BackgroundHen's egg exposure through impaired skin barrier is considered a major mechanism of sensitization to eggs. However, the impact of filaggrin (FLG) gene loss‐of‐function mutations on the natural history of egg sensitization lacks consensus among studies.ObjectiveTo evaluate the association between the natural course of egg sensitization and FLG mutations.MethodsWe used Japanese and the UK birth cohorts (CHIBA and MAAS) to identify the longitudinal patterns of egg sensitization until mid‐school age and examined the relationship between the identified patterns and FLG mutations. Sensitization was assessed using egg white‐specific IgE levels or skin prick tests (SPTs). Egg allergy was confirmed by parental reports and sensitization. Latent class growth analysis identified longitudinal patterns.ResultsThree similar patterns of egg sensitization (persistent, early‐onset remitting, and no/low grade classes) were identified in both cohorts, with differing prevalence estimates. The proportion of children with egg allergy in the persistent class at 7 or 8 years of age was 23% (CHIBA) and 20% (MAAS). Consistently in both cohorts, FLG mutations were significantly associated only with the persistent class. Children with FLG mutations had an approximately four‐fold increased risk of being in the persistent sensitization class (RRRs: 4.3, 95%C.I. (1.2–16.0), p = .03 in CHIBA; 4.3 (1.3–14.7), p = .02 in MAAS).ConclusionFLG loss‐of‐function mutations are associated with persistent egg sensitization in both Japanese and European ethnicities, and the mutations might be a potential biomarker for identifying the risk of persistent egg sensitization/allergy in early infancy. Future studies should incorporate oral food challenges to confirm this relationship.

中文翻译：

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儿童期卵子致敏的轨迹：亚洲和欧洲的两个出生队列


背景母鸡通过受损的皮肤屏障接触鸡蛋被认为是对鸡蛋过敏的主要机制。然而，丝聚蛋白 （FLG） 基因功能丧失突变对卵子致敏自然史的影响在研究中缺乏共识。目的评价卵子致敏自然病程与 FLG 突变的相关性。方法我们使用日本和英国的出生队列 （CHIBA 和 MAAS） 来确定直到学龄中期鸡蛋致敏的纵向模式，并检查了已识别的模式与 FLG 突变之间的关系。使用蛋清特异性 IgE 水平或皮肤点刺试验 （SPT） 评估致敏性。鸡蛋过敏通过父母报告和致敏证实。潜在类增长分析确定了纵向模式。结果在两个队列中发现了三种相似的卵子致敏模式（持续性、早发性缓解和无/低级别类别），患病率估计值不同。7 岁或 8 岁时持续组对鸡蛋过敏的儿童比例为 23% （CHIBA） 和 20% （MAAS）。在两个队列中，FLG 突变始终仅与持续性类别显著相关。具有 FLG 突变的儿童处于持续致敏类别的风险大约增加四倍（RRR：4.3,95%CI（1.2-16.0），千叶县 p = .03;4.3 （1.3-14.7），MAAS 中 p = .02）。结论FLG 功能丧失突变与日本和欧洲种族的持续卵子致敏有关，这些突变可能是识别婴儿早期持续性卵子致敏/过敏风险的潜在生物标志物。未来的研究应纳入口服食物挑战来证实这种关系。