Elevated cord serum immunoglobulin e increases the risk of allergic sensitization at age 4 and 10 and asthma at age 10

Abstract

Purpose Evidence suggests that elevated cord serum immunoglobulin E (CS-IgE) is a risk factor for allergic sensitization in early childhood. Whether CS-IgE is a risk for asthma is controversial. We hypothesize that elevated CS-IgE levels increase the risk of allergic sensitization (positive skin prick test) and asthma at age 10 years. The hypotheses were tested in a 10-year follow-up of a birth cohort. Methods CS-IgE was available for 1358 of 1456 children born between 1989 and 1990 at Isle of Wight, UK. The cohort was evaluated for allergic diseases at ages 1, 2, 4, and 10 years. Outcomes of interest were positive skin prick tests and asthma. Skin prick tests for six allergens were performed on 981 children at age 4 and 1036 at age 10. Asthma was defined based on physician's diagnosis. Exposure was elevated levels of CS-IgE (≥0.5 kU/L). We used logistic regression to estimate the risk of asthma and allergic sensitization for elevated levels of CS-IgE. Results At ages 4 and 10 years, 16.7% and 27.0% of children, respectively, showed allergic sensitization. The risk of allergic sensitization was higher for those with elevated CS-IgE at both age 4 (odds ratio OR = 2.05, 95% confidence interval CI = 1.28–3.30) and age 10 (OR =1.73, 95% CI = 1.13–2.65). The prevalence of asthma was 10.3% at age 1–2, 15.2% at age 4, and 12.8% at age 10. The association of asthma and elevated CS-IgE was not significant at ages 1 to 2 or at 4, but it reached significance at age 10 (OR = 1.66, 95% CI = 1.05–2.62). Conclusion Our findings suggest that elevated CS-IgE is not only a risk factor for allergic sensitization at ages 4 and 10 years, but also a risk factor for asthma at age 10, probably related to late onset of asthma. This study provides further evidence that the susceptibility for asthma in children may be programmed in utero.