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Asthma severity and atopy: how clear is the relationship?
W D Carroll1, W Lenney, F Child
1Department of Child Health, Derbyshire Children's Hospital, Mickleover, Derby, UK.
Archives of Disease in Childhood
|January 31, 2006
Summary
In children with asthma, greater atopy correlates with increased asthma severity. This includes higher immunoglobulin E (IgE) levels and skin prick test reactivity, impacting hospital admissions and treatment needs.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Genetics of Asthma
Background:
- The link between asthma severity and atopy is complex and often inconsistent in research.
- Previous studies frequently failed to establish significant correlations between clinical asthma severity or lung function and markers of atopic sensitization.
Purpose of the Study:
- To investigate the relationship between increasing asthma severity and atopic sensitization in a pediatric asthma cohort.
- To determine if atopic sensitization is a contributing factor to asthma severity in children.
Main Methods:
- Recruited 400 children (aged 7-18 years) with asthma for a multicenter genetics study.
- Collected detailed phenotypic data, including measures of asthma severity and atopic sensitization.
- Employed multilevel models to analyze associations, accounting for individual and family-level variations.
Main Results:
- Total serum IgE levels correlated with increased asthma severity scores, reduced FEV1, and greater airway obstruction.
- Increased skin prick test reactivity to aeroallergens was associated with higher risk of hospital admission, inhaled steroid use, and airway obstruction.
- These associations remained statistically significant after adjusting for age, gender, and birth order.
Conclusions:
- In children with asthma, increasing levels of atopy are associated with greater asthma severity.
- The specific associations between asthma severity, skin prick tests, and total serum IgE levels exhibit subtle differences.