High prevalence of sensitization to aeroallergens in children 4 yrs of age or younger with symptoms of allergic disease

The assumption that sensitization to aeroallergens is rare in preschool children is based on population studies in which most subjects have little or no symptoms of atopic disease. We assessed the prevalence of atopic sensitization in children 0 to 4 yr of age presenting with symptoms of allergic disease by reviewing results of all specific immunoglobulin (IgE) tests performed in our hospital laboratory in children 4 yr of age or younger between 1985 and 2003. Tests were ordered by general practitioners or hospital‐based pediatricians in children presenting with symptoms of allergic disease. Specific IgE tests to a panel of common food and inhalant allergens were performed in 2946 children; a specific IgE concentration >0.35 kU/l was considered positive. Overall, 505 (17%) tests were positive to aeroallergens: 346 (12%) for house dust mite, 257 (9%) for dog dander, 240 (8%) for cat dander, and 197 (7%) for grass pollen. Positive tests were more common in boys (19.2%) than in girls (14.2%, p < 0.01), irrespective of age. Although sensitization to food allergens was more common in 0‐<3 yr olds, aeroallergen and food allergen showed comparable prevalence rates in 3‐<5 yr olds. Sensitization to aeroallergens is common in preschool children with symptoms of allergic disease, and more common in boys than in girls. Screening tests for allergy in infants and toddlers should include inhalant allergens.     

Bronchial asthma after early childhood wheezing: a follow-up until 4.5–6 years of age

Over a period of 12 months from 1981 to 1982, 83 patients aged less than 2 years were treated in hospital for acute bronchiolitis. The children were followed-up prospectively; 68 (83%) completed the study until 4.5–6.0 years of age. At this age, 17 (25%) of the 68 children with bronchiolitis still suffered from wheezing attacks. These 17 asthmatics suffered from both atopic dermatitis (29 versus 6%) and allergic rhinitis (29 versus 8%) more frequently than non-asthmatic children. In contrast, positive results in the skin prick tests were almost equally common (29 and 20%) in asthmatic and non-asthmatic children. In these tests, allergies to birch pollen, timothy grass pollen and house dust mite were most common; asthma was particularly associated with house dust mite allergy. The presence of atopic dermatitis, elevated immunoglobulin E values and repeated wheezing episodes between I and 2 years of age were significant risk factors for later asthma. In conclusion, the risk for later asthma is increased after early childhood bronchiolitis; the frequency of asthma was 25% in the present study. Our results confirm that atopics are at a greater risk of developing asthma later in childhood than non-atopics; the risk was significant from 1 year of age onwards.     

Determinants of total and specific IgE in infants with atopic dermatitis

ETAC (Early Treatment of the Atopic Child), a multi-centre predominantly European study to investigate the potential for cetirizine to prevent the development of asthma in infants with atopic dermatitis has completed enrolment: 817 children have been randomised to 18 months' treatment with either active or placebo and a subsequent 18 months of post-treatment follow-up. Results of the therapeutic effects will not be available for some time, but the study has provided an opportunity to investigate influences on sensitization to allergens in a large cohort of 1-2 years olds with already established atopic dermatitis, resident in different countries and in different environments.
The study shows that in infants with atopic dermatitis, raised serum total IgE has significantly different determinants from that a specific allergen sensitization. In infancy, increased total IgE is more affected by factors increasing risk of intercurrent infection and non-specific airway inflammation, such as environmental tobacco smoke exposure (p < 0.001) and the use of gas cookers (p=0.02). Specific allergen sensitization as represented by detectable IgE antibodies is influenced primarily by allergen exposure. In Sweden, low level exposure to allergens is associated with reduced specific allergen sensitization rates even though the infants already have atopic dermatitis.     

标准化屋尘螨变应原特异性免疫治疗对儿童变应性鼻炎合并哮喘的临床疗效

目的 评估标准化屋尘螨变应原特异性免疫治疗(specific immunotherapy,SIT)对儿童变应性鼻炎合并哮喘的临床疗效.方法 选择我院42例接受标准化屋尘螨SIT的变应性鼻炎合并哮喘儿童为研究对象.所有患儿治疗前、治疗1年后均进行变应原皮肤点刺试验、测定血清屋尘螨和粉尘螨特异性IgE水平、进行肺功能测定和自觉症状评分.结果 治疗1年后屋尘螨和粉尘螨的皮肤指数和自觉症状评分均较治疗前显著降低(P＜0.01,P＜0.05),而治疗前后屋尘螨和粉尘螨特异性IgE水平、肺功能(肺活量、第1秒用力呼气量、最大呼气中段流量)均无明显变化(P＞0.05).结论 变应性鼻炎合并哮喘儿童给予SIT1年后其皮肤敏感性显著改善,临床症状明显好转,但对气道炎症的影响有待于进一步的观察.     

Comparison of two IgE antibody tests with skin test and clinical history in asthmatic patients

The multiple allergosorbent chemiluminescent assay (MAST-CLA) is a system to measure total and allergen-specific IgE in human serum by means of a chemiluminescent immuno-enzymatic system. The test has been compared with skin test, RAST and clinical history in 67 atopic, asthmatic children. The individual percentage agreement between MAST-CLA and skin test was grass pollen 67%, tree pollen 82%, cat 76%, dog 84%, house dust mite 87%, alternaria 64%, aspergillus 79%, cladosporium 84%, penicillium 93%, milk 78% and egg 76% and between MAST-CLA and RAST was grass pollen 62%, tree pollen 72%, cat 75%, dog 72% and mite 87%. The total IgE levels on MAST-CLA did not agree with PRIST results. MAST-CLA was randomly duplicated and proved repToducible in 85% of tests. Changes between positive and negative results occurred in only 4% of tests. Clinical history predicted allergy diagnosis accurately in 21 (31. 5%) cases whilst MAST-CLA provided additional information in 14 (21%). MAST-CLA proved least reliable for grass pollen allergy diagnosis, which has prompted a change in allergen composition for this assay. MAST-CLA is a simple in vitro test for specific IgE to 35 allergens which compares favourably with RAST. The variation in correlates with other techniques of allergy diagnosis, however, indicates that there are differences in credibility for each result within the multiple test system.     

Cockroach allergy in a group of Turkish children with respiratory allergies

Exposure to cockroach may lead to exacerbations of bronchial asthma and/or allergic rhinitis in sensitized patients. Although there is a widespread belief that cockroach allergy is a common problem in patients with respiratory allergies, little is known in Turkish children. In order to investigate the prevalence and characteristics of cockroach allergy in respiratory allergic children, we performed a study in newly referred children with respiratory allergies. All patients underwent questionnaire-interview and skin prick tested with common inhalant allergens in addition to two cockroach allergens: Blatella germanica (Bg) and Periplaneta americana (Pa). A subgroup of patients was also serologically investigated for specific IgE against Bg and house dust mite. Three hundred- and thirty-seven children aged 2-16 years were recruited for the study and 77.7% of these were atopic, with the most common indoor and outdoor allergens of house dust mite (47.5%) and grass pollens (45.1%), respectively. According to the prick test results, allergies to Bg and Pa were 11.9% and 7.4%, respectively, and there was a weak correlation between size of the prick test and specific IgE levels for Bg allergen. Almost 30% of the cockroach-sensitive patients were allergic to both cockroach antigens. Seventy percent of cockroach-sensitive patients were also sensitive to house dust mite, and only 1% were monosensitive. Dwellings in the Middle Anatolia and Black Sea regions were less commonly infested by cockroach compared to the dwellings in other regions. In conclusion, our preliminary study showed that cockroach sensitization is common among children with respiratory allergies irrespective of infestation history, suggesting that addition of cockroach allergen to the routine allergy screening panel is critical.     

屋尘螨皮下特异性免疫治疗的哮喘患儿肺功能及免疫学动态变化

目的：动态观察屋尘螨变应原皮下特异性免疫治疗对哮喘患儿的肺功能和免疫学影响。方法：屋尘螨过敏的轻中度哮喘患儿32例,分成治疗组(n=15)和对照组(n=17)。治疗组吸入糖皮质激素的同时加用屋尘螨变应原皮下特异性免疫治疗,对照组仅予吸入糖皮质激素治疗。检测治疗前、治疗后3月、6月、12月、18月、24月肺通气功能,观察治疗前、治疗后12月及24月哮喘发作次数并测定血清总IgE、屋尘螨特异性IgE、屋尘螨特异性IgG4、嗜酸细胞阳离子蛋白（ECP）、IL-10、IL-4及IFN-γ的变化。结果：治疗组患儿治疗后肺通气功能各项参数稳定在正常或接近正常水平;无哮喘急性发作病例的百分率治疗后高于治疗前,随治疗时间的延长而增加（P<0.05）;治疗后屋尘螨特异性IgG4高于治疗前,随着治疗时间延长而增加（P<0.01）;治疗后血清总IgE、屋尘螨特异性IgE、ECP、IL-10、IL-4、IFN-γ水平与治疗前比较,差异无统计学意义。对照组患儿治疗前后各项指标比较,差异均无统计学意义。结论：屋尘螨过敏的轻中度哮喘患儿经屋尘螨变应原皮下特异性免疫治疗2年后,肺通气功能保持正常或接近正常,无哮喘急性发作病例增加,可能与血清屋尘螨特异性IgG4浓度增高有关。［中国当代儿科杂志,2010,12（9）：715-719］     

House dust mite allergen reduction and allergy at 4 yr: Follow up of the PIAMA-study

Exposure to high allergen levels in early life is a risk factor for the development of allergy. We previously reported limited effects of mite allergen impermeable mattress covers in the prevention and incidence of asthma and mite allergy (PIAMA) cohort at the age of 1 and 2 yr. We now present the results of follow-up at 4 yr objectives. To examine the effects of early reduction of house dust mite (HDM) allergen exposure by means of mattress covers on the incidence of allergy and asthma symptoms in the PIAMA birth cohort at the age of 4 yr. High-risk children (allergic mother) were prenatally recruited and randomly allocated to three groups; receiving mite allergen impermeable mattress covers (n = 416), placebo covers (n = 394) or no intervention (n = 472). At 4 yr of age, atopy was assessed by questionnaire; specific Immunoglobulin E (IgE) to inhalant and food allergens was measured in serum. Dust samples collected from the children's mattresses were analysed for mite allergens. Dermatophagoides farinae1 allergen (Der f 1) levels in dust were reduced in the active group. However, Dermatophagoides pteronissinus 1 (Der p 1) levels, sensitization and atopic symptoms were similar in all groups. We found no effect of mite allergen impermeable mattress covers on sensitization and atopy at 4 yr. Moreover, the allergen reducing effects of the covers had disappeared for one of the two mite allergens that were measured.     

影响儿童哮喘尘螨特异性免疫疗效的因素分析

目的：探讨影响尘螨过敏性哮喘患儿特异性免疫治疗（SIT）疗效的因素。方法：监测99例哮喘患儿接受标准化屋尘螨SIT半年（S1期）、1年（S2期）、1年半（S3期）、2年（S4期）以后的哮喘控制水平,分析患儿初诊年龄、哮喘病程、哮喘程度分级、初始血清特异性（sIgE）浓度、是否合并过敏性鼻炎或异位性皮炎、是否合并吸入糖皮质激素治疗及疗程中出现局部和全身副作用情况对哮喘控制水平的影响。 结果：随着SIT疗程的进行,临床控制病例显著增加,未控制病例则明显减少（P<0.01）;患儿初诊年龄在S1和S3期,以及合并过敏性鼻炎或异位皮炎在S1期均显著影响了哮喘的控制水平（均P<0.01）;SIT治疗各期临床控制组的初始血清sIgE浓度均显著高于临床未控制组（均P<0.05）;S1和S2期初始哮喘程度分级较高的患儿较初始哮喘程度分级较低的患儿达到临床控制的比例显著增高（均P<0.05）。结论：SIT的长期疗效可能与疗程长短及总剂量呈正相关;治疗前初始血清sIgE浓度高的患儿较浓度低的患儿可能更早达到临床控制。     

Exposure to a high concentration of mite allergen in early infancy is a risk factor for developing atopic dermatitis: A 3-year follow-up study

The cause of allergy is multi-factorial, and the development of an allergic disease seems to be the result of an interaction between genetic and environmental factors. The goal for preventing the development of allergic diseases is to avoid sensitization to allergens. The aim of this work was to study whether or not exposure to environmental allergens early in infancy would influence the occurence of various allergic diseases in later life. On an annual basis, a total of 931 healthy newborns were followed-up until they reached 3 years of age. The occurence of allergic diseases was recorded by trained medical students during visits. Measurement of Dermatophagoides pteronyssinus (Der p 1) concentration in house dust was performed when each baby was 18 and 36 months old. Total and specific immunoglobulin E (IgE) antibodies against Der p 1, cow's milk, and egg white were evaluated at birth and at 18 months of age. The following results were obtained: at 3 years of age, 10.4% had bronchial asthma (BA), 21.4% atopic dermatitis (AD), 7.0% urticaria, and 46.8% had experienced wheezing; higher family allergy scores led to a higher incidence of AD (p=0.0012); exposure to a mite allergen concentration of 1 µg/g of dust may be associated with a higher incidence of AD (p=0.0156); the presence of Der p 1 IgE antibody at 18 months of age was associated with a higher incidence of BA (p=0.0001); and children sensitized to egg whites at 18 months of age had an increased risk of developing AD at 3 years of age (p=0.0187). Hence, early exposure to mite allergen is a risk factor for the development of atopic dermatitis, but seems not to be related to the development of bronchial asthma. Early sensitization to egg whites increases the risk of developing AD. The early detection of serum Der p 1 IgE antibody is associated with a higher incidence of bronchial asthma.     

The influence of exposure to house dust mite, cat, pollen and fungal allergens in the home on primary sensitisation in asthma

The homes of 68 atopic asthmatic children were studied to estimate the concentrations of perennial and seasonal aeroallergens (Der pl, Fel d1, grass pollen, tree pollen, Cladosporium , Aspergillaceae and Alternaria ) to which children were likely to have been exposed during their first few months of life, by sampling in the child's month of birth. There was a strong association between the presence or absence of the house dust mite allergen Der p1 in the air with the skin test and IgE antibody test results (p < 0.001), with a similar association for cat allergen Pel d 1 (p < 0.01), when using a low volume sampler (equivalent to the minute tidal volume of a small baby). No significant correlation was found between levels of allergen in carpet dust and air in the same room. There was a strong indication that the presence of a cat at birth was linked with a higher risk of development of allergy to cat, but high levels of Fel d 1 were sometimes found in homes even when there was no cat present, indicating that allergen may be introduced from other sources. The levels of tree pollen were significantly higher in the homes of tree pollen-allergic children than in the homes of patients without this sensitivity (p < 0.01); and the degree of sensitivity, determined by RAST, correlated significantly to the level of tree pollen in the home (p < 0.001). However, no relationship was found between specific sensitivity and the levels of Cladosporium , Aspergillaceae, Alternaria or grass pollen measured in the homes. The effect of high allergen exposure was most prominent in children under 7 yr and not beyond that age.     

Early events in atopy

The prevalence of allergic diseases, such as allergic asthma, allergic rhinitis and atopic dermatitis, has increased during the last decade. It is generally accepted that the increased prevalence of allergic diseases is due to a disturbed T-helper lymphocyte (T(h)) T(h1)-T(h2) balance, leading to more expression of T(h2) features. Decreased postnatal microbiological stimulation (i.e. improvements in public health, reduction in family size, increased usage of antibiotics) results in an increased possibility of ongoing postnatal T(h2) reactions. Furthermore, increased postnatal allergen exposure, especially to house dust mite, is known to facilitate the existence of T(h2) features. Therefore, identification of early markers of allergy such as increased total IgE in cord blood offers the possibility to initiate adequate primary prevention in subjects at risk. Primary prevention measures constitute merely of avoidance of early allergen contacts (foods and inhalants) and avoidance of pollution exposure (i.e. passive smoking). At the moment, insufficient data are available concerning the preventive effect of medication on the development of allergic diseases. However, studies on the early use of cetirizine suggest that the occurrence of asthma can be prevented or delayed in young children suffering from atopic eczema. CONCLUSION: because identification of the atopic newborn is now possible, adequate early prevention can be instigated.     

Atopy patch testing in children with asthma and rhinitis symptoms allergic to house dust mite

The atopy patch test (APT) is generally used to assess immunoglobulin E (IgE) mediated sensitization to allergens in patients with atopic dermatitis, but its diagnostic role in children with respiratory allergy is still controversial. The aim of the study was to evaluate APT with house dust mite (HDM) in children with asthma and rhinitis symptoms allergic to HDM and its relevance to skin prick test (SPT) diameters and specific IgE levels. The study population consisted of 33 children, aged 8-16 yr (median: 12 yr) with asthma and 30 children with allergic rhinitis in the same age range (median: 11 yr). All patients had positive SPT results and high serum specific IgE levels for Dermatophagoides pteronyssinus APT was performed on back skin of all patients with 200 index of reactivity (IR)/ml of D. pteronyssinus allergen extracts in petrolatum (Stallerpatch) and evaluated at 72 h. Of 63 patients, 16 (25%) showed a positive patch test result. APT with HDM showed 30% (10/33) positivity among the patients with asthma and 20% (6/30) positivity among the patients with allergic rhinitis. APT presented no significant correlation with age, SPT diameter, serum total and specific IgE levels for D. pteronyssinus, nasal provocation test or pulmonary function test results. Patch testing with HDM may partly identify mite sensitive children with respiratory allergy. Positive APT results may imply that delayed hypersensitivity reactions play a role in children with asthma and rhinitis allergic to HDM.     

Exposure to indoor allergens and development of allergy

House dust contains several indoor allergens which can elicit hypersensitivity and various atopic symptoms, especially in childhood. This review article focusses on house dust mite hypersensitivity to one of the most important species, Dermatophagoides , as a model. A clear dose-response relationship has been demonstrated between house dust mite allergen exposure in mattress dust samples and sensitization, i.e. serum IgE to Dermatophagoides and positive histamine release from basophil leukocytes to one of the major allergens from Dermatophagoides pteronyssinus, Der p I. 2 μg major allergen of Dermatophagoides /g of dust and 8 μg major allergen of cat/g of dust have been suggested to be threshold concentrations above which the risk of sensitization in genetically predisposed atopic children is significantly increased. Epidemiological studies showed house dust mite allergens to be one of the most important risk factors in the development of atopic airway disease. A relation between age at onset of the first wheezing episode and house dust mite allergen exposure at the age of 1 year has been observed. There are various factors influencing house dust mite growth, and many studies have been performed to reduce house dust mite allergen exposure. Until now, none of the approaches appeared to have achieved sufficient mite and mite allergen reduction.     

Early sensitisation and development of allergic airway disease - risk factors and predictors

The development and phenotypic expression of allergic airway disease depends on a complex interaction between genetic and several environmental factors, such as exposure to food, inhalant allergens and non-specific adjuvant factors (e.g. tobacco smoke, air pollution and infections). The first months of life seem to be a particularly vulnerable period and there is evidence that sensitisation is related to the level of allergen exposure during early life. At present, the combination of atopic heredity and elevated cord-blood IgE seems to result in the best predictive discrimination as regards development of allergic disease at birth. Early sensitisation, cow's milk allergy and atopic eczema are predictors for later development of allergic airway disease.Exposure to indoor allergens, especially house dust mite allergens, is a risk factor for sensitisation and development of asthma later in childhood in high-risk infants and infants with early atopic manifestations.     

Sublingual immunotherapy for pediatric allergic rhinitis: The clinical evidence

Allergic rhinitis is estimated to affect 10%-20% of pediatric population and it is caused by the IgE-sensitization to environmental allergens, most importantly grass pollens and house dust mites. Allergic rhinitis can influence patient’s daily activity severely and may precede the development of asthma, especially if it is not diagnosed and treated correctly. In addition to subcutaneous immunotherapy, sublingual immunotherapy (SLIT) represents the only treatment being potentially able to cure allergic respiratory diseases, by modulating the immune system activity. This review clearly summarizes and analyzes the available randomized, double-blinded, placebo-controlled trials, which aimed at evaluating the effectiveness and the safety of grass pollen and house dust mite SLIT for the specific treatment of pediatric allergic rhinitis. Our analysis demonstrates the good evidence supporting the efficacy of SLIT for allergic rhinitis to grass pollens in children, whereas trials regarding pediatric allergic rhinitis to house dust mites present lower quality, although several studies supported its usefulness.     

Cytokine production, activation marker, and skin homing receptor in children with atopic dermatitis and bronchial asthma

T cells are known to develop a critical role in the pathogenesis of atopic dermatitis (AD) and bronchial asthma. T cells involved in AD express the skin homing receptor CLA, but no lung homing receptor has been identified in bronchial asthma. We compared different cell markers and the cytokine production in T cells from children with AD or bronchial asthma. We studied the involvement of CLA+ and CLA- T-cell subpopulations in these diseases. We studied 20 children with acute AD lesions, 15 with mild persistent asthma, and 15 non-atopic controls. All patients were sensitized to house dust mite (DP) and evaluated during the acute phase. Total and specific IgE were measured by immunoassay and the expression of different cell markers and the cytokine production was analyzed by flow cytometry in peripheral blood mononuclear cells. Total IgE was significantly higher in AD children and IgE to DP in the asthmatic children. There was a significant increase in CD25+ CD4+ cells in asthmatic children and in HLA-DR+ CD4+ and HLA-DR+ CD8+ cells in AD. In the CD4+ subsets, there was an increase in IL-13, IL-5 and TNF-alpha in AD compared to controls, a decrease in IFN-gamma in asthmatic children compared to controls, and an increase in IL-13, IL5, IL2, TNF-alpha, and IFN-gamma in the AD compared to asthmatic children. Changes in cytokine production were mainly detected in CLA+ cells in AD and in CLA- cells in asthma. Differences exist in total and specific IgE, activation markers, and cytokine patterns between AD children and children with asthma, with the former expressing a Th2 pattern whereas in asthmatic children we only detected a decrease in IFN-gamma. Moreover, the subpopulations (CLA+ vs. CLA-) expressing these changes were different, indicating that the underlying mechanisms in the two diseases are not exactly the same.     

FOXP3 mRNA expression at 6 months of age is higher in infants who develop atopic dermatitis, but is not affected by giving probiotics from birth

Factors that influence immune regulation in early life may be implicated in the rise in allergic disease, including reduced microbial burden. The aim of the study was to examine the infant regulatory T-cell function in relation to (a) probiotic supplementation for the first 6 months of life and (b) the subsequent development of an early allergic phenotype. Two hundred and thirty-one allergic, pregnant women were recruited into a randomized, controlled trial. The infants received either a probiotic or placebo daily for the first 6 months of life. One hundred and seventy-eight children completed the study, with blood samples available from 118 (60 placebo; 58 probiotic). CD4(+)CD25(+)CTLA4(+)T-regulatory phenotype and allergen-induced FOXP3 mRNA expression were compared in relation to this intervention as well as according to evidence of early disease (atopic dermatitis). The administration of probiotics was not associated with any significant differences in the proportion of circulating CD4(+)CD25(+)CTLA4(+)cells, or in the resting expression of FOXP3. There were also no relationships between these parameters and patterns of gut colonization, and this probiotic did not reduce the risk of atopic dermatitis. Children who developed atopic dermatitis (n = 36/118) had significantly higher induced FOXP3 expression following stimulation with both house dust mite (HDM) (p = 0.017) and ovalbumin (OVA) allergens (p = 0.021) than those that did not develop atopic dermatitis. Although this relationship was seen in both the probiotic and placebo groups, it was more pronounced in the probiotic group. However, regression analysis demonstrated that higher allergen-induced FOXP3 expression was predicted by the presence of atopic dermatitis (p = 0.018) rather than probiotics supplementation (p = 0.217). The higher levels of allergen-induced FOXP3 in atopic dermatitis suggest activation of these compensatory mechanisms rather than a primary defect in this pathway. Probiotic supplementation and gut colonization did not appear to substantially modify these regulatory pathways, or the risk of developing atopic dermatitis.     

Long-term evaluation of the impact of the h1-receptor antagonist cetirizine on the behavioral,cognitive, and psychomotor development of very young children with atopic dermatitis

The impact of the prolonged use of cetirizine at high dose (0.25 mg/kg twice a day over 18 mo) on behavior and cognitive ability was examined in a double-blind, randomized, placebo-controlled trial (ETAC-Early Treatment of the Atopic Child) designed to establish whether it was possible to prevent young children (1-2 y old at study entry) with atopic dermatitis from developing asthma. Well-validated and standardized measures of behavior (Behavior Screening Questionnaire) and cognition (McCarthy Scales of Children's Abilities) were used. In addition, the ages of attainment of psychomotor milestones were established. These measures were taken between an average of 32 and 53 mo of age, both during the study treatment with cetirizine or placebo and after the study treatment had been discontinued. The Behavior Screening Questionnaire was completed at least once on approximately 300 children in each group and on approximately 200 children on five occasions. The McCarthy Scales of Children's Abilities were administered to approximately 100 in each group at three different times. There were no significant differences between the cetirizine and placebo groups on either of the behavior and cognition measures or in psychomotor milestones during or after the study treatment. These findings suggest that there are no adverse effects on behavior or learning processes associated with the prolonged use of cetirizine in young children with atopic dermatitis.     

喘息性疾病患儿过敏原检测分析

目的分析喘息性疾病婴幼儿过敏情况,以利早期干预治疗。方法用UniCAP全自动检测仪和皮肤点刺试验对243例喘息性疾病婴幼儿(毛细支气管炎、伴喘息的支气管炎或肺炎、婴幼儿哮喘)进行过敏原筛查和特异性IgE测定。结果1.婴儿期过敏原以食物为主(P=0.03),幼儿期气媒性过敏原阳性率达67.2%;婴幼儿期主要的食物过敏原为牛奶、鸡蛋白;气媒性过敏原是户尘螨。2.进行过敏原特异性IgE测定时,皮肤点刺试验阳性比例低(0～37.5%)。结论婴儿出生后即食入蛋白质,胃肠道功能未健全,易发生食物过敏;幼儿期添加易致敏食物,且在户外时间增多,食物和吸入性过敏均明显。UniCAP系统是一种用于筛查和寻找变应原的较为准确的方法。