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

• Published in: Journal of allergy and clinical immunology 2011-10, Vol.128 (4), p.782-788.e9
• Main Authors: Lodge, Caroline J., MBBS, GradDipEpi, Lowe, Adrian J., BBSc, MPH, PhD, Gurrin, Lyle C., BSc(Hons), PhD, Hill, David J., MBBS, FRACP, Hosking, Clifford S., MD, FRACP, FRACPA, Khalafzai, Rida U., MBBS, MPH, Hopper, John L., BA, BSc, MSc, PhD, Matheson, Melanie C., BSc, MAppSc, PhD, Abramson, Michael J., MBBS, BMedSc(Hons), PhD, FRACP, FAFPHM, Allen, Katrina J., MBBS, BMedSc, FRACP, PhD, Dharmage, Shyamali C., MBBS, MSc, MD, PhD
• Format: Article
• Language: English
• Subjects: Age; Age Factors; Allergens - adverse effects; Allergens - immunology; Allergic diseases; Allergies; Allergy and Immunology; Animals; asthma; Australia - epidemiology; Biological and medical sciences; Birth cohort; Child; Child, Preschool; Chronic obstructive pulmonary disease, asthma; Dermatophagoides pteronyssinus; eczema; Eczema - epidemiology; Eczema - etiology; Eczema - immunology; Female; Follow-Up Studies; Food; Food allergies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; house dust mite; Humans; Hypersensitivity; Immunopathology; Infant; Infant, Newborn; Male; Medical sciences; Pneumology; Predictive Value of Tests; Pyroglyphidae; Respiratory Sounds; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; sensitization; Skin allergic diseases. Stinging insect allergies; Skin Tests; wheeze
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2011.06.038

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.