Appearance of atopic disease in relation to serum IgE antibodies in children followed up from birth for 4 to 15 years

Sigurs, Nele; Hattevig, G.; Kjellman, Bengt; Kjellman, N‐I Max; Nilsson, Lennart; Björkstén, Bengt

doi:10.1016/0091-6749(94)90184-8

Cited by 148 publications

(93 citation statements)

References 29 publications

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“…Although sensitization to any certain inhalant allergen alone, probably as a result of small numbers of positive cases, was not significant in predicting asthma, sensitization to inhalant allergens as a mixture was highly predictive, which is consistent with the Dutch findings. 21 Opposite to the observations of a North American group 22 and in line with a Scandinavian pediatric study, 16 specific IgE to house dust mites was rare, as is typical in the northern climate, and it was not able to predict later asthma.…”

Section: Discussionmentioning

confidence: 71%

“…3 The storage of serum samples as frozen for several years, as was done in the present study, has not significantly interfered with the results. 3 The detection concentration for specific IgE, 0.35 kU/L, has been used by Sigurs et al 16 Other investigators have preferred higher cutoff concentrations, such as 0.70 kU/L, for "positive" results. 17,18 According to the manufacturer, the specific IgE concentrations of 0.35 kU/L to 0.69 kU/L are comparable to RAST class 1, the concentrations of 0.70 kU/L to 3.49 kU/L to RAST class 2, and the concentrations of Ն3.50 kU/L to RAST classes 3 to 4.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the diagnosis of asthma, being based on the presence of symptoms, the need for maintenance medication, and the changes in lung function tests, was done at the age when symptomatic children have real asthma, not any more transient wheezing. 1,2 Other studies on specific IgE in infants have been either cross-sectional studies in wheezing infants with 22,23 or without 24 controls or follow-ups of nonselected 17 or selected 16,18,25 birth cohorts or of children selected by other criteria 26 not particularly aiming at the outcome of wheezing infants. In addition, such large panels of allergens, such as Phadiatop Combi, or automated quantitative methods for determining specific IgE antibodies, such as UniCAP, have been rarely available.…”

Section: Discussionmentioning

confidence: 99%

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Allergen-Specific Immunoglobulin E Antibodies in Wheezing Infants: The Risk for Asthma in Later Childhood

Kotaniemi‐Syrjänen¹,

Reijonen²,

Romppanen³

et al. 2003

PEDIATRICS

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ABSTRACT. Objective. To evaluate whether the measurement of specific immunoglobulin E (IgE) antibodies to food and/or inhalant allergens in infants who are hospitalized for wheezing can be used to predict later asthma.Methods. Eighty-two children who were hospitalized for wheezing at <2 years of age were followed prospectively until early school age. The baseline data and the characteristics of infancy had been collected at enrollment. At school age, the children were evaluated for asthma and allergic manifestations, including skin prick tests to common inhalant allergens. Frozen serum samples obtained during the index episode of wheezing were available for 80 children for determination of food and inhalant allergen-specific serum IgE antibodies by fluoroenzyme-immunometric assay, UniCAP, applying the Phadiatop Combi allergen panel.Results. Asthma was present in 32 (40%) children at school age. Food-specific IgE antibodies of >0.35 kU/L were found in 37 (46%) wheezing infants, but only specific IgE to wheat and to egg white at the level of >0.35 kU/L were significantly associated with later asthma. In regard to specific IgE to the mixture of food allergens, the cutoff level of >0.70 proved to be significant. Inhalant allergen-specific IgE of >0.35 kU/L was found only in 14 cases (18%), but when present, it was significantly predictive of asthma. Elevated levels of specific IgE antibodies to food or inhalant allergens were significantly associated with allergic rhinitis and skin-test reactivity at school age.Conclusions. When present in wheezing infants, specific IgE of >0.35 kU/L to wheat, egg white, or inhalant allergens are predictive of later childhood asthma. Consequently, detection of those specific IgE antibodies in wheezing infants may facilitate the early diagnosis of asthma, especially in cases with no clinically evident atopic manifestations. A pproximately 20% of all children experience wheezing in infancy, 1 and these children are at increased risk for asthma in later childhood. On the basis of recent prospective follow-up data, up to 40% of them experience asthma at school age. 2 The majority of children with asthma have clinically evident atopic manifestations in later childhood, although allergies may not be apparent in infancy. 2,3 Total serum immunoglobulin E (IgE), 2 blood eosinophilia, 2 and serum eosinophil cationic protein (ECP) 4 are markers that are often used to determine subclinical atopy and susceptibility to respiratory allergy. However, these markers are nonspecific, and to point out the allergen-specific responses, skin prick tests (SPTs) or radioallergosorbent tests (RAST) thus far have had to be performed. Both of these tests are qualitative, and for technical reasons, only a restricted number of allergens are applicable in SPTs in young children. These tests may also be susceptible to technical errors and variations as a result of either nonstandardized or nonautomated methods. Consequently, new approaches are needed to screen those prone to atopy or allergen-induced asthma among ...

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Allergen-Specific Immunoglobulin E Antibodies in Wheezing Infants: The Risk for Asthma in Later Childhood

Kotaniemi‐Syrjänen¹,

Reijonen²,

Romppanen³

et al. 2003

PEDIATRICS

View full text Add to dashboard Cite

show abstract

“…The corresponding formation of sIgE to exposed allergens in the susceptible individual frequently starts with foods (e.g. hen's egg, cow's milk, peanut, soy and wheat), followed by the inhalant allergens like dust mite, cat dander, and later pollen [7][8][9]. Pollen-driven allergy in the respiratory tract (but also to some structurally related foods) may further complicate the picture [10,11].…”

Section: Ige Antibody-mediated Allergic Diseasementioning

confidence: 99%

In vitro diagnosis of allergy: how to interpret IgE antibody results in clinical practice

Ahlstedt

Murray

2006

Primary Care Respiratory Journal

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SummaryThe basis of any diagnosis of allergy requires a good history and examination, which should then provide a certain degree of confidence as to whether or not allergy is present. However, the diagnosis cannot be confirmed on the basis of symptoms alone, because both allergic and non-allergic conditions can present with similar symptoms. Based on prevalence figures, about half of the patients presenting with allergic symptoms in primary care may be non-allergic. Therefore, allergy testing in the form of specific IgE (sIgE) measurement and/or skin prick testing is an invaluable aid in demonstrating both the presence and severity of such an allergy. The usefulness of such tests extends beyond just the positive or negative result. Often, more information can be gleaned by using the test results in a form of a continuous variable in order to determine the likelihood that allergy can be attributed as an explanation for patients' symptoms and disease. In this review, we describe the rationale for utilising specific IgE antibody tests in diagnosing allergy. Furthermore, to optimize the information gained from allergy testing, we describe how to employ one particular well-validated IgE testing system for determining the likelihood that an individual patient's disease can be attributed to allergy.

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“…Apparently, there is high expression variability of the disease among family members but these individuals are inherently more prone to precipitously developing atopic disease. Moreover, atopic patients enter phases of remission or aggravation, the nature of which is complex and implies intra-and interindividual changes/differences in gene-gene regulatory interactions (20).…”

Section: Discussionmentioning

confidence: 99%

Kinetics of Gene Induction After FcεRI Ligation of Atopic Monocytes Identified by Suppression Subtractive Hybridization

Bubnoff

Matz

Cazenave

et al. 2002

The Journal of Immunology

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The high-affinity receptor for IgE, FcεRI, on APCs plays an important role in the initiation and chronicity of inflammatory atopic diseases. To understand the molecular regulation of FcεRI-mediated processes, differentially expressed genes are of great interest to be identified. Suppression subtractive cDNA hybridization has been used to identify genes induced after FcεRI stimulation on atopic monocytes. Overexpression of the identified genes was determined by semiquantitative RT-PCR analysis of transcripts from the tester (stimulated) and driver (unstimulated) monocytes. Results were confirmed and kinetics of the transcripts established using blood cells from additional atopics at 4 and 24 h of FcεRI induction. The following sequences were identified: monocyte chemoattractant protein 1, macrophage-inflammatory protein 1β, IL-6, βA subunit of inhibin/activin, IFN-stimulated gene of 54 kDa, IL-1R antagonist, and kynurenine 3-monooxygenase. Chemokines are highly expressed during the early and late phase after FcεRI cross-linking, whereas proinflammatory and differentiation stimuli rapidly decline after an initial overexpression. Kynurenine 3-monooxygenase, an enzyme involved in the degradation of the amino acid tryptophan, is significantly up-regulated during the late phase after 24 h of FcεRI induction. These results demonstrate that the analysis of the profile of gene induction following activation of FcεRI on atopic monocytes may reveal how these cells might participate in the regulation of atopic disorders.

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Appearance of atopic disease in relation to serum IgE antibodies in children followed up from birth for 4 to 15 years

Cited by 148 publications

References 29 publications

Allergen-Specific Immunoglobulin E Antibodies in Wheezing Infants: The Risk for Asthma in Later Childhood

Allergen-Specific Immunoglobulin E Antibodies in Wheezing Infants: The Risk for Asthma in Later Childhood

In vitro diagnosis of allergy: how to interpret IgE antibody results in clinical practice

Kinetics of Gene Induction After FcεRI Ligation of Atopic Monocytes Identified by Suppression Subtractive Hybridization

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