Allergic sensitization trajectories to age 8 years in the Singapore GUSTO cohort

Allergic sensitization trajectories to age 8 years in the Singapore GUSTO cohort

World Allergy Organization Journal

10.1016/j.waojou.2022.100667

http://dx.doi.org/10.1016/j.waojou.2022.100667

Hui Xing Lau, Zhaojin Chen, Yiong Huak Chan, Elizabeth Huiwen Tham, Anne Eng Neo Goh, Hugo Van Bever, Oon Hoe Teoh, Neerja Karnani, Peter D. Gluckman, Kok Hian Tan, Fabian Kok Peng Yap, Keith M. Godfrey, Johan G. Eriksson, Yap Seng Chong, Bee Wah Lee, Lynette Pei-chi Shek, Evelyn Xiu Ling Loo

15 July 2022

Lau, H. X., Chen, Z., Chan, Y. H., Tham, E. H., Goh, A. E. N., Van Bever, H., Teoh, O. H., Karnani, N., Gluckman, P. D., Tan, K. H., Yap, F. K. P., Godfrey, K. M., Eriksson, J. G., Chong, Y. S., Lee, B. W., Shek, L. P.-C., & Loo, E. X. L. (2022). Allergic sensitization trajectories to age 8 years in the Singapore GUSTO cohort. World Allergy Organization Journal, 15(7), 100667. https://doi.org/10.1016/j.waojou.2022.100667

Background: Allergic sensitization is linked to allergy development, with early sensitization often associated with worse outcomes. We aimed to identify if distinct allergic sensitization trajectories existed within a diverse and multi-ethnic Asian cohort. Methods: We administered modified ISAAC questionnaires in the first 8 years and conducted skin prick testing at ages 18 months, 3, 5 and 8 years in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. We used latent class analysis to derive allergic sensitization trajectories, and adjusted odds ratios (AOR) to evaluate predictive risk factors and associations with allergic comorbidities. Results: Among 997 children, three trajectories were identified: early food and mite sensitization (16.2%), late mite sensitization (24.2%) and no/low sensitization (59.6%). Early food and mite sensitization was associated with early eczema by 6 months [AOR (95%CI) 4.67 (1.78-12.28)], increased risk of wheeze by 3-8 years (ARR 1.72-1.99) and eczema in the first 8 years of life (ARR 1.87-2.41). Late mite sensitization was associated with female sex [AOR 0.58 (0.35-0.96)], cesarean section [AOR 0.54 (0.30-0.98)], early eczema by 6 months [AOR 3.40 (1.38-8.42)], and increased risk of eczema by 18 months [ARR 1.47 (1.03-2.08)] and 8 years [ARR 1.35 (1.05-1.73)]. Conclusion: Early onset of eczema and early allergic sensitization were strongly associated. Early sensitization, especially to house dust mites, was associated with increased risks of developing wheeze and eczema, pointing to the importance of developing preventive perinatal interventions and effective therapeutics for sensitized toddlers.

Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)

This research / project is supported by the National Medical Research Council - Translational and Clinical Research (TCR) Flagship Program
Grant Reference no. : NMRC/TCR/004-NUS/2008

This research / project is supported by the National Medical Research Council - Translational and Clinical Research (TCR) Flagship Program
Grant Reference no. : NMRC/TCR/012-NUHS/2014

This research is supported by core funding from: Singapore Institute for Clinical Sciences
Grant Reference no. : NA

This research / project is supported by the National Medical Research Council - Transition Award grant
Grant Reference no. : MOH-TA18nov-003

Supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator [NF-SI- 0515-10042] and NIHR Southampton Biomedical Research Centre [IS-BRC-1215-20004]), the European Union (Erasmus+Programme ImpENSA 598488- EPP-1-2018-1-DE-EPPKA2-CBHE-JP) and the British Heart Foundation (RG/15/17/3174)

https://oar.a-star.edu.sg/communities-collections/articles/19930

1939-4551

Singapore Institute for Clinical Sciences

https://doi.org/10.1016/j.waojou.2022.100667