Predictive value of food sensitization and filaggrin mutations in children with eczema

被引：26

作者：

Filipiak-Pittroff, Birgit ^{[1
,2
]}

Schnopp, Christina ^{[3
]}

Berdel, Dietrich ^{[2
]}

Naumann, Aline ^{[6
]}

Sedlmeier, Simon ^{[3
]}

Onken, Anna ^{[3
]}

Rodriguez, Elke ^{[7
]}

Foelster-Holst, Regina ^{[7
]}

Baurecht, Hansjoerg ^{[4
,7
]}

Ollert, Markus ^{[3
]}

Ring, Johannes ^{[3
]}

Cramer, Claudia ^{[8
]}

von Berg, Andrea ^{[2
]}

Bauer, Carl Peter ^{[5
]}

Herbarth, Olf ^{[9
]}

Lehmann, Irina ^{[10
]}

Schaaf, Beate

Koletzko, Sibylle ^{[11
]}

Wichmann, Heinz-Erich ^{[1
]}

Heinrich, Joachim ^{[1
]}

Weidinger, Stephan ^{[7
]}

机构：

[1] German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Epidemiol, Neuherberg, Germany

[2] Marien Hosp, Wesel, Germany

[3] Tech Univ Munich, Dept Dermatol & Allergy, Munich, Germany

[4] Tech Univ Munich, GSISH, Munich, Germany

[5] Tech Univ Munich, Dept Pediat, Munich, Germany

[6] Univ Tubingen, Dept Med Biometry, Tubingen, Germany

[7] Univ Kiel, Dept Dermatol Venereol & Allergy, Kiel, Germany

[8] Univ Dusseldorf, IUF Leibniz Res Inst Environm Med, D-40225 Dusseldorf, Germany

[9] Univ Leipzig, Fac Med Environm Med & Environm Hyg, Leipzig, Germany

[10] UFZ Helmholtz Ctr Environm Res, Dept Human Exposure Res & Epidemiol, Leipzig, Germany

[11] Univ Munich, Dr von Hauner Childrens Hosp, Munich, Germany

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY | 2011年 / 128卷 / 06期

关键词：

Eczema; atopic dermatitis; asthma; food sensitization; food allergy; filaggrin; prediction; INFANT NUTRITIONAL INTERVENTION; PROSPECTIVE BIRTH COHORT; ATOPIC-DERMATITIS; ALLERGIC SENSITIZATION; NATURAL COURSE; RISK-FACTORS; FOLLOW-UP; HENS EGG; ASTHMA; PREVALENCE;

D O I：

10.1016/j.jaci.2011.09.014

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

Background: It was reported that in infants with eczema and food sensitization, the presence of a filaggrin (FLG) null mutation predicts future asthma with a specificity and positive predictive value of 100%. Objectives: We sought to evaluate the predictive value of food sensitization and food allergy, FLG haploinsufficiency, and their combination in infants with early-onset eczema for persistent eczema and childhood asthma. Methods: The German Infant Nutritional Intervention (GINI) and Influence of Lifestyle-related Factors on the Immune System and the Development of Allergies in Childhood (LISA) birth cohorts, as well as a collection of 65 cases of early-onset eczema with and without food allergy were investigated. Results: The risk for asthma was significantly increased by food sensitization (positive diagnostic likelihood ratios [PLRs] of 1.9 [95% CI, 1.1-3.4] in the GINI cohort and 5.5 [95% CI, 2.8-10.8] in the LISA cohort) and the presence of an FLG mutation (PLRs of 2.9 [95% CI, 1.2-6.6] in the GINI cohort and 2.8 [95% CI, 1.0-7.9] in the LISA cohort) with a rather high specificity (79.1% and 92.9% in the GINI cohort and 89.0% and 91.7% in the LISA cohort, respectively) but low sensitivity (40.0% and 39.3% in the GINI cohort and 31.6% and 23.5% in the LISA cohort, respectively). Likewise, the risk for persistent eczema was increased. In the clinical cases neither food allergy nor FLG mutations had a significant effect. The combination of both parameters did not improve prediction and reached positive predictive values of 52.3% (GINI cohort), 66.9% (LISA cohort), and 30.6% (clinical cases), assuming an asthma prevalence in children with early eczema of 30%. Conclusion: Early food sensitization and the presence of an FLG mutation in infants with early eczema increase the risk for later asthma, but the combination of the 2 factors does not represent a clinically useful approach to reliably identify children at risk. (J Allergy Clin Immunol 2011;128:1235-41.)

引用

页码：1235 / U573

页数：12

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