유아기의 흡입 항원 감작이 알레르기 비염과 천식에 미치는 영향

Abstract

Purpose: Inhalant allergen sensitization is a well-known risk factor for asthma and allergic rhinitis (AR). However, there are few recent data on the prevalence of allergic sensitization in the general population of preschool Korean children. This study assessed the association between early-life sensitization and respiratory allergic diseases. Methods: This study analyzed data from the COCOA (COhort for Childhood Origin of Asthma and allergic diseases) cohort including 1,925 children at age 3 and 988 children at age 7. New-onset allergic diseases were defined as those not diagnosed before age 6 and diagnosed after age 7. Skin prick tests and serum specific IgE tests were performed at ages 3 and 7. Provocholine challenge test was performed at age 7. Results: House dust mite (HDM) was the most frequently sensitized allergen at both ages 3 and 7 (Dermatophagoides pteronyssinus 13.1%, Dermatophagoides farina 14.4%; 33.8%, 39.3%, respectively). Sensitization to indoor allergens at ages 3 and 7 increased risks for new-onset AR (adjusted odds ratio [aOR], 2.80; 95% confidence interval [CI], 2.05–3.84 and aOR, 5.70; 95% CI, 3.13–10.29), asthma (aOR, 2.89; 95% CI, 1.65–5.03 and aOR, 2.68; 95% CI, 1.10–6.51) and bronchial hyperresponsiveness (BHR) (aOR, 2.14; 95% CI, 1.45–3.14 and aOR, 1.69; 95% CI, 1.25–2.30). Early persistent sensitization to HDM was a risk factor for new-onset AR (aOR, 5.25; 95% CI, 1.69–16.30), asthma (aOR, 4.07; 95% CI, 1.19–13.87) and BHR (aOR, 2.82; 95% CI, 1.80–4.43). Conclusion: Early persistent sensitization to HDM is associated with increased risk of new-onset AR, asthma and BHR. Early-life assessment of sensitization is important in predicting future respiratory allergic disease development.