tampere, Tampere, Finland

[9] Univ Helsinki, Childrens Hosp, Helsinki, Finland

[10] Helsinki Univ Hosp, Helsinki, Finland

[11] Univ Helsinki, Res Programs Unit, Diabet & Obes, Helsinki, Finland

[12] Folkhalsan Res Ctr, Helsinki, Finland

[13] Tampere Univ Hosp, Dept Pediat, Tampere, Finland

[14] Landesamt Gesundheit & Lebensmittelsicherheit, Erlangen, Germany

[15] German Ctr Lung Res DZL, Munich, Germany

关键词: Latent class analysis;    unsupervised clustering;    IgE;    atopy;    allergy;    diabetes type 1 risk;    wheezing;    Finland;    Estonia;    severe atopy;   

DOI  :  10.1016/j.jaci.2018.12.1014

来源: Elsevier

【 摘 要 】

Background: The prevalence of atopy is associated with a Western lifestyle, as shown by studies comparing neighboring regions with different socioeconomic backgrounds. Atopy might reflect various conditions differing in their susceptibility to environmental factors. Objective: We sought to define phenotypes of atopic sensitization in early childhood and examine their association with allergic diseases and hereditary background in Finland and Estonia. Methods: The analysis included 1603 Finnish and 1657 Estonian children from the DIABIMMUNE multicenter young children cohort. Specific IgE levels were measured at age 3, 4, and 5 years, respectively, and categorized into 3 CAP classes. Latent class analysis was performed with the statistical software package poLCA in R software. Results: Both populations differed in terms of socioeconomic status and environmental determinants, such as pet ownership, farm-related exposure, time spent playing outdoors, and prevalence of allergic diseases (all P <.001). Nevertheless, we found similar latent classes in both populations: an unsensitized class, a food class, 2 inhalant classes differentiating between seasonal and perennial aeroallergens, and a severe atopy class. The latter was characterized by high total and specific IgE levels and strongly associated with wheeze (odds ratio [OR], 5.64 [95% CI, 3.07-10.52] and 4.56 [95% CI, 2.35-8.52]), allergic rhinitis (OR, 22.4 [95% CI, 11.67-44.54] and 13.97 [95% CI, 7.33-26.4]), and atopic eczema (OR, 9.39 [95% CI, 4.9-19.3] and 9.5 [95% CI, 5.2-17.5] for Finland and Estonia, respectively). Environmental differences were reflected in the larger seasonal inhalant atopy class in Finland, although composition of classes was comparable between countries. Conclusion: Despite profound differences in environmental exposures, there might exist genuine patterns of atopic sensitization. The distribution of these patterns might determine the contribution of atopic sensitization to disease onset.

【 授权许可】

Free