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. 2024;185(12):1233-1243.
doi: 10.1159/000539968. Epub 2024 Jul 26.

Allergy in Young Adults Associates with Elevated Fractional Exhaled Nitric Oxide Levels and IgE-Verified Parental Allergy but Is Confounded by Self-Reported Symptoms

Ulrika Hellberg  1   2 , Eva Sverremark-Ekström  3 , Anna Nopp  1   2 , Caroline Nilsson  1   2
Affiliations

Allergy in Young Adults Associates with Elevated Fractional Exhaled Nitric Oxide Levels and IgE-Verified Parental Allergy but Is Confounded by Self-Reported Symptoms

Ulrika Hellberg et al. Int Arch Allergy Immunol. 2024.

Abstract

Introduction: Knowledge of IgE-verified allergy in young adults is limited as most studies are based on self-reported data. Allergic heredity is important in allergy development in early life, but less is known about the hereditary component later in life. The aim was to investigate IgE-verified and self-reported allergy and asthma at 20 years of age in association to parental allergy and environmental factors.

Methods: In total, 281 individuals born into the cohort of well-characterized parents regarding allergic disease were followed to 20 years of age. The participants were categorized by parental allergy and examined regarding allergic diseases (IgE sensitization and allergic symptoms) at 2, 5, 10, and 20 years of age. FeNO was measured at 10 and 20 years.

Results: In total, 45% of the study participants were allergic, with twice as many self-reported cases at age 20. Rhinitis was key to distinguishing confirmed allergy from self-reported. Having two allergic parents and increased FeNO were associated with an increased prevalence of allergic disease at 20 years. From a longitudinal perspective, rhinitis increased from childhood to young adulthood, in all heredity groups.

Conclusion: In this longitudinal study, we have shown that two allergic parents as well as increased FeNO levels seem to be of importance for being allergic at 20 years old. Self-reported allergy was overreported - a result that should be considered in future survey-based reports on allergic diseases.

Keywords: Allergic heredity; Asthma; Fractional exhaled nitric oxide; IgE-verified allergy; Longitudinal cohort; Rhinitis.

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Conflict of interest statement

C. Nilsson reports grants to institution from Aimmune Therapeutics, a Nestlé Company. Material for IgE analyzes from Thermo Fisher used in academic studies. Lecture fees were received from: MEDA, ALK, Thermo Fisher, and GSK. Eva Sverremark-Ekström has received honoraria for lectures and a grant for another research project from BioGaia AB. No conflict of interest reported from the other authors.

Figures

Fig. 1.
Fig. 1.
Flowchart of the BIAS cohort follow-ups from baseline, 2, 5, 10, and 20 years of age.
Fig. 2.
Fig. 2.
Venn diagram over distribution of IgE sensitization to birch, timothy, cat, and dog, among participants with allergic rhinitis. Made by using: https://bioinformatics.psb.ugent.be/webttls/Venn/.
Fig. 3.
Fig. 3.
a Overall allergy by heredity 2–20 years of age, 2 years (n = 264), 5 years (n = 241), 10 years (n = 204), and 20 years (n = 142), percentage of IgE-verified allergy at each age. b–e IgE-verified allergy development among allergic individuals at each follow-up, by heredity from 2 years (n = 49), 5 years (n = 72), 10 years (n = 67) to 20 years of age (n = 64) divided in phenotypes; allergic asthma (b), atopic dermatitis (c), food allergy (d), and allergic rhinitis (e).
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