Pattern of allergen-specific ige at 2 years- predicts atopic asthma at 10 years-of-age in an echo cohort

Rationale: Severe asthma in childhood is associated with high levels of morbidity but the cause and progression of severe asthma during childhood is poorly understood. Early identification of children who will develop severe asthma might allow preventive treatment. Methods: We studied an ECHO cohort in the CREW consortium, WHEALS, a general-risk, ethnically diverse, birth cohort from the Detroit area. At 2 years, 594 children were examined including total and allergen specific IgE (sIgE) to 10 allergens: dog, cat, Alternaria, cockroach, Dermatophagoides farinae, common ragweed, timothy grass, hen\u27s egg, peanut and milk. Latent class analysis yielded 4 sensitization patterns, as previously published. The patterns were: (1) low to no, (2) highly multisensitized for foods and inhalants, (3) milk and egg dominated; (4) peanut and inhalant allergen dominated. A physician reviewed the subject\u27s history of breathing difficulties, performed an examination, evaluated skin tests and spirometry at age 10 years and classified the child as having asthma. Repeat analysis of total and specific IgE to the same 10 allergens, plus a mold mixture, was performed and atopy defined as at least one sIgE ≥ 0.35 IU/ml. We evaluated whether the 4 sensitization patterns from 2 years impacted total IgE and atopic asthma at age 10. Results: At 10 years, the children\u27s geometric mean total IgEs related to the four 2-year patterns were: (1) 42.1, (2) 821, (3) 161 and (4) 180 IU/ml. The differences between (1) low/no sensitization and all other early patterns were significant,