The Relationship of Parental Allergy and IgE to the Risk of Food Allergy in Offspring
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Erica K. Ridley, MD, Alexandra R. Sitarik, MS, Christine L.M. Joseph, PhD, Haejin Kim, MD, Edward M. Zoratti, MD FAAAAI, Dennis R. Ownby, MD FAAAAI, Christine Cole Johnson, PhD MPH FAAAAI

RATIONALE: Allergic parents are often concerned about their children’s development of food allergy. Assuming a degree of genetic susceptibility, they may unnecessarily restrict their offspring’s diet. However, the degree to which parental factors are associated with food allergy development is unclear and potential predictive associations may vary by race/ethnicity.

METHODS: Data from 761 children enrolled in the racially diverse WHEALS birth cohort in southeast Michigan were analyzed. Sensitization to milk, egg, and peanut was determined via skin prick test (SPT) and specific IgE (sIgE) at age 2-3, and a diagnosis of food allergy (FA) was determined via a panel of allergists following review of clinical and laboratory data. Maternal total IgE, sIgE to 8 common allergens, and parental report of race and atopy (asthma, history of food allergies, etc.) were used as variables for predictive modeling. Predicted probabilities from logistic regression models were used to construct receiver operating characteristic (ROC) curves.

RESULTS: When all parental history and IgE covariates were considered jointly, sensitization to foods by sIgE or SPT in the children was not well-predicted (Area Under the Curve [AUC]=0.60, 0.64, respectively) regardless of race. However, FA diagnosis prediction was significantly better among African-American children compared to non-African American children (AUC=0.78, 0.58, respectively; p=0.047). This appeared to be primarily driven by maternal atopy and total IgE, which achieved the largest individual AUC values among African-American children (AUC=0.62, 0.69, respectively).

CONCLUSIONS: Parental history of allergic disease combined with IgE assessment is predictive of physician-diagnosed FA, but only among African-American children.