What is it about?

The rising prevalence of allergic diseases worldwide represents an important health program. An allergy prediction test at birth may help physicians and parents to early identify newborn infants at risk of developing allergic diseases in the future and hopefully initiate preventive strategies at an early stage. Cord blood immunoglobulin E (IgE) has been suggested as a potential marker for predicting allergic diseases, but it’s role in the real world is unclear. This prompted our research group to conduct a population-based cohort study to investigate whether cord blood IgE levels at birth predict the occurrence of atopy (also known as allergic sensitization to common allergens), allergic diseases, and allergic airway inflammation (in terms of exhaled nitric oxide levels).

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Why is it important?

Our study has identified an optimal cutoff value of cord blood IgE at 0.24 KU/L in predicting allergic sensitization, asthma and elevated exhaled nitric oxide levels in schoolchildren. Specifically, cord blood IgE levels ≥0.24 kU/L are associated with a 2.6-fold increased risk of allergic sensitization (particularly sensitization to mites, animals, and foods) and a 2.4-fold increased risk of asthma at school age. This study is also the first in the world to demonstrate that increased cord blood IgE levels at birth predict allergic airway inflammation, as measured by exhaled nitric oxide, at school age. The key message for physicians and parents is that cord blood IgE may serve as a useful clinical tool for early identification of newborns at risk of subsequent allergic sensitization and allergic airway inflammation at school age. Physicians may recommend parents of newborn infants with increased cord blood IgE levels to implement preventive measures and early recognition of suspicious allergy symptoms.

Perspectives

Few data are available in Asian children regarding the validity of cord blood IgE levels in predicting future allergic diseases. We are pleased to share these interesting findings and will apply the evidence of this research into clinical practice. Hopefully the evidence will diffuse to clinical practice elsewhere in the future.

Hsin-Ju Lee

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This page is a summary of: Cord blood IgE predicts allergic sensitization, elevation of exhaled nitric oxide, and asthma in schoolchildren, Pediatric Allergy and Immunology, August 2022, Wiley,
DOI: 10.1111/pai.13838.
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