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Atopy and house dust mite sensitization as risk factors for asthma in children
M Miraglia Del Giudice1, M Pedullà, G L Piacentini
1Clinica Pediatrica, Seconda Università di Napoli, Italy.
Insights
Asthma is linked to atopy in children over 7 years old. Sensitization to house dust mites is a key factor for asthma in older children with allergic symptoms.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Clinical Immunology
Background:
- Emerging evidence indicates asthma may not always correlate with atopy.
- This study investigates the relationship between atopy, asthma, and allergen sensitization in children presenting with allergic symptoms.
Purpose of the Study:
- To determine the frequency of atopy and asthma in children with allergic symptoms.
- To assess sensitization to common allergens in relation to asthma and atopy.
- To explore age-dependent associations between atopy, asthma, and allergen sensitization.
Main Methods:
- A cohort of 1426 children with allergic symptoms was evaluated.
- Standardized diagnostic methods were used for bronchial asthma, allergic rhino-conjunctivitis, food allergy, and atopic dermatitis.
- Atopy was confirmed by positive skin tests to at least one allergen.
Main Results:
- Of 1426 children, 629 (44%) were atopic and 769 (56%) were non-atopic.
- Asthma prevalence was similar in both atopic (64%) and non-atopic (64%) children.
- Non-atopic asthma was more common in children aged 0-3 years, while atopy was significantly associated with asthma in children aged 7+ years (OR 1.85).
- House dust mite (HDM) sensitization showed a significant association with asthma symptoms in older children (OR 4.8).
Conclusions:
- Asthma is associated with atopy in children from age 7 onwards.
- House dust mite sensitization is a significant factor contributing to asthma in older children.
- The relationship between asthma and atopy is age-dependent and influenced by specific allergen sensitization.
Background:
Recent evidence suggests that asthma is not invariably related to atopy. The aim of this study was to evaluate the frequency of atopy, asthma and sensitization to eight common allergens in a large group of children with allergic symptoms.
Methods:
1426 children referred to our Paediatric Asthma and Allergy Center because of allergic symptoms were examined. Bronchial asthma, allergic rhino-conjunctivitis, food allergy and atopic dermatitis were diagnosed with standardized methods. Atopy was diagnosed if at least one skin test was positive.
Results:
Of the 1426 children examined, 629 (44%) were atopic and 769 (56%) were non-atopic. Asthma was diagnosed in the same proportion (i.e., 64%) of atopic and non-atopic children. However, after division into age groups, non-atopic asthma was significantly more prevalent (chi2 = 8.46) in children between 0 and 3 years old (group 1). On the other hand, atopy was significantly associated with asthma only in group 3 (odds ratio 1.85). Furthermore, a significant association with asthma symptoms was found for house dust mite (HDM) in group 3 (odds ratio 4.8).
Conclusions:
Asthma is related to atopy in pre-selected children only from the age of 7 years. House dust mite sensitization seems to be an important determinant of asthma in these "older" children.