Development Of Atopic Sensitization In Finnish And Estonian Children – A Latent Class Analysis In A Multicenter Cohort

Publication date: Available online 23 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Felicitas Schmidt, Alexander J. Hose, Susanne Mueller-Rompa, Tabea Brick, Anu-Maaria Hämäläinen, Aleksandr Peet, Vallo Tillmann, Onni Niemelä, Heli Siljander, Mikael Knip, Juliane Weber, Erika von Mutius, Markus J. Ege, DIABIMMUNE Study Group

Abstract

Background

The prevalence of atopy is associated with a western lifestyle as illustrated by studies comparing neighboring regions with different socioeconomic backgrounds. Atopy might reflect various conditions differing in their susceptibility to environmental factors.

Objective

To define phenotypes of atopic sensitization in early childhood and to examine their association with allergic diseases and hereditary background in Finland and Estonia

Methods

The analysis included 1603 Finnish and 1657 Estonian children from the DIABIMMUNE multicenter young children cohort. Specific IgE levels were measured at age 3, 4 and 5 respectively, and categorized into three CAP classes. Latent Class Analysis (LCA) was performed with the statistic software package poLCA in R.

Results

Both populations differed in terms of socioeconomic status and environmental determinants such as pet ownership, farm-related exposure, time of playing outdoors and prevalence of allergic diseases (all p-values <0.001). Nevertheless, we found similar latent classes (LC) in both populations: an unsensitized class, a food class, two inhalant classes differentiating between seasonal and perennial aero-allergens, and a severe atopy class. The latter was characterized by high total and specific IgE levels and strongly associated with wheeze (odds ratio 5.64 [3.07-10.52] and 4.56 [2.35-8.52]), allergic rhinitis (22.4 [11.67-44.54] and 13.97 [7.33-26.4]) and atopic eczema (9.39 [4.9-19.3] and 9.5 [5.2-17.5], for Finland and Estonia, respectively). Environmental differences were reflected in the larger seasonal inhalant atopy class in Finland though composition of classes was comparable between countries.

Conclusion

Despite profound differences in environmental exposures there may exist genuine patterns of atopic sensitization. The distribution of these patterns may determine the contribution of atopic sensitization to disease onset.

Graphical abstract

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