Predictors of allergen sensitization in Singapore children from birth to 3 years
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Published on: June 4, 2017
Evelyn Xiu Ling Loo1, Jordan Zheng Ting Sim2, Anne Goh3
1Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.
Insights
Early eczema and wheeze in infants are key predictors of developing allergies later in life. This finding highlights potential vulnerabilities in skin and airway barriers to environmental allergens.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Dermatology
Background:
- Allergen sensitization, a precursor to allergic diseases, typically emerges in childhood.
- Factors influencing sensitization patterns include genetics and environment, with potential age-related changes.
- Understanding early predictors is crucial for timely intervention.
Purpose of the Study:
- To identify predictors of allergen sensitization within the first three years of life.
- To analyze data from the "Growing Up in Singapore Towards Healthy Outcomes" (GUSTO) prospective birth cohort study.
- To establish early risk factors for developing allergic sensitization.
Main Methods:
- Data collected via interviews on demographics, family history, lifestyle, and child health.
- Skin prick testing (SPT) performed at 18 and 36 months for inhalant and food allergens.
- Analysis included 849 children for 18-month SPT and 649 for 36-month SPT, ensuring clinical phenotypes preceded sensitization.
Main Results:
- Eczema before 18 months strongly predicted positive SPT at 18 months (aOR 4.5).
- Children with eczema before 18 months showed increased risk of new sensitization at 36 months (aOR 3.4).
- Wheeze before 18 months was associated with new sensitization at 36 months (aOR 3.2); rhinitis was not significantly associated.
Conclusions:
- Early-onset eczema and wheeze are significant risk factors for subsequent allergen sensitization.
- These findings suggest impaired skin or airway barriers may increase susceptibility to allergens.
- Interventions targeting early skin and respiratory health could mitigate allergy development.
Background:
Immune responses in allergic diseases begin with allergen sensitization, which usually occurs in childhood. Allergen sensitization involves a complex interplay of genetic and environmental factors, and sensitization patterns may change with age.
Objective:
To determine the predictors of allergen sensitization in the first 3 years of life in the growing up in Singapore towards healthy outcomes (GUSTO) prospective birth cohort study.
Methods:
Interviewers collected information on demographics, family history of allergy, social and lifestyle factors, and the child's health. We analyzed data from 849 children who completed skin prick testing (SPT) to inhalant allergens (house dust mites: Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis) and food allergens (egg, peanut and cow's milk) to assess risk factors for allergen sensitization at 18 months. To ensure that clinical phenotypes preceded allergen sensitization, we also analyzed data from 649 children who had a negative skin prick test at 18 months and completed skin prick testing at 36 months.
Results:
We observed a significant association between eczema reported before 18 months and a positive SPT at 18 months [aOR 4.5 (1.9-10.7)]. Ninety-five (14.6 %) children with negative SPTs at 18 months developed positive tests at 36 months. Onset of eczema before 18 months was associated with an increased risk of new allergen sensitization at 36 months among children non-sensitized at 18 months [aOR 3.4 (1.2-9.3)]. An association was seen between wheeze reported before 18 months and new allergen sensitization at 36 months [aOR 3.2 (1.1-9.1)]. We found no significant association, however, between rhinitis reported before 18 months and new allergen sensitization at 36 months.
Conclusions:
Early onset of eczema and wheeze are risk factors for later allergen sensitization, suggesting a possible increased susceptibility to allergen exposure through an impaired skin barrier or defective airway epithelium. Trial registration NCT01174875 Registered 1 July 2010, retrospectively registered.
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