Cord serum IgE and early detection of the atopic phenotype: Suitable for routine screening?

Abstract

Cord serum IgE has been shown to be a valuable marker for the prediction of atopy. Our study was designed to verify these findings for possible systematic screening recommendation. Our study consisted of 338 children who were followed from birth to 18 months. Cord serum IgE was measured by paper immunosorbent test and radioimmunoassay. All other data (sex, family history and environment, diet, occurrence of atopic manifestations) were recorded. Of the 338 children, 118 (34.9%) developed obvious clinical symptoms of atopy during the study period. Using the receiver operator curve we found an IgE level of 1.20 IU/ml to be the best cut-off point as a predictor of atopy with 95% specificity but 13% sensitivity. Combination with other predictors such as sex, family history, environmental factors and diet did not increase the predictive value of the test. Because of this low sensitivity we conclude that cord serum IgE is insufficient to detect individuals at risk for atopy even if associated with genetic and environmental factors. Thus it should not be recommended for routine screening purposes; more sensitive markers are needed.

Variability of total serum immunoglobulin E levels from birth to the age of 10 years. A prospective evaluation in a large birth cohort (German Multicenter Allergy Study)

“…Furthermore, this study supports previous reports suggesting that the determination of tIgE from cord blood or during the first years of life may not be helpful for the diagnosis or prediction of atopy [20][21][22].…”

Maternal interpersonal trauma and cord blood IgE levels in an inner-city cohort: A life-course perspective

“…Although there is no agreement on the threshold level that is associated with increased risk of clinical atopic disorders, several studies have found that cord blood IgE levels between 0.9 and 1.3 IU/mL are associated with significantly increased risk particularly in relation to early sensitization in later childhood. 38,45 Indeed, cord blood IgE levels in general are a weaker predictor of later atopic risk unless the more extreme levels are considered. Use of lower cutoff values in prior research 46 results in significant changes in the sensitivity, specificity, and positive predictive value.…”

Cord Blood Soluble CD14 Predicts Wheeze and Prolonged Cough in Young Children: The PATCH Study

“…However, the sensitivity of cord blood IgE was quite low at 8.5-33% [21][22][23] . A family history of atopic disease or maternal total IgE levels was more sensitive than the level of cord blood IgE to detect children at risk of atopy [22,40] .…”

“…Cord blood immunoglobulin E (IgE) has received much attention over the years. However, because of its low sensitivity, it is not a reliable predictive marker of atopic diseases [21][22][23] . Various soluble cytokines and cytokine receptors in cord blood, such as sCD30, sCD23 and the IL-4 receptor, have also been studied, but none has been found to be a significant predictive factor for atopic disorders [24,25] .…”