NEW YORK (Reuters Health) – During the first year of life, infants who have positive skin tests for hen's egg, cow's milk or both are at a higher risk of developing adult asthma, UK researchers report.
Dr. Richard Sporik from Poole Hospital, and colleagues collected data on 100 infants of atopic parents. The children were examined and skin prick tests and IgE measurements were taken yearly for the first 5 years. Bronchial hyperresponsiveness was measured when the subjects were 11 and 22 years of age. Of the 100 in the initial cohort, 73 were followed for 5 years, 67 for 11 years and 63 for 22 years.
Among the 23 adult subjects who reported wheezing in the past year, 15 had signs of bronchial hyperresponsiveness, indicating that these subjects were asthmatic.
Twenty-eight percent of the subjects exhibited wheeze before 2 years of age, but this was not significantly linked to developing adult asthma or adult wheezing (odds ratio 0.9) the researchers found.
The only independent predictor of adult asthma that emerged from the data was a positive skin test to hen's egg or cow's milk during the first year of life (odds ratio 10.7, p = 0.001), the UK team reports in the November issue of the Journal of Allergy and Clinical Immunology.
A positive test had a sensitivity of 57% and a specificity of 89%, Dr. Sporik and colleagues note. "The relatively low sensitivity (57%) indicates that many adult asthmatic subjects will not exhibit this early marker, but because of the low numbers, the estimation of sensitivity was not very reliable," they add.
"Overall, these results suggest that skin prick testing at 1 year of age merits further study as a marker of persistent adult asthma. At present, any therapeutic interventions in young children will need to be carefully balanced between potential benefits and the intrusiveness of the therapeutic program."