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Elevated neonatal salivary anti‐casein immunoglobulin A antibodies as an indicator of atopic risk

Elevation of salivary SIgA‐anti‐casein has been shown to occur in newborn infants at risk of allergy. The present study was designed to follow 158 infants over 3 years to relate the onset of clinical disease to SIgA levels at birth. Newborn infants were divided into 3 groups according to their risk of allergy: Group I, (n= 62; no allergy risk); Group II, (n ‐30; low allergy risk); Group III (n= 66; high risk group). The groups were matched for smoking, social background, sex, and dietary habits of the patients. SIgA‐anti‐casein was determined by a direct ELIS A. During the first year 59 infants developed atopic diseases (n= 37 of Groups I and II; n= 22 of Group III). After 3 years 37/61 infants of the high risk group had developed allergic symptoms. The frequency of atopic disease correlated with increased salivary antibody titers at birth (p < 0.05). 54% of infants with antibody titers > 250 EU/ml developed atopic symptoms at 1 year, 76% high risk infants with this titer developed atopic symptoms at 3 years of age. This study provides evidence that elevation of SIgA‐anti‐casein at birth not only reflects atopic risk as defined by cord blood IgE or family history, but correlates with the actual development of allergic disease during the first 3 years of life.