High prevalence of aeroallergen sensitization among infants of atopic parents

Abstract

Objective-To present methodology to identify atopic parents and determine the prevalence of sensitization to 15 aeroallergens in their infant offspring.Study design-A birth cohort of infants was identified from birth records; an infant was enrolled if 1 of the parents reported allergy respiratory symptoms and had a positive skin prick test (SPT) to a common aeroallergen. At age 1 year, these infants were tested to the same aeroallergens.Results-Of the 680 enrolled infants, 28.4% were SPT+ to 1 or more aeroallergens and/or food, and 18.0% were positive to 1 or more aeroallergens. By category of allergens, 9.7% were sensitized to pollens, 7.5% to molds, 4.3% to house dust mite and/or cockroach, and 3.4% to dog and/or cat. Of the infants who were positive to an aeroallergen, 65.7% remained positive at age 2 years.Conclusions-Infants born to atopic parents with percutaneous sensitization to aeroallergens are at increased risk for aeroallergen sensitization during infancy, which persists to age 2 years. These findings suggest that current clinical practices, which generally avoid skin testing before age 2 years, be reassessed in this population of high-risk children.In the Third National Health and Nutrition Examination Survey, (NHANES III), conducted in 1988-1994, 50% of children age 4 to 17 years exhibited a positive skin prick test (SPT) to at least 1 of 4 aeroallergens. 1 Over the last 2 decades, these high rates of aeroallergen sensitization have been accompanied by an estimated doubling in the incidence of allergic respiratory diseases, with an 11% gap for asthma attacks (26% vs 15%) between black and white children. 2,3 Aside from food allergies and atopic dermatitis, the potential for development of atopic respiratory disorders in infancy is often deemphasized, even though sensitization to allergens at younger ages has been shown to be more important than sensitization later in childhood for the development of wheezing symptoms and asthma. 4,5 Thus, early recognition of aeroallergen sensitization during the first and second years of life may facilitate surveillance of infants at highest risk for later expression of allergic respiratory disease. 6Although parental history of asthma and allergic rhinitis 7-9 are important risk factors for childhood asthma, 10-12 little is known about percutaneous sensitization profiles of infants born to parents with confirmed aeroallergen sensitization. This is due in part to the difficulties NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript inherent in performing the SPT in infants as well as parents, despite the fact that this procedure can be safely performed in patients of all ages and is more sensitive than in vitro measurements of serum-specific IgE. 13 Moreover, in all but 1 birth cohort study of infants in which SPT has been performed, the number of aeroallergens evaluated was 7 or less. 14-17Here we report methods used to precisely identify atopic parents and successfully recruit their high-risk infants for the Cincinnati Childhood All...

Exposure to Traffic-related Particles and Endotoxin during Infancy Is Associated with Wheezing at Age 3 Years

“…The Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) is a prospective birth cohort study of children born to atopic parents in the greater Cincinnati metropolitan area (27). A previous report found that infants exposed to high levels of traffic-related particles were significantly more likely to have parental reported wheezing without a cold before age 1 (28).…”

“…Detailed information regarding the study's objectives, recruitment methods, air monitoring, and protocols is available (27,30,31). Children enrolled in the study were identified from birth records.…”

“…Infants were eligible for study recruitment if their residence at time of birth was either less than 400 m from a major road (defined as > 1,000 trucks/d) or more than 1,500 m from a major road. Additionally, all enrolled infants had at least one atopic parent confirmed by symptoms and skin prick test (SPT) to 15 aeroallergens (27).…”

Parental Snoring and Environmental Pollutants, but Not Aeroallergen Sensitization, Are Associated with Childhood Snoring in a Birth Cohort

“…26,27 Briefly, CCAAPS children were born in the Cincinnati, Ohio area between 2001 and 2003. 27 Study eligibility required having a parent with at least 1 allergy or asthma symptom along with confirmed aeroallergen sensitization, and residing either near (<400 m) or far (>1,500 m) from the nearest major roadway (defined as >1,000 trucks/day).…”

“…[22][23][24][25] The Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS), a prospective birth cohort with longitudinal follow-up, has characterized snoring throughout childhood. 26 Sensitization at age 1 was identified as a risk factor for habitual snoring (HS) in this birth cohort born to atopic parents. 23 Thus, the study objectives were to determine whether atopy, along with other early clinical and environmental risk factors, predicts the risk of HS at age 7.…”