Document Detail


Cow's milk allergy as a predictor of bronchial hyperresponsiveness and airway inflammation at school age.
MedLine Citation:
PMID:  20618346     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cow's milk allergy (CMA) has been found to be associated with an increased incidence of asthma at school age. However, prospective population-based studies of CMA and the development of airway inflammation and bronchial hyperresponsivess (BHR) are lacking.
OBJECTIVE: The aims of this study was to evaluate CMA as a risk factor for BHR and airway inflammation presented later in childhood.
METHODS: We followed prospectively 118 children with CMA and invited them to a clinical visit at a mean age of 8.6 years including the measurement of exhaled nitric oxide (FE(NO) ) and bronchial challenge with histamine. Ninety-four patients and 80 control subjects from the same cohort participated.
RESULTS: At school age, children with a history of CMA had higher FE(NO) levels (P=0.0009) and more pronounced responsiveness to histamine (P=0.027) than their controls. Stratified analysis showed a significant difference only in IgE-positive CMA. Multinomial logistic regression analysis showed that IgE-positive CMA [odds ratio (OR) 3.51; 95% confidence intervals (CI) 1.56-7.90; P=0.002] and a history of wheeze during the first year of life (OR 2.81; 95% CI 1.16-6.84; P=0.023) were independent explanatory factors for increased FE(NO) , and IgE-positive CMA (OR 3.37; 95% CI 1.03-10.97; P=0.044) and parental smoking (OR 3.41; 95% CI 1.14-10.22; P=0.028) for increased BHR, whereas for IgE-negative CMA, no associations with FE(NO) or BHR were found. In the CMA group, those exposed to CM very early at the maternity hospital, had less BHR (P=0.002).
CONCLUSIONS: Compared with their controls, children with a history of IgE-positive CMA show signs of airway inflammation, expressed as higher FE(NO) , and more pronounced bronchial responsiveness to histamine at school age. In contrast to IgE-negative CMA, IgE-positive CMA is a significant predictor of increased FE(NO) and BHR at school age. Very early exposure to CM was associated with less BHR.
Authors:
L P Malmberg; K M Saarinen; A S Pelkonen; E Savilahti; M J Mäkelä
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology     Volume:  40     ISSN:  1365-2222     ISO Abbreviation:  Clin. Exp. Allergy     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-12     Completed Date:  2011-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8906443     Medline TA:  Clin Exp Allergy     Country:  England    
Other Details:
Languages:  eng     Pagination:  1491-7     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Department of Allergy, Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland. pekka.malmberg@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Animals
Bronchial Hyperreactivity / complications*,  immunology
Bronchial Provocation Tests
Cattle
Child
Exhalation
Female
Humans
Immunoglobulin E / blood,  immunology
Infant
Infant, Newborn
Male
Milk / immunology
Milk Hypersensitivity / complications*,  immunology
Nitric Oxide / analysis
Pneumonia / complications*,  immunology
Respiratory Function Tests
Risk Factors
Skin Tests
Chemical
Reg. No./Substance:
10102-43-9/Nitric Oxide; 37341-29-0/Immunoglobulin E
Comments/Corrections
Comment In:
Clin Exp Allergy. 2010 Oct;40(10):1439-41   [PMID:  20937060 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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