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Longitudinal Patterns of Skin Prick Test Sensitization in Early Childhood Predicts Risk for Asthma at Age 7
Monday, February 23, 2015: 3:00 PM
General Assembly Theater B (Convention Center)
Jessica S. Tan, MD, MPH, , , , , , ,
Rationale: Few studies have examined longitudinal patterns of allergic sensitization during early childhood to identify children at risk for developing asthma. We hypothesized that patterns of allergic sensitization based on longitudinal skin prick testing (SPT) can identify children at risk for asthma at age 7.

Methods: We identified children in the Cincinnati Childhood Allergy and Air Pollution Study birth cohort who completed SPT to four common indoor aeroallergens: cat, dog, dust mite(DM) and cockroach(CR) at ages 1, 2, 3 and 4 years. Children were defined as having asthma at age 7 by parental report of lower respiratory symptoms with confirmation by pre and post bronchodilator spirometry and/or methacholine testing. Unsupervised clustering techniques were used to identify groups of children having similar longitudinal patterns of aeroallergen sensitization.

Results: A total of 458 children were included in this analysis; of these 17% (n =78) were diagnosed with asthma at age 7. Five clusters of children based on SPT results were identified: non-atopic, cockroach-sensitized, persistent cat-sensitized, late persistent DM-sensitized and early transient DM-sensitized. Children in two clusters, persistent cat and early transient DM sensitization, were at significantly increased risk of developing asthma by age 7 (OR [95%CI] 2.6 [1.5-5.2] and 3.8 [1.5-8.8] respectively) compared to non-atopic children.

Conclusions: Children with persistent cat sensitization and early transient DM sensitization were significantly more likely to develop asthma by age 7; late DM and CR sensitization was not associated with asthma development. Longitudinal SPT may distinguish subgroups of allergic children at highest risk for developing asthma.