Basic and clinical immunology
Change in prevalence of IgE sensitization and mean total IgE with age and cohort

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Background

Cross-sectional studies show that the prevalence of IgE sensitization is lower in older age groups than younger age groups. This could reflect either a decrease in sensitization with aging or a higher prevalence of sensitization in more recent birth cohorts.

Objective

To assess change in IgE sensitization and mean total IgE in young adults as they age.

Methods

Serum specific IgE to common allergens and total IgE were measured on 2 occasions about 9 years apart in 6371 young adults living in 28 centers, mainly in Western Europe, who took part in the European Community Respiratory Health Survey II. Outcomes were analyzed by using generalized estimating equations, and adjustments were made for differences between laboratory measures on the 2 occasions.

Results

Overall, there was no net change in the prevalence of sensitization to at least 1 of house dust mite, grass, or cat (net change per 10 years of follow-up, −0.1%; 95% CI, −1.7% to 1.5%), although there was a fall in mean total IgE (ratio of geometric mean total IgE, 0.86; 95% CI, 0.79 to 0.93). There was evidence that sensitization to at least 1 allergen was higher in more recent cohorts, and this was largely explained by a higher prevalence of sensitization to grass.

Conclusion

The disease burden associated with IgE sensitization in adults, and particularly with IgE sensitization to grass, is likely to continue to increase for some time despite current evidence that the increase in allergy seen in children may have ceased.

Section snippets

Study subjects

The methods for ECRHS I and ECRHS II have been published in more detail elsewhere,14, 15 and further information is available from the study Web site (www.ecrhs.org).

In ECRHS I, participating centers were each selected as an area defined by pre-existing administrative boundaries with a population of at least 150,000 people. A community-based sampling frame was used to select randomly at least 1500 men and 1500 women age 20 to 44 years, who were sent a short postal questionnaire. A random sample

Results

A total of 6137 subjects (52.3 %) of the 11,719 subjects who provided a blood sample in the first survey took part in ECRHS II and went on to provide a sample in the second. There was variation in the response between centers (minimum, 25.2% in Bordeaux; maximum, 82.4% in Reykjavik). Overall response rates were lower in younger subjects, subjects with symptoms, and subjects who reported smoking at baseline, with no significant (P > .05) variation in these patterns between centers (see Table E3 in

Discussion

This large multicenter study examined changes in serum specific IgE in young and middle-aged adults. There was no significant change in the prevalence of being sensitized to at least 1 environmental allergen over a 10-year period. There was some evidence that the prevalence of sensitization to at least 1 allergen decreased more in the older age groups than in the younger age groups, but these age-related changes were small in comparison with the differences between cohorts. More recent birth

Coordinating center

Project Leader: P. Burney; Statistician: S. Chinn; Principal Investigator: D. Jarvis; Project Coordinator: J. Knox; Principal Investigator: C. Luczynska; Assistant Statistician: J. Potts; Data Manager: S. Arinze.

Steering committee for ECRHS II

Professor Josep M. Antó, Institut Municipal d'Investigació Mèdica (Institut Municipal d'Investigació Mèdica–Institut Municipal d' Assistència Sanitària), Universitat Pompeu Fabra; Professor Peter Burney, Kings College London (Project Leader); Dr Isa Cerveri, University of Pavia; Professor Susan Chinn, Kings College London; Professor Roberto de Marco, University of Verona; Dr Thorarinn Gislason, Iceland University Hospital; Dr Joachim Heinrich, GSF—Institute of Epidemiology; Associate Professor

Principal investigators and senior scientific team

Belgium: South Antwerp and Antwerp City (P. Vermeire, J. Weyler, M. Van Sprundel, V. Nelen); Estonia: Tartu (R. Jogi, A. Soon); France: Paris (F. Neukirch, B. Leynaert, R. Liard, M. Zureik), Grenoble (I. Pin, J. Ferran-Quentin); Germany: Erfurt (J. Heinrich, M. Wjst, C. Frye, I. Meyer); Iceland: Reykjavik (T. Gislason, E. Bjornsson, D. Gislason, T. Blondal, A. Karlsdottir); Italy: Turin (M. Bugiani, P. Piccioni, E. Caria, A. Carosso, E. Migliore, G. Castiglioni), Verona (R. de Marco, G.

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    The coordination of ECRHS II was supported by the European Commission as part of their Quality of Life program.

    The following bodies supported the local studies in ECRHS II included in this article. Albacete: Fondo de Investigaciones Santarias (grant codes, 97/0035-01, 99/0034-01, and 99/0034-02), Hospital Universitario de Albacete, Consejeria de Sanidad; Antwerp: Fund for Scientific Research—Flanders, Belgium (grant code, G.0402.00), University of Antwerp, Flemish Health Ministry; Barcelona: Sociedad Española de Neumología y Cirugía Torácica, Public Health Service (grant code, R01 HL62633-01), Fondo de Investigaciones Santarias (grant codes, 97/0035-01, 99/0034-01, and 99/0034-02), Consell Interdepartamental de Recerca i Innovació Tecnològica (grant code, 1999SGR 00241) Instituto de Salud Carlos III; Red de Centros de Epidemiología y Salud Pública, C03/09, Red de Bases moleculares y fisiológicas de las Enfermedades Respiratorias, C03/011 and Red de Grupos Infancia y Medio Ambiente G03/176; Basel: Swiss National Science Foundation, Swiss Federal Office for Education and Science, Swiss National Accident Insurance Fund; Bergen: Norwegian Research Council, Norwegian Asthma and Allergy Association, Glaxo Wellcome AS, Norway Research Fund; Bordeaux: Institut Pneumologique d'Aquitaine; Erfurt: GSF—National Research Centre for Environment and Health, Deutsche Forschungsgemeinschaft (grant code, FR 1526/1-1); Galdakao: Basque Health Department; Goteborg: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Grenoble: Programme Hospitalier de Recherche Clinique—Direction de la Recherche Clinique (DRC) de Grenoble 2000 number 2610, Ministry of Health, Direction de la Recherche Clinique, Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, Centre Hospitalier Universitaire (CHU) de Grenoble, Comite des Maladies Respiratoires de l'Isere; Hamburg: GSF—National Reasearch Centre for Environment and Health, Deutsche Forschungsgemeinschaft (grant code, MA 711/4-1); Ipswich and Norwich: Asthma UK (formerly known as National Asthma Campaign); Huelva: Fondo de Investigaciones Santarias (grant codes, 97/0035-01, 99/0034-01, and 99/0034-02); Montpellier: Programme Hospitalier de Recherche Clinique—DRC de Grenoble 2000 number 2610, Ministry of Health, Direction de la Recherche Clinique, CHU de Grenoble, Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, Aventis (France), Direction Régionale des Affaires Sanitaires et Sociales Languedoc-Roussillon; Oviedo: Fondo de Investigaciones Santarias (grant codes, 97/0035-01, 99/0034-01, and 99/0034-02); Paris: Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, Union Chimique Belge—Pharma (France), Aventis (France), Glaxo France, Programme Hospitalier de Recherche Clinique—DRC de Grenoble 2000 number 2610, Ministry of Health, Direction de la Recherche Clinique, CHU de Grenoble; Pavia: Glaxo-SmithKline Italy, Italian Ministry of University and Scientific and Technological Research (MURST), Local University Funding for Research 1998 and 1999; Portland: American Lung Association of Oregon, Northwest Health Foundation, Collins Foundation, Merck Pharmaceutical; Reykjavik: Icelandic Research Council, Icelandic University Hospital Fund; Tartu: Estonian Science Foundation; Turin: Azienda Sanitaria Locale 4 Regione Piemonte (Italy), Azienda Ospedaliera Centro Traumatologico Ospedaliero/Centro Traumatologico Ortopedico—Istituto Clinico Ortopedico Regina Maria Adelaide Regione Piemonte (Italy), Ministero dell'Universitá e della Ricerca Scientifica (Italy), Glaxo Wellcome spa (Verona, Italy); Umeå: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Uppsala: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Verona: University of Verona, MURST, GlaxoSmithKline Italy.

    The following bodies supported ECRHS I for centers in ECRHS II. Belgian Science Policy Office, National Fund for Scientific Research; Ministère de la Santé, Glaxo France, Insitut Pneumologique d'Aquitaine, Contrat de Plan Etat-Région Languedoc-Rousillon, Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés, Comité National Contre les maladies Respiratoires et la Tuberculose (90MR/10, 91AF/6), Ministre delegué de la santé, Réseau National de Santé Publique, France; GSF, and the Bundesminister für Forschung und Technologie, Bonn, Germany; Ministero dell'Universitá e della Ricerca Scientifica e Tecnologica, Consiglio Nazionale delle Ricerche, Regione Veneto grant number 381/05.93, Italy; Norwegian Research Council project number 101422/310; Dutch Ministry of Wellbeing, Public Health and Culture, Netherlands; Ministero Sanidad y Consumo FIS (grants #91/0016060/00E-05E and #93/0393), and grants from Hospital General de Albacete, Hospital General Juan Ramón Jiménenz, Consejeria de Sanidad Principado de Asturias, Spain; Swedish Medical Research Council, Swedish Heart Lung Foundation, Swedish Association Against Asthma and Allergy; Swiss National Science Foundation grant 4026-28099; National Asthma Campaign, British Lung Foundation, Department of Health, South Thames Regional Health Authority, United Kingdom; United States Department of Health, Education and Welfare Public Health Service (grant #2 S07 RR05521-28).

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