Margarine and butter consumption, eczema and allergic sensitization in children. The LISA birth cohort study

It has been hypothesized that margarine intake is associated with allergic diseases. However, the epidemiological evidence in children is limited. The aim of the present study was to assess the relationship between dietary intake of margarine and butter with eczema and allergic sensitization in 2-yr-old children. Data of 2582 children at the age of 2 yr with complete information on exposure to diet and allergic outcome were analyzed in a German prospective birth cohort study (LISA). Margarine and butter intake were estimated from a semiquantitative food frequency questionnaire about general fat use at home combined with questions on the child's spread intake. Multiple logistic regression analysis was applied comparing predominant margarine and predominant butter intake with consumption of both butter and margarine. Predominant margarine intake was positively associated with lifetime prevalence of symptomatic eczema (aOR: 1.71; 95% CI: 1.12-2.61) and doctor-diagnosed eczema (aOR: 2.10; 95% CI: 1.36-3.25) and allergic sensitization against inhalant allergens (aOR: 2.10; 95% CI: 1.01-4.41) at the age of 2 yr. No statistically significant associations were found for butter intake. Stratification for parental history of atopic diseases indicated that children at high risk of atopic diseases have higher effect estimates for margarine intake compared to children without parental history of atopic diseases. Stratification for sex also showed higher effect estimates in boys. Children with predominant margarine consumption had an increased risk for eczema and allergic sensitization, while butter intake was no predictor for allergic diseases. However, we could not determine whether margarine is a causal risk factor or whether other lifestyle factors have influenced this association.     

Aeroallergen sensitization in pediatric allergic rhinitis in Singapore: Is air‐conditioning a factor in the tropics?

Singapore is a unique blend of a tropical environment with a high standard of hygiene and public health care. The objective was to define the prevalence, clinical characteristics, and environmental risk factors of specific aeroallergen sensitization in pediatric allergic rhinitis patients in this unique environment. The method adopted was a retrospective analysis of allergic rhinitis patients, undergoing aeroallergen skin prick testing (SPT), in the outpatient specialty clinic of the KK Children's hospital, from July 2001 to June 2002. A total of 202 patients were included, 161 (80%) males, 167 (83%) Chinese, age mean 7.6 yr (range 2-14 yr). The most prevalent clinical symptoms were: watery rhinorrhea 61%, blocked nose 61%, sneezing 52%, snoring 17%, and epistaxis 12%. SPT results were positive for house dust mites in 97% of children, pets (20%), molds (19%), pollens (15%), and kapok (10%). Mold sensitization was significantly more prevalent in households without air-conditioning (aircon), 49% vs. 10% with aircon (odds ratio 9.4, 95% CI 3.8-22.9). Polysensitization (sensitization to three or more allergens) was similarly more prevalent in households without aircon, 51% vs. 14% with aircon (odds ratio 6.4, 95% CI 2.8-14.7). It was concluded that indoor aeroallergen sensitization is the major associated factor with clinical allergic rhinitis in children in Singapore. Patients living in households without air-conditioning are at increased risk of mold sensitization and polysensitization.     

A prospective study of wheezing in young children: The independent effects of cockroach exposure, breast-feeding and allergic sensitization

The objective of this study was to evaluate risk factors for persistent wheezing in a group of 2-4-year-old children after an index-wheezing episode in infancy. Eighty infants who had been seen at the Emergency Department for an episode of acute wheezing were followed for 2 yr in this prospective study. Caregivers completed a questionnaire, and children underwent clinical evaluation and skin prick testing 2 yr following the index-wheezing episode. Detection of respiratory viruses and analysis of exposure to major indoor allergens were carried out at enrollment. Immunoglobin E antibodies were measured at the beginning of the study and at the end of follow-up, using the CAP system. Logistic regression analysis was performed to identify factors associated with persistent wheezing. Seventy-three children (44 boys) completed the study. After 2 yr, 38 (52%) reported three or more wheezing episodes in the past 12 months (persistent wheezers). Independent risk factors for persistence of wheezing were allergic sensitization and exposure to cockroach allergen in the kitchen. Breast-feeding for at least 1 month was a protective factor. A strong association between allergic sensitization and persistence of wheezing was found in a group of very young children living in a subtropical area.     

Childhood hypo‐adiponectinaemia but not hyper‐leptinaemia is associated with insulin insensitivity 6 years later

Kynde I, Heitmann BL, Bygbjerg IC, Andersen LB, Helge JW. Childhood hypo‐adiponectinaemia but not hyper‐leptinaemia is associated with insulin insensitivity 6 years later. Background: Biomarkers of metabolism and inflammation may predict children with increased diabetes risk. Objective: To study plasma adiponectin, leptin, IL‐8, and hepatocyte growth factor (HGF) in childhood and their independent associations with insulin insensitivity, cross‐sectional and in 6‐yr prospective. Subjects: Danish 8‐ to 10‐yr‐olds and 14‐ to 16‐yr‐olds from the European Youth Heart Studies I and II. Methods: Cross‐sectional (n = 386) and prospective (n = 246) linear regressions of baseline concentrations of plasma biomarkers and insulin insensitivity at baseline and 6 yr later. Adjustments were made at four progressive steps for sex, sexual maturity, body mass index (BMI), other biomarkers, physical activity, and school location as well as baseline insulin insensitivity in prospective analyses. Insulin insensitivity was measured using homeostasis model assessment standardized to the sample mean [homoestasis model assessment (HOMA) Z‐scores]. Plasma biomarkers were quantified using solid‐phase protein immunoassays. Overweight was defined as the highest BMI tertile. Results: Among overweight but not lean children at baseline, one SD difference in baseline plasma adiponectin was associated with ?0.41 SD difference in HOMA Z‐scores 6 yr later (p = 0.006). At baseline, one SD difference in plasma leptin was associated with 0.36 SD difference in HOMA Z‐scores (p =< 0.0001) among 8‐ to 10‐yr‐olds, but a prospective association was not found. Conclusions: We found a direct relationship between childhood hypo‐adiponectinaemia and insulin insensitivity in adolescence. This association was stronger for overweight than for normal weight children. Hyper‐leptinaemia was associated with concurrent insulin insensitivity at baseline but not 6 yr later.     

Low levels of interferon‐γ in nasal fluid accompany raised levels of T‐helper 2 cytokines in children with ongoing allergic rhinitis

The T‐helper 2 (Th2) cytokines interleukin‐(IL‐) 4, IL‐5, IL‐6, IL‐10 and the Th1 cytokine IFN‐γ and their associations with eosinophils, eosinophilic cationic protein (ECP) and immunoglobulin (Ig) E were studied in nasal lavage fluid from 60 school children with allergic seasonal rhinitis and 36 nonatopic healthy controls, before and during the pollen season. Eosinophil differential counts and IgE increased significantly in the patients during the pollen season. The eosinophil differential counts, ECP and IgE were all significantly higher during the season than in specimens simultaneously obtained from the nonatopic controls. Before season, the levels of ECP and IgE, but not eosinophils, were significantly higher in the patients than in the controls. During the season the nasal lavage fluid levels of IFN‐γ were significantly lower and the IL‐4/IFN‐γ quotients significantly higher in the allergic than in the control children. In the allergic children, but not in the controls, the nasal fluid levels of the Th2 cytokines IL‐4, IL‐5 and IL‐10 increased during the season, and together with IL‐6, were correlated with the differential counts of eosinophils, and with the levels of ECP and IgE. These findings are compatible with the hypothesis that a deficient release of the Th1 cytokine IFN‐γ plays an important role in the pathogenesis of allergic inflammation. Regardless of whether the defective IFN‐γ secretion is primary or a consequence of suppression by other cytokines, it will in the atopic subjects enhance the release of Th2 cytokines, which in turn will facilitate the development of allergic inflammation.     

Allergic sensitization is associated with rhinovirus‐, but not other virus‐, induced wheezing in children

Jartti T, Kuusipalo H, Vuorinen T, Söderlund‐Venermo M, Allander T, Waris M, Hartiala J, Ruuskanen O. Allergic sensitization is associated with rhinovirus‐, but not other virus‐, induced wheezing in children.
Pediatr Allergy Immunol 2010: 21: 1008–1014.
© 2010 John Wiley & Sons A/S Background: Data on the link between atopy and viral wheeze are limited. Aim: To evaluate the association between IgE sensitization and viral infection in wheezing children. Methods: This is an observational study in hospitalized wheezing children (n = 247; median age 1.6 ; interquartile range 1.1, 2.9). Eighteen respiratory viral infections were studied using all available methods. A specific immunoglobulin E (IgE) sensitization for common food and aeroallergens and other atopy‐related variables including total IgE, blood and nasal eosinophils, exhaled nitric oxide, eczema and atopic eczema, parental allergy and asthma, number of wheezing episodes, positive asthma predictive index or asthma and use of inhaled corticosteroid were correlated with specific viral etiology. Results: Atopy was closely associated with sole rhinovirus etiology (n = 58) but not with sole respiratory syncytial virus, sole enterovirus, sole human bocavirus, sole other virus, mixed viral, or virus negative etiology. The number of sensitizations was particularly associated with sole rhinovirus etiology (odds ratio 4.59; 95% confidence interval 1.78, 11.8; adjusted to age and sex), followed by aeroallergen sensitization (respectively; 4.18; 2.00, 8.72), total IgE level (2.06; 1.32, 3.21), food allergen sensitization (2.02; 1.08, 3.78), and nasal eosinophil count (1.52; 1.08, 2.13). Conclusions: According to our data, allergic sensitization is positively linked to rhinovirus‐, but not other virus‐, associated wheezing and calls attention for studies to test rhinovirus‐associated wheezing as a part of asthma risk indices.     

High salivary secretory IgA antibody levels are associated with less late‐onset wheezing in IgE‐sensitized infants

To cite this article: Sandin A, Björkstén B, Böttcher MF, Englund E, Jenmalm MC, Bråbäck L. High salivary secretory IgA antibody levels are associated with less late‐onset wheezing in IgE‐sensitized infants. Pediatr Allergy Immunol 2011; 22 : 477–481. Low levels of secretory IgA (SIgA) and transient IgA deficiency have been associated with an increased risk for allergy, but data are conflicting. The aim was to assess the relationship between salivary SIgA antibody levels at 1 yr and wheezing at age four in a birth cohort, in particular the possible protective role of salivary SIgA in sensitized children. Saliva samples were obtained from all children (n = 67) with a positive skin prick test (SPT) at 1 yr and 212 children with a negative SPT. In all, 200 of these children responded to questionnaires at 4 yrs and 183 were skin prick tested at that age. The levels of salivary SIgA and salivary IgA antibodies to the most common food allergen egg and inhalant allergen cat were analyzed by ELISA. Serum was analyzed for IgE antibodies to egg and cat. Development of late‐onset wheezing was associated with low SIgA levels in children with positive SPT to at least one allergen both at 1 and 4 yrs of age (p = 0.04), as well as in children with circulating IgE antibodies to egg or cat at 1 yr (p = 0.02). None of nine persistently sensitized children with SIgA levels in the upper quartile developed wheezing, when compared to 10/20 children with lower levels (p = 0.01). Older siblings, more than three infections during infancy, at least one smoking parent, and male gender, were all associated with SIgA in the upper quartile. In conclusion, high levels of SIgA antibodies in sensitized infants were associated with significantly less late‐onset wheezing, supporting a protective role against development of asthmatic symptoms. Recurrent infections and other factors supporting an increased microbial pressure during infancy were associated with high levels of salivary SIgA.     

Cross-sectional study of allergic disorders associated with breastfeeding in Japan: The Ryukyus Child Health Study

Uncertainties remain as to whether breastfeeding is protective against childhood allergic disorders. Positive relationships of breastfeeding with asthma and atopic eczema were observed in two previous Japanese studies. This cross-sectional study investigated the association between the feeding pattern after birth and the prevalence of allergic disorders during the past 12 months in Japanese schoolchildren. Study subjects were 24,077 children aged 6-15 yr in Okinawa. The outcomes were based on diagnostic criteria from the International Study of Asthma and Allergies in Childhood. Allowance was made for age, sex, number of siblings, smoking in the household, paternal and maternal history of asthma, atopic eczema, and allergic rhinitis, and paternal and maternal educational level. Breastfeeding, regardless of exclusivity, for 13 months or longer and exclusive breastfeeding for 4-11 months were independently associated with a higher prevalence of atopic eczema, particularly among children without a parental allergic history. A clear positive dose-response relationship was observed between prolonged duration of breastfeeding, regardless of exclusivity, but not exclusive breastfeeding, and the prevalence of atopic eczema. We found a significant positive trend for atopic eczema across the three categories (formula milk, partial and exclusive breastfeeding) in the first 4 months of life although the odds ratio for exclusive breastfeeding was not statistically significant. No material association was found between the feeding pattern after birth and the prevalence of wheeze or allergic rhinoconjunctivitis. Prolonged breastfeeding may be associated with a higher prevalence of atopic eczema in Japanese children.