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Published on: September 27, 2017
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.
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.
Introduction:
The atopic march describes the progression from early eczema to food allergies and asthma. In Japan, early-onset atopic dermatitis (AD) is linked to allergic diseases, but the role of peanut sensitization-a known asthma risk factor in Western populations-remains uncertain because of its lower prevalence. This study aimed to evaluate whether peanut sensitization predicts asthma development in Japanese children with AD and to compare its predictive value with other common allergens.
Methods:
We conducted a retrospective cohort study of 203 children under age two with physician-diagnosed AD who underwent simultaneous measurement of specific immunoglobulin E to egg white, peanut, and house dust mite at a tertiary Allergy Center in Tokyo. Participants were followed until age six. Sensitization was categorized as none, mono (one allergen), or oligo (≥2 allergens). Associations with asthma development were evaluated using multivariate logistic regression and decision tree analysis.
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), as were oligo-sensitization and allergic rhinitis. Decision tree analysis identified peanut sensitization as the most influential predictor, with an 83% asthma incidence among children with both peanut sensitization and rhinitis. Logistic regression confirmed peanut sensitization as an independent risk factor (adjusted odds ratio: 2.74, 95% confidence interval: 1.44-5.24).
Conclusions:
Peanut sensitization in infancy strongly predicts asthma in Japanese children with AD. Early allergen-specific sensitization profiling may help identify high-risk children and support targeted asthma prevention strategies.
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