Abstract

Immunoglobulin E (IgE) plays a key role in allergy disease pathogenesis, but little is known about the environmental factors associated with higher IgE levels in infants. The aim of this study was to determine the risk factors for elevated serum total IgE infants living in Havana. Eight hundred and seventy-seven infants provided blood samples. Data on allergic disease symptoms and a wide range of exposures were collected. The median IgE was 35 IU/ml (interquartile range 13-96). The risk of having an IgE level above the median was higher for children who had been breastfed for 4 months or more (adjusted odds ratio (OR) 1.28; 95% confidence interval (CI): 1.02-1.61) and for children who reported cockroaches in their home (OR 1.30; 95% CI: 1.03-1.63). The risk was lower for children whose mother was in paid employment (OR 0.73; 95% CI: 0.54-0.97 compared with those who did not), for children living in homes where gas and electricity were used for cooking (OR 0.45; 95% CI: 0.32-0.62 compared with electricity only) and for children with domestic pets at birth (OR 0.83; 95% CI: 0.70-1.00). There was no association between paracetamol use and serum IgE levels. Associations between gas fuel use and maternal employment indicate that IgE levels in early life are lower in children who may be living in relative affluence. The discrepancy in the effect of early exposure to pets or cockroaches may reflect differences in these allergens, or be confounded by relative affluence. Further investigation of this cohort will determine how these effects translate into the expression of allergic disease in later life.

Highlights

  • Allergic disease is increasing in prevalence globally and is most common in the more affluent, urbanised and economically developed countries (Asher et al 2006)

  • Of the 1956 infants who participated in the original survey, 877 (45%) infants provided blood samples for analysis of serum Immunoglobulin E (IgE) levels

  • In the final-adjusted analysis, there were significant differences in the risk of having higher serum IgE levels for those who lived in La Lisa and Arroyo Naranjo compared with those who live in Habana del Este (Table 2)

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Summary

Introduction

Allergic disease is increasing in prevalence globally and is most common in the more affluent, urbanised and economically developed countries (Asher et al 2006). Investigators have clearly demonstrated that serum IgE is a risk factor for allergic disease in older children (Sears et al 1991; Sporisk et al.1995; Simpson et al 2005), there are few populationbased studies with IgE measurement in children under 2 years (Martinez et al 1995), and little is known about the risk factors that modify IgE levels in this age group. Environmental factors that modify serum IgE represent an important area of research as these are potentially modifiable risk factors for allergic diseases, and in particular asthma (Sears et al 1991; Sporisk et al 1995; Simpson et al 2005). The hypothesis that IgE is important in the pathogenesis of asthma has been recently supported by the development of interventions designed to reduce serum IgE in the treatment of asthma in children (Busse et al 2011)

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