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Published on: April 13, 2010
[Relation between asthma and atopy markers in children and young adults]
A Pereira Vega1, J L Sánchez Ramos, J A Maldonado Pérez
1Sección de Neumología, Hospital Juan Ramón Jiménez, Huelva.
Insights
Atopy markers, total IgE level and skin tests, relate differently to childhood and adult asthma. Skin tests are more indicative in children, while IgE levels are more relevant in adults.
Area of Science:
- Allergy and Immunology
- Respiratory Medicine
- Pediatric Pulmonology
Background:
- Atopy is a key factor in allergic diseases, including bronchial asthma.
- Understanding age-specific relationships between atopy markers and asthma is crucial for diagnosis and management.
- Previous research suggests potential differences in atopy's role across age groups.
Purpose of the Study:
- To investigate whether atopy, assessed by total IgE level and skin test reactivity, is associated with bronchial asthma similarly in children and young adults.
- To determine the differential utility of IgE levels and skin tests in diagnosing asthma across different age demographics.
Main Methods:
- A cross-sectional study involving 353 children (11-15 years) and 208 adults (20-44 years) from Huelva, Spain.
- Subjects completed respiratory symptom questionnaires (ECRHS) and underwent methacholine challenge tests (MT).
- Atopy was measured via total IgE levels (IgEt) and skin tests (ST); bronchial asthma was defined by recent wheezing and positive ST.
Main Results:
- Asthma prevalence was 4.5% in children and 5.3% in adults.
- Multiple regression analysis revealed skin tests (ST) were significantly related to asthma in children (p=0.023), while IgE levels (IgEt) were significant in adults (p=0.0005).
- IgE levels showed better discrimination in adults (sensitivity 90.9%), whereas ST was more useful in children.
Conclusions:
- The relationship between atopy markers and bronchial asthma differs significantly between children and adults.
- Skin test reactivity is a more relevant indicator of asthma in children.
- Total IgE levels are more indicative of asthma in adults, suggesting age-specific diagnostic approaches.
Abstract:
The aim of this study was to assess whether atopy, measured as total IgE level (IgEt) and/or skin test (ST) reactivity is related to bronchial asthma in the same way in children and young adults. Three hundred fifty-three children between 11 and 15 years of age (mean 12.6 years) and 208 adults between 20 and 44 years old (mean 32.1 years) were selected randomly as representative of persons living in the city of Huelva (Spain). All subjects filled out a questionnaire on respiratory symptoms (The European Community Respiratory Health Survey--[ECRHS]) and were given a methacholine challenge test (MT) with results expressed as PD20 as well as IgEt and ST assessments of atopy. We defined bronchial asthma as the association of having experienced wheezing within the last 12 months and having a positive ST. Among children, 4.5% suffered bronchial asthma. Among adults the proportion was 5.3%. The IgEt value that best discriminated between asthmatics and non asthmatics was 145.5 U/ml in children (sensitivity 75% and specificity 69.1%) and 96.6 U/ml in adults (sensitivity 90.9% and specificity 73.6%). A logarithmic transformation (log IgEt) was used to study the relation between bronchial asthma and IgEt. By simple analysis, IgEt and ST were related to bronchial asthma in children (p = 0.002 and p < 0.0001, respectively), while only IgEt (p < 0.001) was related in adults. By multiple regression analysis, controlling for both factors simultaneously as well as for smoking in adults, we found that ST (p = 0.023) but not IgEt was related in children, whereas IgEt (p = 0.0005) but not ST was related in adults. We conclude that the two markers of atopy studied are related to bronchial asthma differently and have different manifestations at different stages of life. ST is more useful in children, whereas IgE determination is of more use in adults.
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