Peripheral blood eosinophils and IL‐4 in infancy in relation to the appearance of allergic disease during the first 6 years of life

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Abstract
Eosinophils in peripheral blood and serum levels of interleukin (IL)‐4 were analysed at 3 and 18 months and at 6 years in a prospective study comprising 67 children, of whom the majority had atopic heredity. The children were monitored from birth up to 6 years of age and the findings were related to family history of allergy and development of allergic disease. Twenty‐nine children (43%) of the original group of 67 children were diagnosed as allergic at the age of six. Fifteen of 23 children with eosinophilia (>4 × 108 eosinophils/l) at 3 months of age were regarded as allergic at 6 years, when compared with 12 out of 38 children with normal eosinophil counts at 3 months (χ2 = 6.7, p < 0.01). Children with detectable IL‐4 in serum at 18 months were more often allergic at 6 years, when compared with those children with no detectable IL‐4 (χ2 = 8.6, p < 0.01). Furthermore, the allergic children had a mean IL‐4 value of 0.35 μg/l (95% CI: 0.10–1.48) at 18 months, when compared with 0.17 μg/l (95% CI: 0.10–0.72, p < 0.001) in the non‐allergic children. At 6 years of age, only nine children had detectable levels of IL‐4 and five of them were classified as allergic. Eosinophilia at this age was also associated with allergic disease. We conclude that eosinophilia during infancy and increased levels of IL‐4 at 18 month of age are associated with allergic disease during the first 6 years of life. This might indicate that the first 2 years of life are particularly important for the development of allergy.

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