Quantitative analysis of IgE antibodies to food and inhalant allergens in 4-year-old children reflects their likelihood of allergic disease

Authors

  • M. Wickman,

    1. Department of Occupational and Environmental Health, Stockholm County Council
    2. National Institute of Environmental Medicine, Karolinska Institutet
    3. Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
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  • G. Lilja,

    1. Sachs's Children's Hospital, Institute of Södersjukhuset, Karolinska Institutet, Stockholm
    2. Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
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  • L. Söderström,

    1. Pharmacia Diagnostics AB, Uppsala
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  • M. v. H. Hamsten,

    1. Unit of Clinical Immunology and Allergy, Department of Medicine, Karolinska Institutet
    2. Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
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  • S. Ahlstedt

    1. National Institute of Environmental Medicine, Karolinska Institutet
    2. Pharmacia Diagnostics AB, Uppsala
    3. Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
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Magnus Wickman
Department of Occupational and Environmental
Health Norrbacka
level 3
Karolinska Hospital
SE-171 76 Stockholm
Sweden

Abstract

Background:  It is well established that early diagnosis of allergic disease is warranted.

Methods:  In a prospective birth cohort study (BAMSE) 3743 children at 4 years of age were included. Children were classified as having any allergic disease, e.g. asthma, suspected allergic rhinitis (suspAR), eczema or oro-gastro-intestinal symptoms with questionnaire. Blood was obtained from 2612 of these children and analysed for IgE antibodies (ab) towards 14 common food and airborne allergens.

Results:  Positive IgE ab results were found in 38% of the children with any allergic disease, whereas such IgE ab results were found in 17% among those without any allergic disease. Furthermore, among children with any allergic disease the median summated IgE ab levels were 10.7 kUA/l compared with 1.5 kUA/l among those without such symptoms. The highest IgE ab levels were found to birch, peanut, cat and horse. When the sum of the IgE-ab levels towards the selected allergens was at least 34 kUA/l, or, alternatively, more than four allergen tests were positive, there was a 75% likelihood of identifying the individual with any allergic disease. To identify those with asthma, as well as those with suspAR, a significant interaction was found for the combination of the sum of IgE-ab levels and number of allergens positive at test. For eczema only, the number of positive allergens at test was associated to the likelihood of such disease.

Conclusions:  In children, 4 years of age, allergic disease was frequently not associated with the presence of single positive IgE antibody results, whereas increased IgE ab levels were significantly more prevalent among those with allergic disease. Thus, testing a certain profile of airborne and food allergens, and utilizing the sum of the IgE-ab levels in combination with the number of allergens positive at tests, may represent a more efficient diagnostic tool then to use just single positive IgE-ab results.

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