Sensibilisation allergénique au cours des huit premières années de vie, facteurs et morbidité associés dans la cohorte de naissances PARIS

Abstract : Background. The first years of life appear to be critical for the development of allergic sensitization. Objectives. This thesis aims: i) to describe allergic sensitization profiles in infants and children, ii) to assess the link between these sensitization profiles and allergic morbidity, and iii) to identify risk factors for allergic sensitization. Methods. This work concerns children involved in the Pollution and Asthma Risk: an Infant Study (PARIS) population-based prospective birth cohort. Allergic sensitization was assessed in 1,860 18-month-old infants and 1,007 8/9-year-old children by specific IgE measurements towards 16 and 19 allergens, respectively. Lifelong health and living condition data were collected by repeated standardized questionnaires. Sensitization profiles and morbidity profiles were identified using unsupervised classification, and related to each other by multinomial logistic regression. Finally, risk factors for early allergic sensitization were assessed by multivariate logistic regression. Results. As soon as 18 months of age, 13.8% of children were sensitized and 6.2%, multi-sensitized. When 8/9 years old, corresponding prevalence was 34.5% and 19.8%, respectively. Sensitization profiles identified in infancy (3) and in childhood (5) differed in terms of allergic morbidity. Risk factor analysis allowed to clarify the role of early exposure to allergens and microorganisms on allergic sensitization. Conclusion. This thesis improves the natural history of allergic sensitization understanding, as soon as the first years of life. This knowledge is essential for subsequent disease preventing.
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Stephan Gabet. Sensibilisation allergénique au cours des huit premières années de vie, facteurs et morbidité associés dans la cohorte de naissances PARIS. Allergologie. Université Sorbonne Paris Cité, 2017. Français. ⟨NNT : 2017USPCB031⟩. ⟨tel-01908958⟩

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