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Gueye-Ndiaye S, Gunnlaugsson S, Li L, Gaffin JM, Zhang Y, Sofer T, Owens J, Gold DR, Adamkiewicz G, Phipatanakul W, Redline S. Asthma and Sleep-disordered Breathing Overlap in School-aged Children. Ann Am Thorac Soc 2024; 21:986-989. [PMID: 38446416 PMCID: PMC11160122 DOI: 10.1513/annalsats.202312-1023rl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Affiliation(s)
- Seyni Gueye-Ndiaye
- Boston Children’s HospitalBoston, Massachusetts
- Brigham and Women’s HospitalBoston, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
| | - Sigfus Gunnlaugsson
- Boston Children’s HospitalBoston, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
| | - Le Li
- Brigham and Women’s HospitalBoston, Massachusetts
| | - Jonathan M. Gaffin
- Boston Children’s HospitalBoston, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
| | - Ying Zhang
- Brigham and Women’s HospitalBoston, Massachusetts
| | - Tamar Sofer
- Brigham and Women’s HospitalBoston, Massachusetts
| | - Judith Owens
- Boston Children’s HospitalBoston, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
| | - Diane R. Gold
- Brigham and Women’s HospitalBoston, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
- Harvard T.H. Chan School of Public HealthBoston, Massachusetts
| | | | - Wanda Phipatanakul
- Boston Children’s HospitalBoston, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
| | - Susan Redline
- Brigham and Women’s HospitalBoston, Massachusetts
- Harvard T.H. Chan School of Public HealthBoston, Massachusetts
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Howard R, Fontanella S, Simpson A, Murray CS, Custovic A, Rattray M. Component-specific clusters for diagnosis and prediction of allergic airway diseases. Clin Exp Allergy 2024; 54:339-349. [PMID: 38475973 DOI: 10.1111/cea.14468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Previous studies which applied machine learning on multiplex component-resolved diagnostics arrays identified clusters of allergen components which are biologically plausible and reflect the sources of allergenic proteins and their structural homogeneity. Sensitization to different clusters is associated with different clinical outcomes. OBJECTIVE To investigate whether within different allergen component sensitization clusters, the internal within-cluster sensitization structure, including the number of c-sIgE responses and their distinct patterns, alters the risk of clinical expression of symptoms. METHODS In a previous analysis in a population-based birth cohort, by clustering component-specific (c-s)IgEs, we derived allergen component clusters from infancy to adolescence. In the current analysis, we defined each subject's within-cluster sensitization structure which captured the total number of c-sIgE responses in each cluster and intra-cluster sensitization patterns. Associations between within-cluster sensitization patterns and clinical outcomes (asthma and rhinitis) in early-school age and adolescence were examined using logistic regression and binomial generalized additive models. RESULTS Intra-cluster sensitization patterns revealed specific associations with asthma and rhinitis (both contemporaneously and longitudinally) that were previously unseen using binary sensitization to clusters. A more detailed description of the subjects' within-cluster c-sIgE responses in terms of the number of positive c-sIgEs and unique sensitization patterns added new information relevant to allergic diseases, both for diagnostic and prognostic purposes. For example, the increase in the number of within-cluster positive c-sIgEs at age 5 years was correlated with the increase in prevalence of asthma at ages 5 and 16 years, with the correlations being stronger in the prediction context (e.g. for the largest 'Broad' component cluster, contemporaneous: r = .28, p = .012; r = .22, p = .043; longitudinal: r = .36, p = .004; r = .27, p = .04). CONCLUSION Among sensitized individuals, a more detailed description of within-cluster c-sIgE responses in terms of the number of positive c-sIgE responses and distinct sensitization patterns, adds potentially important information relevant to allergic diseases.
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Affiliation(s)
- Rebecca Howard
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Sara Fontanella
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Angela Simpson
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Clare S Murray
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Magnus Rattray
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Elsiwi B, Eskenazi B, Bornman R, Obida M, Kim J, Moodie EE, Mann KK, Chevrier J. Maternal exposure to pyrethroid insecticides during pregnancy and respiratory allergy symptoms among children participating in the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE). ENVIRONMENTAL RESEARCH 2024; 242:117604. [PMID: 38000632 PMCID: PMC10962214 DOI: 10.1016/j.envres.2023.117604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/30/2023] [Accepted: 11/04/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Pyrethroid insecticides use for indoor residual spraying (IRS) in malaria-endemic areas results in high levels of exposure to local populations. Pyrethroids may cause asthma and respiratory allergies but no prior study has investigated this question in an IRS area. METHODS We measured maternal urinary concentrations of pyrethroid metabolites (cis-DBCA, cis-DCCA, trans-DCCA, 3-PBA) in samples collected at delivery from 751 mothers participating in the Venda Health Examination of Mothers, Babies, and their Environment (VHEMBE), a birth cohort study based in Limpopo, South Africa. At 3.5-year and 5-year follow-up visits, caregivers of 647 and 620 children, respectively, were queried about children's respiratory allergy symptoms based on validated instruments. We applied marginal structural models for repeated outcomes to estimate associations between biomarker concentrations and asthma diagnosis as well as respiratory allergy symptoms at ages 3.5 and 5 years. RESULTS We found that a10-fold increase in maternal urinary cis-DCCA, trans-DCCA and 3-PBA concentrations were associated with more than a doubling in the risk of doctor-diagnosed asthma (cis-DCCA: RR = 2.1, 95% CI = 1.3, 3.3; trans-DCCA: RR = 2.1, 95% CI = 1.1, 3.9; 3-PBA: RR = 2.4, 95% CI = 1.0, 5.8) and an about 80% increase in the risk of wheezing or whistling in the chest (cis-DCCA: RR = 1.8, 95% CI = 1.1, 3.0; trans-DCCA: RR = 1.7, 95% CI = 1.1, 2.6; 3-PBA: RR = 1.8, 95% CI = 1.0, 3.3) and suspected asthma (cis-DCCA: RR = 1.8, 95% CI = 1.1, 3.1; trans-DCCA: RR = 1.8, 95% CI = 1.1, 2.8). We also observed that higher concentrations of cis-DBCA and 3-PBA were related to increases in the risks of dry cough at night (RR = 3.5, 95% CI = 1.3, 9.5) and seasonal rhinoconjunctivitis (RR = 2.0, 95% CI = 1.1, 3.9), respectively. CONCLUSION Maternal exposure to pyrethroids may increase the risk of asthma and other respiratory allergy symptoms among preschool children from an IRS area.
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Affiliation(s)
- Basant Elsiwi
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, USA
| | - Riana Bornman
- University of Pretoria Institute for Sustainable Malaria Control, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Muvhulawa Obida
- University of Pretoria Institute for Sustainable Malaria Control, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Joanne Kim
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Erica Em Moodie
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Koren K Mann
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Jonathan Chevrier
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.
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Gueye-Ndiaye S, Hauptman M, Yu X, Li L, Rueschman M, Castro-Diehl C, Sofer T, Owens J, Gold DR, Adamkiewicz G, Metwali N, Thorne PS, Phipatanakul W, Redline S. Multilevel Risk Factors for Sleep-Disordered Breathing-Related Symptom Burden in an Urban Pediatric Community-Based Sample. CHEST PULMONARY 2023; 1:100019. [PMID: 38222082 PMCID: PMC10786403 DOI: 10.1016/j.chpulm.2023.100019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
BACKGROUND Pediatric sleep-disordered breathing (SDB) disproportionately affects children with low socioeconomic status (SES). The multilevel risk factors that drive these associations are not well understood. RESEARCH QUESTION What are the associations between SDB risk factors, including individual health conditions (obesity, asthma, and allergies), household SES (maternal education), indoor exposures (environmental tobacco smoke [ETS] and pests), and neighborhood characteristics (neighborhood disadvantage), and pediatric SDB symptoms? STUDY DESIGN AND METHODS Cross-sectional analyses were performed on 303 children (aged 6-12 years) enrolled in the Environmental Assessment of Sleep Youth study from 2018 to 2022. Exposures were determined by caregiver reports, assays of measured settled dust from the child's bedroom, and neighborhood-level Census data (deriving the Childhood Opportunity Index to characterize neighborhood disadvantage). The primary outcome was the SDB-related symptom burden assessed by the OSA-18 questionnaire total score. Using linear regression models, we calculated associations between exposures and SDB-related symptom burden, adjusting for sociodemographic factors, then health conditions, indoor environment, and neighborhood factors. RESULTS The sample included 303 children (39% Hispanic, Latino, Latina, or Spanish origin; 30% Black or African American; 22% White; and 11% other). Increasing OSA-18 total scores were associated with low household SES after adjustment for demographic factors, and with asthma, allergies, ETS, pests (mouse, cockroach, and rodents), and an indoor environmental index (sum of the presence of pests and ETS; 0-2) after adjusting for sociodemographic factors. Even after further adjusting for asthma, allergies, and neighborhood disadvantage, ETS and pest exposure were associated with OSA-18 (ETS: β = 12.80; 95% CI, 7.07-18.53, also adjusted for pest; pest exposure: β = 3.69; 95% CI, 0.44-6.94, also adjusted for ETS). INTERPRETATION In addition to associations with ETS, a novel association was observed for indoor pest exposure and SDB symptom burden. Strategies to reduce household exposure to ETS and indoor allergens should be tested as approaches for reducing sleep health disparities.
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Affiliation(s)
- Seyni Gueye-Ndiaye
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Marissa Hauptman
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Xinting Yu
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Le Li
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Michael Rueschman
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Cecilia Castro-Diehl
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Tamar Sofer
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Judith Owens
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Diane R Gold
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Gary Adamkiewicz
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Nervana Metwali
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Peter S Thorne
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Wanda Phipatanakul
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
| | - Susan Redline
- Harvard Medical School (S. G.-N., M. H., X. Y., L. L., M. R., C. C.-D., J. O., D. R. G., W. P., and S. R.); the Division of Sleep and Circadian Disorders (S. G.-N., X. Y., L. L., M. R., C. C.-D., and S. R.), Brigham and Women's Hospital; the Division of Pulmonary and Sleep Medicine(S. G.-N.), Boston Children's Hospital; the Division of General Pediatrics (M. H.), Boston Children's Hospital; the Region1 New England Pediatric Environmental Health Specialty Unit (PEHSU) (M. H.); the Department of Statistics (T. S.), Harvard T.H. Chan School of Public Health; the Division of Neurology (J. O.), Boston Children's Hospital; the Department of Medicine (D. R. G.), Brigham and Women's Hospital; the Department of Environmental Medicine (D. R. G. and G. A.), Harvard T.H. Chan School of Public Health; the Department of Occupational and Environmental Health (N. M. and P. S. T.), University of Iowa College of Public Health; the Division of Allergy/Immunology (W. P.), Boston Children's Hospital; and the Department of Epidemiology (S. R.), Harvard T.H. Chan School of Public Health
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Lu C, Liu Z, Liao H, Yang W, Li Q, Liu Q. Effects of early life exposure to home environmental factors on childhood allergic rhinitis: Modifications by outdoor air pollution and temperature. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 244:114076. [PMID: 36113271 DOI: 10.1016/j.ecoenv.2022.114076] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is growing evidence that allergic rhinitis (AR) is associated with indoor environmental factors, but their role in childhood AR during early life remains unclear. OBJECTIVE To investigate the association of preconceptional, prenatal, early postnatal, and current exposure to home environmental factors with childhood AR, and to further explore whether this association can be interacted by outdoor air pollution and temperature. METHODS A retrospective cohort study of 8689 preschool children was conducted during 2019-2020 in Changsha, China. A standard questionnaire was used to collect data on each family's health outcomes and home environments. We considered home environmental exposures during one year before conception, pregnancy, first year of life, and past year. Associations of indoor air pollution and allergens with AR were assessed by multiple logistic regression models. RESULTS Pre-birth exposure to indoor air pollution emitted by new furniture or redecoration and dampness related allergen derived from mold/damp stains and mold/damp clothes or bedding during 1 year before conception and pregnancy was significantly associated with increased AR, with adjusted ORs (95% CI) ranging from 1.35 (1.05-1.75) to 1.87 (1.55-2.27). Childhood AR was also significantly related with post-birth exposure to dampness related indoor allergen including mold/damp stains and mold/damp clothes or bedding in first year and past year and pollen allergen including total and nonflowing plants in past year, with a range of ORs (95% CI) from 1.20 (1.01-1.42) to 1.79 (1.42-2.27). We identified that pre-birth, particularly in utero exposure to both indoor air pollution from renovation and dampness related allergens, played a key role in AR development compared to post-birth exposures, and accumulative effect was observed with the highest risk of AR. High exposure to traffic-related air pollution (TRAP) including outdoor PM2.5, NO2, CO, and O3, as well as living near traffic road not only significantly increased adverse effect of home environmental factors but also decreased protective effect of household dogs on childhood AR. Early life exposure to low temperature in pregnancy and high temperature in first year significantly increased AR risk of home environmental exposure. Sensitivity analysis indicated that some sub-groups were more susceptible to AR risk of home environmental exposure. CONCLUSION Our study suggests that pre-birth exposure to home environmental factors played an important role in AR development and this effect can be interacted by TRAP and temperature, which supports a hypothesis of "(pre)fetal origin of childhood AR".
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Zijing Liu
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Hongsen Liao
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Wenhui Yang
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Qin Li
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Qin Liu
- XiangYa School of Public Health, Central South University, Changsha, China.
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6
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Xing Y, Wang MH, Leung TF, Wong CK, Roponen M, Schaub B, Li J, Wong GWK. Poultry exposure and environmental protection against asthma in rural children. Allergy 2022; 77:2949-2960. [PMID: 35531632 DOI: 10.1111/all.15365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/17/2022] [Accepted: 04/02/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Asthma is one of the most common chronic diseases in childhood, and the prevalence has been increasing over the past few decades. One of the most consistent epidemiological findings is that children living in a farming or rural environment are protected from development of asthma and allergies, but the protective factors in rural China are not clear. METHODS A community-based, cross-sectional epidemiological study was performed in a total of 17,587 children aged 5-8 years, 3435 from Hong Kong (urban) and 14,152 from Conghua (rural county in southern China). Asthma and allergic symptoms as well as environmental exposures were ascertained by using a standardized and validated questionnaire. RESULTS The prevalence of current wheeze was significantly lower in rural Conghua than that of urban Hong Kong (1.7% vs. 7.7%, p < 0.001). A lower rate of asthma ever was also reported in rural children compared with their urban counterparts (2.5% vs. 5.3%, p < 0.001). After adjusting for confounding factors, exposure to agricultural farming (adjusted odds ratio 0.74, 95% confidence interval: 0.56-0.97) and poultry (0.75, 0.59-0.96) were the most important factors associated with the asthma-protective effect in the rural area. Further propensity score-adjusted analysis indicated that such protection conferred by living in the rural environment was mainly attributable to poultry exposure. CONCLUSIONS We confirmed that the prevalence of asthma and atopic disorders was significantly lower in rural children when compared with their urban peers. Exposure to poultry and agricultural farming are the most important factors associated with asthma protection in the rural area.
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Affiliation(s)
- Yuhan Xing
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Maggie H Wang
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Ting-Fan Leung
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Chun-Kwok Wong
- Department of Chemical Pathology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Marjut Roponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Bianca Schaub
- Pediatric Allergology, Department of Pediatrics, Dr von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Jing Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Gary W K Wong
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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7
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Schoos AM, Chawes BL, Bønnelykke K, Stokholm J, Rasmussen MA, Bisgaard H. Increasing severity of early-onset atopic dermatitis, but not late-onset, associates with development of aeroallergen sensitization and allergic rhinitis in childhood. Allergy 2022; 77:1254-1262. [PMID: 34558075 DOI: 10.1111/all.15108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 05/27/2021] [Accepted: 08/19/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early exposure to allergens through a defect skin barrier has been proposed as a mechanism for inducing sensitization and development of allergic diseases. We hypothesized that early-onset, severe atopic dermatitis (AD) is associated with development of aeroallergen sensitization and allergic rhinitis. METHODS We included 368 children from the Copenhagen Prospective Studies on Asthma in Childhood2000 (COPSAC2000 ) at-risk mother-child cohort. AD was diagnosed prospectively based on Hanifin&Rajka's criteria and severity assessed using the Scoring Atopic Dermatitis (SCORAD) index. Early-onset AD was defined as debut ≤1 year, late-onset as debut from 1-6 years. Aeroallergen sensitization and allergic rhinitis were diagnosed at ages 6-7 and 12 years. Associations between early-onset and late-onset AD and allergy endpoints were calculated using general estimating equations (GEE) models to compute the overall odds ratios (OR) for both time points. RESULTS Early-onset AD (yes/no) and severity (SCORAD) were associated with development of aeroallergen sensitization during childhood; GEE OR = 1.68 [1.08; 2.62], p = .02 and 1.08 [1.03; 1.12], p < .001, whereas late-onset AD showed a borderline significant association and late-onset severity showed no association; GEE OR = 1.65 [0.92; 2.94], p = .08 and 1.01 [0.97; 1.06], p = .55. The same trend was seen for allergic rhinitis with significant association between early-onset AD and allergic rhinitis; GEE OR = 1.56 [1.01; 2.41], p = .04 and severity; GEE OR = 1.09 [1.05; 1.13], p < .001, whereas late-onset AD showed no association. The effects on sensitization and rhinitis of early-onset versus late-onset AD severity were significantly different: p-interactionsensitization = .03 and p-interactionrhinitis < .01. CONCLUSION Increasing severity of early-onset AD, but not late-onset AD, associates with aeroallergen sensitization and allergic rhinitis later in childhood.
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Affiliation(s)
- Ann‐Marie Malby Schoos
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
- Department of Pediatrics Slagelse Sygehus Slagelse Denmark
| | - Bo Lund Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
- Department of Pediatrics Slagelse Sygehus Slagelse Denmark
| | - Morten Arendt Rasmussen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Herlev and Gentofte Hospital University of Copenhagen Copenhagen Denmark
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8
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Strachan DP, Rutter CE, Asher MI, Bissell K, Chiang CY, El Sony A, Ellwood E, Ellwood P, García-Marcos L, Marks GB, Morales E, Mortimer K, Pearce N, Pérez-Fernández V, Robertson S, Silverwood RJ. Worldwide time trends in prevalence of symptoms of rhinoconjunctivitis in children: Global Asthma Network Phase I. Pediatr Allergy Immunol 2022; 33:e13656. [PMID: 34453861 PMCID: PMC9012331 DOI: 10.1111/pai.13656] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/28/2021] [Accepted: 08/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Global Asthma Network (GAN), by using the International Study of Asthma and Allergies in Childhood (ISAAC) methodology, has updated trends in prevalence of symptoms of childhood allergic diseases, including non-infective rhinitis and conjunctivitis ('rhinoconjunctivitis'), which is reported here. METHODS Prevalence and severity of rhinoconjunctivitis were assessed by questionnaire among schoolchildren in GAN Phase I and ISAAC Phase I and III surveys 15-23 years apart. Absolute rates of change in prevalence were estimated for each centre and modelled by multi-level linear regression to compare trends by age group, time period and per capita national income. RESULTS Twenty-seven GAN centres in 14 countries surveyed 74,361 13- to 14-year-olds ('adolescents') and 45,434 6- to 7-year-olds ('children'), with average response proportions of 90% and 79%, respectively. Many centres showed highly significant (p < .001) changes in prevalence of rhinoconjunctivitis in the past year ('current rhinoconjunctivitis') compared with ISAAC. The direction and magnitude of centre-level trends varied significantly (p < .001) both within and between countries. Overall, current rhinoconjunctivitis prevalence decreased slightly from ISAAC Phase III to GAN: -1.32% per 10 years, 95% CI [-2.93%, +0.30%] among adolescents; and -0.44% [-1.29%, +0.42%] among children. Together, these differed significantly (p < .001) from the upward trend within ISAAC. Among adolescents, centre-level trends in current rhinoconjunctivitis were highly correlated with those for eczema symptoms (rho = 0.72, p < .0001) but not with centre-level trends in asthma symptoms (rho = 0.15, p = .48). Among children, these correlations were positive but not significant. CONCLUSION Symptoms of non-infective rhinoconjunctivitis among schoolchildren may no longer be on the increase globally, although trends vary substantially within and between countries.
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Affiliation(s)
- David P Strachan
- Population Health Research Institute, St George's, University of London, London, UK
| | - Charlotte E Rutter
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Monica Innes Asher
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag, Auckland, New Zealand
| | - Karen Bissell
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag, Auckland, New Zealand
| | - Chen-Yuan Chiang
- International Union Against Tuberculosis and Lung Disease, Paris, France.,Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Asma El Sony
- Epidemiological Laboratory (Epi-Lab) for Public Health, Research and Development, Khartoum, Sudan
| | - Eamon Ellwood
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag, Auckland, New Zealand
| | - Philippa Ellwood
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag, Auckland, New Zealand
| | - Luis García-Marcos
- Paediatric Allergy and Pulmonology Units, Virgen de la Arrixaca University Children's Hospital, University of Murcia and IMIB Bio-health Research Institute, Murcia, Spain.,ARADyAL Allergy Network, Edificio Departamental-Laib, Murcia, Spain
| | - Guy B Marks
- Respiratory & Environmental Epidemiology, University of New South Wales, Sydney, New South Wales, Australia
| | - Eva Morales
- Department of Public Health Sciences, University of Murcia, Murcia, Spain.,IMIB Bio-health Research Institute, Edificio Departamental-Laib, Murcia, Spain
| | | | - Neil Pearce
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Virginia Pérez-Fernández
- IMIB Bio-health Research Institute, Edificio Departamental-Laib, Murcia, Spain.,Department of Paediatrics, University of Murcia, Murcia, Spain
| | - Steven Robertson
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard J Silverwood
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.,Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
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9
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Yum HY, Ha EK, Shin YH, Han MY. Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis. Clin Exp Pediatr 2021; 64:373-383. [PMID: 32777916 PMCID: PMC8342874 DOI: 10.3345/cep.2020.00822] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/15/2020] [Accepted: 07/27/2020] [Indexed: 12/17/2022] Open
Abstract
Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis, which involves nasal symptoms without evidence of systemic allergic inflammation or infection, is a heterogeneous entity with diverse manifestations and intensities. Nonallergic rhinitis accounts for 16%-89% of the chronic rhinitis cases, affecting 1%-50% (median 10%) of the total pediatric population. The clinical course of nonallergic rhinitis is generally rather mild and less likely to be associated with allergic comorbidities than allergic rhinitis. Here, we aimed to estimate the rate of coexisting comorbidities of nonallergic rhinitis. Nonallergic rhinitis is more prevalent during the first 2 years of life; however, its underestimation for children with atopic tendencies is likely due to low positive rates of specific allergic tests during early childhood. Local allergic rhinitis is a recently noted phenotype with rates similar to those in adults (median, 44%; range, 4%-67%), among patients previously diagnosed with nonallergic rhinitis. Idiopathic rhinitis, a subtype of nonallergic rhinitis, has been poorly studied in children, and its rates are known to be lower than those in adults. The prevalence of nonallergic rhinitis with eosinophilia syndrome is even lower. A correlation between nonallergic rhinitis and pollution has been suggested owing to the recent increase in nonallergic rhinitis rates in highly developing regions such as some Asian countries, but many aspects remain unknown. Conventional treatments include antihistamines, intranasal corticosteroids, and recent treatments include combination of intranasal corticosteroids with azelastin or decongestants. Here we review the prevalence, diagnosis, comorbidities, and treatment recommendations for nonallergic rhinitis versus allergic rhinitis in children.
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Affiliation(s)
- Hye Yung Yum
- Department of Pediatrics, Seoul Medical Center, Seoul, Korea
| | - Eun Kyo Ha
- Department of Pediatrics, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Yoon Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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10
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Ruran HB, Adamkiewicz G, Cunningham A, Petty CR, Greco KF, Gunnlaugsson S, Stamatiadis N, Sierra G, Vallarino J, Alvarez M, Hayden LP, Sheils CA, Weller E, Phipatanakul W, Gaffin JM. Air quality, Environment and Respiratory Outcomes in Bronchopulmonary Dysplasia, the AERO-BPD cohort study: design and adaptation during the SARS-CoV-2 pandemic. BMJ Open Respir Res 2021; 8:e000915. [PMID: 34193433 PMCID: PMC8249170 DOI: 10.1136/bmjresp-2021-000915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Almost half of all school-age children with bronchopulmonary dysplasia (BPD) have asthma-like symptoms and more suffer from lung function deficits. While air pollution and indoor respiratory irritants are known to affect high-risk populations of children, few studies have objectively evaluated environmental contributions to long-term respiratory morbidity in this population. This study aimed to examine the role of indoor environmental exposures on respiratory morbidity in children with BPD. METHODS AND ANALYSIS The Air quality, Environment and Respiratory Ouctomes in BPD (AERO-BPD) study is a prospective, single-centre observational study that will enrol a unique cohort of 240 children with BPD and carefully characterise participants and their indoor home environmental exposures. Measures of indoor air quality constituents will assess the relationship of nitrogen dioxide (NO2), particulate matter (PM2.5), nitric oxide (NO), temperature and humidity, as well as dust concentrations of allergens, with concurrently measured respiratory symptoms and lung function.Adaptations to the research protocol due to the SARS-CoV-2 pandemic included remote home environment and participant assessments. ETHICS AND DISSEMINATION Study protocol was approved by the Boston Children's Hospital Committee on Clinical Investigation. Dissemination will be in the form of peer-reviewed publications and participant information products. TRIAL REGISTRATION NUMBER NCT04107701.
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Affiliation(s)
- Hana B Ruran
- Boston Children's Hospital Division of Pulmonary and Respiratory Diseases, Boston, Massachusetts, USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Amparito Cunningham
- Boston Children's Hospital Division of Immunology, Boston, Massachusetts, USA
| | - Carter R Petty
- Boston Children's Hospital, Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston, Massachusetts, USA
| | - Kimberly F Greco
- Boston Children's Hospital, Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston, Massachusetts, USA
| | - Sigfus Gunnlaugsson
- Boston Children's Hospital Division of Pulmonary and Respiratory Diseases, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Natalie Stamatiadis
- Boston Children's Hospital Division of Pulmonary and Respiratory Diseases, Boston, Massachusetts, USA
| | - Gabriella Sierra
- Boston Children's Hospital Division of Pulmonary and Respiratory Diseases, Boston, Massachusetts, USA
| | - Jose Vallarino
- Department of Environmental Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Marty Alvarez
- Department of Environmental Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Lystra P Hayden
- Boston Children's Hospital Division of Pulmonary and Respiratory Diseases, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Catherine A Sheils
- Boston Children's Hospital Division of Pulmonary and Respiratory Diseases, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Edie Weller
- Boston Children's Hospital, Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Wanda Phipatanakul
- Boston Children's Hospital Division of Immunology, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Jonathan M Gaffin
- Boston Children's Hospital Division of Pulmonary and Respiratory Diseases, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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11
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Pape K, Schlünssen V, Lodge CJ, Perret JL, Walters EH, Bui D, Erbas B, Svanes C, Hamilton GS, Thomas PS, Hougaard KS, Abramson MJ, Dharmage SC, Lowe AJ. Is self-reported history of eczema and hay fever a valid measure of atopy in those who report current asthma? Allergy 2020; 75:2981-2984. [PMID: 32511771 DOI: 10.1111/all.14440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/02/2020] [Accepted: 05/30/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Kathrine Pape
- National Research Center for the Working Environment Copenhagen Denmark
- Department of Public Health Institute of Environmental and Occupational Medicine Aarhus University Aarhus Denmark
| | - Vivi Schlünssen
- National Research Center for the Working Environment Copenhagen Denmark
- Department of Public Health Institute of Environmental and Occupational Medicine Aarhus University Aarhus Denmark
| | - Caroline Jane Lodge
- Allergy and Lung Health Unit Melbourne School of Population and Global Health University of Melbourne Melbourne Vic. Australia
| | - Jennifer L. Perret
- Allergy and Lung Health Unit Melbourne School of Population and Global Health University of Melbourne Melbourne Vic. Australia
- Department of Respiratory and Sleep Medicine Austin Hospital Melbourne Vic. Australia
| | - E. Haydn Walters
- Allergy and Lung Health Unit Melbourne School of Population and Global Health University of Melbourne Melbourne Vic. Australia
| | - Dinh Bui
- Allergy and Lung Health Unit Melbourne School of Population and Global Health University of Melbourne Melbourne Vic. Australia
| | - Bircan Erbas
- Allergy and Lung Health Unit Melbourne School of Population and Global Health University of Melbourne Melbourne Vic. Australia
| | - Cecilie Svanes
- Department of Global Public Health and Primary Care Centre for International Health University of Bergen Bergen Norway
- Department of Occupational Medicine Haukeland Hospital Bergen Norway
| | - Garun S. Hamilton
- School of Clinical Sciences Monash University Melbourne Vic. Australia
- Monash Lung and SleepMonash Health Melbourne Vic. Australia
| | - Paul S. Thomas
- Prince of Wales’ Clinical School, UNSW and Respiratory Medicine Prince of Wales’ Hospital Randwick NSW Australia
| | - Karin S. Hougaard
- National Research Center for the Working Environment Copenhagen Denmark
- Department of Public Health University of Copenhagen Copenhagen Denmark
| | - Michael J. Abramson
- School of Public Health & Preventive Medicine Monash University Melbourne Vic. Australia
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit Melbourne School of Population and Global Health University of Melbourne Melbourne Vic. Australia
| | - Adrian J. Lowe
- Allergy and Lung Health Unit Melbourne School of Population and Global Health University of Melbourne Melbourne Vic. Australia
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12
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Doyen V, Casset A, Divaret-Chauveau A, Khayath N, Peiffer G, Bonniaud P, Dalphin JC, De Blay F. [Diagnosis of allergy in asthma]. Rev Mal Respir 2020; 37:243-256. [PMID: 32057505 DOI: 10.1016/j.rmr.2019.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 07/06/2019] [Indexed: 01/01/2023]
Abstract
Allergy is a hypersensitivity reaction induced by immunological mechanisms. In asthma, allergy has a complex role and is usually IgE mediated. Allergy must be evaluated during the work up but evidence of IgE sensitivity does not mean that allergens play a role in the pathophysiology of the disease. The clinical relevance of the sensitivity has to be considered. This paper describes current available tools to screen for IgE sensitivity, allergen exposure and their role in asthma.
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Affiliation(s)
- V Doyen
- Clinique d'immuno-allergologie, université Libre de Bruxelles (ULB), CHU Brugmann, place Van Gehuchten, 4, 1020 Bruxelles, Belgique.
| | - A Casset
- CNRS, CAMB UMR7199, université de Strasbourg, 67000 Strasbourg, France
| | - A Divaret-Chauveau
- Unité d'allergologie pédiatrique, hôpital d'enfants, CHRU de Nancy, 54000 Nancy, France; EA3450 développement adaptation et handicap (DevAH), université de Lorraine, 54000 Nancy, France; UMR 6249 Chrono-environment, CNRS et université de Franche-Comté, Besançon, France
| | - N Khayath
- Chest diseases department, Strasbourg University Hospital, 1, place de l'Hôpital, 67000 Strasbourg, France; Federation of translational medicine EA 3070, University of Strasbourg, BP426, 67091 Strasbourg, France
| | - G Peiffer
- Service de pneumologie, CHU Metz-Thionville, 57000 Metz, France
| | - P Bonniaud
- Service de pneumologie et soins intensifs respiratoires, hôpital François-Mitterrand, CHU Dijon-Bourgogne, 21079 Dijon, France
| | - J-C Dalphin
- UMR 6249 Chrono-environment, CNRS et université de Franche-Comté, Besançon, France; Service de pneumologie, CHU de Besançon, Besançon, France
| | - F De Blay
- Chest diseases department, Strasbourg University Hospital, 1, place de l'Hôpital, 67000 Strasbourg, France; Federation of translational medicine EA 3070, University of Strasbourg, BP426, 67091 Strasbourg, France
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13
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Pham MN, Andrade J, Mishoe M, Chun Y, Bunyavanich S. Perceived Versus Actual Aeroallergen Sensitization in Urban Children. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:1591-1598.e4. [PMID: 30654198 DOI: 10.1016/j.jaip.2018.12.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 12/22/2018] [Accepted: 12/28/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Individuals often report allergy to specific aeroallergens, but allergy testing can reveal disparate sensitization. OBJECTIVE To characterize the agreement between perceived and actual sensitization to individual aeroallergens in an urban pediatric population. METHODS A total of 253 children were enrolled from pediatric clinics in New York, NY. Detailed questionnaires regarding perceived sensitization and serum specific IgE measurements to 10 common aeroallergens were completed. Agreement between perceived and actual sensitization (sIgE ≥ 0.35 kUA/L) to individual aeroallergens was assessed by Cohen's kappa. Multivariable logistic regression models adjusted for potential confounders were used to test for associations between perceived and actual sensitization. RESULTS A total of 161 (63.6%) of 253 children reported perceived sensitization to 1 or more aeroallergen, and 203 (80.2%) were actually sensitized to 1 or more aeroallergen. Agreement between perceived and actual aeroallergen sensitization was fair for most aeroallergens, with greatest agreement for cat dander (κ, 0.42; 95% CI, 0.32-0.53) and dust (κ, 0.32; 95% CI, 0.20-0.44). Models adjusted for potential confounders showed nearly 6-fold odds of sensitization to cat dander given perceived cat allergy (adjusted odds ratio, 5.82; 95% CI, 2.91-11.64), and over 2-fold odds of sensitization to Dermatophagoides pteronyssinus, Dermatophagoides farinae, dog dander, or grass pollen given perceived sensitization to their respective allergens. Among children with no perceived sensitization, actual sensitization ranged from 5.4% to 30.4%, and was more common for indoor versus outdoor allergens, including cockroach. CONCLUSIONS Children who perceive allergen sensitization to cat, dog, dust, or grass are likely to demonstrate actual sensitization to these individual allergens. Children with no perceived sensitization to allergens are nonetheless frequently sensitized.
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Affiliation(s)
- Michele N Pham
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jade Andrade
- Mindich Child Health and Development Institute and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michelle Mishoe
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Yoojin Chun
- Mindich Child Health and Development Institute and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Supinda Bunyavanich
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; Mindich Child Health and Development Institute and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY.
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14
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Kim DH, Lim DH, Samra M, Kim EH, Kim JH. How Accurate Are the ISAAC Questions for Diagnosis of Allergic Rhinitis in Korean Children? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071527. [PMID: 30029503 PMCID: PMC6068583 DOI: 10.3390/ijerph15071527] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/06/2018] [Accepted: 07/12/2018] [Indexed: 11/16/2022]
Abstract
Background: The aims of this study were to investigate the prevalence of allergic rhinitis (AR) and the accuracy of the International Study of Asthma and Allergies in Childhood (ISAAC) questions for diagnosis of AR, in Korean children. Methods: Students that participated in an allergic disease prevalence survey in 2010⁻2017 were evaluated (n = 18,425) using questionnaires and a skin prick test (SPT). Age-stratified (5-7, 8-10, 11-13, 14-16 years) prevalence of four rhinitis questions, accuracy of the questions for AR, and proportion of comorbidities in the AR and non-AR (NAR) groups were evaluated. Results: The proportion of students responding to the questionnaire that ever had symptoms of AR since birth, that is, the prevalence of "symptom, ever" was 47.6%. Based on the questionnaire and SPT, overall prevalence of AR and NAR were 21% and 26.5%, respectively. The sensitivity, specificity, and accuracy of "symptom, ever" were 57.5%, 58.4%, and 58.1%, respectively, and those of "diagnosis, ever", who had ever been diagnosed with AR, were 39.8%, 76.9%, and 63.4%, respectively. Questionnaire-based asthma, atopic dermatitis, and food allergy were significantly associated with the AR group compared to the NAR group. Conclusions: Since the AR accuracy of the questionnaire is about 60%, it should be considered that the questionnaire based survey overestimates the true prevalence of AR in Korean children.
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Affiliation(s)
- Dong Hyun Kim
- Department of Pediatrics, Inha University School of Medicine, Incheon 22332, Korea.
| | - Dae Hyun Lim
- Department of Pediatrics, Inha University School of Medicine, Incheon 22332, Korea.
- Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Ministry of Environment, Incheon 22332, Korea.
| | - Mona Samra
- Department of Pediatrics, Inha University School of Medicine, Incheon 22332, Korea.
- Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Ministry of Environment, Incheon 22332, Korea.
| | - Eun Hye Kim
- Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Ministry of Environment, Incheon 22332, Korea.
| | - Jeong Hee Kim
- Department of Pediatrics, Inha University School of Medicine, Incheon 22332, Korea.
- Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Ministry of Environment, Incheon 22332, Korea.
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15
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Holzmann D, Willi U, Nadal D. Allergic Rhinitis as a Risk Factor for Orbital Complication of Acute Rhinosinusitis in Children. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/194589240101500606] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this article is to determine allergic rhinitis and age as potential risk factors for the development of orbital complications of acute rhinosinusitis in children. One hundred two children presenting with orbital swelling were investigated by computed tomography (CT) of the paranasal sinuses and the orbit as well as for underlying allergic rhinitis. Sixty (58.8%) patients had orbital complications of clinical and radiological acute rhinosinusitis. They were grouped accordingly: preseptal cellulitis (n = 24), periostitis (n = 10), and subperiosteal abscess (n = 26). No abscess within the orbit or cavernous sinus thrombosis was found. Thirty-four (56.7%) of the 60 patients underwent allergy investigation. Allergic rhinitis was found in 9 (64.3%) of 14 children with preseptal cellulitis, in 1 (25%) out of 4 children with periostitis, and in 13 (76.5%) out of 17 children with subperiosteal abscess. The prevalence of allergic rhinitis was significantly higher in patients presenting in pollen season from February to August (17:4) than in patients presenting in the period between September and January (6:7). Thus, allergic rhinitis may be a cofactor in the pathogenesis of orbital complications of acute rhinosinusitis. According to our study population, age only influences the type of orbital complication of acute rhinosinusitis in the sense that older children are more likely to develop subperiosteal abscess, whereas younger children develop preseptal cellulitis.
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Affiliation(s)
- David Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zürich and University Children's Hospital, Zürich, Switzerland
| | - Ulrich Willi
- Departments of Radiology, University Children's Hospital, Zürich, Switzerland
| | - David Nadal
- Infectious Disease, University Children's Hospital, Zürich, Switzerland
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16
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Passali D, Cingi C, Staffa P, Passali F, Muluk NB, Bellussi ML. The International Study of the Allergic Rhinitis Survey: outcomes from 4 geographical regions. Asia Pac Allergy 2018; 8:e7. [PMID: 29423374 PMCID: PMC5796967 DOI: 10.5415/apallergy.2018.8.e7] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 01/08/2017] [Indexed: 11/07/2022] Open
Abstract
Background Allergic rhinitis (AR) is a global health problem and is characterised by one or more symptoms, including sneezing, itching, nasal congestion and rhinorrhea. Objective We investigated the features of AR and the physician's approach to the management of AR patients in four geographical regions. Methods In this cross-sectional study, a questionnaire survey concerning AR was completed by Honorary and Corresponding Members of the Italian Society of Rhinology from different countries among 4 world geographical regions—Asia, Europe, the Americas, and Africa. Results The prevalence of AR was reported to be 15%–25%. Children and adolescents, as well as young adults, were the age groups more affected by AR with comorbidities of asthma, sinusitis, conjunctivitis, and nasal polyposis. Nasal symptoms of AR were more intense in the spring (51.92%) and autumn (28.85%). The most common aero-allergens were pollen and mites (67.31%), animal dander and pollutants (23.08%), and fungal allergens (21.15%). Allergen-specific immunotherapy was prescribed for both perennial and seasonal allergens (32.69%) via sublingual swallow (46.15%) and subcutaneous (32.69%) routes. For the AR patients, the most prescribed drugs were intranasal corticosteroids (86.54%) and oral H1-antihistamines (82.69%). Conclusion A network of experts can improve our knowledge concerning AR epidemiology, and together with guidelines, could assist practitioners and otolaryngologists in standardising the diagnosis and treatment of AR.
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Affiliation(s)
- Desiderio Passali
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Siena, 53100 Siena, Italy
| | - Cemal Cingi
- Department of Otorhinolaryngology - Head and Neck Surgery, Osmangazi University, Faculty of Medicine, 26040 Eskisehir, Turkey
| | - Paola Staffa
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Siena, 53100 Siena, Italy
| | | | - Nuray Bayar Muluk
- Department of Otorhinolaryngology - Head and Neck Surgery, Kırıkkale University, Faculty of Medicine, 71450 Kırıkkale, Turkey
| | - Maria Luisa Bellussi
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Siena, 53100 Siena, Italy
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Alvarez Zallo N, Aguinaga-Ontoso I, Alvarez-Alvarez I, Guillén-Grima F, Azcona San Julian C. The influence of gender and atopy in the relationship between obesity and asthma in childhood. Allergol Immunopathol (Madr) 2017; 45:227-233. [PMID: 28126313 DOI: 10.1016/j.aller.2016.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/11/2016] [Accepted: 09/21/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND The objective of the study was to examine the relationship between asthma and overweight-obesity in Spanish children and adolescents and to determine whether this relationship was affected by gender and atopy. METHODS The study involves 8607 Spanish children and adolescents from the International Study of Asthma and Allergies in Childhood phase III. Unconditional logistic regression was used to obtain adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for the association between asthma symptoms and overweight-obesity in the two groups. Afterwards, it was stratified by sex and rhinoconjunctivitis. RESULTS The prevalence of overweight and obesity in 6-7-year-old children was 18.6% and 5.2% respectively and in 13-14 year-old teenagers was 11.4% and 1.1% respectively. Only the obese children, not the overweight children, of the 6-7 year old group had a higher risk of any asthma symptoms (wheezing ever: OR 1.68 [1.15-2.47], asthma ever: OR 2.29 [1.43-3.68], current asthma 2.56 [1.54-4.28], severe asthma 3.18 [1.50-6.73], exercise-induced asthma 2.71 [1.45-5.05]). The obese girls had an increased risk of suffering any asthma symptoms (wheezing ever: OR 1.73 [1.05-2.91], asthma ever: OR 3.12 [1.67-5.82], current asthma 3.20 [1.65-6.19], severe asthma 4.83[1.94-12.04], exercise-induced asthma 3.68 [1.67-8.08]). The obese children without rhinoconjunctivitis had a higher risk of asthma symptoms. CONCLUSIONS Obesity and asthma symptoms were associated in 6-7 year-old children but not in 13-14 year-old teenagers. The association was stronger in non-atopic children and obese girls.
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Affiliation(s)
- N Alvarez Zallo
- Extrahospitalary Pediatric Emergency Service, Osasunbidea, Pamplona, Navarra, Spain.
| | | | | | - F Guillén-Grima
- Department of Health Sciences, Public University of Navarra, Spain; Preventive Medicine, Clínica Universidad de Navarra, Pamplona, Navarra, Spain; Navarra Institute for Health Research (IdiSNA), Spain
| | - C Azcona San Julian
- Navarra Institute for Health Research (IdiSNA), Spain; Paediatric Endocrinology Unit, Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
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18
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Schoos AMM, Chawes BL, Melén E, Bergström A, Kull I, Wickman M, Bønnelykke K, Bisgaard H, Rasmussen MA. Sensitization trajectories in childhood revealed by using a cluster analysis. J Allergy Clin Immunol 2017; 140:1693-1699. [PMID: 28347735 DOI: 10.1016/j.jaci.2017.01.041] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 12/19/2016] [Accepted: 01/04/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Assessment of sensitization at a single time point during childhood provides limited clinical information. We hypothesized that sensitization develops as specific patterns with respect to age at debut, development over time, and involved allergens and that such patterns might be more biologically and clinically relevant. OBJECTIVE We sought to explore latent patterns of sensitization during the first 6 years of life and investigate whether such patterns associate with the development of asthma, rhinitis, and eczema. METHODS We investigated 398 children from the at-risk Copenhagen Prospective Studies on Asthma in Childhood 2000 (COPSAC2000) birth cohort with specific IgE against 13 common food and inhalant allergens at the ages of ½, 1½, 4, and 6 years. An unsupervised cluster analysis for 3-dimensional data (nonnegative sparse parallel factor analysis) was used to extract latent patterns explicitly characterizing temporal development of sensitization while clustering allergens and children. Subsequently, these patterns were investigated in relation to asthma, rhinitis, and eczema. Verification was sought in an independent unselected birth cohort (BAMSE) constituting 3051 children with specific IgE against the same allergens at 4 and 8 years of age. RESULTS The nonnegative sparse parallel factor analysis indicated a complex latent structure involving 7 age- and allergen-specific patterns in the COPSAC2000 birth cohort data: (1) dog/cat/horse, (2) timothy grass/birch, (3) molds, (4) house dust mites, (5) peanut/wheat flour/mugwort, (6) peanut/soybean, and (7) egg/milk/wheat flour. Asthma was solely associated with pattern 1 (odds ratio [OR], 3.3; 95% CI, 1.5-7.2), rhinitis with patterns 1 to 4 and 6 (OR, 2.2-4.3), and eczema with patterns 1 to 3 and 5 to 7 (OR, 1.6-2.5). All 7 patterns were verified in the independent BAMSE cohort (R2 > 0.89). CONCLUSION This study suggests the presence of specific sensitization patterns in early childhood differentially associated with development of clinical outcomes. Using such patterns in future research might provide more robust and clinically relevant results.
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Affiliation(s)
- Ann-Marie M Schoos
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Bo L Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Sachs Children's Hospital, Södersjukhuset, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Inger Kull
- Sachs Children's Hospital, Södersjukhuset, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Wickman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Sachs Children's Hospital, Södersjukhuset, Stockholm, Sweden
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - Morten A Rasmussen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Food Science, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Dziekanski M, Marcelino TDF. Quality of Life in Pediatric Patients with Allergic Rhinitis treated at the Medical Clinic of Integrated Education - Unisul. Int Arch Otorhinolaryngol 2017; 21:371-376. [PMID: 29018501 PMCID: PMC5629077 DOI: 10.1055/s-0037-1599095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 01/06/2017] [Indexed: 01/17/2023] Open
Abstract
Introduction Allergic rhinitis is a common disease among children and adolescents, reaching up to 40% of the population. During childhood, it is usually underdiagnosed because it has nonspecific symptoms. It has a negative impact on quality of life and may predispose to comorbidities. The diagnosis is clinical and treatment aims prevention. Objective The objective of this study is to evaluate the quality of life in pediatric patients with allergic rhinitis. Methods This is an observational study with cross-sectional design. The population consisted of pediatric patients with allergic rhinitis treated at the Medical Clinic of Integrated Education (MCIE) - Universidade do Sul de Santa Catarina - Unisul, Tubarão, SC, Brazil. We collected data from March to June 2016 through the application of the Sociodemographic and Health Questionnaire, rhinitis module of the International Study of Asthma and Allergies in Childhood Questionnaire and the Rhinoconjunctivitis Quality of Life Questionnaire Modified. Results Out of the 69 respondents, 52.2% were boys with a mean age of 10.13 years old. The predominant education level of parents/guardians was incomplete second grade and average income level was two minimum wages. 81.2% said they had previous treatment for AR, 30.4% had asthma and 7.2% eczema. Incidence of patients smoking was absent and family (parents/guardians) smoking was 17.4%. March to July were the months of highest symptom occurrence, slightly disturbing daily activities. The mean value of severity was 51.9, nasal symptoms were the most uncomfortable, and nasal itchiness was the most cited. Conclusion Our results highlight that allergic symptoms negatively impact the life of people with allergic rhinitis, with a predominance of nasal symptoms, especially nasal itchy, representing a poor quality of life of the interviewed.
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Affiliation(s)
- Mariana Dziekanski
- Medical School, Campus Tubarão Ringgold Standard Institution, Universidade do Sul de Santa Catarina - Unisul, Tubarão, SC, Brazil
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20
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Kim DH, Park YS, Jang HJ, Kim JH, Lim DH. Prevalence and allergen of allergic rhinitis in Korean children. Am J Rhinol Allergy 2017; 30:72-8. [PMID: 27216339 DOI: 10.2500/ajra.2013.27.4317] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND In recent decades, the amount of data about allergic rhinitis (AR) in Korean National Health Insurance Service has increased. OBJECTIVE To investigate the prevalence and quality of sensitized allergens of AR in Korean children and adolescents. METHODS This study obtained the results of the Korean International Study of Asthma and Allergies in Childhood questionnaires and the skin-prick test (SPT) results of 14,356 students who participated in a health screening from 2010 to 2014. AR was defined as one with current symptoms of AR with at least one or more positive results of an SPT with inhalant allergens. RESULTS The prevalence of AR in children was 20.8%. Positive rates of the allergen group were 87.3% for house-dust mites, 37.0% for pollen, 12.4% for mold, and 8.4% for pets. The common allergens in descending order were Dermatophagoides pteronyssinus, Dermatophagoides farinae, Betula, Humulus, Alnus, and Alternaria. As the children became older, pollen-sensitization rates tended to increase (p value for trends, <0.001). In metropolitan and middle inland areas, weed pollen was the most common pollen. The rates of tree-pollen sensitization were the highest at the seaside and in the southern inland. The most common comorbid allergic diseases associated with AR were pollen allergy and allergic conjunctivitis at 37.0% and 34.5%, respectively. CONCLUSIONS This was the first study conducted in Korea to investigate the prevalence of AR in the general population by using both questionnaires and SPTs. The allergens used for the SPTs were chosen based on the common allergens in this study, and this current pollen data will contribute to establish the cause of increasing AR prevalence in Korea.
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Affiliation(s)
- Dong Hyun Kim
- Department of Pediatrics, Inha University School of Medicine, Incheon, Republic of Korea
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21
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den Dekker HT, Sonnenschein-van der Voort AMM, Jaddoe VWV, Reiss IK, de Jongste JC, Duijts L. Breastfeeding and asthma outcomes at the age of 6 years: The Generation R Study. Pediatr Allergy Immunol 2016; 27:486-92. [PMID: 27062455 DOI: 10.1111/pai.12576] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Breastfeeding is associated with a lower risk of asthma symptoms in early childhood, but its effect at older ages remains unclear. We examined the associations of duration and exclusiveness of breastfeeding with asthma outcomes in children aged 6 years, and whether these associations were explained by atopic or infectious mechanisms. METHODS We performed a population-based prospective cohort study among 5675 children. Information about breastfeeding was collected by questionnaires. At age 6 years, we measured interrupter resistance (Rint) and fractional exhaled nitric oxide (FeNO). Information about wheezing patterns (early (≤3 years only), late (>3 years only), persistent (≤3 and >3 years)), and current asthma at 6 years was derived from repeated questionnaires. RESULTS Compared to children who were ever breastfed, those who were never breastfed had lower FeNO levels (sympercent (95% CI): -16.0 (-24.5, -7.5)) and increased risks of late and persistent wheezing (OR(95% CI): 1.69 (1.06, 2.69) and 1.44 (1.00, 2.07), respectively). Shorter duration of breastfeeding was associated with early wheezing and current asthma (1.40 (1.14, 1.73) and 2.19 (1.29, 3.71), respectively). Less exclusive breastfeeding was associated with early wheezing (1.28 (1.08, 1.53)). Breastfeeding duration and exclusiveness were not associated with FeNO or Rint. The associations were not explained by inhalant allergies, partly by lower respiratory tract infections in early life, and to a lesser extent by lower respiratory tract infections in later life. CONCLUSIONS Breastfeeding patterns may influence wheezing and asthma in childhood, which seems to be partly explained by infectious mechanisms.
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Affiliation(s)
- Herman T den Dekker
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Agnes M M Sonnenschein-van der Voort
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Irwin K Reiss
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Johan C de Jongste
- Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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22
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Malan L, Baumgartner J, Calder PC, Smuts CM. Low immune cell ARA and high plasma 12-HETE and 17-HDHA in iron-deficient South African school children with allergy. Prostaglandins Leukot Essent Fatty Acids 2016; 110:35-41. [PMID: 27255641 DOI: 10.1016/j.plefa.2016.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/11/2016] [Accepted: 05/11/2016] [Indexed: 01/20/2023]
Abstract
Allergy has been associated with altered fatty acid and inflammatory status. In this cross-sectional study of 321 rural iron deficient (ID) South African children (aged 6-11 years), a subsample (n=111) of children with parent-reported allergy data were divided into an allergic (n=30) and non-allergic (n=81) group and compared. PBMC arachidonic acid (ARA; P=0.010) and the PBMC ARA to dihomo-gamma-linolenic acid (DGLA) ratio (P=0.035) were lower in the allergic children. Plasma 12-hydroxyeicosatetraenoic acid and 17-hydroxydocosahexaenoic acid (17-HDHA) were higher (P=0.040 and 0.020, respectively) in the allergic group. Thus, a fatty acid composition and lipid mediator levels indicative of increased release of ARA from PBMC membranes, increased inflammation as well as the resolving thereof, were associated with parent-reported allergy symptoms. This study used baseline data of an intervention study which was registered at clinicaltrials.gov as NCT01092377.
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Affiliation(s)
- L Malan
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa.
| | - J Baumgartner
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - P C Calder
- The Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre in Nutrition, Southampton University Hospital NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - C M Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
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Pols DHJ, Wartna JB, Moed H, van Alphen EI, Bohnen AM, Bindels PJE. Atopic dermatitis, asthma and allergic rhinitis in general practice and the open population: a systematic review. Scand J Prim Health Care 2016; 34:143-50. [PMID: 27010253 PMCID: PMC4977936 DOI: 10.3109/02813432.2016.1160629] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 01/31/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine whether significant differences exist between the self-reported prevalence of atopic disorders in the open population compared with physician diagnosed prevalence of atopic disorders in general practice. METHODS Medline (OvidSP), PubMed Publisher, EMBASE, Google Scholar and the Cochrane Controlled Clinical Trials Register databases were systematically reviewed for articles providing data on the prevalence of asthma, allergic rhinitis and eczema in a GP setting. Studies were only included when they had a cross-sectional or cohort design and included more than 100 children (aged 0-18 years) in a general practice setting. All ISAAC studies (i.e. the open population) that geographically matched a study selected from the first search, were also included. A quality assessment was conducted. The primary outcome measures were prevalence of eczema, asthma and allergic rhinitis in children aged 0-18 years. RESULTS The overall quality of the included studies was good. The annual and lifetime prevalences of the atopic disorders varied greatly in both general practice and the open population. On average, the prevalence of atopic disorders was higher in the open population. CONCLUSION There are significant differences between the self-reported prevalence of atopic disorders in the open population compared with physician diagnosed prevalence of atopic disorders in general practice. Data obtained in the open population cannot simply be extrapolated to the general practice setting. This should be taken into account when considering a research topic or requirements for policy development. GPs should be aware of the possible misclassification of allergic disorders in their practice. Key Points Epidemiological data on atopic disorders in children can be obtained from various sources, each having its own advantages and limitations. On average, the prevalence of atopic disorders is higher in the open population. GPs should take into account the possible misclassification of atopic disorders in their practice population. Policymakers should be aware that data obtained in the open population cannot simply be extrapolated to the general practice setting.
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Affiliation(s)
- D. H. J. Pols
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, The Netherlands
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Yoshida K, Sasaki M, Adachi Y, Itazawa T, Odajima H, Saito H, Akasawa A. Factors associated with the severity of childhood rhinoconjunctivitis. Allergol Int 2016; 65:166-171. [PMID: 26657129 DOI: 10.1016/j.alit.2015.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/18/2015] [Accepted: 10/19/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Allergic rhinitis is one of the most common chronic diseases in children. Although it has a large impact on the patient's quality of life, little is known about the factors associated with its severity. The aim of this study was to assess the factors associated with the severity of rhinoconjunctivitis among children in the general population. METHODS A survey was conducted using an online research panel in 2012. Parents were asked to answer an International Study of Asthma and Allergies in Childhood-based questionnaire to identify children with current rhinoconjunctivitis and evaluate factors associated with the severity of its symptoms. Severity was rated according to the degree of impairment caused by the symptoms in the patient's daily life. RESULTS Among 26,725 children aged 6-12 years old, rhinoconjunctivitis was defined in 5175 (19.4%), and of these, 688 children (13.3% of children with current rhinoconjunctivitis) presented severe symptoms. Living in areas with a high cedar and cypress pollen count and having concurrent eczema were associated with severe rhinoconjunctivitis [adjusted OR (95% CI): 1.21 (1.00-1.46) and 1.45 (1.20-1.75), respectively]. Further, a maternal history of asthma and allergic rhinitis was a significant risk factor for severe rhinoconjunctivitis [1.34 (1.04-1.74) and 1.30 (1.10-1.53), respectively]. However, living with fur-bearing animals (pets) before 1 year of age proved to be a protective factor against severe rhinoconjunctivitis [0.70 (0.52-0.94)]. CONCLUSIONS Environmental factors such as pets and pollen, together with comorbidities and a maternal history of allergic diseases, play an important role in determining the severity of rhinoconjunctivitis.
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Affiliation(s)
- Koichi Yoshida
- Division of Allergy, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
| | - Mari Sasaki
- Division of Allergy, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Yuichi Adachi
- Department of Pediatrics, University of Toyama, Toyama, Japan
| | - Toshiko Itazawa
- Department of Pediatrics, University of Toyama, Toyama, Japan
| | - Hiroshi Odajima
- Department of Pediatrics, Fukuoka National Hospital, Fukuoka, Japan
| | - Hirohisa Saito
- Department of Allergy and Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Akira Akasawa
- Division of Allergy, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
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Cazzoletti L, Ferrari M, Olivieri M, Verlato G, Antonicelli L, Bono R, Casali L, Cerveri I, Marchetti P, Pirina P, Rossi A, Villani S, de Marco R. The gender, age and risk factor distribution differs in self-reported allergic and non-allergic rhinitis: a cross-sectional population-based study. Allergy Asthma Clin Immunol 2015; 11:36. [PMID: 26640494 PMCID: PMC4669616 DOI: 10.1186/s13223-015-0101-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/21/2015] [Indexed: 11/10/2022] Open
Abstract
Background Few population-based studies have assessed the prevalence and the risk factors of non-allergic rhinitis (NAR) in comparison to allergic rhinitis (AR). Moreover, epidemiologic data on rhinitis in the elderly subjects and in southern Europe are scarce. Objective This study aimed at estimating the prevalence and at comparing the risk factor distribution of AR and NAR in a general population sample aged 20–84 years in Italy. Methods A questionnaire on respiratory symptoms and risk factors was administered to random samples of the Italian population aged 20–44 (n = 10,494) 45–64 (n = 2167) and 65–84 (n = 1030) in the frame of the Gene Environment Interactions in Respiratory Diseases (GEIRD) study. Current AR and NAR were defined according to the self-reported presence of nasal allergies or of nasal symptoms without a cold or the flu. Results NAR showed a significant descending pattern in females from 12.0 % (95 % CI 11.1, 13.1) in the 20–44 year age class, to 7.5 % (5.4, 10.3) in the 65–84 year age class (p = 0.0009), and a roughly stable pattern in males, from 10.2 % (9.3, 11.2) to 11.1 % (8.4, 13.9) (p = 0.5261). AR decreased from 26.6 % (25.7, 27.6) in 20–44 years age class to 15.6 % (13.3, 18.0) in the 65–84 years age class (p < 0.0001), without gender difference. Subjects living near industrial plants and ex- and current smokers had a higher risk of NAR. Current smokers had a lower risk and subjects living in a Mediterranean climate a higher risk of AR. Conclusion AR and NAR are fairly distinct conditions, as they have a different age, gender and risk factor distribution.
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Affiliation(s)
- Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
| | - Marcello Ferrari
- Unit of Respiratory Diseases, Department of Internal Medicine, University of Verona, Verona, Italy
| | - Mario Olivieri
- Unit of Occupational Medicine, University Hospital of Verona, Verona, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
| | - Leonardo Antonicelli
- Allergy Unit, Department of Internal Medicine, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Lucio Casali
- Unit of Respiratory Diseases, Department of Internal Medicine, University of Perugia, Perugia, Italy
| | - Isa Cerveri
- Division of Respiratory Diseases, Istituto di Ricovero e Cura a Carattere Scientifico "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
| | - Pietro Pirina
- Institute of Respiratory Diseases, University of Sassari, Sassari, Italy
| | - Andrea Rossi
- Unit of Respiratory Diseases, Department of Internal Medicine, University of Verona, Verona, Italy
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Roberto de Marco
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
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Sun W, Svendsen ER, Karmaus WJJ, Kuehr J, Forster J. Early-life antibiotic use is associated with wheezing among children with high atopic risk: a prospective European study. J Asthma 2015; 52:647-52. [PMID: 25539024 DOI: 10.3109/02770903.2014.999284] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Little is known about the relationship between antibiotic use and asthma in the children with a higher risk of allergic sensitization. We examine the association between the use of specific therapeutic antibiotics in the first year of life and development of wheezing by 36 months among children with a higher risk of allergic sensitization. METHODS A multi-center prospective cohort study was conducted among children at high risk for allergic sensitization. A validated questionnaire was used to prospectively collect information on antibiotic use and potential risk factors for wheezing from parents or guardians of 606 children from three European countries at 6, 12, 24 and 36 months of age. Multivariate linear and logistic regression models were used to adjust for potential confounders and effect modifiers and to estimate the association of antibiotic use with the development of early childhood wheezing. RESULTS Of the antibiotics assessed, only macrolide use in the first year of life was associated with increasing risk for wheezing by 36 months, after adjusting for gender, socioeconomic status, breast feeding >6 months, tobacco smoke exposure, family history of asthma, and respiratory infection (RR = 1.09; 95% CI 1.05-1.13). To avoid a bias by indication, we analyzed children with and without respiratory infection separately. Similar associations were observed for macrolides use in children who had no respiratory infection. CONCLUSIONS In European children with a familial risk for allergic sensitization, we found a positive association between macrolide use in the first year of life and wheezing until 36 months old which was independent of the effect of respiratory infection.
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Affiliation(s)
- Wenjie Sun
- a School of Food Science, Guangdong Pharmaceutical University , Zhongshan , China
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27
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White MJ, Kodaman NM, Harder RH, Asselbergs FW, Vaughan DE, Brown NJ, Moore JH, Williams SM. Genetics of Plasminogen Activator Inhibitor-1 (PAI-1) in a Ghanaian Population. PLoS One 2015; 10:e0136379. [PMID: 26322636 PMCID: PMC4556460 DOI: 10.1371/journal.pone.0136379] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 08/03/2015] [Indexed: 11/18/2022] Open
Abstract
Plasminogen activator inhibitor 1 (PAI-1), a major modulator of the fibrinolytic system, is an important factor in cardiovascular disease (CVD) susceptibility and severity. PAI-1 is highly heritable, but the few genes associated with it explain only a small portion of its variation. Studies of PAI-1 typically employ linear regression to estimate the effects of genetic variants on PAI-1 levels, but PAI-1 is not normally distributed, even after transformation. Therefore, alternative statistical methods may provide greater power to identify important genetic variants. Additionally, most genetic studies of PAI-1 have been performed on populations of European descent, limiting the generalizability of their results. We analyzed >30,000 variants for association with PAI-1 in a Ghanaian population, using median regression, a non-parametric alternative to linear regression. Three variants associated with median PAI-1, the most significant of which was in the gene arylsulfatase B (ARSB) (p = 1.09 x 10−7). We also analyzed the upper quartile of PAI-1, the most clinically relevant part of the distribution, and found 19 SNPs significantly associated in this quartile. Of note an association was found in period circadian clock 3 (PER3). Our results reveal novel associations with median and elevated PAI-1 in an understudied population. The lack of overlap between the two analyses indicates that the genetic effects on PAI-1 are not uniform across its distribution. They also provide evidence of the generalizability of the circadian pathway’s effect on PAI-1, as a recent meta-analysis performed in Caucasian populations identified another circadian clock gene (ARNTL).
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Affiliation(s)
- Marquitta J. White
- Center for Human Genetics Research, Vanderbilt University, Nashville, Tennessee, United States of America
- Department of Genetics and Institute of Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America
| | - Nuri M. Kodaman
- Center for Human Genetics Research, Vanderbilt University, Nashville, Tennessee, United States of America
- Department of Genetics and Institute of Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America
| | - Reed H. Harder
- Department of Genetics and Institute of Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America
| | - Folkert W. Asselbergs
- Department Heart & Lungs, University Medical Center Utrecht, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands
- Institute of Cardiovascular Science, University College London, 222 Euston Road, London, United Kingdom
- Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands
| | - Douglas E. Vaughan
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Nancy J. Brown
- Department of Medicine Vanderbilt University, Nashville, Tennessee, United States of America
| | - Jason H. Moore
- Department of Genetics and Institute of Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America
| | - Scott M. Williams
- Department of Genetics and Institute of Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America
- * E-mail:
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28
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Chu L, Rennie D, Cockcroft D, Pahwa P, Dosman J, Hagel L, Karunanayake C, Lawson J. Agreement between questionnaire report of allergy-related outcomes in school-age children and objective measures of atopy: the Saskatchewan rural health study. Clin Exp Allergy 2015; 45:1337-45. [DOI: 10.1111/cea.12533] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 03/10/2015] [Accepted: 03/16/2015] [Indexed: 12/25/2022]
Affiliation(s)
- L. Chu
- Department of Community Health and Epidemiology; Saskatoon SK Canada
- Canadian Centre for Health and Safety in Agriculture; University of Saskatchewan; Saskatoon SK Canada
| | - D. Rennie
- Canadian Centre for Health and Safety in Agriculture; University of Saskatchewan; Saskatoon SK Canada
| | - D. Cockcroft
- Canadian Centre for Health and Safety in Agriculture; University of Saskatchewan; Saskatoon SK Canada
- Division of Respiratory Medicine; University of Saskatchewan; Saskatoon SK Canada
| | - P. Pahwa
- Canadian Centre for Health and Safety in Agriculture; University of Saskatchewan; Saskatoon SK Canada
| | - J. Dosman
- Canadian Centre for Health and Safety in Agriculture; University of Saskatchewan; Saskatoon SK Canada
| | - L. Hagel
- Canadian Centre for Health and Safety in Agriculture; University of Saskatchewan; Saskatoon SK Canada
| | - C. Karunanayake
- Canadian Centre for Health and Safety in Agriculture; University of Saskatchewan; Saskatoon SK Canada
| | - J. Lawson
- Canadian Centre for Health and Safety in Agriculture; University of Saskatchewan; Saskatoon SK Canada
- Department of Medicine; University of Saskatchewan; Saskatoon SK Canada
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Grabenhenrich LB, Keil T, Reich A, Gough H, Beschorner J, Hoffmann U, Bauer CP, Forster J, Schuster A, Schramm D, Nitsche O, Zepp F, Lee YA, Bergmann R, Bergmann K, Wahn U, Lau S. Prediction and prevention of allergic rhinitis: A birth cohort study of 20 years. J Allergy Clin Immunol 2015; 136:932-40.e12. [PMID: 25976706 DOI: 10.1016/j.jaci.2015.03.040] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 03/12/2015] [Accepted: 03/27/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) is one of the most common chronic diseases, usually starting in the first 2 decades of life. Information on predictors, risk, and protective factors is missing because of a lack of long-term prospective studies. OBJECTIVE Our aim was to examine early-life environmental and lifestyle determinants for AR up to age 20 years. METHODS In 1990, the Multicenter Allergy Study included 1314 newborns in 5 German cities. Children were evaluated at 19 time points. A Cox regression model examined the associations between 41 independent early-life factors and onset of AR (as the primary outcome), including sensitization against aeroallergens and the secondary outcomes of nonallergic rhinitis and AR plus asthma. RESULTS Two hundred ninety subjects had AR within 13,179 person years observed. The risk of AR was higher with a parental history of AR (adjusted hazard ratio [aHR], 2.49; 95% CI, 1.93-3.21), urticaria (aHR, 1.32; 95% CI, 1.00-1.74), or asthma (aHR, 1.29; 95% CI, 0.95-1.75). Early allergic sensitization (aHR, 4.53; 95% CI, 3.25-6.32), eczema within the first 3 years of life (aHR, 1.83; 95% CI, 1.38-2.42), male sex (aHR, 1.28; 95% CI, 1.02-1.61), and birthday in summer or autumn (aHR, 1.26; 95% CI, 1.00-1.58) were independent predictors of AR up to age 20 years. None of the other socioeconomic, environmental, lifestyle, pregnancy, and birth-related factors were associated with AR. CONCLUSION Only nonmodifiable factors, particularly early allergic sensitization or eczema and parental AR, predicted AR up to age 20 years. No modifiable aspects of early-life environment or lifestyle were identified as targets for primary prevention.
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Affiliation(s)
- Linus B Grabenhenrich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Thomas Keil
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Andreas Reich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Hannah Gough
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - John Beschorner
- Department of Pediatrics, Westmecklenburg Hospital, Hagenow, Germany
| | - Ute Hoffmann
- Department of Pediatrics, Technical University of Munich, Munich, Germany
| | - Carl-Peter Bauer
- Department of Pediatrics, Technical University of Munich, Munich, Germany
| | | | - Antje Schuster
- Department of Pediatrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Dirk Schramm
- Department of Pediatrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Oliver Nitsche
- Center for Pediatric and Adolescent Medicine, University Medical Center Mainz, Mainz, Germany
| | - Fred Zepp
- Center for Pediatric and Adolescent Medicine, University Medical Center Mainz, Mainz, Germany
| | | | - Renate Bergmann
- Department of Obstetrics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Karl Bergmann
- Department of Obstetrics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrich Wahn
- Department of Pediatric Pneumology and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Susanne Lau
- Department of Pediatric Pneumology and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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30
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Patterns of IgE responses to multiple allergen components and clinical symptoms at age 11 years. J Allergy Clin Immunol 2015; 136:1224-31. [PMID: 25935108 PMCID: PMC4649774 DOI: 10.1016/j.jaci.2015.03.027] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 03/12/2015] [Accepted: 03/18/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND The relationship between sensitization to allergens and disease is complex. OBJECTIVE We sought to identify patterns of response to a broad range of allergen components and investigate associations with asthma, eczema, and hay fever. METHODS Serum specific IgE levels to 112 allergen components were measured by using a multiplex array (Immuno Solid-phase Allergen Chip) in a population-based birth cohort. Latent variable modeling was used to identify underlying patterns of component-specific IgE responses; these patterns were then related to asthma, eczema, and hay fever. RESULTS Two hundred twenty-one of 461 children had IgE to 1 or more components. Seventy-one of the 112 components were recognized by 3 or more children. By using latent variable modeling, 61 allergen components clustered into 3 component groups (CG1, CG2, and CG3); protein families within each CG were exclusive to that group. CG1 comprised 27 components from 8 plant protein families. CG2 comprised 7 components of mite allergens from 3 protein families. CG3 included 27 components of plant, animal, and fungal origin from 12 protein families. Each CG included components from different biological sources with structural homology and also nonhomologous proteins arising from the same biological source. Sensitization to CG3 was most strongly associated with asthma (odds ratio [OR], 8.20; 95% CI, 3.49-19.24; P < .001) and lower FEV1 (P < .001). Sensitization to CG1 was associated with hay fever (OR, 12.79; 95% CI, 6.84-23.90; P < .001). Sensitization to CG2 was associated with both asthma (OR, 3.60; 95% CI, 2.05-6.29) and hay fever (OR, 2.52; 95% CI, 1.38-4.61). CONCLUSIONS Latent variable modeling with a large number of allergen components identified 3 patterns of IgE responses, each including different protein families. In 11-year-old children the pattern of response to components of multiple allergens appeared to be associated with current asthma and hay fever but not eczema.
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Thomsen GF, Schlünssen V, Skadhauge LR, Malling TH, Sherson DL, Omland Ø, Sigsgaard T. Are allergen batch differences and the use of double skin prick test important? BMC Pulm Med 2015; 15:33. [PMID: 25886946 PMCID: PMC4397883 DOI: 10.1186/s12890-015-0021-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 03/10/2015] [Indexed: 11/10/2022] Open
Abstract
Background Skin prick tests (SPT) are widely used both in clinical diagnostics and in research. The standardization of allergen extracts is well documented to be crucial for the validity of SPT, whereas less emphasis has been placed on reproducibility and the SPT procedure itself. The objectives of this study are to clarify how the double skin prick test procedure influence the sensitivity and specificity of the test and to analyse the differences in weal size in skin prick tests between two batches of allergen extracts from the same vendor. Methods The association between rhinitis and SPT was assessed among 1135 persons from a general population sample. SPT was performed twice with 10 common aeroallergens. In a subsample of 90 persons SPT was performed simultaneously with five of the allergens using different batches. Results Thirty percent had at least one positive SPT. Among asthmatics this number was 62%. Only minor differences were seen between the sizes of two weals from the same batch. A second SPT with the same batch did not change the association between rhinitis and sensitization. When performing SPT with two different batches disagreement was observed in 2% (Birch) to 11% (Cat) of the subjects. Conclusions Performing SPT twice with the same allergen batch does not enhance the validity of the test, and value of double testing can be questioned. Considerable differences in SPT response with different batches from the same manufacturer were observed. Thus inter batch differences in allergen extracts might be a source of variability.
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Affiliation(s)
- Gert F Thomsen
- Department of Occupational Medicine, Hospital of Southwest Denmark, Finsensgade 35, 6700, Esbjerg, Denmark.
| | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark. .,Department of Occupational Medicine, Danish Ramazzini centre, Aarhus University Hospital, Aarhus, Denmark.
| | - Lars R Skadhauge
- Department of Occupational Medicine, Hospital of Southwest Denmark, Finsensgade 35, 6700, Esbjerg, Denmark. .,Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Tine Halsen Malling
- Department of Occupational Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark.
| | - David L Sherson
- Department of Occupational Medicine, Odense University Hospital, Odense, Denmark. .,Department of Pulmonal Medicine, Odense University Hospital, Odense, Denmark.
| | - Øyvind Omland
- Department of Occupational Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark. .,Department of Health Science and Technology, The Faculty of Medicine; Aalborg University Hospital, Aalborg, Denmark.
| | - Torben Sigsgaard
- Department of Public Health, Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark.
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Eldeirawi KM, Kunzweiler C, Atek A, Persky VW. Antibiotic use in infancy and the risk of asthma in Mexican American children. J Asthma 2015; 52:707-14. [PMID: 25584659 DOI: 10.3109/02770903.2015.1004338] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE This study examined the associations of antibiotic use in infancy with lifetime doctor-diagnosed asthma and current wheeze among Mexican American children. METHODS In a population-based, cross-sectional investigation, parents of 2023 children 4-18 years of age completed a questionnaire/interview addressing respiratory conditions, antibiotic use, and covariates. RESULTS In adjusted analyses, among children without history of ear infections in infancy, children who used antibiotics ≥3 times and 1-2 times were more likely to report doctor-diagnosed asthma compared with their peers who did not use antibiotics in infancy [adjusted odds ratio (aOR) = 5.14, 95% confidence interval (CI): 2.88-9.17, and aOR = 2.15, 95% CI: 1.26-3.69, respectively, p trend < 0.0001]. The respective aORs for current wheeze were 3.67 (95% CI: 1.95-6.89) and 1.63 (95% CI: 0.91-2.95). Antibiotic use in infancy was not associated with asthma or current wheeze in children who had ear infections in infancy. In additional analyses, antibiotic use in infancy was associated with asthma in children without parental history of asthma or allergies (aOR = 2.73, 95% CI: 1.70-4.39) but not in those with parental history of asthma or allergies. Among Mexico-born participants born in rural areas, antibiotic use in infancy was associated with a seven-fold increase in risk of asthma (aOR = 7.21, 95% CI: 1.46-35.65), while the association was non-significant in Mexico-born children born in urban areas in Mexico. CONCLUSIONS Antibiotic use in infancy may increase the risk of asthma and wheezing, but these associations were limited to subgroups of children.
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Affiliation(s)
- Kamal M Eldeirawi
- a Department of Health Systems Science , College of Nursing, University of Illinois at Chicago , Chicago , IL , USA
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Simons E, Kwon S, Yang C, Dell SD. Prediction of childhood atopy by questionnaire. Clin Exp Allergy 2015; 45:835-7. [PMID: 25678339 DOI: 10.1111/cea.12510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E Simons
- Clinical Epidemiology and Health Services Research, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
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Schoos AMM, Chawes BLK, Følsgaard NV, Samandari N, Bønnelykke K, Bisgaard H. Disagreement between skin prick test and specific IgE in young children. Allergy 2015; 70:41-8. [PMID: 25224528 DOI: 10.1111/all.12523] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Skin prick test (SPT) and measurement of serum-specific IgE (sIgE) level are important tools for the clinician to diagnose allergic sensitization. However, little is known about the agreement between the two methods in young children. METHODS SPT and sIgE levels were assessed simultaneously for 16 common inhalant and food allergens at age ½, 1½, 4, and 6 years in 389 children from the Copenhagen Prospective Study on Asthma in Childhood2000 (COPSAC2000 ) at-risk birth cohort. Agreement between the two methods for diagnosing inhalant and food allergic sensitization at the four age points was analyzed using kappa statistics. RESULTS The prevalence of inhalant allergen sensitization increased during childhood diagnosed by both sIgE levels (0.6% to 4.2% to 18.1% to 24.8%, P < 0.0001) and SPT results (1.5% to 3.8% to 8.4% to 15.4%, P < 0.0001). In contrast, the prevalence of food sensitization increased during childhood when diagnosed from sIgE (7.8% to 12.1% to 15.0% to 18.9%, P < 0.0001), but decreased when diagnosed from SPT (5.3% to 5.1% to 3.7% to 3.0%, P = 0.05). Overall, the agreement between SPT and sIgE levels was poor to moderate (all κ-coefficients ≤ 0.60) and decreased from moderate to slight for food allergens by increasing age (κ-coefficients: 0.46 to 0.31 to 0.16 to 0.14). CONCLUSION There is a substantial disagreement between SPT and sIgE for diagnosing allergic sensitization in young children, which increases with age for food sensitization. Choice of assessment method therefore has major impact on results with wide implications for both clinical practice and research.
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Affiliation(s)
- A.-M. M. Schoos
- Copenhagen Prospective Studies on Asthma in Childhood; Faculty of Health and Medical Sciences; University of Copenhagen & Danish Pediatric Asthma Center; Gentofte Hospital, University of Copenhagen; Copenhagen Denmark
| | - B. L. K. Chawes
- Copenhagen Prospective Studies on Asthma in Childhood; Faculty of Health and Medical Sciences; University of Copenhagen & Danish Pediatric Asthma Center; Gentofte Hospital, University of Copenhagen; Copenhagen Denmark
| | - N. V. Følsgaard
- Copenhagen Prospective Studies on Asthma in Childhood; Faculty of Health and Medical Sciences; University of Copenhagen & Danish Pediatric Asthma Center; Gentofte Hospital, University of Copenhagen; Copenhagen Denmark
| | - N. Samandari
- Copenhagen Prospective Studies on Asthma in Childhood; Faculty of Health and Medical Sciences; University of Copenhagen & Danish Pediatric Asthma Center; Gentofte Hospital, University of Copenhagen; Copenhagen Denmark
| | - K. Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood; Faculty of Health and Medical Sciences; University of Copenhagen & Danish Pediatric Asthma Center; Gentofte Hospital, University of Copenhagen; Copenhagen Denmark
| | - H. Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood; Faculty of Health and Medical Sciences; University of Copenhagen & Danish Pediatric Asthma Center; Gentofte Hospital, University of Copenhagen; Copenhagen Denmark
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Codispoti CD, LeMasters GK, Levin L, Reponen T, Ryan PH, Biagini Myers JM, Villareal M, Burkle J, Evans S, Lockey JE, Khurana Hershey GK, Bernstein DI. Traffic pollution is associated with early childhood aeroallergen sensitization. Ann Allergy Asthma Immunol 2014; 114:126-33. [PMID: 25499550 DOI: 10.1016/j.anai.2014.10.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 10/08/2014] [Accepted: 10/28/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND No large, prospective, epidemiologic study has investigated the association between diesel exhaust particle (DEP) exposure and early aeroallergen sensitization and allergic rhinitis (AR) at 4 years of age. OBJECTIVE To determine how exposure to traffic exhaust during infancy is associated with aeroallergen sensitization and AR at 4 years of age and the predictive utility of the wheal area at 1 to 3 years of age on AR at 4 years of age. METHODS Infants born to aeroallergen sensitized parents were evaluated annually with skin prick tests to 15 aeroallergens with measurement of wheal areas. At 4 years of age, AR was defined as at least one positive aeroallergen skin prick test result and the presence of sneezing and a runny nose without a cold or flu. Infant (DEP) exposure was estimated using data from 27 air sampling monitors and a land use regression model. RESULTS Complete data were available for 634 children at 4 years of age. Prevalence of AR increased annually from 6.9% to 21.9%. A positive trend was observed for high DEP exposure and aeroallergen sensitization at 2 and 3 years of age (odds ratio, 1.40; 95% confidence interval, 0.97-2.0) and (odds ratio, 1.35; 95% confidence interval, 0.98-1.85) but not with AR. At 2 years of age, every 1-mm(2) increase in the wheal area of timothy and Alternaria significantly increased the odds of AR at 4 years of age. At 3 years of age, every 1-mm(2) increase in the wheal area of fescue, dog, and Penicillium significantly increased the odds of AR at 4 years of age. CONCLUSION DEP exposure enhances the risk of early aeroallergen sensitization. Aeroallergen wheal area at 2 and 3 years of age is associated with AR at 4 years of age.
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Affiliation(s)
- Christopher D Codispoti
- Department of Internal Medicine, Division of Immunology/Allergy, University of Cincinnati, Cincinnati, Ohio; Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio; Division of Immunology, Microbiology, and Allergy, Rush University Medical Center, Chicago, Illinois.
| | - Grace K LeMasters
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Linda Levin
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Tiina Reponen
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Patrick H Ryan
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jocelyn M Biagini Myers
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Manuel Villareal
- Department of Internal Medicine, Division of Immunology/Allergy, University of Cincinnati, Cincinnati, Ohio
| | - Jeff Burkle
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Sherry Evans
- Department of Internal Medicine, Division of Immunology/Allergy, University of Cincinnati, Cincinnati, Ohio
| | - James E Lockey
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | | | - David I Bernstein
- Department of Internal Medicine, Division of Immunology/Allergy, University of Cincinnati, Cincinnati, Ohio
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Cibella F, Ferrante G, Cuttitta G, Bucchieri S, Melis MR, La Grutta S, Viegi G. The burden of rhinitis and rhinoconjunctivitis in adolescents. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2014; 7:44-50. [PMID: 25553262 PMCID: PMC4274469 DOI: 10.4168/aair.2015.7.1.44] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/11/2014] [Accepted: 04/16/2014] [Indexed: 12/18/2022]
Abstract
Purpose Rhinitis and conjunctivitis are common diseases worldwide that are frequently associated. Nevertheless, the risk factors for rhinoconjunctivitis are not well-described and the impact of conjunctivitis on rhinitis and asthma in children remains unknown. This study explored the different risk factors and evaluated the burden of rhinoconjunctivitis among adolescents. Methods This was a cross-sectional study conducted on a random sample of schoolchildren, aged 10-17 years, using skin prick tests and a self-administered questionnaire on respiratory health investigating the impact of rhinitis and rhinoconjunctivitis on daily activities. Results A complete evaluation was obtained for 2,150 children. The prevalence of rhinitis alone was 18.2% and rhinitis associated with conjunctivitis was 20.5%. Rhinoconjunctivitis was more frequently associated with females, a parental history of atopy, domestic exposure to mold/dampness, passive smoke exposure, and reported truck traffic in residential streets. Moreover, rhinoconjunctivitis was associated with a higher level of allergic sensitization. The prevalence of current asthma was 1.7% in subjects without rhinitis or rhinoconjunctivitis, 5.1% in rhinitis and 10.7% in rhinoconjunctivitis. In a logistic model, rhinoconjunctivitis yielded a 2-fold risk for current asthma with respect to rhinitis. Subjects with rhinoconjunctivitis had poorer quality of life (QoL); there was an impact on daily activities in 4.6% of rhinitis and 10.7% of rhinoconjunctivitis. Conclusions Ocular symptoms increase the role of rhinitis as a risk factor for asthma and its impact on daily activities in children.
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Affiliation(s)
- Fabio Cibella
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giuliana Ferrante
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giuseppina Cuttitta
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Salvatore Bucchieri
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Mario R Melis
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Stefania La Grutta
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giovanni Viegi
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
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Garbutt JM, Sterkel R, Mullen KB, Conlon B, Leege E, Bloomberg G, Strunk RC. Using parental perceptions of childhood allergic rhinitis to inform primary care management. Clin Pediatr (Phila) 2014; 53:758-63. [PMID: 24803628 PMCID: PMC4222999 DOI: 10.1177/0009922814533590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe parents' experience with their child's allergic rhinitis (AR) to inform management by the primary care provider (PCP). STUDY DESIGN Two hundred parents with a child 7 to 15 years old with AR symptoms within the past 12 months completed a paper survey. RESULTS The child's AR was identified as a significant problem in spring (89.3%), fall (63.4%), summer (50.3%), and winter (21.4%); 51.3% had persistent disease. AR symptoms most commonly interfered with the child's outdoor activities and sleeping, and frequently bothered the parent and other family members. Most parents (88.3%) wanted to know what their child was allergic to and had many concerns about treatment options. A total of 62.9% had sought AR care from the PCP in the past 12 months. CONCLUSIONS Many families experience significant morbidity from their child's AR and turn to their PCP for help. We identified opportunities for the PCP to reduce AR morbidity.
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Affiliation(s)
- Jane M. Garbutt
- Department of Pediatrics, Washington University St Louis, St. Louis, MO,Department of Medicine, Washington University St Louis, St. Louis, MO
| | - Randall Sterkel
- Department of Pediatrics, Washington University St Louis, St. Louis, MO,St Louis Children’s Hospital, St. Louis, MO
| | - Kathy B. Mullen
- Department of Pediatrics, Washington University St Louis, St. Louis, MO
| | - Bridget Conlon
- Department of Pediatrics, Washington University St Louis, St. Louis, MO
| | - Erin Leege
- Department of Pediatrics, Washington University St Louis, St. Louis, MO
| | - Gordon Bloomberg
- Department of Pediatrics, Washington University St Louis, St. Louis, MO
| | - Robert C. Strunk
- Department of Pediatrics, Washington University St Louis, St. Louis, MO
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Chawes BL, Bønnelykke K, Jensen PF, Schoos AMM, Heickendorff L, Bisgaard H. Cord blood 25(OH)-vitamin D deficiency and childhood asthma, allergy and eczema: the COPSAC2000 birth cohort study. PLoS One 2014; 9:e99856. [PMID: 24925304 PMCID: PMC4055727 DOI: 10.1371/journal.pone.0099856] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 05/19/2014] [Indexed: 01/12/2023] Open
Abstract
Background Epidemiological studies have suggested an association between maternal vitamin D dietary intake during pregnancy and risk of asthma and allergy in the offspring. However, prospective clinical studies on vitamin D measured in cord blood and development of clinical end-points are sparse. Objective To investigate the interdependence of cord blood 25-hydroxyvitamin D (25(OH)-Vitamin D) level and investigator-diagnosed asthma- and allergy-related conditions during preschool-age. Methods Cord blood 25(OH)-Vitamin D level was measured in 257 children from the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2000) at-risk mother-child cohort. Troublesome lung symptoms (TROLS), asthma, respiratory infections, allergic rhinitis, and eczema, at age 0–7 yrs were diagnosed exclusively by the COPSAC pediatricians strictly adhering to predefined algorithms. Objective assessments of lung function and sensitization were performed repeatedly from birth. Results After adjusting for season of birth, deficient cord blood 25(OH)-Vitamin D level (<50 nmol/L) was associated with a 2.7-fold increased risk of recurrent TROLS (HR = 2.65; 95% CI = 1.02–6.86), but showed no association with respiratory infections or asthma. We saw no association between cord blood 25(OH)-Vitamin D level and lung function, sensitization, rhinitis or eczema. The effects were unaffected from adjusting for multiple lifestyle factors. Conclusion Cord blood 25(OH)-Vitamin D deficiency associated with increased risk of recurrent TROLS till age 7 years. Randomized controlled trials of vitamin D supplementation during pregnancy are needed to prove causality.
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Affiliation(s)
- Bo L. Chawes
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark
| | - Pia F. Jensen
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark
| | - Ann-Marie M. Schoos
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark
| | - Lene Heickendorff
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark
- * E-mail:
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Hartwig IRV, Bruenahl CA, Ramisch K, Keil T, Inman M, Arck PC, Pincus M. Reduced levels of maternal progesterone during pregnancy increase the risk for allergic airway diseases in females only. J Mol Med (Berl) 2014; 92:1093-104. [PMID: 24890522 DOI: 10.1007/s00109-014-1167-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 04/25/2014] [Accepted: 05/09/2014] [Indexed: 12/17/2022]
Abstract
Observational as well as experimental studies support that prenatal challenges seemed to be associated with an increased risk for allergic airway diseases in the offspring. However, insights into biomarkers involved in mediating this risk are largely elusive. We here aimed to test the association between endogenous and exogenous factors documented in pregnant women, including psychosocial, endocrine, and life style parameters, and the risk for allergic airway diseases in the children later in life. We further pursued to functionally test identified factors in a mouse model of an allergic airway response. In a prospectively designed pregnancy cohort (n = 409 families), women were recruited between the 4th and 12th week of pregnancy. To investigate an association between exposures during pregnancy and the incidence of allergic airway disease in children between 3 and 5 years of age, multiple logistic regression analyses were applied. Further, in prenatally stressed adult offspring of BALB/c-mated BALB/c female mice, asthma was experimentally induced by ovalbumin (OVA) sensitization. In addition to the prenatal stress challenge, some pregnant females were treated with the progesterone derivative dihydrodydrogesterone (DHD). In humans, we observed that high levels of maternal progesterone in early human pregnancies were associated with a decreased risk for an allergic airway disease (asthma or allergic rhinitis) in daughters (adjusted OR 0.92; 95% confidence interval [CI] 0.84 to 1.00) but not sons (aOR 1.02, 95% CI 0.94-1.10). In mice, prenatal DHD supplementation of stress-challenged dams attenuated prenatal stress-induced airway hyperresponsiveness exclusively in female offspring. Reduced levels of maternal progesterone during pregnancy-which can result from high stress perception-increase the risk for allergic airway diseases in females but not in males. Key messages: Lower maternal progesterone during pregnancy increases the risk for allergic airway disease only in female offspring. Prenatal progesterone supplementation ameliorates airway hyperreactivity in prenatally stressed murine offspring.
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Affiliation(s)
- Isabel R V Hartwig
- Laboratory for Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,
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Hatzler L, Panetta V, Illi S, Hofmaier S, Rohrbach A, Hakimeh D, Bauer CP, Hoffman U, Forster J, Zepp F, Schuster A, Stock P, Wahn U, Keil T, Lau S, Matricardi PM. Parental hay fever reinforces IgE to pollen as pre-clinical biomarker of hay fever in childhood. Pediatr Allergy Immunol 2014; 25:366-73. [PMID: 24953296 DOI: 10.1111/pai.12248] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/30/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND An early IgE response to grass or birch pollen can anticipate seasonal allergic rhinitis to pollen later in life or remain clinically silent. OBJECTIVE To identify risk factors early in life that allow discriminating pathogenic from non-pathogenic IgE responses and contribute to the development of seasonal allergic rhinitis to grass pollen. METHODS The German Multicentre Allergy Study examined a birth cohort born in 1990. A questionnaire was yearly administered and blood samples collected at age 1,2,3,5,6,7,10,13 yr. The definition of the primary outcome grass- and birch-pollen-related seasonal allergic rhinitis (SARg, SARb) was based on nasal symptoms in June/July and April, respectively. Serum IgE antibodies to Phleum pratense and Betula verrucosae extracts were monitored with immune-enzymatic singleplex assays. RESULTS Of the 820 examined children, 177 and 148 developed SARg and SARb, respectively. Among healthy children aged 3 or more years, IgE to grass pollen was the strongest risk factor of SARg (OR 10.39, 95%CI 6.1-17.6, p < 0.001), while parental hay fever was the only risk factor in early childhood independently associated with future SARg (1 parent: OR 2.56, 95%CI 1.4-4.5, p < 0.001; 2 parents: OR 4.17, 95%CI 1.7-10.1) and SARb (1 parent OR: 5.21, 95%CI 2.20-12.4, p < 0.001; 2 parents: OR 8.02, 95%CI 2.0-32.9, p < 0.001). Parental hay fever was associated with an increase of the concentration of pollen-specific IgE in seropositive subjects, after the age of 6 and was also a hallmark of molecularly more complex specific IgE responses to grass or birch pollen at age 6 or older. CONCLUSIONS Parental hay fever and specific IgE to grass and/or birch pollen are strong pre-clinical determinants and potentially good predictors of seasonal allergic rhinitis.
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Affiliation(s)
- Laura Hatzler
- Department of Paediatric Pneumology & Immunology, Charité University Medical Centre, Berlin, Germany
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Moussu L, Saint-Pierre P, Panayotopoulos V, Couderc R, Amat1 F, Just J. Determinants of allergic rhinitis in young children with asthma. PLoS One 2014; 9:e97236. [PMID: 24831804 PMCID: PMC4022721 DOI: 10.1371/journal.pone.0097236] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 04/16/2014] [Indexed: 11/18/2022] Open
Abstract
Background In the preschool period, allergic rhinitis (AR) is infrequent and thus under-diagnosed. However, recent works have highlighted the occurrence of AR in toddlers although the causes of AR in this young population remain unknown. The objective of this study was to identify determinants of AR in young children with asthma. Methods We carried out a case-control study of 227 children with active asthma and enrolled in the Trousseau Asthma Program. AR and other allergic diseases (asthma, food allergy and eczema) were diagnosed by medical doctors using standardized questionnaires. Parental history of AR and asthma, biological markers of atopy (total IgE, blood eosinophilia, allergic sensitization towards food and aeroallergens) and environmental parameters were also collected. Results Forty one of the children (18.1%) had AR. By univariate logistic regression analysis, AR was mainly associated with peanut sensitization (OR = 6.75; p = 0.002); food allergy (OR = 4.31; p = 0.026); mold exposure (OR = 3.81 p<0.01) and parental history of AR (OR = 1.42; p = 0.046). Due to the strong link between food allergy and peanut sensitization three models of multivariate logistic regression were performed and confirmed that AR is associated with peanut sensitization but also food allergy and mold exposure. A random forest analysis was also performed to explain AR. The results reinforced the logistic analysis that peanut sensitization and mold exposure were the principal determinants of AR. Conclusions & Clinical Relevance These results stress the importance of investigating AR in young children with asthma to potentially diagnose a particularly severe allergic asthmatic phenotype. Moreover, these data evoke the hypothesis that peanut could be an aeroallergen.
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Affiliation(s)
- Lise Moussu
- Allergology department, Centre de l′Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (Assistance Publique Hôpitaux de Paris) - Université Pierre et Marie Curie, Paris, France
| | - Philippe Saint-Pierre
- Laboratoire de Statistiques Théoriques et Appliquées, Université Pierre et Marie Curie, Paris, France
| | - Virginie Panayotopoulos
- Allergology department, Centre de l′Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (Assistance Publique Hôpitaux de Paris) - Université Pierre et Marie Curie, Paris, France
| | - Rémy Couderc
- Service de Biochimie et Biologie Moléculaire, Hôpital d'Enfants Armand-Trousseau (Assistance Publique Hôpitaux de Paris), Paris, France
| | | | - Jocelyne Just
- Allergology department, Centre de l′Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (Assistance Publique Hôpitaux de Paris) - Université Pierre et Marie Curie, Paris, France
- * E-mail:
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Dell SD, Jerrett M, Beckerman B, Brook JR, Foty RG, Gilbert NL, Marshall L, Miller JD, To T, Walter SD, Stieb DM. Presence of other allergic disease modifies the effect of early childhood traffic-related air pollution exposure on asthma prevalence. ENVIRONMENT INTERNATIONAL 2014; 65:83-92. [PMID: 24472824 DOI: 10.1016/j.envint.2014.01.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 12/20/2013] [Accepted: 01/01/2014] [Indexed: 05/21/2023]
Abstract
Nitrogen dioxide (NO2), a surrogate measure of traffic-related air pollution (TRAP), has been associated with incident childhood asthma. Timing of exposure and atopic status may be important effect modifiers. We collected cross-sectional data on asthma outcomes from Toronto school children aged 5-9years in 2006. Lifetime home, school and daycare addresses were obtained to derive birth and cumulative NO2 exposures for a nested case-control subset of 1497 children. Presence of other allergic disease (a proxy for atopy) was defined as self-report of one or more of doctor-diagnosed rhinitis, eczema, or food allergy. Generalized estimating equations were used to adjust for potential confounders, and examine hypothesized effect modifiers while accounting for clustering by school. In children with other allergic disease, birth, cumulative and 2006 NO2 were associated with lifetime asthma (OR 1.46, 95% CI 1.08-1.98; 1.37, 95% CI 1.00-1.86; and 1.60, 95% CI 1.09-2.36 respectively per interquartile range increase) and wheeze (OR 1.44, 95% CI 1.10-1.89; 1.31, 95% CI 1.02-1.67; and 1.60, 95% CI 1.16-2.21). No or weaker effects were seen in those without allergic disease, and effect modification was amplified when a more restrictive algorithm was used to define other allergic disease (at least 2 of doctor diagnosed allergic rhinitis, eczema or food allergy). The effects of modest NO2 levels on childhood asthma were modified by the presence of other allergic disease, suggesting a probable role for allergic sensitization in the pathogenesis of TRAP initiated asthma.
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Affiliation(s)
- Sharon D Dell
- The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada; Department of Pediatrics, University of Toronto, Canada.
| | - Michael Jerrett
- University of California, Berkeley, 50 University Hall MC7360, Mail Drop Suite 710, Geographic Information Health and Exposure Science Laboratory (GIS HEAL), School of Public Health, Berkeley, CA 94720-7360, USA.
| | - Bernard Beckerman
- University of California, Berkeley, 50 University Hall MC7360, Mail Drop Suite 710, Geographic Information Health and Exposure Science Laboratory (GIS HEAL), School of Public Health, Berkeley, CA 94720-7360, USA.
| | - Jeffrey R Brook
- Environment Canada, Air Quality Research Division, 4905 Dufferin St., Toronto, ON M3H 5T4, Canada; Dalla Lana School of Public Health, University of Toronto, Canada.
| | - Richard G Foty
- The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
| | - Nicolas L Gilbert
- Public Health Agency of Canada, Maternal and Infant Health Section, 200 Églantine Dr., 1910C, Ottawa, ON K1A 0K9, Canada.
| | - Laura Marshall
- The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
| | - J David Miller
- Carleton University, Department of Chemistry, College of Natural Sciences, 228 Steacie Building, Ottawa, ON K1S 5B6, Canada.
| | - Teresa To
- The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada; Dalla Lana School of Public Health, University of Toronto, Canada.
| | - Stephen D Walter
- Department of Clinical Epidemiology and Biostatistics, McMaster University, CRL, Room 233, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
| | - David M Stieb
- Health Canada, Population Studies Division, 445-757 West Hastings Street, Federal Tower, Vancouver, BC V6C 1A1, Canada.
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Topal E, Bakirtas A, Yılmaz O, Karagöl IHE, Arslan U, Arga M, Demirsoy MS, Turktas I. Predictive factors to differentiate between allergic and nonallergic rhinitis in children. Int Forum Allergy Rhinol 2014; 4:447-52. [PMID: 24574308 DOI: 10.1002/alr.21312] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/28/2014] [Accepted: 01/29/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although symptoms and signs of allergic rhinitis (AR) and nonallergic rhinitis (NAR) are similar, treatment and follow-up are different. We aimed to find predictive factors that can be used in primary health care to differentiate AR from NAR. METHODS We made a retrospective analysis of cases aged 6-18 years old who were diagnosed as having chronic rhinitis within a 1-year period. Skin-prick tests were done and severity of rhinitis symptoms was recorded on a visual analog scale in all patients. RESULTS There were 472 cases whose medical records were complete and included in the analysis. The median age was 11 (interquartile range [IQR], 5) years. AR was diagnosed in 363 patients (76.9%) and was different from NAR with respect to: median age (p = 0.042), seasonality of the symptoms (p = 0.002), persistent symptoms (p = 0.003), moderate/severe according to visual analogue scale (VAS) score (p = 0.017), conjunctivitis (p < 0.001), parental history of AR (p = 0.026), rhinorrhea (p < 0.001), sneezing (p = 0.005), mucosal pallor (p = 0.004), and response to antihistamines (p = 0.035). All parameters with a significance of p < 0.1 between AR and NAR were included in logistic regression analysis. Seasonality, sneezing, moderate/severe rhinitis, and response to antihistamines were identified as significant independent parameters to differentiate AR from NAR. CONCLUSION Features of rhinitis patients with seasonality, sneezing, moderate/severe rhinitis, and response to antihistamines may help in differentiation of AR from NAR at the primary care level.
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Affiliation(s)
- Erdem Topal
- Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey
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El-Zein M, Parent ME, Siemiatycki J, Rousseau MC. History of allergic diseases and lung cancer risk. Ann Allergy Asthma Immunol 2014; 112:230-6. [PMID: 24439421 DOI: 10.1016/j.anai.2013.12.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 12/02/2013] [Accepted: 12/22/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND The exact nature and direction of the association between a history of allergic diseases and lung cancer risk remain controversial. OBJECTIVE To examine the association between self-reported history of allergic diseases and lung cancer using data from a population-based case-control study conducted in the Montreal metropolitan area (1996-2002). METHODS The study is based on interview data collected from 1,169 incident lung cancer cases and 1,486 controls. Separate logistic regression models were used to estimate the relative risk of lung cancer, using odds ratios (ORs) and 95% confidence intervals (CIs), in subjects with vs without asthma, eczema, or hay fever after adjustment for several sociodemographic and lifestyle factors, including smoking. RESULTS For asthma, the OR was 0.90 (95% CI 0.65-1.24), which decreased to 0.76 (95% CI 0.54-1.08) for subjects whose onset was more than 2 years before lung cancer diagnosis or interview and then to 0.64 (95% CI 0.44-0.93) when restricted to subjects who reported using medication for their asthma. For eczema, the point estimate was 0.73 (95% CI 0.48-1.12), which decreased to 0.63 (95% CI 0.38-1.07) when considering eczema only in those who reported medication use. Hay fever showed the strongest inverse association with lung cancer (OR 0.37, 95% CI 0.24-0.59). CONCLUSION All 3 allergic diseases examined were inversely associated with lung cancer, although the strength of the protective effect varied. History of allergic diseases seems to have a protective role in lung cancer incidence, after consideration of potential confounders, including lifetime smoking history.
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Affiliation(s)
- Mariam El-Zein
- INRS-Institut Armand-Frappier, Université du Québec, Laval, Quebec, Canada
| | - Marie-Elise Parent
- INRS-Institut Armand-Frappier, Université du Québec, Laval, Quebec, Canada; Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Jack Siemiatycki
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Marie-Claude Rousseau
- INRS-Institut Armand-Frappier, Université du Québec, Laval, Quebec, Canada; Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
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45
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Maternal intake of vitamins A, E and K in pregnancy and child allergic disease: a longitudinal study from the Danish National Birth Cohort. Br J Nutr 2013; 111:1096-108. [PMID: 24229579 DOI: 10.1017/s0007114513003395] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fat-soluble vitamins A, E and K have been shown to play roles in immunity and inflammation, but studies on child allergic disease have been few and inconsistent. The aim of the present study was to examine the relationship between maternal intake of vitamins A, E and K in mid-pregnancy and child asthma and allergic rhinitis. We used data on 44 594 mother-child pairs from the Danish National Birth Cohort. Maternal intake of fat-soluble vitamins was calculated based on the information from a validated FFQ completed in mid-pregnancy. At 18 months, interviews with the mothers were conducted to evaluate doctor-diagnosed child asthma. At age 7 years, we assessed child asthma and allergic rhinitis using questions from the International Study of Asthma and Allergies in Childhood questionnaire and by national registries on hospital contacts and medication use. Current asthma was defined as asthma diagnosis and wheeze in the past 12 months by maternal report. We calculated multivariable risk ratios and 95 % CI by comparing the highest v. lowest quintile (Q) of maternal vitamin A, E and K intake in relation to child allergic disease outcomes. Maternal total vitamin K intake was directly associated with ever admitted asthma (Q5 v. Q1: 1·23, 95 % CI 1·01, 1·50) and current asthma at 7 years (Q5 v. Q1: 1·30, 95 % CI 0·99, 1·70). Weak inverse associations were present for maternal vitamin A and E intake during pregnancy with child allergic rhinitis. Maternal vitamin K intake during pregnancy may increase the risk of child asthma, and should be explored further on a mechanistic level. Conversely, maternal vitamin A and E intake may protect against child allergic rhinitis.
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Morais-Almeida M, Santos N, Pereira AM, Branco-Ferreira M, Nunes C, Bousquet J, Fonseca JA. Prevalence and classification of rhinitis in preschool children in Portugal: a nationwide study. Allergy 2013; 68:1278-88. [PMID: 24053488 DOI: 10.1111/all.12221] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 01/20/2023]
Abstract
BACKGROUND Information on rhinitis epidemiology in preschool children is scarce. OBJECTIVES To estimate, in children with 3-5 years of age, current rhinitis prevalence, to describe rhinitis symptoms and associated sociodemographic characteristics, and to report allergic rhinitis and its impact on asthma (ARIA) classification. METHODS Cross-sectional, nationwide, population-based study including children aged 3-5 years. A multistep selection strategy was used to obtain a representative sample. Data were collected at kindergartens and parish centers by face-to-face interview to caregivers, using an adapted ISAAC questionnaire. 'Current rhinitis' (CR) was defined as the presence of ≥1 rhinitis symptom (repeated sneezing and/or itchy nose, blocked nose for >1 h, or runny nose without having a cold/flu) in the last year. Rhinitis lasting ≥4 days/week and ≥4 consecutive weeks was classified as persistent. Moderate-severe disease interfered 'a moderate amount' or 'a lot' in daily activities. RESULTS Five thousand and eighteen children were included. CR prevalence was 43.4% [95% CI (42.0-44.8%); n = 2179] and that of physician-diagnosed rhinitis was 11.7% [95% CI (10.8-12.6%); n = 588]. Of children with CR, 67% reported blocked nose, 48% rhinorrhea, and 46% sneezing/itchy nose. Considering ARIA classification, 30% of the population had mild intermittent, 3% mild persistent, 7% moderate-severe intermittent, and 3% moderate-severe persistent rhinitis. Children with CR had more current wheezing, physician-diagnosed asthma, self-reported food allergy, and family history of allergic disease. These characteristics were also associated with persistent and moderate-severe rhinitis. CONCLUSIONS This is the first nationwide population-based study reporting rhinitis prevalence and ARIA classification in preschool children. In this age-group, rhinitis is frequent and underdiagnosed. About 25% children with rhinitis presented moderate-severe disease.
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Affiliation(s)
| | | | | | | | | | - J. Bousquet
- Department of Allergy and Respiratory Diseases; University Hospital and INSERM; Montpellier; France
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Jones M, Jeal H, Harris JM, Smith JD, Rose ML, Taylor AN, Cullinan P. Association of maternal anti-HLA class II antibodies with protection from allergy in offspring. Allergy 2013; 68:1143-9. [PMID: 23991716 DOI: 10.1111/all.12213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND Recent studies have suggested that the birth order effect in allergy may be established during the prenatal period and that the protective effect may originate in the mother. HLA class II disparity between mother and foetus has been associated with significantly increased Th1 production. In this study, we investigated whether production of HLA antibodies 4 years after pregnancy with index child is associated with allergic outcomes in offspring at 8 years. METHODS Anti-HLA class I and II antibodies were measured in maternal serum (n = 284) and levels correlated to numbers of pregnancies and birth order, and allergic outcomes in offspring at 8 years of age. RESULTS Maternal anti-HLA class I and II antibodies were significantly higher when birth order, and the number of pregnancies were larger. Anti-HLA class II, but not class I antibodies were associated with significantly less atopy and seasonal rhinitis in the offspring at age 8 years. Mothers with nonatopic (but not atopic) offspring had a significant increase in anti-HLA class I and II antibodies with birth order. CONCLUSION This study suggests that the 'birth order' effect in children may be due to parity-related changes in the maternal immune response to foetal antigens. We have observed for the first time an association between maternal anti-HLA class II antibodies and protection from allergy in the offspring. Further work is required to determine immunologically how HLA disparity between mother and father can protect against allergy.
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Affiliation(s)
- M. Jones
- Department of Occupational and Environmental Medicine; Imperial College; London; UK
| | - H. Jeal
- Department of Occupational and Environmental Medicine; Imperial College; London; UK
| | - J. M. Harris
- Department of Occupational and Environmental Medicine; Imperial College; London; UK
| | - J. D. Smith
- Transplant Immunology Group; Royal Brompton and Harefield Foundation NHS Trust; Harefield; London; UK
| | - M. L. Rose
- Transplant Immunology Group; Royal Brompton and Harefield Foundation NHS Trust; Harefield; London; UK
| | - A. N. Taylor
- Department of Occupational and Environmental Medicine; Imperial College; London; UK
| | - P. Cullinan
- Department of Occupational and Environmental Medicine; Imperial College; London; UK
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Yoshida K, Adachi Y, Akashi M, Itazawa T, Murakami Y, Odajima H, Ohya Y, Akasawa A. Cedar and cypress pollen counts are associated with the prevalence of allergic diseases in Japanese schoolchildren. Allergy 2013; 68:757-63. [PMID: 23621581 DOI: 10.1111/all.12164] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Patients allergic to pollen have been known to become more symptomatic during pollen season compared with the nonpollen season. However, there are few studies regarding whether higher exposure to pollen might increase the prevalence of allergic diseases. METHODS An ecological analysis was conducted to evaluate whether pollen exposure is associated with the prevalence of allergic diseases in schoolchildren. Pollen count data of Japanese cedar (Cryptomeria japonica) and Japanese cypress (Chamaecyparis obtusa), which are the major pollen allergens in Japan, were obtained from each prefecture. The prevalence of allergic diseases in schoolchildren in each prefecture was based on a nationwide cross-sectional survey using the International Study of Asthma and Allergies in Childhood questionnaire. RESULTS After omitting three prefectures where pollen data were not available, data of 44 prefectures were analysed. The prevalence of allergic rhinoconjunctivitis in children aged 6-7 years was positively associated with both cedar and cypress pollen counts (P = 0.01, both), whereas the prevalence of allergic rhinoconjunctivitis in children aged 13-14 years was positively associated with only cypress pollen counts (P = 0.003). Furthermore, the prevalence of asthma was positively associated with cedar pollen counts in 6- to 7-year-old children (P = 0.003) but not cypress pollen counts in either age group. CONCLUSIONS There are ecological associations between pollen counts and the prevalence of allergic diseases in Japanese schoolchildren. Further studies are needed to determine whether the difference between the effects of cedar and cypress pollens is attributable to pollen counts or allergenicity.
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Affiliation(s)
- K. Yoshida
- Division of Allergy; Tokyo Metropolitan Children's Medical Center; Tokyo; Japan
| | - Y. Adachi
- Department of Pediatrics; University of Toyama; Toyama; Japan
| | - M. Akashi
- Department of Pediatrics; Saitama City Hospital; Saitama; Japan
| | - T. Itazawa
- Department of Pediatrics; University of Toyama; Toyama; Japan
| | - Y. Murakami
- Department of Pediatrics; Fukuoka National Hospital; Fukuoka; Japan
| | - H. Odajima
- Department of Pediatrics; Fukuoka National Hospital; Fukuoka; Japan
| | - Y. Ohya
- Division of Allergy; National Center for Child Health and Development; Tokyo; Japan
| | - A. Akasawa
- Division of Allergy; Tokyo Metropolitan Children's Medical Center; Tokyo; Japan
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Følsgaard NV, Chawes BLK, Bønnelykke K, Jenmalm MC, Bisgaard H. Cord blood Th2-related chemokine CCL22 levels associate with elevated total-IgE during preschool age. Clin Exp Allergy 2013; 42:1596-603. [PMID: 23106659 DOI: 10.1111/j.1365-2222.2012.04048.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Early-life immune deviation is suspected in the inception of atopic disease. OBJECTIVE To investigate the association between cord blood chemokines and the subsequent development of atopic biomarkers and clinical end-points during the first 6 years of life. METHODS The Th1-associated chemokines CXCL10 and CXCL11 and the Th2-associated chemokines CCL17 and CCL22 were assessed in cord blood of asymptomatic at-risk newborn children from the Copenhagen Prospective Study on Asthma in Childhood (COPSAC(2000) ) birth cohort and associated with the longitudinal development of biomarkers and clinical end-points of asthma, eczema, and allergic rhinitis during the first 6 years of life. RESULTS Cord blood CCL22 levels were significantly associated to total-IgE levels measured at four time-points during the first 6 years of life; overall odds ratio, 1.54 [CI, 1.25-1.89; P < 0.0001]. CXCL10 and CXCL11 were not associated with development of any atopic disorders or biomarkers. CONCLUSION AND CLINICAL RELEVANCE High cord blood levels of the Th2 related chemokine CCL22 were significantly associated with high total- IgE levels during the first 6 years of life, but not with specific sensitization, asthma, eczema or allergic rhinitis. This suggests an inborn skewing of the immune system in healthy newborns developing elevated total- IgE later in life.
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Affiliation(s)
- N V Følsgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital, Gentofte, Denmark
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50
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Williams DC, Edney G, Maiden B, Smith PK. Recognition of allergic conjunctivitis in patients with allergic rhinitis. World Allergy Organ J 2013; 6:4. [PMID: 23663473 PMCID: PMC3646537 DOI: 10.1186/1939-4551-6-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 01/23/2013] [Indexed: 11/10/2022] Open
Abstract
AIMS To identify the incidence of allergic conjunctivitis in patients with allergic rhinitis. METHODS One hundred and eighty seven consecutive patients with allergic rhinitis (AR) were directly questioned if they have allergic conjunctivitis (AC) and this was clarified using standard screening questions relating to red, itchy and watery eyes recorded through a total ocular symptom score (TOSS). Patients were also asked about further symptoms that may be attributable to AC: eyelid dermatitis, frequent blinking; eye sensitivity and frontal headache from squinting or. blinking. All patients were given a drop of olopatadine hydrochloride 0.1% in each eye to help identify "silent" disease. 20 healthy non-atopic controls were also treated with olopatadine drops and questioned on ocular symptoms. RESULTS Fifty five percent of patients with AR were identified as having AC by direct questioning and the use of the TOSS questionaire. A further 41% were identifiable by asking additional questions and performing therapeutic challenge with olopadatine. CONCLUSIONS AC is a frequent comorbid condition occurring in 95% of our patients with AR. Only 55% of patients were able to identify that they had AC based on standard screening questions. Additional specific questioning and a therapeutic challenge in suspected patients can help identify patients who may benefit from treatment of AC.
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Affiliation(s)
- Daniel C Williams
- Department, Institute, School of Medicine Gold Coast Campus, Griffith University, 16 High Street, Gold Coast 4222, Australia
| | - Gabrielle Edney
- Department, Institute, School of Medicine Gold Coast Campus, Griffith University, 16 High Street, Gold Coast 4222, Australia
| | - Bianca Maiden
- Department, Institute, School of Medicine Gold Coast Campus, Griffith University, 16 High Street, Gold Coast 4222, Australia
| | - Peter K Smith
- Department, Institute, School of Medicine Gold Coast Campus, Griffith University, 16 High Street, Gold Coast 4222, Australia
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