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Early predictors for developing allergic disease and asthma: examining separate steps in the 'allergic march'
C Almqvist1, Q Li, W J Britton
1Woolcock Institute of Medical Research, Camperdown, NSW, Australia; University of Sydney, Sydney, NSW, Australia. catarina.almqvist@ki.se
Summary
In children, early eczema predicts future allergen sensitization, while early sensitization predicts wheeze, asthma, and rhinitis. Managing childhood eczema may help prevent allergic sensitization.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
- Respiratory Medicine
Background:
- Allergic disease symptoms and allergen sensitization are linked, but early childhood predictors of sensitization are unclear.
- Understanding these precursors is crucial for early intervention strategies.
Purpose of the Study:
- To identify early clinical predictors of allergen sensitization in children.
- To examine how early sensitization affects the development of wheeze, asthma, rhinitis, and eczema.
Main Methods:
- The Childhood Asthma Prevention Study followed children with a family history of asthma.
- Assessments at 18 months and 5 years included allergen sensitization, IgE levels, and respiratory/skin symptoms.
- Statistical analyses identified predictors of sensitization and symptom onset.
Main Results:
- In non-sensitized 18-month-olds, eczema predicted sensitization by age 5 (aRR 1.67).
- In asymptomatic 18-month-olds, sensitization predicted wheeze (aRR 2.41), asthma (aRR 4.66), and rhinitis (aRR 1.77) by age 5.
- Sensitization at 18 months did not predict eczema development by age 5.
Conclusions:
- Childhood eczema, not wheeze or rhinitis, predicts subsequent allergen sensitization.
- Early eczema may promote sensitization, suggesting eczema management could reduce sensitization prevalence.
- Early allergen sensitization is a significant predictor of developing asthma and related respiratory conditions.
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