Abstract
Background : We aimed to investigate food allergen
sensitization as a prognostic factor of new onset wheezing episodes as
well as of wheezing severity during follow up in young children with
recurrent wheezing. Our secondary aim was to compare serum levels of
Club Cell-16 (CC-16) and surfactant protein D (SP-D) among wheezing
children with and without food allergen sensitization as potential
pathogenetic indicators of the association between food allergen
sensitivity and wheezing. Methods : This was a prospective
cohort study among children with recurrent wheezing; specific-IgE to
five common foods allergens was assessed at baseline and children were
followed-up for one year for new onset wheezing episodes. Baseline
wheezing severity score, CC-16 and SP-D levels were measured.
Results : We enrolled 295 children among which 44 were food
specific IgE (Fx5) (+). Poisson regression analysis with food allergen
sensitivity, age and wheezing score at presentation revealed that Fx5
positivity changed yearly frequency of wheeze by a factor of 1.66
(p=0.05, 95%CI: (0.99-2.75)). Age changed the yearly frequency of
wheeze by a factor of 0.95 (p=0.005, 95%CI: (0.92-0.99)). One-point
change in wheezing score at presentation changed the wheezing frequency
in the following year by a factor of 1.11 (p=0.005, 95%CI:
(0.67-1.99)). Levels of CC-16 and SP-D were not significantly different
between the two groups (p=0.679 and p=0.988). Conclusion : Food
allergen sensitization defined as serum specific IgE positivity
irrespective of food associated clinical allergy findings is associated
with worse prognosis of wheezing in children.