The sum of specific IgEs to indoor allergens at age 3 years predicts persistence of wheeze at age 5 years

RATIONALE: Wheezing before the age 3 years often resolves, but may persist throughout life as asthma. It would be clinically useful to predict which children with early life wheeze will become persistent wheezers. We investigated the relationship between levels of specific IgE and persistence of wheeze within the setting of a prospective birth cohort.METHODS: Subjects with parentally reported wheeze before age 3 years were categorized as transient early wheezers (TEW) if the wheezing had resolved by age 5 years or persistent wheezers (PW) if they were still wheezing at age 5 years. Level of specific IgE to mite, cat, dog egg and milk were measured at age 3 years. Logistic regression was used to analyse the relationship between the levels of specific IgE and the persistence of wheeze at age 5 years.RESULTS: A full data set was available on 55 children who had reported wheeze by age 3 years, 30 TEW and 25 PW. For individual allergens, there was a trend towards an increase in the risk of PW with increasing levels of mite, cat and dog specific IgE (p≤0.1), with no association seen for egg and milk (p>0.2). The sum of specific IgE to mite and cat was significantly associated with PW (OR 3.12, 95% CI 1.11-8.74, p=0.03), similarly for sum of mite, cat and dog IgE (2.88, 1.08-7.66, p=0.03).CONCLUSIONS: The level of specific IgE to indoor inhalant allergens in children who have wheezed before age 3 years predicts the persistence of wheeze to age 5 years. RATIONALE: Wheezing before the age 3 years often resolves, but may persist throughout life as asthma. It would be clinically useful to predict which children with early life wheeze will become persistent wheezers. We investigated the relationship between levels of specific IgE and persistence of wheeze within the setting of a prospective birth cohort. METHODS: Subjects with parentally reported wheeze before age 3 years were categorized as transient early wheezers (TEW) if the wheezing had resolved by age 5 years or persistent wheezers (PW) if they were still wheezing at age 5 years. Level of specific IgE to mite, cat, dog egg and milk were measured at age 3 years. Logistic regression was used to analyse the relationship between the levels of specific IgE and the persistence of wheeze at age 5 years. RESULTS: A full data set was available on 55 children who had reported wheeze by age 3 years, 30 TEW and 25 PW. For individual allergens, there was a trend towards an increase in the risk of PW with increasing levels of mite, cat and dog specific IgE (p≤0.1), with no association seen for egg and milk (p>0.2). The sum of specific IgE to mite and cat was significantly associated with PW (OR 3.12, 95% CI 1.11-8.74, p=0.03), similarly for sum of mite, cat and dog IgE (2.88, 1.08-7.66, p=0.03). CONCLUSIONS: The level of specific IgE to indoor inhalant allergens in children who have wheezed before age 3 years predicts the persistence of wheeze to age 5 years.