Parental hay fever reinforces IgE to pollen as pre-clinical biomarker of hay fever in childhood

Pediatr Allergy Immunol. 2014 Jun;25(4):366-73. doi: 10.1111/pai.12248.


Background: An early IgE response to grass or birch pollen can anticipate seasonal allergic rhinitis to pollen later in life or remain clinically silent.

Objective: To identify risk factors early in life that allow discriminating pathogenic from non-pathogenic IgE responses and contribute to the development of seasonal allergic rhinitis to grass pollen.

Methods: The German Multicentre Allergy Study examined a birth cohort born in 1990. A questionnaire was yearly administered and blood samples collected at age 1,2,3,5,6,7,10,13 yr. The definition of the primary outcome grass- and birch-pollen-related seasonal allergic rhinitis (SARg, SARb) was based on nasal symptoms in June/July and April, respectively. Serum IgE antibodies to Phleum pratense and Betula verrucosae extracts were monitored with immune-enzymatic singleplex assays.

Results: Of the 820 examined children, 177 and 148 developed SARg and SARb, respectively. Among healthy children aged 3 or more years, IgE to grass pollen was the strongest risk factor of SARg (OR 10.39, 95%CI 6.1-17.6, p < 0.001), while parental hay fever was the only risk factor in early childhood independently associated with future SARg (1 parent: OR 2.56, 95%CI 1.4-4.5, p < 0.001; 2 parents: OR 4.17, 95%CI 1.7-10.1) and SARb (1 parent OR: 5.21, 95%CI 2.20-12.4, p < 0.001; 2 parents: OR 8.02, 95%CI 2.0-32.9, p < 0.001). Parental hay fever was associated with an increase of the concentration of pollen-specific IgE in seropositive subjects, after the age of 6 and was also a hallmark of molecularly more complex specific IgE responses to grass or birch pollen at age 6 or older.

Conclusions: Parental hay fever and specific IgE to grass and/or birch pollen are strong pre-clinical determinants and potentially good predictors of seasonal allergic rhinitis.

Keywords: birch and grass pollen; immunoglobulin E; prediction; risk factors; seasonal allergic rhinitis.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Allergens / immunology
  • Antigens, Plant / immunology
  • Betula / immunology
  • Biomarkers / blood
  • Child
  • Child of Impaired Parents*
  • Child, Preschool
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Immunoglobulin E / blood
  • Immunoglobulin E / immunology*
  • Male
  • Phleum / immunology
  • Pollen / immunology*
  • Predictive Value of Tests
  • Rhinitis, Allergic, Seasonal / epidemiology*
  • Rhinitis, Allergic, Seasonal / immunology*


  • Allergens
  • Antigens, Plant
  • Biomarkers
  • Immunoglobulin E