IgE levels in cord blood and at 4–5 days of age: relation to clinical symptoms of atopic disease up to 18 months of age

Abstract

To evaluate the variation in serum IgE levels during the neonatal period and its relation to the development of atopy, 83 infants with a heredity of atopy were studied with regard to the concentration of IgE in cord blood (CB) and capillary blood on the fourth or fifth day of life. During the neonatal period, the average IgE level remained unchanged in the whole group but there were large individual changes. Among 22 infants with CB-IgE levels greater than or equal to 0.9 kU/l the IgE concentrations in 50% decreased below this value on days 4-5. The correlation between maternal IgE and CB-IgE concentrations (rs = 0.41; P less than 0.001) was interpreted as indicating a probable contamination with maternal blood. This view was supported by the presence of an elevated IgA level and of IgE antibodies against inhalant allergens in 16% of the cord blood samples of which 69% had an IgE level exceeding 0.9 kU/l. It therefore seems preferable to collect the blood samples on the fourth or fifth day. However, in the 74 infants available for atopic classification at 18 months of age, the positive predictive value of IgE determinations was low: on days 4-5 25-38% and in CB 42%. A high CB-IgE level may merely be an indication of the mother's atopic state.

Sensitization does not develop in utero

“…One previous study supports that cord blood specific IgE against inhalant allergens is caused by materno-fetal transfer of IgE because 2/3 of cord blood samples with such IgE showed markedly decreasing total IgE values from birth to 4 to 5 days of age. 22 Another earlier study contrasts with the current study in also detecting house dust mite specific IgE in cord blood in the absence of such IgE in maternal blood and finding no correlation between cord blood and maternal levels of specific IgE. 6 However, our results question the validity of those findings.…”

“…29 Furthermore, the frequency of cord blood IgE against inhalant allergens is similar to a previous report of cord blood IgE against inhalant allergens in infants of atopic mothers. 22 This study included children of mothers with asthma. Because cord blood specific IgE is dependent on maternal specific IgE, the frequency of cord blood specific IgE would be lower in an unselected population.…”

Transfer of maternal IgE can be a common cause of increased IgE levels in cord blood

“…21 Such transfer of IgE would not be prevented by strict sampling procedures and is not accounted for by IgA measuring. A previous study by Lilja et al 22 supports that the IgA method does not control sufficiently for maternofetal transfer of IgE.…”

Significance of Immunoglobulin E in Umbilical Blood in Relation to an Allergic Family History, Seasonality, Child Immunity and the Impact of Applied Non-pathogenic E. coli on Children’s Microbiome

“…The elucidation of IgE in cord blood of children does not only have a theoretical significance in determining future life dynamics, but most importantly plays a prognostic role for the risk of allergy, especially if the concentrations exceed two standard deviations above normal levels [7,12,16]. This is however somewhat controversial [19].…”

“…This in turn results in increased permeability of the intestinal mucosa to potential antigens and thus leading to increasing production of IgE. This process is enhanced by a deficit of T suppressive lymphocytes-a state that is typically found in allergic diseases [15,16]. IgE is carrier of reagin activity.…”