House dust mite sensitization in toddlers predicts current wheeze at age 12 years

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:128

Article

Lodge, Caroline J.^1,3  Lowe, Adrian J.³  Hill, David J.³  Hosking, Clifford S.⁵  Abramson, Michael J.⁶  Allen, Katrina J.^2,3,4  Dharmage, Shyamali C.³ 

[1] Univ Melbourne, Sch Populat Hlth, Fac Med Dent & Hlth Sci, Ctr Mol Environm Genet & Analyt Epidemiol, Melbourne, Vic 3010, Australia

[2] Univ Melbourne, Dept Paediat, Melbourne, Vic 3010, Australia

[3] Murdoch Childrens Res Inst, Melbourne, Vic, Australia

[4] Royal Childrens Hosp, Dept Allergy, Melbourne, Vic, Australia

[5] John Hunter Childrens Hosp, Newcastle, NSW, Australia

[6] Monash Univ, Melbourne, Vic, Australia

关键词: Birth cohort;    asthma;    wheeze;    eczema;    sensitization;    house dust mite;   

DOI  :  10.1016/j.jaci.2011.06.038

来源: Elsevier

【 摘 要 】

Background: Identification of children at risk of developing asthma provides a window of opportunity for risk-reducing interventions. Allergen sensitization might identify high-risk children. Objective: We sought to determine whether skin prick tests (SPTs) to individual allergens up to age 2 years predict wheeze at age 12 years. Methods: In a birth cohort of 620 children oversampled for familial allergy, sensitization was assessed by using SPTs (monosensitized, polysensitized, or either) to 6 allergens at ages 6, 12, and 24 months. Wheeze and eczema were recorded 18 times during the first 2 years. Current wheeze was recorded at age 12 years. Adjusted associations were evaluated by multiple logistic regression. Results: A positive SPT to house dust mite (HDM) at age 1 or 2 years predicted wheeze at age 12 years (adjusted odds ratio: 1 year, 3.31 [95% CI 1.59-6.91]; 2 years, 6.37 [95% CI, 3.48-11.66]). Among wheezy 1-year-olds, those who were HDM sensitized had a 75% (95% CI, 51% to 91%) probability of wheeze at age 12 years compared with a 36% (95% CI, 23% to 50%) probability among those not sensitized. Among eczematous 1-year-olds, those who were HDM sensitized had a 67% (95% CI, 45% to 84%) probability of wheeze at age 12 years compared with a 35% (95% CI, 25% to 45%) probability among those not sensitized. Among 1-year-old children with both eczema and wheeze, the probability of wheeze at age 12 years was 64% (95% CI, 35% to 87%) if HDM sensitized and 50% (95% CI, 26% to 74%) if not. Conclusion: HDM sensitization at age 1 or 2 years in wheezing and eczematous children at increased familial allergy risk predicts asthma and may inform management of these high-risk groups. (J Allergy Clin Immunol 2011;128:782-8.)

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