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30-10-2011 | Immunology | Article

Food sensitization and FLG mutations increase risk for long-term eczema, asthma


Free abstract

MedWire News: Food sensitization and fillagrin gene (FLG) mutations in addition to infantile eczema increase the risk for long-term eczema or asthma in older children, report researchers.

Eczema or atopic dermatitis is very common in young children with an estimated prevalence in the general population of up to 20%, but many grow out of the condition in later childhood.

To test whether factors such as allergic food sensitization and having null mutations in the eczema-associated gene FLG in addition to infant-onset eczema predict longer duration of eczema and the onset of asthma in older children, Joachim Heinrich (German Research Center for Environmental Health, Neuherberg, Germany) and colleagues followed up children in two birth cohorts for 10 years.

In total, 188 children from the German Infant Nutritional Intervention (GINI) and 240 from the Influence of Lifestyle-related Factors on the Immune System and the Development of Allergies in Childhood (LISA) birth cohorts who had early onset eczema (before the age of 3 years) were included in the study.

The researchers also included 65 children who were not enrolled in either birth cohort who also had early onset eczema (clinical case series).

The GINI and LISA cohorts were followed up until the age of 10 years and the clinical case series children until the age of 8 years for incident asthma and persistence of infant eczema.

Of those tested across all three cohorts, 110 children had food sensitization or allergy and 379 did not. In addition, 54 children had FLG null mutations and 297 did not.

Food sensitization and FLG null mutations were significantly associated with increased risk for incident asthma at age 8-10 years in both the GINI and LISA cohorts, with respective positive diagnostic likelihood ratios (PLRs) of 1.9 and 5.5 for food sensitization and 2.9 and 2.8 for FLG null mutations, in comparison with neither factor.

Children with food sensitization or FLG null mutations were also more likely to have persistent eczema at age 8-10 years than those with neither factor, but the associations were not statistically significant.

Having food sensitization or FLG null mutations did not significantly predict asthma or persistent eczema in the clinical case series, note Heinrich and team.

"From a public health perspective, our results are important and demonstrate the need for other risk prediction scores that include specific biomarkers that are sufficiently uncorrelated with established clinical risk factors and achieve clinical utility," conclude the authors in the Journal of Allergy and Clinical Immunology.

By Helen Albert

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