Natural history of allergic sensitization in infants with early‐onset atopic dermatitis: results from ORCA Study
Open accessAbstract
BACKGROUND: Early-onset atopic dermatitis (AD) is a particular phenotype that may convey a risk of developing multiple sensitizations to allergens but little is known about the pathway of sensitization. The aims of this study were to describe the natural history of sensitization to allergens for this phenotype and to identify the most predictive marker associated with the risk of developing sensitization to inhaled allergens in a well-selected cohort of infants with AD. METHODS: Infants with active AD were enrolled and prospectively explored for biological markers of atopy every year until the age of 6 yr. Allergic sensitization was defined as the presence of positive specific IgEs to allergens and multiple sensitizations as being sensitized to ≥2 allergens. Elevated blood eosinophilia was defined as an eosinophil blood count ≥470 eosinophils/mm(3) and elevated total IgE as a serum IgE level ≥45 kU/l. RESULTS: Two hundred and twenty-nine infants were included. Elevated blood eosinophilia was observed at baseline in 60 children (26.2%) and elevated total IgE in 85 (37.1%). When elevated at baseline, eosinophilia and IgE levels remained significantly higher during the follow-up period. Sensitization to food allergens decreased from 58% to 34%, whereas sensitization to inhaled allergens increased over time from 17% to 67%. Initial multiple sensitizations to food allergens were the most predictive factor for the risk of developing sensitization to inhaled allergens at 6 yr (OR 3.72 [1.68-8.30] p < 0.001). CONCLUSIONS: In the early-onset AD phenotype, multiple sensitization to food allergens conveys a higher risk of sensitization to inhaled allergens than single sensitization.
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In the HealthNut study, 5,276 children with AD monitored during the first four years of life demonstrated an increased risk of developing food allergies, such as peanut and egg allergies.
“In the HealthNut study, 5,276 children with AD were monitored during the first four years of life, demonstrating an increased risk of developing food allergies, such as peanut and egg allergies.”
From Update on the pathogenesis of atopic dermatitis. (2024) · cites this paper as [13]
The Abstract describes the ORCA study, which enrolled 229 infants with atopic dermatitis and followed them to age 6—not a HealthNut cohort of 5,276 children followed for four years. The ‘Changes in specific IgEs’ section reports that food-allergen sensitization decreased during follow-up; the paper does not report the claimed increased risk of developing peanut or egg allergy. (LLM, conf=0.88)
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Experimental — accuracy not yet measuredInfants with eczema are exposed to food antigens through the skin, inducing immune cells and producing IgE antibodies (allergic sensitization).
“Therefore, infants with eczema are exposed to food antigens through the skin, inducing immune cells, and producing IgE antibodies (allergic sensitization).”
From Update on the pathogenesis of atopic dermatitis. (2024) · cites this paper as [13]
On p. 356, the paper suggests that allergens enter through the skin in early-onset eczema and describes how they can encounter antigen-presenting cells, initiate a Th2 response, and lead to sensitization. It also links food sensitization to IgE. The citing sentence presents this proposed pathway as an established process for infants with eczema generally, whereas the paper uses qualified language and studies infants with early-onset atopic dermatitis. (LLM, conf=0.85)
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Cites
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Del Giacco, S. R., Bakirtas, A., Bel, E., Custovic, A., Diamant, Z., Hamelmann, E., Heffler, E., Kalayci, Ö., Saglani, S., Sergejeva, S., et al. (2017) · Allergy · doi:10.1111/all.13072 · Cited by 130 · see citing works
Amat, F., Soria, A., Tallon, P., Bourgoin‐Heck, M., Lambert, N., Deschildre, A., & Just, J. (2018) · Clinical & Experimental Allergy · doi:10.1111/cea.13156 · Cited by 73 · see citing works
Self-citationUpdate on the pathogenesis of atopic dermatitis.
Criado, P. R., Miot, H. A., Bueno-Filho, R., Ianhez, M., Criado, R. F. J., & de Castro, C. C. S. (2024) · Anais brasileiros de dermatologia · doi:10.1016/j.abd.2024.06.001 · Cited by 66 · see citing works
- Authors
- Just, J., Deslandes‐Boutmy, E., Amat, F., Desseaux, K., Nemni, A., Bourrat, E., Sahraoui, F., Pansé, I., Bagot, M., & Fouéré, S.
- Affiliations
- Inserm (FR)
- Service de biostatistique et informatique médicale Hôpital Saint‐Louis, INSERM, U 717 Université Paris 7 Paris France
- Hôpital Armand-Trousseau (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Corresponding author
- Just, Jocelyne
- Venue
- Pediatric Allergy and Immunology
- Publisher
- Wiley
- Published
- 2014-11
- Volume
- 25
- Issue
- 7
- Pages
- 668-673
- ISSN
- 0905-6157 (ISSN-L)
- 1399-3038
- OpenAlex
- W2016672520
- Cited by
- 42
- References
- 1
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 6 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 9 · 2015: 8
- FWCI
- 8.02
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Pediatric Allergy and Immunology (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Keywords
- early-onset atopic dermatitis, allergen sensitization, infants, food sensitization, multiple sensitization, peripheral eosinophilia, total IgE, natural history (disease), predictive biomarkers
- MeSH terms
- Allergens, Child, Child, Preschool, Dermatitis, Atopic, Eosinophilia, Female, Follow-Up Studies, Food, Food Hypersensitivity, Humans, Immunoglobulin E, Immunization, Infant, Infant, Newborn, Male, Medical History Taking, Prospective Studies, Cohort Studies, Age of Onset
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