This longitudinal study was conducted with a group of mothers living in Vancouver and Winnipeg, Canada. Mothers of high risk children were recruited in their third trimester and ‘high risk’ was defined as having at least one parent with asthma or two parents with other IgE allergic diseases. Then house dust samples were collected and a questionnaire regarding health and exposures were completed before birth and at ages 1, 2 and 7. Additionally at years 2 and 7 allergy skin tests were performed on the following allergens: house dust mite, cat and dog dander, peanuts, eggs, cow’s milk, wheat and soy. Atopy was defined as one or more positive skin tests for any allergen. Also, cord blood IgE (CD-IgE) levels were collected at birth.
CD-IgE was detectable (≥0.5 KU/l) in 19.3% of the 285 children. A high percentage of children with detectable CD-IgE had a maternal history of asthma (p-value of 0.001), maternal atopy [adjusted OR 2.21 (1.01-4.84)], and were born in the winter months [adjusted OR 4.07 (1.68-9.83)]. Additionally at 7 years, detectable CD-IgE was associated with increased risks for atopy [OR 2.22 (1.11-4.41)], positive skin test reactions against any aeroallergen [OR 2.25 (1.13-4.47)] and recurrent wheeze [OR 2.51 (1.09-5.76)].
The data that they collected looks really interesting so make sure to look at the two tables they provided. Although this was a small study, the authors noted that this information can lead to targeted prevention efforts for infants who may be at higher risk for developing asthma. I think it’s most interesting that being born in the winter months was found to have a significant association with detectable CD-IgE. This is probably due to the increased exposure to inhalant allergens after birth but who knew the season you were born in may have that effect!
You can find the article at:
http://0-www3.interscience.wiley.com.impulse.ucdenver.edu/journal/123193720/issue
Elevated cord blood IgE is associated with recurrent wheeze and atopy at 7 yrs in a high risk cohort
Ferguson, Alexander A (12/2009). "Elevated cord blood IgE is associated with recurrent wheeze and atopy at 7 yrs in a high risk cohort". Pediatric allergy and immunology (0905-6157), 20 (8), p. 710.
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That's a very interesting article, thanks, Julie. Did they say where the cord blood IgE comes from? We like to think that only IgG crosses to the fetus from the mother, so did the fetus actually get IgE going in utero? That would be something, as they don't get IgG going until later, and IgE is past IgG on the DNA C-region "loop-out" pathway!
ReplyDeleteThe article certainly has some interesting implications, though you may already be suspicious about these kids who come from high risk parents and looking out for allergic manifestations. One issue I had with the study is that I couldn't find a breakdown of what percentaage of the high CD-IgE patients here put in the treatment arm vs not. If it turned out that more of the high CD-IgE ended up not getting the preventive treatment, then this could obviously skew your results (more may end up with worse outcome given continued exposure).
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