IgE Sensitization Patterns of Mothers and Their Offspring in the First Five Years of Life The CHILD Study

Understanding allergic sensitization patterns, which act as indicators for allergic diseases, is crucial for prevention, early diagnosis, treatment strategies, and trial design. Molecular allergology can be more precise and helps to identify patients with food allergy with a high pre-test probability. Unfortunately, sensitization data at a molecular level are limited for North American birth cohorts. In the CHILD study, we aimed to identify allergic sensitization in Canadian mothers and follow the longitudinal trajectories of their children from ages 1-5 years for the most crucial allergens.

Five hundred paired samples from children at 12 and 60 months were included based on the child's characteristics. Serum from each child and their corresponding mother was included if the child had skin prick test (SPT) reactions of ≥ 2 mm to one or more allergens. In addition, non-sensitized (SPT-negative) children (n = 261), with or without AD or asthma, were included. Specific IgE (sIgE) levels were measured using a multiplex allergen microarray. Participants were considered sensitized when sIgE ≥ 0.3 kUa/L to at least one allergen was recorded.

We observed persistent sIgE sensitization to peanut allergens (Ara h 1, Ara h 2, and Ara h 6) in children 12 to 60 months of age. However, sensitization to the tree nuts cashew (Ana o 2, Ana o 3), hazelnut (Cor a 14), walnut (Jug r 1, Jug r 2), and pistachio (Pis v 1-3) appeared to be more frequent at 60 months. Notably, resolution of sIgE sensitization to the key marker allergens from the 2S albumin group (Ara h 2, Cor a 14, Jug r 1, Ana o 3, and Ses i 1) was observed in approximately 25% of children.

These findings provide a comprehensive picture of IgE sensitization in this cohort. They also suggest a likelihood of loss of sensitization to key 2S albumins, which are excellent markers of food allergy with systemic reactions.