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

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 x 10(8) 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 (chi2 = 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 (chi2 = 8.6, p < 0.01). Furthermore, the allergic children had a mean IL-4 value of 0.35 microg/l (95% CI: 0.10-1.48) at 18 months, when compared with 0.17 microg/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.