A high neonatal serum eosinophil cationic protein level is a risk factor for atopic symptoms
| Autor: | Enrico Bertino, G Guala, F Altare, R Russo, Claudio Fabris, G Monti, A Peltran, P Savant-Levet, L Ferrero, Alessandra Coscia |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2004 |
| Předmět: |
Hypersensitivity
Immediate medicine.medical_specialty Allergy education atopy Gastroenterology Atopy Radioallergosorbent Test Ribonucleases fluids and secretions Predictive Value of Tests Risk Factors newborn Internal medicine Immunopathology medicine Humans eosinophil Risk factor Univariate analysis Eosinophil cationic protein business.industry Infant Newborn Blood Proteins General Medicine Allergy prediction and prevention Eosinophil Granule Proteins Eosinophil medicine.disease medicine.anatomical_structure eosinophil cationic protein Relative risk Pediatrics Perinatology and Child Health Immunology business |
| Popis: | To show whether neonatal eosinophil counts (EC) and eosinophil cationic protein (ECP) can be used in assessing the risk of atopy, alone or in combination with family history of atopy (FHa).A group of 63 newborns was included: 38 with FHa, 25 without FHa. A blood sample was collected on the 4th day of life for EC and ECP evaluation. Clinical follow-up was conducted after 1, 3, 6, 12, 18, 24 and 36 mo. The chi2 test and the Student's t-test were used to compare dichotomic and continuous variables, respectively. Variables shown to be significant by univariate analysis were evaluated with a multivariate regression model and the relative risks (RR) were estimated.Twenty-six newborns (41%) displayed atopic manifestations during the follow-up. Twenty-one (55%) of 38 newborns with FHa displayed atopic symptoms versus 5/25 (20%) without FHa (p 0.012). Neither EC nor serum ECP levels were significantly different between newborns with FHa and newborns without. ECP levels did not differ between newborns with single heredity and newborns with dual heredity. EC did not differ significantly between newborns who developed atopy and those who did not. Instead, serum ECP levels were significantly higher in newborns who developed atopy (mean 27.9 microU/l vs 16.8 microU/l). Atopic manifestations appeared in 16 (62%) of 26 newborns with ECPor = 18 microU/l compared with 10 (27%) of 37 with ECP18 microU/l (p = 0.006). In the multivariate regression model, with ECP18 microU/l and no FHa as reference class, the class 1 (no FHa and ECPor = 18 microU/l) has a low RR (1.4), class 2 (FHa and ECP18 microU/l) an intermediate RR (2.7) and class 3 (FHa and ECPor = 18 microU/l) a very high RR (16.3).Neonatal serum ECP levels, in contrast with EC, were significantly higher in newborns who developed atopic manifestations during follow-up. The risk of atopy was about twice as great when ECP wasor = 18 microU/l (and four times as great in multivariate analysis). When serum ECP was combined with FHa, the RR for newborns with FHa and ECPor = 18 microU/l was 16 times greater than for those without FHa and ECP18 microU/l. The identification of newborns at "extremely high atopic risk" (FHa and ECPor = 18 microU/l) may be expecially useful--in clinical practice--in newborns with only one atopic parent or sibling, for whom it is not universally agreed that dietary and environmental prevention measures should be applied. |
| Databáze: | OpenAIRE |
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