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IgE screening in 1701 newborn infants and the development of atopic disease during infancy
Insights
Newborn screening for immunoglobulin E (IgE) in cord blood can predict atopic disease risk. High IgE levels and family history significantly increase the likelihood of developing conditions like asthma.
Area of Science:
- Pediatrics
- Immunology
- Allergy
Background:
- Atopic diseases, such as atopic dermatitis and bronchial asthma, are common in infants.
- Predicting the risk of atopic disease in newborns is crucial for early intervention.
Purpose of the Study:
- To investigate the association between cord blood immunoglobulin E (IgE) levels and the development of atopic disease in infants.
- To determine the predictive value of family history and cord blood IgE for atopic disease.
Main Methods:
- Cord blood samples from 1701 newborn infants were screened for IgE levels using the Phadebas IgE PRIST technique.
- Infants were monitored for the development of atopic disease during the first 18 months of life.
- Family history of atopy was recorded for each infant.
Main Results:
- 8.3% of infants developed atopic disease within the first 18 months.
- Infants with a family history had a 10.5% risk, while those with high cord blood IgE had a 70% risk.
- A combination of high cord blood IgE and family history resulted in a 73% risk, versus 3% for low IgE and no family history.
- High cord blood IgE correlated with higher IgE and positive radioallergosorbent tests later in life.
Conclusions:
- Cord blood IgE screening, especially when combined with family history, is a valuable tool for predicting atopic disease risk in newborns.
- Genetic factors influencing IgE response appear to be present at birth.
- IgE screening in cord blood is recommended for infants with a strong family history of atopy.
Abstract:
IgE screening was done using the Phadebas IgE PRIST technique on the cord blood of 1701 newborn infants. Of these 8.3% developed obvious or probable atopic disease, predominantly atopic dermatitis and bronchial asthma, during the first 18 months of life. Of infants with a family history of atopic disease 10.5% developed such illness; the corresponding figure for infants with an initially high IgE concentration was 70%. Atopic disease developed in 73% of infants with a high IgE concentration in cord blood and a family history, but in only 3% of infants with a low IgE and no family history. A high IgE concentration in cord blood was associated with a high IgE and a positive radioallergosorbent test at between ages 18 and 24 months more often than was a low initial IgE level, indicating that in man as in animals there are high and low IgE responders already genetically coded at birth. IgE screening in cord blood is recommended if there is obvious atopy in both parents or if severe atopic disease if present in a sibling or in one parent.