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Genetic and environmental influences on atopic immune response in early life
N López1, S de Barros-Mazón, M M Vilela
1Department of Pediatrics, State University of Campinas (UNICAMP), Brazil.
Insights
Serum immunoglobulin E (IgE) at 12 months is a strong indicator for identifying infants at risk of developing atopic disease. Environmental factors significantly influence immune responses to atopy in early life.
Area of Science:
- Pediatrics
- Immunology
- Allergy Research
Background:
- Atopic diseases, such as wheezing, cow's milk allergy, and atopic dermatitis, are common in infancy.
- Early identification of infants at risk for atopy is crucial for timely intervention and management.
Purpose of the Study:
- To prospectively follow 114 newborns for clinical manifestations of atopy during their first year of life.
- To measure serum immunoglobulin E (IgE) levels at birth and at 3, 6, 9, and 12 months.
- To evaluate the influence of various factors on atopic disease development and IgE levels.
Main Methods:
- Prospective follow-up of 114 term newborns.
- Quantification of total serum IgE using microparticle enzyme immunoassay (MEIA).
- Clinical assessment for obvious and probable atopic disease, including recurrent wheezing, cow's milk allergy, and atopic dermatitis.
Main Results:
- 28.1% of infants developed obvious atopic disease; 10.5% probable atopy; 61.4% no manifestations.
- Higher cord blood IgE levels in infants with obvious atopy (p=0.024).
- Significantly different IgE levels up to 12 months (p=0.0001), with 82.1% sensitivity and 54.1% specificity at 12 months for identifying atopy.
Conclusions:
- Serum IgE at 12 months is a good marker for identifying infants at risk of atopic disease.
- Environmental factors significantly influence the immune response to atopy.
- Factors associated with higher IgE at 12 months included male sex, black race, shorter breastfeeding duration, and lower family income.
Abstract:
The purpose of our study was to carry out a prospective follow-up of 114 newborns at term (including three pairs of twins), regarding clinical manifestations for atopy during the first year of life. Their IgE levels in cord blood samples, at 3, 6, 9 and 12 months of age were measured and the influence of race, sex, breast-feeding, maternal smoking, family income, month of birth, family history and personal manifestations of atopic disease were evaluated. Total serum immunoglobulin E was quantified by microparticle enzyme immuno-assay (MEIA). The study group consisted of 60 (53%) male neonates, 67 (59%) Caucasians and 47 (41%) blacks. In the clinical follow-up, 32 (28.1%) infants developed obvious atopic disease: 29 infants presented recurrent wheezing, two had cow's milk allergy and one had atopic dermatitis. Probable atopic disease developed in 12 (10.5%) infants, whereas 70 (61.4%) infants showed no manifestations. Cord blood IgE levels in infants with obvious atopic disease was higher when compared to those without (p = 0.024), with 70.97% sensitivity and 46.2% specificity. IgE levels were also significantly different up to 12 months in these groups (p = 0.0001), when the sensitivity was 82.1% and the specificity 54.1%. At this age, the IgE levels were higher in infants with obvious atopy than nonatopic disease in relation to male sex (p = 0.015), black race (p = 0.009), breast-feeding for less than 6 months (p = 0.011) and when the family income was less than three times the minimum wage (about US $300) (p = 0.006). There was no association between IgE levels and family history of atopy. We concluded that immune response for atopy was in a large degree influenced by environmental factors and serum IgE at 12 months was a good marker for identifying infants with risk of atopic disease in early life.