Details

Autor(en) / Beteiligte

• Filipiak-Pittroff, Birgit, MSc
• Schnopp, Christina, MD
• Berdel, Dietrich, MD
• Naumann, Aline, MSc
• Sedlmeier, Simon
• Onken, Anna, MD
• Rodriguez, Elke, MSc
• Fölster-Holst, Regina, MD
• Baurecht, Hansjörg, MSc
• Ollert, Markus, MD
• Ring, Johannes, MD, PhD
• Cramer, Claudia, MSc
• von Berg, Andrea, MD
• Bauer, Carl Peter, MD
• Herbarth, Olf, PhD
• Lehmann, Irina, PhD
• Schaaf, Beate, MD
• Koletzko, Sibylle, MD
• Wichmann, Heinz-Erich, MD, PhD
• Heinrich, Joachim, PhD
• Weidinger, Stephan, MD

Titel

Predictive value of food sensitization and filaggrin mutations in children with eczema

Ist Teil von

• Journal of allergy and clinical immunology, 2011-12, Vol.128 (6), p.1235-1241.e5

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2011

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• Background It was reported that in infants with eczema and food sensitization, the presence of a filaggrin (FLG) null mutation predicts future asthma with a specificity and positive predictive value of 100%. Objectives We sought to evaluate the predictive value of food sensitization and food allergy, FLG haploinsufficiency, and their combination in infants with early-onset eczema for persistent eczema and childhood asthma. Methods The German Infant Nutritional Intervention (GINI) and Influence of Lifestyle-related Factors on the Immune System and the Development of Allergies in Childhood (LISA) birth cohorts, as well as a collection of 65 cases of early-onset eczema with and without food allergy were investigated. Results The risk for asthma was significantly increased by food sensitization (positive diagnostic likelihood ratios [PLRs] of 1.9 [95% CI, 1.1-3.4] in the GINI cohort and 5.5 [95% CI, 2.8-10.8] in the LISA cohort) and the presence of an FLG mutation (PLRs of 2.9 [95% CI, 1.2-6.6] in the GINI cohort and 2.8 [95% CI, 1.0-7.9] in the LISA cohort) with a rather high specificity (79.1% and 92.9% in the GINI cohort and 89.0% and 91.7% in the LISA cohort, respectively) but low sensitivity (40.0% and 39.3% in the GINI cohort and 31.6% and 23.5% in the LISA cohort, respectively). Likewise, the risk for persistent eczema was increased. In the clinical cases neither food allergy nor FLG mutations had a significant effect. The combination of both parameters did not improve prediction and reached positive predictive values of 52.3% (GINI cohort), 66.9% (LISA cohort), and 30.6% (clinical cases), assuming an asthma prevalence in children with early eczema of 30%. Conclusion Early food sensitization and the presence of an FLG mutation in infants with early eczema increase the risk for later asthma, but the combination of the 2 factors does not represent a clinically useful approach to reliably identify children at risk.