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Published on: August 7, 2017
Asymptomatic toddlers with house dust mite sensitization at risk of asthma and abnormal lung functions at age 7 years
Kuan-Wen Su1,2,3, Chih-Yung Chiu1,2,4, Ming-Han Tsai1,2
1Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
Insights
Early house dust mite sensitization in toddlers, even without symptoms, significantly increases the risk of developing asthma and other allergies by age 7. This highlights the importance of early detection and intervention for allergic diseases.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Respiratory Medicine
Background:
- Early life sensitization to common allergens like house dust mites is a growing concern.
- Identifying predictive markers for allergic diseases in children is crucial for timely intervention.
- The long-term impact of asymptomatic sensitization on allergic outcomes and lung function requires further investigation.
Purpose of the Study:
- To determine the predictive value of asymptomatic early sensitization to house dust mites.
- To assess the association between early sensitization and allergic outcomes at age 7.
- To evaluate the impact of early sensitization on pulmonary function in children.
Main Methods:
- The Prediction of Allergies in Taiwanese Children (PATCH) birth cohort study followed healthy newborns.
- Early sensitization to Dermatophagoides pteronyssinus was defined by IgE levels at 1.5-2 years.
- Allergic outcomes, fractional exhaled nitric oxide, and pulmonary function were assessed at age 7.
Main Results:
- 28.0% of toddlers showed early sensitization to Dermatophagoides pteronyssinus, with 68.2% being asymptomatic.
- Early sensitization was linked to significantly higher risks of asthma, allergic rhinitis, and atopic dermatitis at age 7.
- Asymptomatic early sensitization predicted increased asthma risk (OR=13.4), allergic rhinitis (OR=10.2), and atopic dermatitis (OR=38.5).
- Children with asymptomatic early sensitization also exhibited higher exhaled nitric oxide and airway hyperresponsiveness.
Conclusions:
- Asymptomatic early house dust mite sensitization in toddlers is a significant predictor of allergic diseases.
- Children with early, asymptomatic sensitization face elevated risks for asthma, allergic rhinitis, and atopic dermatitis by age 7.
- Early sensitization impacts lung function, indicated by elevated exhaled nitric oxide and airway hyperresponsiveness.
Objective:
To evaluate the predictive value of asymptomatic early house dust mite sensitization on allergic outcomes and pulmonary functions in 7-year olds.
Study Design:
The Prediction of Allergies in Taiwanese Children (PATCH) birth cohort study recruited healthy newborns at birth. At age 1.5-2 years, a Dermatophagoides pteronyssinus-specific immunoglobulin E level ≥ 0.35 kU/L was defined as early sensitization. At age 7 years, allergic outcomes were evaluated by pediatric allergists and pulmonologists, and fractional exhaled nitric oxide and pulmonary functions were measured.
Results:
At age 1.5-2 years, 28.0% of toddlers were sensitized to D. pteronyssinus. Among them, 68.2% had no allergic symptoms at that time. At age 7 years, the children with early sensitization had higher risks of asthma (OR = 13.4, 95% CI, 1.2 to 153.0; P = 0.037), allergic rhinitis (OR = 10.2, 95% CI, 2.1 to 49.6; P = 0.004), and atopic dermatitis (OR = 38.5, 95% CI, 2.1 to 696.4; P = 0.014). Notably, even the asymptomatic toddlers with early D. pteronyssinus sensitization had higher probabilities of asthma (12.5% vs. 1.7%, P = 0.040), allergic rhinitis (83.3% vs. 43.1%, P = 0.009), and atopic dermatitis (20.8% vs. 0.0%, P < 0.001) at age 7 years. The asymptomatic toddlers with early sensitization also had higher exhaled nitric oxide levels and higher prevalence of airway hyperresponsiveness at age 7 years.
Conclusion:
Asymptomatic toddlers with early house dust mite sensitization have higher risks of developing asthma, allergic rhinitis, atopic dermatitis, and abnormal lung functions at age 7 years.
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