Development of Sensitization to Multiple Allergen Molecules from Preschool to School Age Is Related to Asthma

Area of Science:

• Pediatric Allergy and Immunology
• Respiratory Medicine
• Molecular Allergology

Background:

• Early-life allergic sensitization is a key risk factor for childhood asthma.
• The specific role of allergen molecules in asthma development remains unclear.
• Understanding why only some sensitized children develop asthma is crucial for targeted interventions.

Purpose of the Study:

• To longitudinally assess sensitization to multiple allergen molecules in children.
• To explore the relationship between molecular sensitization patterns and persistent asthma at age 7.
• To investigate the impact of molecular spreading on asthma development in early-wheezing children.

Main Methods:

• Prospective follow-up of 72 children with early acute wheezing and 43 healthy controls from early preschool age (EPA) to age 7.
• Analysis of allergen molecule sensitization using ImmunoCAP Solid-phase Allergen Chip (ISAC) at EPA and age 7.
• Asthma diagnosis at age 7 based on symptoms, medication use, and spirometry.

Main Results:

• A trend towards higher allergic sensitization in cases versus controls at EPA (23.6% vs. 9.3%).
• Increased sensitization prevalence (23.6% to 38.9%) and IgE-reactive molecules (median 3 to 6.5) in cases from EPA to age 7.
• Each additional allergen molecule sensitized from EPA to age 7 significantly correlated with asthma at age 7 (OR=1.25).

Conclusions:

• Polysensitization to allergen molecules significantly impacts persistent asthma at school age.
• The expansion of molecular sensitization from early preschool to school age is linked to asthma diagnosis in children with a history of early wheezing.
• Molecular allergen profiling provides insights into asthma pathogenesis in at-risk children.