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Bisoffi L, Sassudelli G, Agostinis F, Cogo A, Cutrera R, Dalpiaz I, Di Cicco ME, Guidi B, Grutta SL, Miceli A, Mori F, Piacentini G, Peroni D, Snjiders D, Giovannini M, Baldo E. Pediatric asthma and altitude: a complex interplay between different environmental factors. Ital J Pediatr 2024; 50:42. [PMID: 38448980 PMCID: PMC10918861 DOI: 10.1186/s13052-023-01492-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/09/2023] [Indexed: 03/08/2024] Open
Abstract
Asthma is one of the most common non-communicable diseases, and its prevalence and morbidity are influenced by a wide array of factors that are only partially understood. In addition to individual predisposition linked to genetic background and early life infections, environmental factors are crucial in determining the impact of asthma both on an individual patient and on a population level.Several studies have examined the role of the environment where asthmatic subjects live in the pathogenesis of asthma. This review aims to investigate the differences in the prevalence and characteristics of asthma between the pediatric population residing at higher altitudes and children living at lower altitudes, trying to define factors that potentially determine such differences. For this purpose, we reviewed articles from the literature concerning observational studies assessing the prevalence of pediatric asthma in these populations and its characteristics, such as spirometric and laboratory parameters and associated sensitization to aeroallergens.Despite the heterogeneity of the environments examined, the hypothesis of a beneficial effect of residing at a higher altitude on the prevalence of pediatric asthma could be confirmed, as well as a good profile on airway inflammation in asthmatic children. However, the possibility of a higher hospitalization risk for asthma in children living at higher altitudes was demonstrated. Moreover, a positive association between residing at a higher altitude and sensitization to pollens and between lower altitude and sensitization to house dust mites could be confirmed in some pediatric patients, even if the results are not homogeneous, probably due to the different geographical and climatic regions considered. Nonetheless, further studies, e.g., extensive and international works, need to be conducted to better understand the complex interplay between different environmental factors, such as altitude, and the pathogenesis of asthma and how its prevalence and characteristics could vary due to climate change.
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Affiliation(s)
- Laura Bisoffi
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | | | - Annalisa Cogo
- Center for Exercise and Sport Science, University of Ferrara, Ferrara, Italy
- Institute Pio XII, Misurina, Italy
| | - Renato Cutrera
- Pediatric Pulmonology Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Irene Dalpiaz
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Maria Elisa Di Cicco
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Battista Guidi
- Hospital and Territorial Pediatrics Unit, Pavullo Hospital, Pavullo nel Frignano, Italy
| | - Stefania La Grutta
- National Research Council, Institute of Translational Pharmacology (IFT), Palermo, Italy
| | - Andrea Miceli
- Hospital and Territorial Pediatrics Unit, Pavullo Hospital, Pavullo nel Frignano, Italy
| | - Francesca Mori
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | | | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Deborah Snjiders
- Department of Woman and Child Health (SDB), University of Padova, Padua, Italy
| | - Mattia Giovannini
- Department of Health Sciences, University of Florence, Florence, Italy.
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy.
| | - Ermanno Baldo
- "Giovan Battista Mattei" Research Institute, Stenico, Italy
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