In 2532 Children we Report the Developmental Factors Influencing the Development of Atopic Diseases

Abstract

Allergic asthma and rhinitis, Atopic Dermatitis (AD), urticaria and gastrointestinal allergy, are common diseases of infants and children. It was recently estimated that 14% of children suffer from AD, 8% from food allergy, and 12% from asthma [1,2]. The cumulated incidence of these diseases in adolescents has been estimated between 25-35%, while the prevalence is about 20% [3]. The phenotypic expression of these illnesses varies extensively, being very mild in some cases, severe in many, and even life threatening in others. Specific IgE antibodies to foods and positive challenge tests to a number of food allergens are frequently present in children with these disorders. Cow's Milk (CM) appears to be the most common offending food both in gastrointestinal (vomiting, diarrhea, etc) and in cutaneous manifestations (urticaria and AD). About 0.5-7% of infants suffer from more or less adverse reactions to CM [4]. Babies particularly of atopic parents are at high risk of developing atopic diseases; therefore they are defined as at-risk babies [5][6][7].conditions. It has been known for centuries that heredity plays an important role in the development of atopy. A child with a negative family history still has about a 5-15% risk of developing atopy. However, children with a parental history of atopic disease are at higher risk for the development of atopic symptoms. It has been found that if one parent is affected, the chances of an offspring being affected vary between 20 and 40%. If both parents are affected the figure increases up to 40-60%, and 50-80% if both show the same allergic manifestations. The risk of atopy in children who have an allergic sibling ranges between 25 and 35% [3,10].The importance of genetic factors is also demonstrated by other data:(I) children with positive family history for atopy develop allergic symptoms earlier than those with a negative family history [11], (II) The higher the incidence the higher the number of affected subjects in the same family [3].Notable differences exist in the so-called predisposition to atopic diseases, and further study appears to be necessary to better delineate the role played by genetic factors in the development of such disorders.In many allergic patients total serum IgE levels are found to be elevated, and it has been shown that a high total serum IgE level in infants is often associated with the subsequent development of atopic symptoms. Therefore, it was proposed that the measurement of IgE by PRIST testing in infants or at birth would have a predictive value in the atopy development. Several investigators have demonstrated that the risk of developing atopic diseases was very high when the cord IgE level was above 0.5 IU/ml [5,8,9,12].Our data shows that a newborn can be considered at risk for atopy when the cord IgE level is above 0.8 IU/ml [5]. We have also shown that neonates of non atopic parents (0.032 + 0