In vitro production of interleukin-4 and interferon-gamma after PHA and PMA stimulation, and mononuclear cell proliferative response to betalactoglobulin and ovalbumin in neonates with different family history of atopy. A follow-up of five years

We have performed the lymphocyte stimulation test (LST) with beta-lactoglob ulin (BLG) and ovalbumin (OVA) and the measurement of interleukin-4 (IL4) a nd interferon-gamma (IFN gamma) in vitro production after phytohemagglutini n (PHA) and phorbol myristate acetate (PMA) stimulation by cord blood monon uclear cells (CBMC) in neonates with biparental heredity (group A), with un iparental heredity (group B), and without atopic disease heredity (group C) . At follow-up, 18 of 55 neonates with a positive family history of atopic disease (9 of 25 neonates of group A and 9 of 30 of group B) versus 3 of 30 neonates of group C showed atopic disease (p < .05). Significant differenc es were not seen in the percentage of neonates with positive (stimulation i ndex [SI] greater than or equal to 3) proliferative responses of CBMC to BL G or OVA, neither among the three groups of neonates with different family history of atopy nor, at follow-up, among children with evidence of atopic disease versus those who were nonatopic. The association of biparental fami ly history of atopy with an SI of 3 or greater to BLG or OVA after 3 days o f culture had a 100% positive predictivity and specificity for the developm ent of atopic disease. On the other hand, the same test after 3 or 8 days o f culture, when associated with absent family history of atopy, had a negat ive predictivity of approximately 90%. Significant differences were not fou nd in the percentage of CBMC samples with detectable levels of IL4 and unde tectable levels of IFN gamma and in the medians and centiles of IL4 and IFN gamma in vitro production among the three groups of neonates with differen t family history of atopy. Also between the atopic and nonatopic groups, we did not observe significative differences in percentage of positive respon ders or medians of cytokine production. The association between the IL4 pro duction and absent family history of atopy had 100% negative predictivity a nd sensitivity for the development of atopic disease. According to our resu lts, the test performed at birth did not show sufficient validity to be pro posed as screening test to define better the neonate at "high risk for atop ic disease.".