Development and isotype diversity of antibodies to inhalant and dietary antigens in childhood atopic eczema

This study demonstrated that a major feature of childhood atopic eczema (AE) is the presence of serum IgG and IgE anti-house dust mite (anti-HDM) antibodies in almost all AE individuals. IgG anti-HDM antibodies, usually of the IgG1 isotype, became prevalent in AE children over the age of 4 years with the highest antibody levels in children in their early teens. In contrast, immunological sensitization to dietary antigens, notably milk and eggs, occurred in both AE children and age-matched non-atopic control children, and was often associated with IgG4 antibodies during early childhood. These became less prevalent with increasing age in control children but persisted in AE children, sometimes together with IgE antibodies. The later occurrence of anti-HDM antibodies in AE children could reflect immunological sensitization following inhalation of antigen, whereas sensitization to dietary antigens appears to be a natural event in early childhood.