Prediction of atopy in the first year of life using cord blood IgE levels and family history
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EUROPEAN JOURNAL OF MEDICAL RESEARCH
Eur J Med Res (2009) 14(Suppl. IV): 227-232
© I. Holzapfel Publishers 2009
PREDICTION OF ATOPY IN THE FIRST YEAR OF LIFE USING CORD BLOOD IgE LEVELS AND FAMILY HISTORY A. J. Sybilski 1, 3, A. Doboszynska 2, B. Samolinski 1
1 Department of the Prevention of Environmental Hazards and Allergology, Warsaw Medical University, Warsaw, Poland; 2 Department of Pediatric and Neonatology, Central Clinical Hospital of Ministry of Internal Affairs, Warsaw, Poland; 3 Department of Clinical Nursing, Warsaw Medical University, Warsaw, Poland
Abstract We assessed correlations of total and specific cordblood IgE (cIgE) levels with allergic symptoms in the first year of life. cIgE levels were determined by an immunoassay test in full-term neonates. This is a prospective study in which a questionnaire was used after birth, and at 6 and 12 months of age. We used multiple logistic regression models to assess the association between the family history of atopy and the incidence of allergy. The infants were divided into groups based on the cIgE level (Group 10.5 IU/ml, n=45). We found the symptoms of atopy in 26 children in Group 1 (40%), 30 (47.6%) in Group 2, and 17 (37.7%) in Group 3; the percentage of atopic diseases was insignificantly different among the three groups. No association between a high total cIgE and specific cIgE with atopy family history and the outcome of atopic diseases was discovered. We conclude that neither total nor specific cIgE level with atopy family history can be used as an indicator to single out high risk infants.
Key words: cord blood, IgE, infant, allergy
INTRODUCTION
Growing incidence of allergic diseases, particularly in highly developed countries, created a need for the precise determination of risk factors for initiation and exacerbation of allergies and, based on these premises, for the development of effective prophylactic programs. Increasingly often, first signs of allergy appear already in early infancy, necessitating implementation of prophylactic measures at the moment of birth, or even earlier – at the time of conception [1]. The process of sensitization begins as early as the 11th week of intrauterine life as a result of contact of the fetus with allergens. Elevated levels of plasma IgE predict an early outburst and greater severity of symptoms of allergy. These findings made scientists assess the level of total IgE in cord blood plasma (cIgE) as a predictive factor for subsequent development of allergy in children. Several studies suggest that an isolated assessment of cIgE is neither sensitive nor specific enough for a reliable prediction of development of allergy. Its diagnostic value increases
considerably when combined with other parameters, such as family history and the total IgE level in the maternal blood [2, 3]. In recent years, sensitivity of diagnostic tools improved considerably, enabling the detection of immunoglobulins at very low concentrations. The aim of the present study was to detect the existence of correlations between
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