Abstract
Background: Classification of atopic sensitization is usually based on allergen specificity at the time of assessment and does not take development aspects into account.
Objective: To find novel classifications of atopic sensitization based on time course, allergen specificity and strength of sensitization, and to compare them to the classical definition of atopy as any specific IgE to food or inhalant allergens.
Methods: Latent class analysis (LCA) was applied to data collected in the PASTURE birth cohort (n=766) assessing specific IgE levels for 5 food and 4 inhalant allergens in cord blood and in peripheral blood at age 1, 4, and 6 years.
Results: The identified LCA classes integrated information from allergen specificity, number of sensitizations and level of individual IgE over time. Five sensitization classes were found, "cowsmilk" (n=142), "mixed food" (n=50), "mixed inhalant" (n=121), "strong seasonal" (n=42), and a reference class (n=411). In contrast to classical definitions, the class “strong seasonal” revealed much stronger associations with disease and reduced lung function than conventional definitions thereby better discriminating symptomatic from asymptomatic sensitization (Tab. 1).
Conclusion: LCA identified a latent phenomenon of severe atopy relevant for disease manifestation and severity thereby identifying children at high risk much more specifically than classical IgE definitions.
- Copyright ©ERS 2015