4. The longitudinal follow-up of the cohort will allow the comparison of sensitization patterns as biomarkers of disease trajectories
As expected, we observed an increase in sensitization in terms of the number of positive c-sIgE and levels of sensitization between the age of 3 and 12 years. Early and multiple sensitizations, in particular to the airborne allergens HDM and grass pollen, are risk factors for the persistence of asthma, recurrence, severity of attacks and long-term lung function impairment (5–9). We did not observe any relationship between mold sensitization and SRW / SA. This is in contrast with other studies showing an association between mold exposure, mold sensitization and asthma exacerbations and/or severe asthma (26–28). However, Mold sensitization was retained in only a limited number of children in our study, 9 preschoolers and 15 school-age children, which did not allow full exploration of its association with severity because of lack of power. The follow-up of this cohort will make it possible to analyze sensitization trajectories and provide new insights into the natural course of sensitization. The pathophysiological mechanisms linking sensitization patterns to persistent and/or severe asthma, with altered lung function, may include an unbalanced immune reaction biased toward a response involving type 2 helper T cells (Th2) in children with early and multiple occurrences of sensitization (9,29) and exacerbated interferon production in response to viral infections in children with late-onset sensitization and asthma (29).