Capture ist issue v2.qxd

March 2002
Specific-IgE tests may indicate asthma risk
and the possibility of prevention
795 infants (aged 1–2 years) with atopic dermatitis (AD) received placebo or cetirizine for 18 months.
This report from the ETAC study group shows that specific-IgE screening of infants with AD indicates those who are at risk of developing asthma.
566 of these children were followed for a further 18 months.
Notably, this is the first study to show that early sensitization to grass Infants sensitive to house dust mite, grass pollen or both were pollen in these children is a risk factor for asthma (relative risk: 1.7, significantly less likely to develop asthma during the treatment The study also shows that preventative treatment with the antihistamine, This difference was sustained in the grass pollen-sensitized group cetirizine, may protect children with certain sensitizations (particularly grass pollen) against the development of asthma. If supported by further Early sensitization (egg, grass pollen, house dust mite or cat) was studies, specific IgE screening of infants with AD may identify those who associated with an increased risk of asthma in the placebo group.
are likely to benefit from preventative treatment.
Citation: Warner JO. A double-blinded, randomized, placebo-controlled trial of
cetirizine in preventing the onset of asthma in children with atopic dermatitis: 18
months’ treatment and 18 months’ posttreatment follow-up. J Allergy Clin Immunol
2001; 108: 929–37.

Atopy in childhood predicts the risk of wheeze
in adolescence
498 children (aged 8–10 years at baseline) were surveyed every 2 The findings of this study add further support to the claim that atopy in years over a period of 10 years and then after a further 5 years.
childhood increases the risk of asthma. However, the data also suggest that there can be a delay of several years before the presence of atopy manifests Atopy at the age of 8–10 years was associated with an increased itself as atopic disease. Indeed, atopy in childhood was a risk factor for the risk (odds ratio: 2.8, confidence interval: 1.5–5.1) of developing onset of wheeze in adolescence or even early adulthood. The prevalence of atopy and wheeze increased in the cohort during the Only 3.2% of the population showed remission of atopy, whereas course of the study. The authors suggest that this may reflect to some extent a general increase in atopy that has occurred over the last 10–20 years.
Citation: Xuan W et al. Risk factors for onset and remission of atopy, wheeze, and
airway hyperresponsiveness. Thorax 2002; 57: 104–9.

Sensitization to food allergens in infancy
predicts aeroallergen sensitization
Children born to at least one atopic parent were followed annually Atopy in infancy is a clear risk factor for asthma in later life. The study for 5 years and then at the ages of 11 and 22 years. In total, indicates that up to 25% of children born to atopic parents may develop 63 individuals remained at the 22-year follow-up.
asthma in later life. Importantly, almost half of those who had a food allergen (milk or egg) in infancy had wheeze after the age of 5 years.
Annual prevalence of wheeze and atopy increased with age.
A striking result in this study is that all the children who were sensitive to a food 60% of those who had asthma in adulthood were sensitive to allergen when younger than 2 years also developed sensitivity to aeroallergens, common allergens by the age of 2 years.
92% by the age of 5 years. Early sensitization was a risk factor for asthma. Sensitization to dietary allergens waned in infancy, but predicted None of the children with positive food sensitizations at the age of 2 years or early sensitization to aeroallergens.
younger showed this allergy in subsequent years. Thus, the authors stress that Citation: Rhodes HL et al. A birth cohort study of subjects at risk of atopy: twenty-two- a single set of sensitization tests cannot safely predict the life-long atopic status year follow-up of wheeze and atopic status. Am J Respir Crit Care Med 2002; 165:

of an individual. Regular testing is justified to chart the allergy march.


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