Cord Blood IgE Levels Tied To Allergy, Asthma Rates

The rising prevalence of allergic diseases worldwide represents an important health problem. Early identification of children at high risk of allergic diseases could be helpful for physicians to recommend preventive measures and apply early interventions.

Cord blood immunoglobulin E (IgE) has been considered as a potential marker for years due to its predictability for allergic diseases, but the results are controversial. Several studies have reported that elevated cord blood IgE may predict allergic diseases and/or allergic sensitization in childhood, whereas other studies failed to find it as a good predictor.

Immunologists at the Chang Gung Memorial Hospital (Taoyuan, Taiwan) included 566 children (321 boys; mean age, 6.5 ± 0.4 years) in a prospective population-based cohort study designed to longitudinally investigate the effects of early-life environmental exposures and genetic predisposition on childhood allergic outcomes. Blood samples were drawn for subsequent measurement of serum total and allergen-specific IgE. Measurements of nitric oxide (FeNO) and pulmonary function were performed in standard procedures.

Serum total IgE was determined by ImmunoCAP (Phadia, Uppsala, Sweden). Allergic sensitization was defined as a positive Phadia Phadiatop Infant test result (≧0.35 PAU/L), detecting allergen-specific IgE against a mix of common inhalant and food allergens. Serum levels of allergen-specific IgE were measured using an automated microfluidic-based multiplexed immunoassay system, the BioIC Allergen-specific IgE Detection Kit- AD40 Panel; Agnitio Science and Technology, Hsinchu, Taiwan). FeNO measurement was performed by chemiluminescence analyzer (CLD 88sp NO analyzer, Ecomedics, Duernten, Switzerland).

The investigators reported that cord blood IgE levels were significantly associated with FeNO levels and serum total IgE levels. Cord blood IgE levels were positively associated with allergic sensitization (adjusted odds ratio [AOR] = 2.22). Specifically, they found significant associations between elevated levels of IgE in cord blood and higher likelihoods for sensitization to house dust mites (Dermatophagoides pteronyssinus and D. farina), dog dander, egg yolk, garlic and baker’s yeast.

Subjects with cord blood IgE ≥0.24 kU/L (the optimal cutoff) were significantly associated with an increased risk of allergic sensitization (AOR = 2.63,) and asthma (AOR = 2.35) than those with cord blood IgE <0.24 kU/L. Subjects with cord blood IgE ≥0.24 kU/L had significantly higher FeNO levels than those with cord blood IgE <0.24 kU/L. There were no significant associations between cord blood IgE levels and pulmonary function parameters.

The authors concluded that that cord blood IgE ≥0.24 kU/L predicts allergic sensitization, FeNO elevation, and asthma among Asian schoolchildren. Specifically, cord blood IgE levels ≥0.24 kU/L was associated with a 2.6-fold increased risk of allergic sensitization, particularly sensitization to mites, animals, and foods, at six years of age. This study suggests that cord blood IgE levels would be useful for early identification of newborns at risk of subsequent allergic sensitization and allergic airway inflammation at school age. The study was published on August 1, 2022 in the journal Pediatric Allergy and Immunology.

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