House dust mite sensitization in toddlers predicts current wheeze at age 12 years

作者：Lodge Caroline J^*; Lowe Adrian J; Gurrin Lyle C; Hill David J; Hosking Clifford S; Khalafzai Rida U; Hopper John L; Matheson Melanie C; Abramson Michael J; Allen Katrina J; Dharmage Shyamali C

来源：Journal of Allergy and Clinical Immunology, 2011, 128(4): 782-U456.

DOI：10.1016/j.jaci.2011.06.038

• Birth cohort
• asthma
• wheeze
• eczema
• sensitization
• house dust mite

Background: Identification of children at risk of developing asthma provides a window of opportunity for risk-reducing interventions. Allergen sensitization might identify high-risk children.
Objective: We sought to determine whether skin prick tests (SPTs) to individual allergens up to age 2 years predict wheeze at age 12 years.
Methods: In a birth cohort of 620 children oversampled for familial allergy, sensitization was assessed by using SPTs (monosensitized, polysensitized, or either) to 6 allergens at ages 6, 12, and 24 months. Wheeze and eczema were recorded 18 times during the first 2 years. Current wheeze was recorded at age 12 years. Adjusted associations were evaluated by multiple logistic regression.
Results: A positive SPT to house dust mite (HDM) at age 1 or 2 years predicted wheeze at age 12 years (adjusted odds ratio: 1 year, 3.31 [95% CI 1.59-6.91]; 2 years, 6.37 [95% CI, 3.48-11.66]). Among wheezy 1-year-olds, those who were HDM sensitized had a 75% (95% CI, 51% to 91%) probability of wheeze at age 12 years compared with a 36% (95% CI, 23% to 50%) probability among those not sensitized. Among eczematous 1-year-olds, those who were HDM sensitized had a 67% (95% CI, 45% to 84%) probability of wheeze at age 12 years compared with a 35% (95% CI, 25% to 45%) probability among those not sensitized. Among 1-year-old children with both eczema and wheeze, the probability of wheeze at age 12 years was 64% (95% CI, 35% to 87%) if HDM sensitized and 50% (95% CI, 26% to 74%) if not.
Conclusion: HDM sensitization at age 1 or 2 years in wheezing and eczematous children at increased familial allergy risk predicts asthma and may inform management of these high-risk groups. (J Allergy Clin Immunol 2011;128:782-8.)

• 出版日期2011-10