House dust mite sensitization in toddlers predict persistent wheeze in children between eight to fourteen years old

Abstract

BackgroundIdentifying toddlers at increased risk of developing persistent wheeze provides an opportunity for risk-reducing interventions. House dust mite (HDM) allergen sensitization might identify this group of high-risk children.ObjectiveWe examined whether a positive skin prick test (SPT) to at least 1 of the 3 HDMs in wheezing toddlers, would serve as a predictor for persistent wheeze at age 8 to 14 years old.MethodsA cohort of 78 children, who had wheezing episodes, and underwent SPT to 3 HDMs between the ages of 2 to 5 years old, were enrolled. SPT results were obtained from the National University Hospital database. Four to 9 years later, the children, currently between 8 to 14 years old, were re-assessed for persistence of asthma symptoms and other atopic disorders via a telephone interview. A validated questionnaire on current wheezing and asthma, developed by the International Study of Asthma and Allergies in Childhood, was used. Fisher's exact test was used to evaluate the association between persistence of asthma and a positive SPT.ResultsOf the 78 children who participated in the study, 42 (53.8%) had a positive SPT and 36 (46.2%) had a negative SPT. Of these, 18 (42.9%) of SPT positive and 7 (19.4%) of SPT negative children had persistence of asthma symptoms. There is a significant association between a positive SPT during the preschool years, and persistence of asthma (p = 0.0314 [<0.05]).ConclusionHDM sensitization at ages 2 to 5 years old in wheezing children predicts persistence of asthma after 4 to 9 years. This in turn may have benefits for management of asthma in this high-risk group.

Associations between postpartum depressive symptoms and childhood asthma diminish with child age

“…Our results are compatible with the lessening effect of other postnatal exposures, such as maternal smoking, on asthma in older children [38]. Environmental exposures beyond infancy, for example exposure of toddlers to house dust mite, may additionally impact lung and immune function to increase risk for asthma [39]. As also reported by Caudri et al [20], the likelihood of childhood asthma in our study was highest for maternal history of asthma, although the association was stronger for younger children.…”

International consensus (ICON) on: clinical consequences of mite hypersensitivity, a global problem

“…At 3 years of age, 31.4% of atopic individuals in a cross sectional study were already sensitized to house dust mites [ 103 ]. House dust mite sensitization in toddlers (age 2–5 years) predict persistent wheeze in children between 8–14 years old [ 104 ]. By 14 years of age, the majority of atopic individuals (more than 90%) were sensitized to house dust mites, many of them to multiple species of dust mites [ 97 ].…”

Aeroallergen sensitization and allergic disease phenotypes in Asia

“…14 HDM sensitization in Singaporean pre-schoolers was also predictive of persistent wheeze in later childhood. 68 The early development of HDM-specific IgE in Japanese infants with atopic dermatitis was also a major risk factor for the development of asthma. 69 In particular, Blomia Tropicalis (particularly Blo t5) was implicated in children with purely respiratory allergy (asthma and allergic rhinitis) compared to children with atopic dermatitis alone, who were sensitized more often to D. Pteronyssinus.…”