NATURAL-HISTORY OF IGE ANTIBODIES IN CHILDREN AT RISK FOR ATOPY

Background: The relationship between atopic diseases and high serum Ig E levels has been emphasized since the mid-sixties, when IgE antibodie s were discovered. A number of environmental factors, such as the type of feeding, passive smoking, viral infections, early mold, house dust mite and pet fur exposure modulate IEE synthesis and affect the devel opment of atopic diseases. Objective: The aim of the present study was to investigate the natural history of total and specific ISE antibodi es in babies at risk for atopy, enrolled in a prospective study for th e prevention of atopic disease, and followed-up from birth to 4 years of age. Methods: One hundred seventy-four babies (90 boys and 84 girls ) at risk for atopy were enrolled in this study. At the last follow-up the children had a median age of 52 months,range 43 tn 74 months diet ary and environmental manipulations for the prevention of atopic disea ses were recommended. All the infants were examined at the ages of 1, 3, 6, 9, and 12 months and twice each year subsequently when detailed histories were taken and signs and symptoms of atopic disease were sou ght. Total and specific IgE to cow milk, egg, soy, wheat, and Dermatop hagoides pteronyssinus (Dpt) were measured at 6 and 12 months of life and then every year. Results: During the first 24 months of life, the number of children with specific IgE to foods (n = 30) was significant ly higher in comparison to the number of children with specific IgE to Dpt (n = 12) (P =.0006). Cow milk and egg were the most common offend ing foods. The number of children with IgE to cow milk (n = 14) was si gnificantly higher than that with IgE to soy (n = 9) (P = .0011). Tota l serum IgE levels were significantly higher in the group of children who developed atopic disease in comparison with the group that did not (P <.01). Conclusion: Dietary and environmental measures may influenc e the IgE response in atopy-prone children, thus confirming the role o f environmental factors in the modulation of the phenotypic expression of atopy.