International variations in associations of allergic markers and diseases in children: ISAAC Phase Two

Weinmayr, G; Genuneit, J; Nagel, G; Bjorksten, B; van Hage, M; Priftanji, A; Cooper, P; Rijkjarv, MA; von Mutius, E; Tsanakas, J; Forastiere, F; Doekes, G; Garrido, JB; Suarez-Varela, MM; Braback, L; Strachan, DP; Isaac Phase Two Study Grp [Inc Pearce, N], ; (2010) International variations in associations of allergic markers and diseases in children: ISAAC Phase Two. Allergy, 65 (6). pp. 766-775. ISSN 0105-4538 DOI:

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P>Background: Circulating allergen-specific IgE (sIgE) and skin prick tests (SPT) are used to define atopy. Downregulation of local inflammatory responsiveness has been proposed to explain a low prevalence of positive SPTs in less affluent countries. We analysed the association between SPTs, total and allergen-specific IgE and their relationships to allergic symptoms in centres with diverse living conditions. Methods: Cross-sectional studies of stratified random samples of 8 to 12-year-old children (n = 7461) used the standardized methodology of Phase Two of the International Study of Asthma and Allergies in Childhood (ISAAC). Symptoms of asthma, rhinitis and eczema were ascertained by parental questionnaires. Skin examination, hypertonic saline bronchial challenge, six aeroallergen SPTs and measurements of serum total IgE and sIgE were performed. Results: In nonaffluent countries, a higher proportion of children with positive SPT had no detectable sIgE (range 37-61%) than in affluent countries (0-37%). Total serum IgE was associated with all disease outcomes among children with both positive SPT and sIgE (P < 0.001), but only with self-reported eczema in children with negative SPTs and negative sIgE. Conclusions: The international pattern of discordance between SPT and sIgE results did not support the downregulation hypothesis. Among children with no evidence of sensitization to common aeroallergens, increased total IgE contributes little to the risk of wheeze and rhinitis in the general population but may play a role in eczema.

Item Type: Article
Keywords: Biological Markers, Child, Cross-Sectional Studies, Eczema, immunology, Humans, Hypersensitivity, diagnosis, immunology, Immunoglobulin E, blood, Questionnaires, Respiratory Sounds, immunology, Rhinitis, immunology, Skin Tests, standards
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Medical Statistics
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 20028376
Web of Science ID: 277320100012


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