Early Life Sensitization Patterns and Risk for Allergic Rhinitis in the WHEALS Birth Cohort: 602

Abstract

Zeinab Saleh, MD, Abigail Chatfield, Suzanne Havstad, MA, Alexandra R. Sitarik, Haejin Kim, MD, Christine L. M. Joseph, PhD, Edward M. Zoratti, MD FAAAAI, Ganesa R. Wegienka, PhD FAAAAI, Dennis R. Ownby, MD FAAAAI, and Christine Cole Johnson, PhD MPH FAAAAI; Henry Ford Hospital, Detroit, MI, Henry Ford Hospital, Detroit, Henry Ford Health System, Detroit, MI, Augusta University, Augusta, GA. RATIONALE: Allergic Rhinitis (AR) is linked to early-life allergen sensitization. Patterns of sensitization may confer differential risk for AR. We assessed whether the risk of childhood AR differed depending upon allergen sensitization profiles at age 2-3 years. METHODS: Allergen sensitization to seven inhalant and three food allergens were assessed by specific IgE at age 2-3 years among participants in the Detroit-area WHEALS birth cohort. Positive tests were defined by specific IgE>_0.35 IU/ml. Four previously identified sensitization patterns at age 2-3 were also examined: low/no sensitization (LS); highly multiplysensitized (HS); milk/egg dominated sensitization (MES) and peanut/ inhalant sensitization (PIS). Current AR was determined by physician evaluation during a study-related visit at age 10-12 years. Relative risks (RR) for AR were calculated for the sensitization frequency and pattern categories determined at age 2-3 years. RESULTS: Compared to 185 non-sensitized children, the risk of AR was not statistically significantly higher for the 69 children with one positive test (RR51.19, 95%CI50.94,1.50; p50.16) but higher for the 91 children with >_2 positive tests (RR51.46, 95%CI51.21,1.75; p<0.001). Compared to 259 LS children, the risk of AR was greater (RR51.68,95% CI51.39, 2.04; p<0.001) for the 13 HS children, the 54 MES children (RR51.25, 95% CI51.01, 1.55; p50.039), and the 19 PIS children (RR51.34, 95% CI51.01, 1.80; p50.046). CONCLUSIONS: Children with multiple (>_2) positive IgE tests at age 23 years were at higher risk for AR in the preteen years. Multi-sensitization as opposed to mono-sensitization may be a marker for allergic predisposition.