Toward improved prediction of risk for atopy and asthma among preschoolers: A prospective cohort study Patrick G. Holt, FAA, Julie Rowe, PhD, Merci Kusel,

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Presentation transcript:

Toward improved prediction of risk for atopy and asthma among preschoolers: A prospective cohort study Patrick G. Holt, FAA, Julie Rowe, PhD, Merci Kusel, MBBS, Faith Parsons, BSc, Elysia M. Hollams, PhD, Anthony Bosco, PhD, Kathy McKenna, PhD, Lily Subrata, PhD, Nicholas de Klerk, PhD, Michael Serralha, BSc(Hons), Barbara J. Holt, BSc, Guicheng Zhang, PhD, Richard Loh, FRACP, Staffan Ahlstedt, PhD, Peter D. Sly, FRACP Journal of Allergy and Clinical Immunology Volume 125, Issue 3, Pages 653-659.e7 (March 2010) DOI: 10.1016/j.jaci.2009.12.018 Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Rates of sensitization to inhalant allergens. Data shown are percentage of the cohort at each age who were sensitized, as defined by relevant allergen-specific IgE titers of 0.35 kU/L or greater. Journal of Allergy and Clinical Immunology 2010 125, 653-659.e7DOI: (10.1016/j.jaci.2009.12.018) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Age-related changes in IgE titers. Fluctuations in HDM-specific IgE titers in individual children who were not (left) or were (right) sensitized at age 5 years. The dotted line indicates the 0.35 kU/L sensitization threshold. Journal of Allergy and Clinical Immunology 2010 125, 653-659.e7DOI: (10.1016/j.jaci.2009.12.018) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Relationship between HDM-IgE titers in individual children at 2 and 5 years. Data shown represent the percentage sensitized to HDM at 5 years among subjects exceeding set IgE cutoffs at 2 years computed at 0.5 kU/L intervals (line of best fit and associated R2 value computed in Excel). In the examples shown, 86.1% of children whose HDM-IgE levels were 0.20 kU/L or greater at 2 years were sensitized at 5 years versus 93.3% of those whose 2-year levels were 0.35 kU/L or greater. Journal of Allergy and Clinical Immunology 2010 125, 653-659.e7DOI: (10.1016/j.jaci.2009.12.018) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Postnatal development of HDM-specific TH memory responses. Data shown are HDM-specific cytokine responses as group means ± SEs, with stratification by sensitization outcome at age 5 years. Dark bars designate sensitized at 5 years, and light bars indicate not sensitized. ∗P < .05, and ∗∗∗P < .001, Mann-Whitney U test. CB, Cord blood. Journal of Allergy and Clinical Immunology 2010 125, 653-659.e7DOI: (10.1016/j.jaci.2009.12.018) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Age-dependent changes in total IgE levels in high-risk children during the first 5 years of life. A, Group data shown as median, interquartile range, and minimum/maximum values. ∗∗P < .01 and ∗∗∗P < .001. B, Age-dependent changes in individual children; population stratified by sensitization status at age 5 years. Journal of Allergy and Clinical Immunology 2010 125, 653-659.e7DOI: (10.1016/j.jaci.2009.12.018) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

TH2 memory responses to HDM allergen in individual children TH2 memory responses to HDM allergen in individual children. HDM-induced IL-4R mRNA production in the overall study population at different time points is shown. Each line represents an individual subject. Journal of Allergy and Clinical Immunology 2010 125, 653-659.e7DOI: (10.1016/j.jaci.2009.12.018) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Probability of wheeze at age 5 years in relation to IgE titers at age 2 years. The population was quartiled by IgE titers, and probability of wheeze at 5 years as a function of IgE titer at 2 years was computed by using univariate logistic regression. Journal of Allergy and Clinical Immunology 2010 125, 653-659.e7DOI: (10.1016/j.jaci.2009.12.018) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions