Prospective Analysis of Individual Aeroallergen and Food Sensitization Patterns in the First Three Years of Life in Patients with Atopic Dermatitis: Preliminary Observations from the Mechanisms of Progression of Atopic Dermatitis to Asthma in Children (MPAACH) Cohort (original) (raw)

2020, Journal of Allergy and Clinical Immunology

RATIONALE: Skin prick testing (SPT) better correlates with clinical allergy, however, many atopic dermatitis (AD) cohorts use IgE to detect sensitization. Longitudinal food and aeroallergen sensitization patterns via SPT have not been evaluated in a large pediatric AD cohort. METHODS: The Mechanisms of Progression of AD to Asthma in Children (MPAACH) cohort followed children with AD annually from age 1-2 years. SPT data for six food and eleven aeroallergens from 203 subjects who completed visits 1 (V1) and 2 (V2) were analyzed. Sensitization patterns were defined as: non-sensitized (no sensitization in V1 or V2), acquired (sensitized in V2 only), transient (sensitized in V1 only) and persistent (sensitized in V1 and V2). RESULTS: At V1 and V2, 51.5% and 49.5% of children were sensitized overall, respectively. Aeroallergen sensitization increased from 37.6% to 43.9% from V1 to V2 while food sensitization decreased from 38.1% to 30.3%. The most common sensitizations at V1 were egg (28.2%), peanut (22.8%), and dog (14.9%). Over one-third (35.0%) of the cohort had persistent sensitization, 12.8% were acquired, 16.3% were transient and 33.0% were non-sensitized. The top persistent allergens were peanut (16.3%), egg (12.8%) and dog (11.3%), the top transient allergens were egg (14.8%), trees (9.4%), and mold (8.4%). The top acquired allergens were trees (13.8%), dog (9.9%), and cat (8.4%). CONCLUSIONS: Predominance of aeroallergen sensitization occurred in V2 of MPAACH which was younger than observed in existing AD cohorts. Peanut was one of the most frequent and persistent sensitizations, supporting early food allergy assessment in children with AD.