Differential Impact of Allergen Sensitization on Asthma Development in High-Risk Japanese Infants with Atopic

Sayaka Hamaguchi1,2, Kotaro Umezawa1, Kenji Toyokuni1

  • 1Allergy Center, National Center for Child Health and Development, Tokyo, Japan.

JMA Journal
|February 12, 2026
PubMed

Insights

Peanut sensitization in infancy is a strong predictor of asthma development in Japanese children with atopic dermatitis (AD). Early allergen testing can identify high-risk children for targeted asthma prevention.

Area of Science:

  • Pediatric Allergy and Immunology
  • Dermatology
  • Pulmonology

Background:

  • The atopic march describes the progression of allergic diseases from early eczema to food allergies and asthma.
  • While atopic dermatitis (AD) is linked to allergic diseases in Japanese children, the role of peanut sensitization, a known asthma risk factor in Western populations, remains unclear due to its lower prevalence.

Purpose of the Study:

  • To evaluate if peanut sensitization predicts asthma development in Japanese children with AD.
  • To compare the predictive value of peanut sensitization against other common allergens for asthma development.

Main Methods:

  • A retrospective cohort study of 203 children under age two with physician-diagnosed AD was conducted.
  • Simultaneous measurement of specific immunoglobulin E to egg white, peanut, and house dust mite was performed.
  • Participants were followed until age six, with asthma development analyzed using logistic regression and decision tree analysis.

Main Results:

  • Asthma developed in 32.0% of participants.
  • Peanut sensitization was significantly more common in the asthma group (53.8% vs. 29.7%, p = 0.001).
  • Decision tree analysis identified peanut sensitization as the most influential predictor of asthma, especially when combined with allergic rhinitis.

Conclusions:

  • Peanut sensitization in infancy is a strong predictor of asthma in Japanese children with AD.
  • Early allergen-specific sensitization profiling can aid in identifying high-risk children.
  • This approach supports the development of targeted asthma prevention strategies.
Abstract

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