Does pertussis infection induce manifestation of allergy?

Abstract

To evaluate whether pertussis induces the development of allergy, a prospective study was performed in 25 children aged 0.8-12.2 years. The patients underwent allergy diagnostics during pertussis infection and at a follow-up visit 8-14 months later. Diagnostic criteria included the medical history of the patients and their families, a modified skin prick test, measurement of serum IgE and radio-allergosorbent test screening for specific sensitizations. At the time of pertussis, serum IgE concentration in the study group was 62 +/- 30 kU/ml. At the follow-up visit, there was a significant increase in serum IgE to 137 +/- 51 kU/ml, which was also significantly higher than IgE in an age-matched control group. Children at a significantly higher risk for developing IgE increase or new allergic sensitizations were those with a family history of allergy or potentially allergic disease in their personal history. Our results indicate that pertussis may induce IgE production in affected children.

Reported pertussis infection and risk of atopy in 8‐ to 12‐yr‐old vaccinated and non‐vaccinated children

“…In vaccinated children however, symptoms are, in general, less serious and specific (22) and if, as was suggested before (17), pertussis is more easily recognized and diagnosed in children predisposed to respiratory morbidity or other atopic disorders, the positive relationships found by several authors may well be due to diagnostic bias. Although one study found an increase in serum IgE 1 yr after pertussis infection, suggesting a causal association (16), the proportion of children evaluated in that study was only about 60% (25 out of the originally 42 included), which may have seriously biased their findings as children without respiratory symptoms may be more likely to withdraw. In summary, evidence for a causal association between pertussis infection and atopic disorders is still inconclusive.…”

“…Also, in several epidemiological studies, positive, albeit mostly weak or very weak, associations of pertussis infection with atopic disorders were found: with asthma in three follow‐up studies (10–12) and in a case–control study (13), with eczema in a cross‐sectional study (14), and with allergic sensitization in a large cross‐sectional study (15). In a small follow‐up study of pertussis‐infected children, the number of children with either elevated serum IgE or with a positive skin prick test had significantly increased about 1 yr after infection (16), especially in children with a family history or personal history of (suspected) allergy. An age‐gender matched control group had IgE levels similar to those of the infected children at the time of infection, suggesting that high IgE was not a risk factor for infection.…”

Down-Regulation of IgE and IgG4 Antibodies to Tetanus Toxoid and Diphtheria Toxoid by Covaccination with Cellular Bordetella pertussis Vaccine

“…This finding conflicts with results from animal studies that indicate an IgE-promoting effect of P toxin with regard to coadministered unrelated Ags (8, 16 -18). In fact, in humans, not only IgE production (19,20), but also the promotion of clinical correlates of atopy, has been a concern with P infection (21-23) or P vaccination (24,25), although a causal relationship has never been established and other studies have failed to show an allergypromoting effect (26 -28).…”

Pertussis vaccination and wheezing illnesses in young children: prospective cohort study

“…Additionally, pertussis vaccination and infection significantly increase IgE antibody concentrations in children 7. We investigated whether pertussis vaccination is associated with an increased incidence of recurrent wheezing in children by analysing data from the Avon longitudinal study of pregnancy and childhood, with follow up to 42 months of age.…”