Prediction of atopy in the first year of life using cord blood IgE levels and family history
6 pages
English
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Prediction of atopy in the first year of life using cord blood IgE levels and family history

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En savoir plus
6 pages
English

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We assessed correlations of total and specific cord-blood IgE (cIgE) levels with allergic symptoms in the first year of life. cIgE levels were determined by an immunoassay test in full-term neonates. This is a prospective study in which a questionnaire was used after birth, and at 6 and 12 months of age. We used multiple logistic regression models to assess the association between the family history of atopy and the incidence of allergy. The infants were divided in to groups based on the cIgE level (Group 1 < 0.1 IU/ml, n = 65; Group 2 0.1-0.5 IU/ml, n = 63; Group 3 > 0.5 IU/ml, n = 45). We found the symptoms of atopy in 26 children in Group 1 (40%), 30 (47.6%) in Group 2, and 17 (37.7%) in Group 3; the percentage of atopic diseases was in significantly different among the three groups. No association between a high total cIgE and specific cIgE with atopy family history and the outcome of atopic diseases was discovered. We conclude that neither total nor specific cIgE level with atopy family history can be used as an indicator to single out high risk infants.

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Publié le 01 janvier 2009
Nombre de lectures 6
Langue English

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December 7, 2009
EUROPEAN JOURNAL OF MEDICAL RESEARCH
Eur J Med Res (2009) 14(Suppl. IV): 227-232
227
© I. Holzapfel Publishers 2009
PREDICTION OFATOPY IN THEFIRSTYEAR OFLIFEUSINGCORDBLOOD IgE LEVELS ANDFAMILYHISTORY
1, 32 1 A. J. Sybilski, A. Doboszynska , B. Samolinski
1 Department ofthe Prevention ofEnvironmental Hazards and Allergology, Warsaw Medical University, Warsaw, Poland; 2 Department ofPediatric and Neonatology, Central Clinical Hospital ofMinistry ofInternal Affairs, Warsaw, Poland; 3 Department ofClinical Nursing, Warsaw Medical University, Warsaw, Poland
Abstract We assessed correlations oftotal and specific cord-blood IgE (cIgE) levels with allergic symptoms in the first year oflife. cIgE levels were determined by an immunoassay test in full-term neonates. This is a prospective study in which a questionnaire was used after birth, and at 6 and 12 months ofage. We used multiple logistic regression models to assess the asso-ciation between the family history ofatopy and the in-cidence ofallergy. The infants were divided into groups based on the cIgE level (Group 1<0.1 IU/ml, n=65; Group 2 0.1-0.5 IU/ml, n=63; Group 3 >0.5 IU/ml, n=45). We found the symptoms ofatopy in 26 children in Group 1 (40%), 30 (47.6%) in Group 2, and 17 (37.7%) in Group 3; the percentage ofatopic diseases was insignificantly different among the three groups. No association between a high total cIgE and specific cIgE with atopy family history and the out-come ofatopic diseases was discovered.We conclude that neither total nor specific cIgE level with atopy family history can be used as an indicator to single out high risk infants.
Key words:cord blood, IgE, infant, allergy
INTRODUCTION
Growing incidence ofallergic diseases, particularly in highly developed countries, created a need for the pre-cise determination ofrisk factors for initiation and ex-acerbation ofallergies and, based on these premises, for the development ofeffective prophylactic pro-grams. Increasingly often, first signs ofallergy appear already in early infancy, necessitating implementation of prophylacticmeasures at the moment ofbirth, or even earlier – at the time ofconception [1]. The process ofsensitization begins as early as the 11th week ofintrauterine life as a result ofcontact of the fetus with allergens. Elevated levels ofplasma IgE predict an early outburst and greater severity of symptoms ofallergy. These findings made scientists assess the level oftotal IgE in cord blood plasma (cIgE) as a predictive factor for subsequent develop-ment ofallergy in children. Several studies suggest that an isolated assessment ofcIgE is neither sensi-tive nor specific enough for a reliable prediction of development ofallergy. Its diagnostic value increases
considerably when combined with other parameters, such as family history and the total IgE level in the maternal blood [2, 3]. In recent years, sensitivity ofdi-agnostic tools improved considerably, enabling the de-tection ofimmunoglobulins at very low concentra-tions. The aim ofthe present study was to detect the exis-tence ofcorrelations between the elevation oftotal cord blood IgE or antigen-specific IgE and the subse-quent development ofclinical symptoms ofatopic diseases within the first 12 months oflife. The authors also wanted to evaluate the usefulness ofthe above outlined parameters as prognostic factors for the de-velopment ofatopic diseases in early infancy and to isolate a group ofchildren at risk ofdeveloping aller-gy.
MATERIAL ANDMETHODS
Our research was a prospective birth cohort study with retrospective analysis ofthe pregnancy. The study was approved by a local Ethics Committee. Two hundred and seven term and healthy neonates (≥37 Hbd, birth body weight ≥2500 g) born in the Depart-ment ofObstetrics ofthe Central Clinical Hospital MSWiA in Warsaw were included in the survey. Most of thechildren (92%) lived in a city. Seventy seven percent ofthe families settled in apartment houses (30% - concrete blocks) and 33% in single family houses. 53% ofinfants’ mothers and 44% fathers had higher education. Directly after delivery, 4 ml ofumbilical blood were obtained by puncture ofthe umbilical vein; the sample was centrifuged and blood plasma thus obtained was frozen to –70°C and stored at this temperature for further analyses. Total concentration ofimmunoglob-ulin IgE was determined by a chemiluminiscence tech-nique ofthe sandwich type assay (ECLIA), using an Elecsys 2010 analyzer (Roche Diagnostics, Mannheim, Germany). Allergen-specific IgE was assessed using a quantitative kit (Allergopharma, Reinbek, Germany). The study was performed using three kits ofantibod-ies: for infant food (hen egg protein, cow milk protein, wheat flour, peanuts, and soy), grass and cereals (cocksfoot - Dactylis glomerata; meadow fescue – Fes-tuca pratensis; perennial ryegrass – Lolium perenne; timothy – Phleum pratense; Kentucky bluegrass – Poa