Abstract
Background: While allergic sensitization and atopic dermatitis (AD) are known to increase the risk for allergic diseases, the impact of different temporal and clinical patterns of sensitization and AD is less well defined. Objective: We investigated patterns of sensitization and AD from early infancy to age 3, and the differential risk of developing allergic diseases within each pattern in a general cohort. Methods: Children (n = 2629) from the Canadian Healthy Infant Longitudinal Development (CHILD) Study underwent skin prick tests and were assessed clinically for AD at ages 1 and 3 years. We applied an unsupervised latent class analysis (LCA) to the following 5 factors at these ages: AD, food sensitization, inhalant sensitization, poly-sensitization to foods and poly-sensitization to inhalants. The risks for developing asthma, allergic rhinitis and food allergy at 3 years were evaluated for each identified group. Results: Five distinct classes were revealed by LCA: healthy (81.8%), atopic dermatitis (7.6%), inhalant sensitization (3.5%), transient sensitization (4.1%) and persistent sensitization (3.2%). Using healthy children as the baseline, children in the “atopic dermatitis” group had the next lowest risk for all allergic outcomes at 3 years; those in the “inhalant sensitization” group had the highest risk for allergic rhinitis; children in the “transient sensitization” group were at an increased risk for food allergy; while children in the “persistent sensitization” group had the highest risk for all allergic diseases. Conclusion and Clinical Relevance: There is substantial heterogeneity among allergen-sensitized children. Researchers and clinicians need to be aware of the non-specificity associated with labelling children simply as “atopic” and “non-atopic” without considering the timing of their atopic history, type of sensitization and AD status. Children with AD who were poly-sensitized to foods at an early age appear to be at greatest risk of developing other allergic diseases.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 48-59 |
| Number of pages | 12 |
| Journal | Clinical and Experimental Allergy |
| Volume | 48 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2018 |
Funding
Funding information Canadian Institutes of Health Research (CIHR), Allergy, Genes and Environment Network of Centres of Excellence (AllerGen NCE, Inc.) We are grateful to all the families who took part in this study, and the whole CHILD team that includes interviewers, nurses, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers and receptionists. We are particularly grateful to Zihang Lu for statistical advice and Melanie St. John for meticulous data checking. The Canadian Institutes of Health Research (CIHR) and the Allergy, Genes and Environment (AllerGen) Network of Centres of Excellence (NCE) provided core funding for CHILD. Additional support has been provided by Health Canada, Environment Canada, Canada Mortgage and Housing Corporation, the Sick Children's Hospital Foundation, Don & Debbie Morrison, the Silver Thread Foundation and the Childhood Asthma Foundation. We also acknowledge the generosity of ALK-Abello, Mississauga, ON, Canada, in supplying all allergens for the study, and Lincoln Diagnostics Inc., Decatur, IL USA, for supplying the Duotip-Test II devices and skin testing kits. M Sears holds the AstraZeneca endowed chair in Respiratory Epidemiology.
Keywords
- allergic rhinitis
- asthma
- atopic dermatitis
- food sensitization
- inhalant sensitization
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology