Association between severity of atopic eczema and degree of sensitization to aeroallergens in schoolchildren

被引:159
作者
Schäfer, T
Heinrich, J
Wjst, M
Adam, H
Ring, J
Wichmann, HE
机构
[1] Tech Univ Munich, Dept Dermatol & Allergy, D-80802 Munich, Germany
[2] Tech Univ Munich, Div Environm Dermatol & Allergol, GSF, D-80802 Munich, Germany
[3] GSF, Environm & Hlth Res Ctr, Inst Epidemiol, Neuherberg, Germany
[4] Univ Munich, Inst Med Data Proc Biometr & Epidemiol, Munich, Germany
关键词
aeroallergens; atopic eczema; atopic dermatitis; East Germany; epidemiology; IgE-mediated sensitization; disease severity;
D O I
10.1016/S0091-6749(99)70025-4
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: A subgroup of patients with atopic eczema exhibits aggravation through contact with aeroallergens. Little is known from population-based studies, however, about the association between the severity of eczematous skin disease and the degree of aeroallergen sensitization. Objective: We sought to investigate the relationship between IgE-mediated allergic sensitization to aeroallergens and severity of atopic eczema in schoolchildren. Methods: A nested case-control analysis on atopic eczema was performed on the basis of a cross-sectional study of 2201 Last German schoolchildren aged 5 to 14 years. Atopic eczema and its severity was identified by dermatologic examination. Total and allergen-specific IgE antibodies to grass and birch pollen, Cladosporium herbarum, Dermatophagoides pteronyssinus, and cat epithelium in serum were determined, and additional information was obtained by means of standardized questionnaire. Results: The overall prevalence of actual atopic eczema was 2.5%. Thirty-seven percent of the children were sensitized to at least one allergen. Children with atopic enema were significantly more often sensitized than those without skin disease (75.0% vs 36.3%; odds ratio. 5.27; 95% confidence interval, 2.54-11.15). This was observed for each single allergen. The prevalence of atopic eczema increased significantly with increasing RAST class (chi(2) trend test for each allergen, P < .0001). Also, the prevalence of sensitization increased with the severity of the disease (chi(2) trend test for each allergen, P < .0001). This association was pronounced for house dust mite and cat allergen. Multiple linear regression analyses showed significant associations between the severity score of atopic eczema and concentrations of allergen-specific IgE to dust mite (P = .032) and cat (P = .014) allergens after adjustment for ses, age, location, and parental predisposition. Conclusions: The degree of sensitization is directly associated with the severity of atopic eczema. We speculate that earl epicutaneous sensitization to aeroallergens may be enhanced by damage of the skin barrier function. The specific IgE response seems to contribute to the severity of the disease in a dose dependent fashion.
引用
收藏
页码:1280 / 1284
页数:5
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