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Hedman L, Andersson M, Bjerg A, Backman H, Klinteberg MA, Winberg A, Rönmark E. Is asthma in children still increasing? 20-year prevalence trends in northern Sweden. Pediatr Allergy Immunol 2024; 35:e14120. [PMID: 38556800 DOI: 10.1111/pai.14120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND In the present study, we describe prevalence trends of asthma and investigate the association with asthma symptoms, use of asthma medication, and asthma severity among 8-year-old children in Norrbotten, Sweden in 1996, 2006, and 2017. METHODS Within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, three pediatric cohorts were recruited in 1996, 2006, and 2017 respectively. Identical methods were used; all children in first and second grade (median age 8 years) in three municipalities were invited to a parental questionnaire survey, completed by n = 3430 in 1996 (97% participation), n = 2585 in 2006 (96%), and n = 2785 in 2017 (91%). The questionnaire included questions about respiratory symptoms and diagnosis, treatment, and severity of asthma. RESULTS The prevalence of wheezing was stable during the study, 10.1% in 1996; 10.8% in 2006; and 10.3% in 2017, p = .621, while physician-diagnosed asthma increased: 5.7%, 7.4%, and 12.2%, p < .001. The use of asthma medication in the last 12 months increased: 7.1%, 8.7%, and 11.5%, p < .001. Among children diagnosed with asthma, the prevalence of asthma symptoms, the impact on daily life, and severe asthma decreased, while the use of inhaled corticosteroids increased from 1996 until 2017. CONCLUSION The prevalence of wheezing was stable among 8-year-old in this area from 1996 to 2017, while the prevalence of physician-diagnosed asthma doubled but without an increase in asthma morbidity. The increase of physician-diagnosed asthma without a coincident increase in asthma morbidity can partly be explained by more and earlier diagnosis among those with mild asthma.
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Affiliation(s)
- Linnea Hedman
- Department of Public Health and Clinical Medicine, The OLIN unit, Umeå University, Umeå, Sweden
| | - Martin Andersson
- Department of Public Health and Clinical Medicine, The OLIN unit, Umeå University, Umeå, Sweden
| | - Anders Bjerg
- The OLIN studies, Norrbotten County Council, Luleå, Sweden
| | - Helena Backman
- Department of Public Health and Clinical Medicine, The OLIN unit, Umeå University, Umeå, Sweden
| | - Maja Af Klinteberg
- Department of Public Health and Clinical Medicine, The OLIN unit, Umeå University, Umeå, Sweden
| | - Anna Winberg
- Department of Clinical Sciences, Section of Pediatrics, Umeå University, Umeå, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, The OLIN unit, Umeå University, Umeå, Sweden
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Almqvist L, Andersson M, Backman H, Rönmark E, Hedman L. No remission in 60% of those with childhood-onset asthma - A population-based cohort followed from 8 to 28 years of age. Respir Med 2024; 224:107581. [PMID: 38417585 DOI: 10.1016/j.rmed.2024.107581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/14/2024] [Accepted: 02/25/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Although remission occur, childhood-onset asthma may persist until adulthood. Since few longitudinal population-based studies have followed a cohort from childhood until adulthood, the knowledge on predictors of persistence of asthma is sparse. AIM To estimate persistence of asthma from 8 to 28 years and its associated factors. METHODS Within the OLIN (Obstructive Lung Disease in Northern Sweden) studies, a cohort was recruited in 1996 (age 8y, n = 3430) and followed annually with questionnaires about asthma and risk factors until 19y. Clinical examinations included skin prick tests (at 8, 12 and 19y) and lung function tests (17 and 19y) whereof a subsample performed bronchial hyperreactivity test. We identified n = 248 with asthma at 8y whereof 170 (69%) participated in a follow-up at 28y (73% of possible to invite). RESULTS Of the 170 participants at 28y, 105 (61.8%) had persistent asthma (women: 49/76, 64.5%; men: 56/94, 59.6%, p = 0.513). Factors collected at recruitment: allergic sensitization (OR7.8, 95%CI 3.0-20.2), severe respiratory infection (OR2.6, 95%CI 1.1-6.3) and higher asthma severity score (OR1.6, 95%CI 1.1-2.4) were associated with asthma at 28y after adjustment for sex, family history of asthma, breastfeeding <3 months and eczema. Replacing allergic sensitization with rhinoconjunctivitis in the model yielded OR3.4 (95%CI 1.5-8.0). Bronchial hyperreactivity at age 17y associated with asthma at 28y (OR9.0, 95%CI 1.7-47.0). CONCLUSIONS Among children with asthma onset by 8y, 62% still had asthma at age 28 years. Persistent asthma was associated with allergic sensitization, rhinoconjunctivitis, severe respiratory infection, a more severe asthma and bronchial hyperreactivity.
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Affiliation(s)
- Linnéa Almqvist
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.
| | - Martin Andersson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Helena Backman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Linnéa Hedman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
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Patel KB, Mims JW, Clinger JD. The Burden of Asthma and Allergic Rhinitis: Epidemiology and Health Care Costs. Otolaryngol Clin North Am 2024; 57:179-189. [PMID: 37833101 DOI: 10.1016/j.otc.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
Allergic rhinitis affects up to 78% of people with asthma, and asthma occurs in 38% of people with allergic rhinitis. Asthma has a prevalence of 8.7% among adults and 6.2% among children and accounts for $50 billion in medical costs and $32 billion in indirect and mortality costs in the United States, respectively. Allergic rhinitis occurs in 5% to 15% of people in the United States. Allergic rhinitis also accounts for a significant health care cost burden, predominantly in terms of indirect costs related to reduced quality of life and presenteeism.
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Affiliation(s)
- Kunjan B Patel
- Department of Otolaryngology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - James W Mims
- Department of Otolaryngology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - John D Clinger
- Department of Otolaryngology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Af Klinteberg M, Winberg A, Andersson M, Rönmark E, Hedman L. Decreasing prevalence of atopic dermatitis in Swedish schoolchildren: three repeated population-based surveys. Br J Dermatol 2024; 190:191-198. [PMID: 37776301 DOI: 10.1093/bjd/ljad370] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND The prevalence of atopic dermatitis (AD) has increased over several decades and now affects about one-fifth of all children in high-income countries (HICs). While the increase continues in lower-income countries, the prevalence of AD might have reached a plateau in HICs. OBJECTIVES To investigate trends in the prevalence of AD and atopic comorbidity in schoolchildren in Sweden. METHODS The study population consisted of three cohorts of children (median age 8 years) in Norrbotten, Sweden, for 1996 (n = 3430), 2006 (n = 2585) and 2017 (n = 2785). An identical questionnaire that included questions from the International Study of Asthma and Allergies in Childhood (ISAAC) protocol was used in all three cohorts. Trends in AD prevalence were estimated, as well as trends in atopic comorbidity. AD prevalence was estimated both according to the ISAAC definition of AD and by adding the reported diagnosis by a physician (D-AD). RESULTS The prevalence of AD decreased in the last decade, from 22.8% (1996) and 21.3% (2006) to 16.3% (2017; P < 0.001). The prevalence of D-AD was lower, but the same pattern of decrease was seen, from 9.3% (1996) and 9.4% (2006) to 5.7% (2017; P < 0.001). In all three cohorts, AD was more common among girls than boys (18.9% vs. 13.8% in 2017; P < 0.001). Children from the mountain inlands had a higher prevalence of AD than children from coastal cities (22.0% vs. 15.1% in 2017; P < 0.001). In comparing D-AD, there were no significant differences between the sexes or between inland or coastal living. Concomitant asthma increased over the years from 12.2% (1996) to 15.8% (2006) to 23.0% (2017; P < 0.001). Concomitant allergic rhinitis and allergic sensitization increased from 1996 (15.0% and 27.5%) to 2006 (24.7% and 49.5%) but then levelled off until 2017 (21.0% and 46.7%). CONCLUSIONS The prevalence of AD among schoolchildren in Sweden decreased over the study period, whereas atopic comorbidity among children with AD increased. Although a decrease was seen, AD is still common and the increase in atopic comorbidity among children with AD, especially the increase in asthma, is concerning.
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Affiliation(s)
- Maja Af Klinteberg
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | - Anna Winberg
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Martin Andersson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Linnea Hedman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
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Hedman L, Strinnholm Å, Jansson SA, Winberg A. Diagnostic intervention improved health-related quality of life among teenagers with food allergy. PLoS One 2024; 19:e0296664. [PMID: 38206952 PMCID: PMC10783743 DOI: 10.1371/journal.pone.0296664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/13/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES The aim was to examine if a diagnostic intervention set up to assess current food allergy to cow's milk, hen's egg, fish, or wheat among teenagers had an impact on generic and disease specific health-related quality of life (HRQL). The study compared HRQL scoring before and two years after the intervention, and in relation to age matched controls without reported food allergy. METHODS The study was performed within the Obstructive Lung Disease in Northern Sweden (OLIN) studies where a cohort study on asthma and allergic diseases among 8-year-old schoolchildren was initiated in 2006. At age 12 years, the 125/2612 (5%) children who reported allergy to cow's milk, hen's egg, fish, or wheat were invited to a diagnostic intervention including clinical examination, blood tests and evaluation by a pediatric allergist. Of 94 participants, 79 completed generic and disease specific HRQL questionnaires. Additionally, a random sample of 200 (62% of invited) children without food allergy from the OLIN cohort answered the generic HRQL questionnaire. The respondents of the HRQL questionnaires were re-examined two years later and 57 teenagers with and 154 without reported allergy participated. RESULTS There were no significant differences in generic HRQL scores between teenagers with and without reported food allergy at study entry, or after the intervention. Among those with reported food allergy, we found a significant improvement in disease specific HRQL after the intervention (mean values: 3.41 vs 2.80, p<0.001). Teenagers with only food allergy had better disease specific HRQL compared to those with one, two or three concomitant allergic diseases, both before and after the intervention. Children with only food allergy significantly improved their HRQL after the intervention, 1.84 vs. 2.87 (p<0.001) but this association was not seen in children with one other allergic disorder (3.16 vs. 3.65, p = 0.121) or those with two or more allergic disorders (3.72 vs. 3.90, p = 0.148). CONCLUSION The diagnostic intervention showed a long-term improvement of disease specific HRQL but not generic HRQL.
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Affiliation(s)
- Linnéa Hedman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Åsa Strinnholm
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Sven-Arne Jansson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Anna Winberg
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
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Rönmark E, Bunne J, Bjerg A, Perzanowski M, Winberg A, Andersson M, Platts-Mills T, Hedman L. Prevalence and risk factors for allergic sensitization: 3 cross-sectional studies among schoolchildren from 1996 to 2017. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2023; 2:100150. [PMID: 37781648 PMCID: PMC10510014 DOI: 10.1016/j.jacig.2023.100150] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 10/03/2023]
Abstract
Background The prevalence of allergic sensitization and allergic diseases has increased for decades in Northern Europe, but recent studies are lacking. Objective We sought to study the prevalence trends of allergic sensitization, associated risk factors, and the association with asthma and allergic rhinitis (AR) among children in Northern Sweden. Methods Three cohorts of children aged 7 to 8 years participated in a skin prick test (SPT) with 10 airborne allergens in 1996, 2006, and 2017, with 2148, 1693, and 1762 participants tested, respectively, representing 87% to 90% of schoolchildren in the catchment communities. Adjusted Poisson regression was used to identify risk factors for allergic sensitization and the association with asthma and AR. Results The prevalence of any positive SPT response increased from 21% in 1996 to 30% in 2006 and remained at 30% in 2017 (P < .001). Sensitization to cat was the most common for all the years. The risk factor pattern for a positive SPT response was similar in all examinations, with positive and significant associations with a family history of allergy (risk ratio, 1.4-1.5) and negative and significant associations with having a cat at home (risk ratio, 0.7-0.8). The prevalence of physician-diagnosed asthma increased, but the association with allergic sensitization weakened. The opposite trends were found for AR-decreasing prevalence and strengthened association with allergic sensitization. Conclusions The prevalence of allergic sensitization increased from 1996 to 2006 but plateaued in the next decade, whereas the risk factor pattern remained stable. The diverging trends of associations between allergic sensitization and asthma and AR suggest secular trends in the clinical management of allergic diseases.
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Affiliation(s)
- Eva Rönmark
- Division of Sustainable Health, Department of Public Health and Clinical Medicine, The OLIN Unit, Umeå University, Umeå
| | - Joakim Bunne
- Division of Sustainable Health, Department of Public Health and Clinical Medicine, The OLIN Unit, Umeå University, Umeå
| | - Anders Bjerg
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm
| | - Matthew Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York
| | - Anna Winberg
- Department of Clinical Sciences, Pediatrics Unit, Umeå University, Umeå
| | - Martin Andersson
- Division of Sustainable Health, Department of Public Health and Clinical Medicine, The OLIN Unit, Umeå University, Umeå
| | - Thomas Platts-Mills
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville
| | - Linnea Hedman
- Division of Sustainable Health, Department of Public Health and Clinical Medicine, The OLIN Unit, Umeå University, Umeå
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Özuygur Ermis SS, Norouzi A, Borres MP, Basna R, Ekerljung L, Malmhäll C, Goksör E, Wennergren G, Rådinger M, Lötvall J, Kankaanranta H, Nwaru BI. Sensitization patterns to cat molecular allergens in subjects with allergic sensitization to cat dander. Clin Transl Allergy 2023; 13:e12294. [PMID: 37632243 PMCID: PMC10422092 DOI: 10.1002/clt2.12294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/21/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The use of molecular allergology has increasingly become common in the diagnosis and management of allergic diseases. However, there is still a lack of data on cat molecular allergens in adults. Therefore, we aimed to uncover the sensitization patterns to cat molecular allergens. METHODS Participants were recruited from the West Asthma Sweden Study, a population-based study enriched with asthma subjects aged 16-75 years. Of 1872, 361 individuals were positive for cat dander immunoglobulin E and were further analysed for cat molecular allergens (Fel d 1/2/4/7). Sensitization patterns were classified as monosensitization, polysensitization, and concomitant sensitization, and were related to demographic and clinical measurements. RESULTS Among cat-sensitized subjects, 84.2% were sensitized to secretoglobin, while 42.4% were sensitized to lipocalins. Nearly half of the subjects were monosensitized to Fel d 1. Polysensitization was observed in 20.2%, and concomitant sensitization to protein families was seen in 7.2%. Asthma prevalence, cat exposure, and rural living were associated with poly- and concomitant sensitization to protein families. Concomitant sensitization to single allergens was more common in those with asthma than in those without, while concomitant sensitization to both Fel d 1 and Fel d 4 was the most common pattern in individuals with asthma. Sensitization patterns also differed according to cat ownership and the degree of urbanization. CONCLUSION Sensitization to molecular allergens was observed in 90.9% of cat-sensitized subjects and showed variations across participants' background characteristics and the presence of asthma. Identification of sensitization patterns to cat allergens might provide better characterization of cat-allergic subjects.
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Affiliation(s)
- Saliha Selin Özuygur Ermis
- Krefting Research CentreInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | | | - Magnus P. Borres
- ImmunoDiagnosticsThermo Fisher ScientificUppsalaSweden
- Department of Maternal and Child HealthUppsala UniversityUppsalaSweden
| | - Rani Basna
- Krefting Research CentreInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Linda Ekerljung
- Krefting Research CentreInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Carina Malmhäll
- Krefting Research CentreInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Emma Goksör
- Department of PediatricsQueen Silvia Children's HospitalUniversity of GothenburgGothenburgSweden
| | - Göran Wennergren
- Department of PediatricsQueen Silvia Children's HospitalUniversity of GothenburgGothenburgSweden
| | - Madeleine Rådinger
- Krefting Research CentreInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Jan Lötvall
- Krefting Research CentreInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Hannu Kankaanranta
- Krefting Research CentreInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Faculty of Medicine and Life SciencesUniversity of TampereTampereFinland
- Department of Respiratory MedicineSeinäjoki Central HospitalSeinäjokiFinland
| | - Bright I. Nwaru
- Krefting Research CentreInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Wallenberg Centre for Molecular and Translational MedicineInstitute of MedicineUniversity of GothenburgGothenburgSweden
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Kakobo PK, Kalala HK, Kelekele JK, Mutombo PB, Nyembue DT, Hellings PW, Kayembe JMN. Determinants of uncontrolled allergic rhinitis in Kinshasa hospitals. FRONTIERS IN ALLERGY 2023; 4:1138537. [PMID: 37034152 PMCID: PMC10073489 DOI: 10.3389/falgy.2023.1138537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/02/2023] [Indexed: 04/11/2023] Open
Abstract
Objective To identify the determinants of uncontrolled allergic rhinitis (UCAR) in a hospital setting in Kinshasa, Democratic Republic of Congo. Methods Hospital-based cross-sectional study of 153 patients with allergic rhinitis (AR). The diagnosis of AR was based on clinical grounds according to the Allergic Rhinitis and its Impact on Asthma (ARIA) criteria. Categorization into controlled AR (CAR) and UCAR was based on the visual analog scale (VAS with cut off point of 5). Binary logistic regression was used to identify factors associated with UCAR. Results Patients with UCAR (60.1%) proportionally outnumbered those with CAR (39.9%). There were significantly more patients younger than 30 years of age among patients with UCAR. Factors significantly associated with UCAR were age below 30 years (OR = 3.31; 95% CI: 1.49-7.36; p = 0.003), low serum vitamin D level (OR = 3.86; 95% CI: 1.72-8.68; p = 0.001), persistent form (OR = 3.11; 95% CI: 1.39-6.98; p = 0.006) and moderate to severe form of AR (OR = 4.31; 95% CI: 1.77-10.49; p = 0.001). Conclusions Factors associated with UCAR in this study population were younger age less than 30 years, low vitamin D level, and persistent as well as moderate to severe AR. Further studies are needed to elucidate the underlying mechanisms favoring the occurrence of these factors.
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Affiliation(s)
- Patricia K. Kakobo
- Department of Otorhinolaryngology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
- Correspondence: Patricia K. Kakobo
| | - Hilaire K. Kalala
- Department of Otorhinolaryngology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Joseph K. Kelekele
- Ophthalmology Department, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Paulin B. Mutombo
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Dieudonné T. Nyembue
- Department of Otorhinolaryngology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Peter W. Hellings
- Department of Otorhinolaryngology-Head and Nose Surgery, University Hospital of Leuven, Leuven, Belgium
- Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
- Upper Airways Research Laboratory, University of Ghent, Ghent, Belgium
| | - Jean-Marie N. Kayembe
- Department of Pneumology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
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9
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Özuygur Ermis SS, Borres MP, Basna R, Ekerljung L, Malmhäll C, Goksör E, Wennergren G, Rådinger M, Lötvall J, Lundbäck B, Kankaanranta H, Nwaru BI. Sensitization to molecular dog allergens in an adult population: Results from the West Sweden Asthma Study. Clin Exp Allergy 2023; 53:88-104. [PMID: 35984703 PMCID: PMC10087160 DOI: 10.1111/cea.14216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/19/2022] [Accepted: 08/15/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND As the prevalence of dog allergy rises, component resolved diagnosis might improve the diagnosis, understanding of the clinical outcomes and the effectiveness of immunotherapy. Considering the paucity of data in adults, the current study characterized the patterns of sensitization to dog molecular allergens in an adult population. METHODS Data were derived from the West Sweden Asthma Study, a population-based and representative sample of adults from western Sweden. Of the 2006 subjects clinically examined, 313 participants sensitized to whole dog allergen extract were measured for specific immunoglobulin E (sIgE) levels to Can f 1, Can f 2, Can f 3, Can f 4, Can f 5 and Can f 6 using ImmunoCAP™. Polysensitization was defined as sensitization to ≥3 components. Overlapping sensitization was defined as having concomitant sensitization to at least two dog molecular allergen families (lipocalin, albumin or prostatic kallikrein). RESULTS Of 313, 218 (70%) subjects tested positive to at least one dog allergen component. Sensitization to Can f 1 (43%) was the most common, followed by Can f 5 (33%) among molecular allergens, while sensitization to lipocalins (56%) was the most common among component families. Polysensitization was found in 22% of all participants and was more common in participants with than in those without asthma. Subjects with asthma were less likely to be monosensitized to Can f 5 than those without asthma. Subjects with asthma had higher IgE levels of Can f 3, Can f 4 and Can f 6 than those without asthma. Overlapping sensitizations also differed between those with asthma and allergic rhinitis and those without. CONCLUSION Increased knowledge about the sensitization patterns of dog allergen components can aid in defining their role in asthma and rhinitis. In complex clinical cases of dog allergy, a detailed analysis of dog allergen components can provide additional information on the nature of sensitization.
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Affiliation(s)
- Saliha Selin Özuygur Ermis
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Respiratory Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Magnus P Borres
- ImmunoDiagnostics, Thermo Fisher Scientific, Uppsala, Sweden.,Department of Maternal and Child Health, Uppsala University, Uppsala, Sweden
| | - Rani Basna
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linda Ekerljung
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carina Malmhäll
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emma Goksör
- Department of Pediatrics, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Göran Wennergren
- Department of Pediatrics, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Madeleine Rådinger
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jan Lötvall
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bo Lundbäck
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hannu Kankaanranta
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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10
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Hedman L, Almqvist L, Bjerg A, Andersson M, Backman H, Perzanowski MS, Rönmark E. Early-life risk factors for development of asthma from 8 to 28 years of age: a prospective cohort study. ERJ Open Res 2022; 8:00074-2022. [PMID: 36655222 PMCID: PMC9835990 DOI: 10.1183/23120541.00074-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/16/2022] [Indexed: 01/21/2023] Open
Abstract
Background The objective was to estimate the incidence rate of asthma from age 8 to 28 years and evaluate early-life risk factors for asthma onset at different ages. Methods In 1996, within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, a cohort of 3430 schoolchildren (97% of invited) was recruited at age 8 years to a prospective study about asthma. The cohort was followed annually from age 8 to 19 years and at 28 years by questionnaire surveys (67% of the original cohort participated). Asthma was categorised as never-asthma, onset age ≤8 years, onset age 9-13 years, onset age 14-19 years or onset age >19 years. Results Of the 3430 individuals in the cohort, 690 (20.1%) reported asthma in any survey. The average incidence rate was 10.0/1000 per year at ≤8 years, 11.9/1000 per year at 9-13 years, 13.3/1000 per year at 14-19 years and 6.1/1000 per year at >19 years. The incidence was higher among boys until age 10 years, but from age 15 years, it became higher among girls. Family history of asthma, allergic sensitisation and breastfeeding <3 months were associated with asthma onset throughout the study. Low birthweight, maternal smoking during pregnancy, severe respiratory infection, rhinoconjunctivitis and eczema were associated with asthma onset ≤8 and 9-13 years. Conclusions The incidence of asthma was high during childhood and the teenage period, and decreased substantially during young adulthood. Early-life factors were associated with asthma onset throughout childhood but had also a lasting effect on asthma incidence until adulthood.
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Affiliation(s)
- Linnéa Hedman
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden,These authors contributed equally to first authorship
| | - Linnéa Almqvist
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden,These authors contributed equally to first authorship
| | | | - Martin Andersson
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Helena Backman
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Matthew S. Perzanowski
- Dept of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Eva Rönmark
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
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11
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Zhu H, Huang Z, Liu T, An N, Gan H, Huang D, Hao C, Luo W, Sun B. Sensitization to Furry Animals in Patients with Suspected Allergic Disease in China: A Multicenter Study. J Asthma Allergy 2022; 15:1701-1712. [PMID: 36452936 PMCID: PMC9704004 DOI: 10.2147/jaa.s390473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/11/2022] [Indexed: 08/30/2023] Open
Abstract
PURPOSE An objective of this study was to investigate the allergen sensitization characteristics of cat, dog and horse dander in patients with suspected allergic diseases in different geographical regions of Chinese mainland. PATIENTS AND METHODS We invited 2377 patients aged 0-86 years with suspected allergic diseases to participate in a cross-sectional survey in 11 provinces in China. Combined with the questionnaires and animal-specific IgE levels, we analyzed the epidemiological characteristics and risk factors of furry animal sensitization in different regions and populations of Chinese Mainland. RESULTS Among the 2377 patients with suspected allergic diseases, 14.9% were sensitized to cat dander, 9.3% to dog dander and 5.5% to horse dander. Animal allergens mainly cause low-level sensitization (class 1-3). There was a significant correlation between cat, dog and horse dander allergen sIgE, with correlation coefficients (rs) all greater than 0.750. The majority (46.5%) of sIgE-positive patients were sensitized to at least two animal allergens simultaneously. The prevalence of these animals all showed a trend of increasing first and then decreasing with age, and all reached the peak in young adolescence. As for the geographical factors, the sensitization rate of cats and dogs in Western was significantly higher than that in Eastern (cat: 18.4% vs 9.2%, dog: 11.6% vs 5.5%, all P < 0.001), however, no significant differences were found in horses. Aged ≤6 years, living in Western, and high animal allergen exposure elevated the risk of cat or dog sensitization. Living on a lower floor (aOR: 0.56) was a protective factor for horse sensitization. CONCLUSION In this representative sample of Chinese patients with suspected allergic diseases, there was an apparent geographic variation in sensitization to cats and dogs. Age factor and living in Western also had a significant impact on animal allergen sensitization rate.
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Affiliation(s)
- Huiqing Zhu
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People’s Republic of China
| | - Zhifeng Huang
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People’s Republic of China
| | - Tingting Liu
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People’s Republic of China
| | - Nairui An
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People’s Republic of China
| | - Hui Gan
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People’s Republic of China
| | - Dongming Huang
- Department of Pediatrics, Boai Hospital of Zhongshan City, Zhongshan, 528400, People’s Republic of China
| | - Chuangli Hao
- Department of Respirology, Children’s Hospital, Soochow University, Suzhou, 215025, People’s Republic of China
| | - Wenting Luo
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People’s Republic of China
| | - Baoqing Sun
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People’s Republic of China
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12
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Kang SY, Yang MS, Borres MP, Andersson M, Lee SM, Lee SP. The association between specific IgE antibodies to component allergens and allergic symptoms on dog and cat exposure among Korean pet exhibition participants. World Allergy Organ J 2022; 15:100709. [PMID: 36321071 PMCID: PMC9574497 DOI: 10.1016/j.waojou.2022.100709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/12/2022] Open
Abstract
Background Component resolved diagnostics (CRD) in dog and cat allergy is not sufficiently investigated, especially regarding new components such as Can f 4, Can f 6, and Fel d 7. The purpose of this study is to evaluate the potential role of CRD with new components in predicting allergic symptoms on dog and cat exposure. Methods Among 552 Korean adults who participated in a pet exhibition and completed questionnaires regarding exposure to dog or cat and allergic symptoms, 522 were venipunctured for measurement of IgE and IgG4 antibody concentration against dog and cat dander extract and underwent skin prick test (SPT). In 238 individuals who were sensitized for both dog and cat dander extract, the dog IgE components (Can f 1–6) and the cat components (Fel d 1/2/4/7) were analyzed. Results An increasing number of sensitizing components was associated with the likelihood of having any allergic symptoms (P < 0.001 for dog and P < 0.01 for cat), and those of asthma (P < 0.01 for dog and P < 0.05 for cat) and rhinoconjunctivitis (P < 0.001 for dog and P < 0.05 for cat). Pairwise correlation of IgE levels was r = 0.56 (P < 0.001) for Can f 6 and Fel d 4, r = 0.74 (P < 0.001) for Can f 1 and Fel d 7 and r = 0.84 (P < 0.001) for Can f 3 and Fel d 2. Conclusions Polysensitization to dog and cat allergen components is associated with high likelihood of having allergic symptoms during exposure to dogs and cats. Cross-reactivity between dog and cat allergen components is also identified. CRD has a potential in fine-tuning prediction for allergic symptoms on dog and cat exposure.
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13
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Käck U, van Hage M, Grönlund H, Lilja G, Asarnoj A, Konradsen JR. Allergic sensitization to lipocalins reflects asthma morbidity in dog dander sensitized children. Clin Transl Allergy 2022; 12:e12149. [PMID: 35510076 PMCID: PMC9058535 DOI: 10.1002/clt2.12149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/20/2022] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background Sensitization to dog is an important risk factor for asthma in children, but the clinical relevance of IgE to available dog‐ and furry animal allergen molecules is uncertain. Methods Spirometry, methacholine challenge, fraction of exhaled nitric oxide, nasal challenge with dog extract and questionnaires were performed in 59 dog‐sensitized children (age 10–18 years). Serum IgE to dog‐, cat‐, horse extracts and the allergen molecules Can f 1–6, Fel d 1, Fel d 2, Fel d 4 and Equ c 1 were evaluated. Results Median numbers of positive IgE results to furry animal allergen molecules among children without asthma was 3, with asthma 5.5 and with troublesome asthma 9 (asthma vs. no asthma; p = 0.039; troublesome asthma vs. no asthma; p = 0.009). The odds ratio for asthma if sensitized to any lipocalin was 7.2 (95% confidence Interval: 1.44–35.9). Children with troublesome asthma had higher IgE levels to the lipocalins Can f 2, Can f 4 and Can f 6 compared to the rest of the study population (44 vs. 4.1 kUA/L, p = 0.015; 5.8 vs. 0.9 kUA/L, p = 0.018 and 1.3 vs. 0.7 kUA/L, p = 0.03 respectively). Furthermore, a positive nasal challenge was more common among children with troublesome asthma (83% vs. 36%, p = 0.036). Conclusions Polysensitization to furry animal allergens and lipocalins is associated with asthma in dog‐sensitized children. Children with troublesome asthma have higher IgE levels to several dog lipocalins than other dog sensitized children. Key message Polysensitization to furry animal allergens and high IgE levels to the dog lipocalins Can f 2, Can f 4 and Can f 6 is associated with asthma severity in dog dander sensitized children. Molecular allergy diagnostics may thus help the clinicians to evaluate the impact of allergic sensitization on asthma morbidity.
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Affiliation(s)
- Ulrika Käck
- Department of Clinical Science and Education Södersjukhuset Karolinska Institutet Stockholm Sweden.,Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden
| | - Marianne van Hage
- Department of Medicine Solna Division of Immunology and Allergy Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| | - Hans Grönlund
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
| | - Gunnar Lilja
- Department of Clinical Science and Education Södersjukhuset Karolinska Institutet Stockholm Sweden.,Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden
| | - Anna Asarnoj
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden.,Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Jon R Konradsen
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden.,Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
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14
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Prevalence of inhaled allergen-specific IgE antibody positivity in the healthy Japanese population. Allergol Int 2022; 71:117-124. [PMID: 34481729 DOI: 10.1016/j.alit.2021.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/26/2021] [Accepted: 08/04/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Measurement of allergen-specific IgE antibodies to inhaled allergens is important for the diagnosis and risk evaluation of allergic diseases such as asthma and allergic rhinitis. This study aimed to elucidate the prevalence of allergen sensitization among the healthy population in Japan using serum samples stocked in the Japanese Red Cross for blood donation. METHODS Age- and gender-stratified serum samples (n = 800) from residents in Tokyo aged 20-59 years were randomly selected from the stocked serum obtained for blood donation in 2005. Total and specific IgE antibodies to 17 inhaled allergens were measured by the ImmunoCAP method. Individuals with positive (≥0.35 UA/mL) specific IgE antibodies to at least one inhaled allergen were defined as atopic. Stocked serums from donors aged 20-29 years in Sapporo, Osaka, Fukuoka, and Okinawa (n = 200 each) were also obtained for the measurement of IgE to six common inhaled allergens, to evaluate regional differences in the rate of positivity. RESULTS Among residents in Tokyo, the prevalence of atopy was 78.0% and highest in men aged 20-29 years (94.0%), which decreased with age. The prevalence of specific IgE antibodies was highest for Japanese cedar pollen (66.8%), followed by cypress pollen (46.8%), Dermatophagoides pteronyssinus (38.3%), and moths (30.1%). Examination of IgE to Japanese cedar pollen, D. pteronyssinus, and moths identified 97.6% of atopic subjects in Tokyo. There were substantial regional differences in the prevalence of pollen IgE positivity. CONCLUSIONS This study demonstrated an extremely high prevalence of positivity in inhaled allergen-specific IgE antibodies among healthy adults in Japan.
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15
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Bunne J, Hedman L, Perzanowski M, Bjerg A, Winberg A, Andersson M, Lundbäck B, Platts-Mills T, Rönmark E. The majority of children sensitized before school-age develop allergic disease before adulthood: a longitudinal population-based study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 10:577-585.e3. [PMID: 34695595 DOI: 10.1016/j.jaip.2021.10.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/17/2021] [Accepted: 10/06/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Allergic sensitization increases the risk of and asthma and allergic rhinitis, but the impact of age at onset of sensitization is less studied. OBJECTIVE To examine the cumulative incidence of asthma and rhinitis up to age 19 years in relation to age at onset of sensitization to airborne allergens. METHOD All children in grade one and two (median age 8 years) in two municipalities in Northern Sweden were invited to skin prick tests and a questionnaire about allergic diseases, and 88% participated. At ages 12 and 19 years the protocol was repeated, and n=1510 individuals participated in all three examinations. Specific IgE was collected in a random sample at age 19, n=770. Onset of sensitization was defined; ≤8 years, 8-12 years, 12-19 years, and never sensitized. Adjusted Poisson regression was utilized to calculate risk ratios. RESULTS At age 19, those sensitized ≤8 year had the highest risk of asthma (RR 4.68 (95%CI 3.14-6.97)) and rhinitis (RR 22.3 (95%CI 13.3-37.6)), and 84% had developed either asthma or rhinitis. The combination of sensitization ≤8 year and family history of allergic diseases rendered high risks for asthma (RR 10.6 (6.71-16.7)) and rhinitis (RR 36.3 (18.9-69.7). Individuals sensitized ≤8 year showed significantly highest level of sensitization, as judged by number of positive skin tests and titers of specific IgE. CONCLUSION The majority of individuals with sensitization ≤8 years developed asthma or rhinitis before young adulthood. The high level of sensitization in early sensitized contribute to the high incidence of allergic airway conditions.
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Affiliation(s)
- Joakim Bunne
- Department of Public Health and Clinical Medicine, Division of Sustainable Health, the OLIN unit, Umeå University, Umeå, Sweden
| | - Linnea Hedman
- Department of Public Health and Clinical Medicine, Division of Sustainable Health, the OLIN unit, Umeå University, Umeå, Sweden
| | - Matthew Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Anders Bjerg
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Winberg
- Department of Clinical Sciences, Pediatrics, Umeå University, Sweden
| | - Martin Andersson
- Department of Public Health and Clinical Medicine, Division of Sustainable Health, the OLIN unit, Umeå University, Umeå, Sweden
| | - Bo Lundbäck
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Platts-Mills
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, VA, USA
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Division of Sustainable Health, the OLIN unit, Umeå University, Umeå, Sweden.
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16
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Molecular mechanisms and treatment modalities in equine Culicoides hypersensitivity. Vet J 2021; 276:105741. [PMID: 34416400 DOI: 10.1016/j.tvjl.2021.105741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 07/07/2021] [Accepted: 08/15/2021] [Indexed: 12/25/2022]
Abstract
Equine Culicoides hypersensitivity (CH) is the most common allergic condition in horses affecting the skin. This review focuses on immunopathology and molecular mechanisms of equine CH. The role of eosinophils is emphasized, as well as disease severity and the influence of long-term chronic allergen exposure on T helper (Th) 2 cells. Using current knowledge from human allergic disorders, similar effects are hypothesized in equine patients. Key aspects of CH diagnosis and treatment are discussed, focusing on allergen specific immunotherapy and allergen-independent approaches, such as targeting hypereosinophilia through interleukin-5 and allergic non-histaminic pruritus though interleukin-31.
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17
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Pothirat C, Chaiwong W. Aeroallergen Sensitization and Clinical Characteristics of Subjects with Chronic Rhinitis in Chiang Mai, Thailand: A Twenty-Year Retrospective Study. J Asthma Allergy 2021; 14:789-795. [PMID: 34262297 PMCID: PMC8274822 DOI: 10.2147/jaa.s315081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of common aeroallergen sensitization in subjects with AR and clinical comparison between AR and Non-AR (NAR) subjects in Thailand remains limited. The primary objective of this study was to illustrate the prevalence of the common aeroallergen sensitization in AR subjects and the differences in clinical characteristics between AR and NAR subjects. Methods Data were retrospectively collected from all subjects with chronic rhinitis who have visited the Chest and Allergy Clinic in three settings in Chiang Mai, Thailand between January 1998 and December 2018. Clinical characteristics and the result of skin prick test (SPT) to common aeroallergen were collected. Results A total of 2164 subjects with chronic rhinitis were enrolled, SPT was performed in 1001 (46.3%); 655 (65.4%) and 346 (34.6%) were AR and NAR, respectively. Mite mixed was the most frequent aeroallergen sensitization in subjects with AR both without asthma and with asthma (86.4% and 85.6%) followed by cockroach mixed (54.4% and 58.9%), grass pollen (38.9% and 40.4%), animal dander (15.5% and 19.9%), and mold mixed (5.7% and 11.0%). Polysensitization was higher in younger adults compared to middle aged adult and older adult (72.5%, 67.4%, and 58.7%, respectively, p=0.041). The AR subjects had lower age, earlier age of disease onset, and longer duration of disease (32.6±16.3 vs 40.2±15.4 years, 24 (10–36) vs 34 years (22–45), 3 (1–10) vs 2 years (0–5), respectively, p<0.001). The AR subjects also had more asthma, conjunctivitis, and family history of chronic rhinitis (22.3% vs 15.6%, 25.3% vs 4.3%, and 58.0% vs 43.3%, respectively, p<0.05). Conclusion The most common aeroallergen for AR (with and without asthma) was mite mixed followed by cockroach mixed and grass pollen. Polysensitization was significant higher in younger adult than middle aged and older adult. AR was significantly associated with asthma, conjunctivitis and family history of chronic rhinitis compared to NAR.
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Affiliation(s)
- Chaicharn Pothirat
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Warawut Chaiwong
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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18
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Papadopoulos NG, Miligkos M, Xepapadaki P. A Current Perspective of Allergic Asthma: From Mechanisms to Management. Handb Exp Pharmacol 2021; 268:69-93. [PMID: 34085124 DOI: 10.1007/164_2021_483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Asthma is a result of heterogenous, complex gene-environment interactions with variable clinical phenotypes, inflammation, and remodeling. It affects more than 330 million of people worldwide throughout their educational and working lives, while exacerbations put a heavy cost/burden on productivity. Childhood asthma is characterized by a predominance of allergic sensitization and multimorbidity, while in adults polysensitization has been positively associated with asthma occurrence. Despite significant improvements in recent decades, asthma management remains challenging. Recently, a group of specialists suggested that the term "asthma" should be preferably used as a descriptive term for symptoms. Moreover, type 2 inflammation has emerged as a pivotal disease mechanism including overlapping endotypes of specific IgE production, while type 2-low asthma includes several disease endotypes. Optimal asthma control requires both appropriate pharmacological interventions, tailored to each patient, as well as trigger avoidance measures. Regular monitoring for maintenance of symptom control, preservation of lung function, and detection of treatment-related adverse effects are warranted. Allergen-specific immunotherapy and the advent of new targeted therapies for patients with difficult to control asthma offer diverse treatment options. The current review summarizes up-to-date knowledge on epidemiology, definitions, diagnosis, and current therapeutic strategies.
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Affiliation(s)
- Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece. .,Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK.
| | - Michael Miligkos
- First Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
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Tummon F, Arboledas LA, Bonini M, Guinot B, Hicke M, Jacob C, Kendrovski V, McCairns W, Petermann E, Peuch VH, Pfaar O, Sicard M, Sikoparija B, Clot B. The need for Pan-European automatic pollen and fungal spore monitoring: A stakeholder workshop position paper. Clin Transl Allergy 2021; 11:e12015. [PMID: 33934521 PMCID: PMC8120382 DOI: 10.1002/clt2.12015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/21/2021] [Indexed: 01/21/2023] Open
Abstract
Background Information about airborne pollen concentrations is required by a range of end users, particularly from the health sector who use both observations and forecasts to diagnose and treat allergic patients. Manual methods are the standard for such measurements but, despite the range of pollen taxa that can be identified, these techniques suffer from a range of drawbacks. This includes being available at low temporal resolution (usually daily averages) and with a delay (usually 3–9 days from the measurement). Recent technological developments have made possible automatic pollen measurements, which are available at high temporal resolution and in real time, although currently only scattered in a few locations across Europe. Materials & Methods To promote the development of an extensive network across Europe and to ensure that this network will respond to end user needs, a stakeholder workshop was organised under the auspices of the EUMETNET AutoPollen Programme. Participants discussed requirements for the groups they represented, ranging from the need for information at various spatial scales, at high temporal resolution, and for targeted services to be developed. Results The provision of real‐time information is likely to lead to a notable decrease in the direct and indirect health costs associated with allergy in Europe, currently estimated between €50–150 billion/year.1 Discussion & Conclusion A European measurement network to meet end user requirements would thus more than pay for itself in terms of potential annual savings and provide significant impetus to research across a range of disciplines from climate science and public health to agriculture and environmental management.
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Affiliation(s)
- Fiona Tummon
- Federal Office of Meteorology and Climatology MeteoSwiss, Payerne, Switzerland
| | | | - Maira Bonini
- Agency for Health Protection of Metropolitan Area of Milan (ATS), Milan, Italy
| | - Benjamin Guinot
- Laboratoire d'Aérologie, CNRS, UPS-Université Toulouse III, Toulouse, France.,Réseau National de Surveillance Aérobiologique, Brussieu, France
| | - Martin Hicke
- Bavarian State Ministry of Health and Care, Munich, Germany
| | | | | | | | | | - Vincent-Henri Peuch
- Copernicus Atmospheric Monitoring Services, European Centre for Medium-Range Weather Forecasts, Reading, UK
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Michaël Sicard
- CommSensLab, Department of Signal Theory and Communications, Universitat Politècnica de Catalunya, Barcelona, Spain.,Ciències i Tecnologies de l'Espai-Centre de Recerca de l'Aeronàutica i de l'Espai/Institut d'Estudis Epacials de Catalunya (CTE-CRAE/IEEC), Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Branko Sikoparija
- BioSensе Institute-Research Institute for Information Technologies in Biosystems, University of Novi Sad, Serbia
| | - Bernard Clot
- Federal Office of Meteorology and Climatology MeteoSwiss, Payerne, Switzerland
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Loraud C, de Ménonville CT, Bourgoin-Heck M, Cottel N, Wanin S, Just J. Emergence of pollen food allergy syndrome in asthmatic children in Paris. Pediatr Allergy Immunol 2021; 32:702-708. [PMID: 33332662 DOI: 10.1111/pai.13435] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Over the last few decades, the level of pollen from birch and homologous trees has increased in parts of Europe. Sensitization to birch pollen allergens (principally Bet v 1) has been associated with food cross-reactivity called pollen food allergy syndrome (PFAS). OBJECTIVE To evaluate changes in allergic diseases due to IgE sensitization over 25 years in asthmatic children. METHODS This was a cross-sectional retrospective study conducted in Paris. We analyzed two cohorts of asthmatic children with similar characteristics explored between 1993-1999 (old cohort = OC) and 2012-2018 (recent cohort = RC). RESULTS 121 children were in the OC and 120 in the RC. An increase in sensitization to tree pollens was found especially for birch pollen, which was 11.6% in the OC and 31% in the RC (P = .0002). Allergic rhinitis prevalence was significantly higher in the RC than in the OC (96% vs 52%, respectively, P < .0001). IgE-mediated food allergy increased from 6% to 16% in the OC and RC, respectively, (P = .01) mainly due to PFAS. In the RC, a higher mean Bet v 1-specific IgE level was observed in children with PFAS compared to children without (105.7 KU/L ± 17.8 and 48.9 kU/L ± 15.7, respectively, P < .05). CONCLUSION Allergic rhinitis and food allergy with tree pollen sensitization have increased in Paris over 25 years mainly due to PFAS. Environmental factors could be responsible for these modifications as described in the literature.
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Affiliation(s)
- Christine Loraud
- Department of Allergology, Hôpital d'Enfants Armand Trousseau, APHP, Paris, France
| | | | - Mélisande Bourgoin-Heck
- Department of Allergology, Hôpital d'Enfants Armand Trousseau, APHP, Paris, France.,Sorbonne Universités, Equipe EPAR, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Paris, France
| | - Nathalie Cottel
- Department of Allergology, Hôpital d'Enfants Armand Trousseau, APHP, Paris, France
| | - Stéphanie Wanin
- Department of Allergology, Hôpital d'Enfants Armand Trousseau, APHP, Paris, France
| | - Jocelyne Just
- Department of Allergology, Hôpital d'Enfants Armand Trousseau, APHP, Paris, France.,Sorbonne Universités, Equipe EPAR, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Paris, France
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21
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Nam JS, Ahn SH, Ha JG, Park JJ, Noh HE, Yoon JH, Kim CH, Cho HJ. Differential Correlations among Allergy Tests According to Indoor Allergens in Allergic Rhinitis. Ann Otol Rhinol Laryngol 2021; 131:71-77. [PMID: 33870717 DOI: 10.1177/00034894211008702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Several allergy tests are used for the diagnosis of allergic rhinitis; however, few studies have reported a direct comparison of the skin prick test (SPT), multiple allergen simultaneous test (MAST), and ImmunoCAP according to specific allergens. This study aimed to evaluate the correlations between each test and allergic rhinitis symptoms and to evaluate the correlations of the MAST and ImmunoCAP with the SPT for representative indoor allergens in Korea. METHODS Electronic medical charts were retrospectively reviewed, and 698 patients with allergic rhinitis who had performed SPT, MAST, and ImmunoCAP were enrolled. Correlations between each allergy test for 4 representative indoor allergens and the symptoms of allergic rhinitis were analyzed. Agreements of the MAST and ImmunoCAP with the SPT were compared according to each allergen. RESULTS The SPT showed higher correlations with allergic rhinitis symptoms for 4 indoor allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat, and dog allergens) than the MAST or ImmunoCAP. In comparison between the MAST and SPT, the least correlation was observed for the dog allergen, whereas between the ImmunoCAP and SPT, the least correlation was observed for the cat allergen. The correlation between the ImmunoCAP and SPT was higher than that between the MAST and SPT for the dog allergen, whereas no significant differences were noted for other allergens. CONCLUSIONS Overall, the SPT showed a higher correlation with allergic rhinitis symptoms than the MAST or ImmunoCAP for 4 indoor allergens. ImmunoCAP showed similar reactivity to MAST; however, it showed better positivity with dog allergen in patients who were reactive to the allergen in the SPT. Care should be taken while evaluating dog allergen sensitization using the MAST.
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Affiliation(s)
- Jae-Sung Nam
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hyeon Ahn
- Department of Otorhinolaryngology, Bundang Jesaeng Hospital, Seongnam, Korea.,Department of Medicine, The Graduate School of Yonsei University, Seoul, Korea
| | - Jong-Gyun Ha
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong-Jin Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Hae Eun Noh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Joo-Heon Yoon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.,Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Chang-Hoon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.,Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung-Ju Cho
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.,Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Korea
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22
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Käck U, Einarsdottir E, van Hage M, Asarnoj A, James A, Nopp A, Krjutškov K, Katayama S, Kere J, Lilja G, Söderhäll C, Konradsen JR. Nasal upregulation of CST1 in dog-sensitised children with severe allergic airway disease. ERJ Open Res 2021; 7:00917-2020. [PMID: 33898616 DOI: 10.1183/23120541.00917-2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/27/2021] [Indexed: 12/27/2022] Open
Abstract
Background The clinical presentation of children sensitised to dog dander varies from asymptomatic to severe allergic airway disease, but the genetic mechanisms underlying these differences are not clear. The objective of the present study was to investigate nasal transcriptomic profiles associated with dog dander sensitisation in school children and to reveal clinical symptoms related with these profiles. Methods RNA was extracted from nasal epithelial cell brushings of children sensitised to dog dander and healthy controls. Blood sample analyses included IgE against dog dander, dog allergen molecules, other airborne and food allergens, basophil activation and white blood cell counts. Clinical history of asthma and rhinitis was recorded, and lung function was assessed (spirometry, methacholine provocation and exhaled nitric oxide fraction). Results The most overexpressed gene in children sensitised to dog dander compared to healthy controls was CST1, coding for Cystatin 1. A cluster of these children with enhanced CST1 expression showed lower forced expiratory volume in 1 s, increased bronchial hyperreactivity, pronounced eosinophilia and higher basophil allergen threshold sensitivity compared with other children sensitised to dog dander. In addition, multi-sensitisation to lipocalins was more common in this group. Conclusions Overexpression of CST1 is associated with more severe allergic airway disease in children sensitised to dog dander. CST1 is thus a possible biomarker of the severity of allergic airway disease and a possible therapeutic target for the future treatment of airborne allergy.
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Affiliation(s)
- Ulrika Käck
- Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Elisabet Einarsdottir
- Dept of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Department of Gene Technology, KTH-Royal Institute of Technology, Solna, Sweden.,Folkhälsan Research Center, Helsinki, Finland
| | - Marianne van Hage
- Dept of Medicine Solna, Division of Immunology and Allergy, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Anna Asarnoj
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna James
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Nopp
- Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Kaarel Krjutškov
- Dept of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,Department of Obstetrics and Gynecology, University of Tartu, Tartu, Estonia.,Competence Centre on Health Technologies, Tartu, Estonia
| | - Shintaro Katayama
- Dept of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,Folkhälsan Research Center, Helsinki, Finland.,University of Helsinki, Stem Cells and Metabolism Research Program, Helsinki, Finland
| | - Juha Kere
- Dept of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,Folkhälsan Research Institute, and Stem Cell and Metabolism Research Program, University of Helsinki, Helsinki, Finland
| | - Gunnar Lilja
- Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Cilla Söderhäll
- Dept of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,These authors contributed equally
| | - Jon R Konradsen
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,These authors contributed equally
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23
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陈 艳, 普 晓, 陈 俊, 王 晓, 王 洪, 王 学. [Sensitization pattern of cat and dog dander allergen in 16 426 patients with allergic diseases]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2021; 35:333-337. [PMID: 33794632 PMCID: PMC10128443 DOI: 10.13201/j.issn.2096-7993.2021.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Indexed: 06/12/2023]
Abstract
Objective:To explore the sensitization feature of cat and dog dander and time trend in northern region. Methods:During year 2017 to year 2019, subjects with self-reported allergic diseases received skin prick test for cat and dog dander allergen. Skin index(SI) ≥2+ was considered as positive SPT. SI2+ was defined as mild sensitization, SI3+ was defined as moderate sensitization while SI4+ was defined as severe sensitization. The age and gender difference of sensitization rate between cat and dog dander allergen was analyzed. Meanwhile, the trend of cat and dog dander sensitization rate was analyzed. Results:Overall, 16 426 subjects were enrolled in this study. ① The sensitization rate of cat dander was significantly higher than dog dander(11.8% vs 6.0%, P<0.001). Severe sensitization rate of cat dander was significantly higher than dog dander(5.9% vs 1.7%, P<0.001) while there was no significant difference of mild sensitization rate. ②Sensitization age of cat dander was younger than dog dander(P<0.001). Sensitization rate of cat and dog dander was higher in subjects ≤18y compared with those >18y(20.2% vs 10.9%, P<0.001; 8.1% vs 5.7%, P<0, 001). The highest sensitization rate was presented in 13-18y age group(27.3% vs 9.9%, P<0.001), following by 7-12y age group(26.0% vs 9.2%, P<0.001). Sensitization rate of cat dander was higher in male than in female(13.7% vs 10.7%, P<0.001) while no gender difference was observed in dog dander sensitization(6.2% vs 5.8%, P=0.411). ③595 subjects(3.6%) were both sensitized to cat and dog dander while 1733 subjects(10.6%) were sensitized either to cat or dog dander. Single sensitization rate of cat dander was higher than single sensitization rate of dog dander(8.2% vs 2.3%, P<0.001). There was a positive correlation between the cat and dog dander sensitization rate(r=0.386, P<0.001). ④During 2017-2019, the sensitization rate of cat dander increased but without significantly statistic difference while dog dander sensitization rate was descending from 7.4% to 4.6% significantly(χ²=38.298, P<0.001). Conclusion:Cat dander sensitization rate was higher than dog dander with a peak age in adolescence. A trend of rising for cat dander allergy and descending for dog dander allergy was observed during the past three years.
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Affiliation(s)
- 艳蕾 陈
- 首都医科大学附属北京世纪坛医院变态反应科(北京,100038)Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- 首都医科大学附属北京世纪坛医院变态反应中心Allergy Center, Beijing Shijitan Hospital, Capital Medical University
| | - 晓瑜 普
- 首都医科大学附属北京世纪坛医院变态反应中心Allergy Center, Beijing Shijitan Hospital, Capital Medical University
- 首都医科大学附属北京世纪坛医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Beijing Shijitan Hospital, Capital Medical University
| | - 俊 陈
- 山东省滨州市中心医院皮肤性病科Department of Dermatology, Binzhou Central Hospital, Shandong Province
| | - 晓艳 王
- 首都医科大学附属北京世纪坛医院变态反应科(北京,100038)Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- 首都医科大学附属北京世纪坛医院变态反应中心Allergy Center, Beijing Shijitan Hospital, Capital Medical University
| | - 洪田 王
- 首都医科大学附属北京世纪坛医院变态反应科(北京,100038)Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- 首都医科大学附属北京世纪坛医院变态反应中心Allergy Center, Beijing Shijitan Hospital, Capital Medical University
| | - 学艳 王
- 首都医科大学附属北京世纪坛医院变态反应科(北京,100038)Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- 首都医科大学附属北京世纪坛医院变态反应中心Allergy Center, Beijing Shijitan Hospital, Capital Medical University
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Mubanga M, Lundholm C, D’Onofrio BM, Stratmann M, Hedman A, Almqvist C. Association of Early Life Exposure to Antibiotics With Risk of Atopic Dermatitis in Sweden. JAMA Netw Open 2021; 4:e215245. [PMID: 33914052 PMCID: PMC8085722 DOI: 10.1001/jamanetworkopen.2021.5245] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Atopic dermatitis is associated with substantial morbidity in childhood. Further understanding of the underlying factors contributing to its onset is needed. OBJECTIVE To assess the association of exposure to antibiotics in the prenatal period and early childhood with risk of atopic dermatitis in a nationwide population in Sweden. DESIGN, SETTING, AND PARTICIPANTS This Swedish nationwide, register-based, prospective cohort study used data on mother-child pairs from the Swedish Medical Birth Register linked to other national registers for information on health, socioeconomic, and demographic data. Participants were followed up until an atopic dermatitis outcome, emigration, death, or the end of the study on December 31, 2015. Data for all singleton children and discordant siblings born between March 1, 2006, and December 31, 2010, were included. Data were analyzed from June 1, 2020, to October 31, 2020. EXPOSURES Maternal exposure to systemic antibiotics during pregnancy as well as the child's exposure to systemic antibiotics during the first year of life, as defined by a dispensed prescription in the Swedish Prescribed Drug Register. MAIN OUTCOMES AND MEASURES Time-to-event analyses were used to estimate the risk of outcome using attained age as a time scale. Atopic dermatitis was defined based on diagnoses in the National Patient Register and medication listed in the Swedish Prescribed Drug Register. Sibling-control analysis was performed to account for shared familial factors. RESULTS Among the 722 767 singleton children, the mean (SD) age was 5.8 (2.4) years and 351 589 (48.6%) were female. During the follow-up period, 153 407 children (21.2%) were exposed to antibiotics in utero and 172 405 children (23.8%) were exposed during the first year of life. The risk of atopic dermatitis among children exposed to prenatal antibiotics was greater than that among children who were not exposed (adjusted hazard ratio [aHR], 1.10; 95% CI, 1.09-1.12). In the sibling-control analysis, no association was observed (aHR, 0.96; 95% CI; 0.92-1.00). Exposure to antibiotics during the first year of life was associated with a greater risk of atopic dermatitis (aHR, 1.52; 95% CI, 1.50-1.55), with attenuated associations in the sibling-control analysis (aHR, 1.24; 95% CI, 1.20-1.29). CONCLUSIONS AND RELEVANCE In this cohort study, exposure to antibiotics in early life was associated with an increased risk of atopic dermatitis in the general Swedish population, but this risk was partially confounded by familial factors. Research on the ways in which antibiotic use and other shared familial factors affect other atopic diseases may be warranted.
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Affiliation(s)
- Mwenya Mubanga
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Lundholm
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Brian M. D’Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychological & Brain Sciences, Indiana University–Bloomington
| | - Marlene Stratmann
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna Hedman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
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25
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Kim SH, Lee J, Oh I, Oh Y, Sim CS, Bang JH, Park J, Kim Y. Allergic rhinitis is associated with atmospheric SO2: Follow-up study of children from elementary schools in Ulsan, Korea. PLoS One 2021; 16:e0248624. [PMID: 33735252 PMCID: PMC7971526 DOI: 10.1371/journal.pone.0248624] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/02/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives The purpose of this study was to examine the association of allergic rhinitis with air pollutant concentrations using the follow-up data of elementary school children in Ulsan, Korea. Methods All students of four elementary schools in Ulsan, South Korea were surveyed at two-year intervals. The survey used data collected five times, over a nine-year period from June 2009 to April 2018. The questionnaire used in the survey was a modified version of the ISAAC (International society of asthma and allergy of children) questionnaire. A skin prick test (SPT) was performed with 24 standard antigens. To estimate the levels of exposure to outdoor air pollution, the concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), and particulate matter 10 μm or less in diameter (PM10) were used. As a dependent variable, a history of allergic rhinitis diagnosed by a doctor during the last 1-year was considered. Logistic regression analysis was used to select variables suitable for the statistical model. The selected variables were then used to assess their association with the dependent variable using the generalized estimation equation. Results Among environmental factors, SO2 was associated with a high risk and PM10 was associated with a low risk of allergic rhinitis. The risk of allergic rhinitis from living in a house built within the last year was high, and the risk from living in a multi-family house or apartment was higher than that from living in a segregated house. History of allergic diseases in the family was a high-risk factor for allergic rhinitis. There was a relationship between a history of bronchiolitis at less than 2 years of age and a high risk of allergic rhinitis. Boys were at a higher risk than girls. Conclusion From the follow-up data of elementary school students in Ulsan, Korea, the concentration of SO2, which is an indicator of the degree of industrialization, was related to the prevalence of allergic rhinitis. Among all the risk factors, history of allergic disease in the parents was the most important factor, and the study reconfirmed the results of the previous studies.
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Affiliation(s)
- Suk Hwan Kim
- POSCO Health Center, POSCO, Pohang, Republic of Korea
| | - Jiho Lee
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Inbo Oh
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Yeonsuh Oh
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Chang Sun Sim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Jin-Hee Bang
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Jungsun Park
- Department of Occupational Health, Catholic University of Daegu, Gyeongsan, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
- * E-mail:
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26
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Schoos AMM, Nwaru BI, Borres MP. Component-resolved diagnostics in pet allergy: Current perspectives and future directions. J Allergy Clin Immunol 2021; 147:1164-1173. [PMID: 33444632 DOI: 10.1016/j.jaci.2020.12.640] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/30/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022]
Abstract
Furry mammals kept as pets are important allergen sources. The prevalence of sensitization to dander from various animals appears to be increasing worldwide. Several mammalian allergens from diverse species and distinct protein families have been characterized, and some are available for component-resolved diagnostics (CRD). This review presents an overview of mammalian aeroallergens, with a focus on cat, dog, and horse allergens. The potential of CRD in fine-tuning the diagnostic workup following traditional methods based on whole- allergen extracts and allergen immunotherapy is discussed. The review highlights the clinical utility of CRD, particularly as a marker/predictor of increased asthma risk and disease severity. Finally, several perspectives of the future implications of CRD are offered in the context of furry animal allergens.
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Affiliation(s)
- Ann-Marie M Schoos
- COpenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Slagelse Sygehus, Slagelse, Denmark.
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Magnus P Borres
- Thermo Fisher Scientific, Uppsala, Sweden; Department of Maternal and Child Health, Uppsala University, Uppsala, Sweden
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Hedman L, Backman H, Stridsman C, Lundbäck M, Andersson M, Rönmark E. Predictors of electronic cigarette use among Swedish teenagers: a population-based cohort study. BMJ Open 2020; 10:e040683. [PMID: 33376167 PMCID: PMC7778771 DOI: 10.1136/bmjopen-2020-040683] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The aim was to identify predictors of electronic cigarette (e-cigarette) use among teenagers. DESIGN AND SETTING A prospective population-based cohort study of schoolchildren in northern Sweden. PARTICIPANTS In 2006, a cohort study about asthma and allergic diseases among schoolchildren started within the Obstructive Lung Disease in Northern Sweden studies. The study sample (n=2185) was recruited at age 7-8 years, and participated in questionnaire surveys at age 14-15 and 19 years. The questionnaire included questions about respiratory symptoms, living conditions, upper secondary education, physical activity, diet, health-related quality of life, parental smoking and parental occupation. Questions about tobacco use were included at age 14-15 and 19 years. PRIMARY OUTCOME E-cigarette use at age 19 years. RESULTS At age 19 years, 21.4% had ever tried e-cigarettes and 4.2% were current users. Among those who were daily tobacco smokers at age 14-15 years, 60.9% had tried e-cigarettes at age 19 years compared with 19.1% of never-smokers and 34.0% of occasional smokers (p<0.001). Among those who had tried e-cigarettes, 28.1% were never smokers both at age 14-15 and 19 years, and 14.4% were never smokers among the current e-cigarette users. In unadjusted analyses, e-cigarette use was associated with daily smoking, use of snus and having a smoking father at age 14-15 years, as well as with attending vocational education, physical inactivity and unhealthy diet. In adjusted analyses, current e-cigarette use was associated with daily tobacco smoking at age 14-15 years (OR 6.27; 95% CI 3.12 to 12.58), attending a vocational art programme (OR 2.22; 95% CI 1.04 to 4.77) and inversely associated with eating a healthy diet (OR 0.74; 95% CI 0.59 to 0.92). CONCLUSIONS E-cigarette use was associated with personal and parental tobacco use, as well as with physical inactivity, unhealthy diet and attending vocational upper secondary education. Importantly, almost one-third of those who had tried e-cigarettes at age 19 years had never been tobacco smokers.
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Affiliation(s)
- Linnea Hedman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University Faculty of Medicine, Umeå, Sweden
- Department of Health Science, Division of Nursing, Luleå University of Technology, Luleå, Sweden
| | - Helena Backman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University Faculty of Medicine, Umeå, Sweden
- Department of Health Science, Division of Nursing, Luleå University of Technology, Luleå, Sweden
| | - Caroline Stridsman
- Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University Faculty of Medicine, Umeå, Sweden
| | - Magnus Lundbäck
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
| | - Martin Andersson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University Faculty of Medicine, Umeå, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University Faculty of Medicine, Umeå, Sweden
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Sabit M, Wong C, Andaya A, Ramos JD. Pollen allergen skin test and specific IgE reactivity among Filipinos: a community-based study. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2020; 16:74. [PMID: 32922458 PMCID: PMC7477877 DOI: 10.1186/s13223-020-00471-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/05/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Despite the clinical importance of pollen allergens among Filipinos, few studies delve into the sensitization profiles of Filipinos against pollen allergens. This study determined the sensitization profile of Filipinos to pollen using skin prick test (SPT) and pollen-specific ELISA. METHODS Pollen from fifteen selected plant sources was collected and extracted for use in sensitization tests. Volunteers were interviewed for their clinical history prior to blood sampling and SPT. The blood samples collected were assessed using Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS The best panel of pollen allergens for the skin prick test was Mangifera indica (64%), Acacia auriculiformis (28%), Mimosa spp. (25%) Amaranthus spinosus (22%), Lantana camara (20%), Pilea microphylla (16%) and Dichanthium aristatum (15%). Young adults had more sensitizations to pollen than among early childhood and elderly. There were more allergic subjects that have rhinitis (61%) than asthma (42%) and atopic dermatitis (35%). Pollen-specific IgE levels show low percent reactivity as compared to the skin test with Cocos nucifera obtaining the highest IgE reactivity (21%). CONCLUSIONS Pollen allergens from both arboreal and herbaceous plants used in this study yielded positive reactivities for both skin tests and specific IgE tests.
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Affiliation(s)
- Maureen Sabit
- The Graduate School, University of Santo Tomas, 1008 Manila, Philippines
- Research Center for the Natural and Applied Sciences, Thomas Aquinas Research Complex, University of Santo Tomas, 1008 Manila, Philippines
- Department of Biological Sciences, College of Science, University of Santo Tomas, 1008 Manila, Philippines
| | - Cecil Wong
- Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Santo Tomas Hospital, 1008 Manila, Philippines
| | - Agnes Andaya
- Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Santo Tomas Hospital, 1008 Manila, Philippines
| | - John Donnie Ramos
- The Graduate School, University of Santo Tomas, 1008 Manila, Philippines
- Research Center for the Natural and Applied Sciences, Thomas Aquinas Research Complex, University of Santo Tomas, 1008 Manila, Philippines
- Department of Biological Sciences, College of Science, University of Santo Tomas, 1008 Manila, Philippines
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Abstract
PURPOSE OF REVIEW The goal of this review is to compress all important information and results of the research in reducing cat allergen exposure using air filtration. Fel d 1 is the major allergen responsible for IgE responses in 90 to 95% of patients with cat allergy. RECENT FINDINGS Reduction of cat allergen in indoor air with different air filtration systems and portable devices has been demonstrated in the majority of the studies. Recently, early and late asthmatic responses were significantly reduced using portable HEPA air cleaners in an environmental exposure chamber. This review provides a comprehensive overview of the current state of airborne Fel d 1 air filtration targeting the most efficient devices in cat allergen reduction. Novel emerging HEPA filters are targeting reduction of cat indoor asthma trigger so patient can might benefit from efficient solution.
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Affiliation(s)
- Alina Gherasim
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, 67000, Strasbourg, France.
| | - Frédéric de Blay
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, 67000, Strasbourg, France.,Chest Diseases Department, Strasbourg University Hospital, 1 place de l'Hôpital, 67000, Strasbourg, France.,Federation of Translational Medicine EA 3070, University of Strasbourg, Strasbourg, France
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Lyons SA, Knulst AC, Burney PGJ, Fernández-Rivas M, Ballmer-Weber BK, Barreales L, Bieli C, Clausen M, Dubakiene R, Fernández-Perez C, Jedrzejczak-Czechowicz M, Kowalski ML, Kummeling I, Mustakov TB, van Os-Medendorp H, Papadopoulos NG, Popov TA, Potts J, Xepapadaki P, Welsing PMJ, Mills ENC, van Ree R, Le TM. Predictors of Food Sensitization in Children and Adults Across Europe. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:3074-3083.e32. [PMID: 32348914 DOI: 10.1016/j.jaip.2020.04.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/30/2020] [Accepted: 04/16/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The geographical variation and temporal increase in the prevalence of food sensitization (FS) suggest environmental influences. OBJECTIVE To investigate how environment, infant diet, and demographic characteristics, are associated with FS in children and adults, focusing on early-life exposures. METHODS Data on childhood and adult environmental exposures (including, among others, sibship size, day care, pets, farm environment, and smoking), infant diet (including breast-feeding and timing of introduction to infant formula and solids), and demographic characteristics were collected from 2196 school-age children and 2185 adults completing an extensive questionnaire and blood sampling in the cross-sectional pan-European EuroPrevall project. Multivariable logistic regression was applied to determine associations between the predictor variables and sensitization to foods commonly implicated in food allergy (specific IgE ≥0.35 kUA/L). Secondary outcomes were inhalant sensitization and primary (non-cross-reactive) FS. RESULTS Dog ownership in early childhood was inversely associated with childhood FS (odds ratio, 0.65; 95% CI, 0.48-0.90), as was higher gestational age at delivery (odds ratio, 0.93 [95% CI, 0.87-0.99] per week increase in age). Lower age and male sex were associated with a higher prevalence of adult FS (odds ratio, 0.97 [95% CI, 0.96-0.98] per year increase in age, and 1.39 [95% CI, 1.12-1.71] for male sex). No statistically significant associations were found between other evaluated environmental determinants and childhood or adult FS, nor between infant diet and childhood FS, although early introduction of solids did show a trend toward prevention of FS. CONCLUSIONS Dog ownership seems to protect against childhood FS, but independent effects of other currently conceived environmental and infant dietary determinants on FS in childhood or adulthood could not be confirmed.
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Affiliation(s)
- Sarah A Lyons
- Department of Dermatology & Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - André C Knulst
- Department of Dermatology & Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Peter G J Burney
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | | | - Barbara K Ballmer-Weber
- Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland; Faculty of Medicine, University of Zürich, Zürich, Switzerland; Clinic for Dermatology and Allergology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Laura Barreales
- Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, UCM, IdISSC, Madrid, Spain
| | - Christian Bieli
- Department of Paediatric Pulmonology, University Children's Hospital, Zürich, Switzerland
| | - Michael Clausen
- Children's Hospital, Landspitali University Hospital, Reykjavik, Iceland
| | | | - Cristina Fernández-Perez
- Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, UCM, IdISSC, Madrid, Spain
| | | | - Marek L Kowalski
- Department of Immunology, Rheumatology, and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Ischa Kummeling
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Tihomir B Mustakov
- Clinical Centre of Allergology of the Alexandrovska Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Harmieke van Os-Medendorp
- Department of Dermatology & Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; Saxion University of Applied Sciences, Deventer, The Netherlands
| | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece; Division of Infection, Immunity and Respiratory Medicine, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom
| | - Todor A Popov
- University Hospital Sv. Ivan Rilski, Sofia, Bulgaria
| | - James Potts
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | | | - Paco M J Welsing
- Division of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E N Clare Mills
- Division of Infection, Immunity and Respiratory Medicine, Manchester Institute of Biotechnology & Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands
| | - Thuy-My Le
- Department of Dermatology & Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Lyons SA, Clausen M, Knulst AC, Ballmer-Weber BK, Fernandez-Rivas M, Barreales L, Bieli C, Dubakiene R, Fernandez-Perez C, Jedrzejczak-Czechowicz M, Kowalski ML, Kralimarkova T, Kummeling I, Mustakov TB, Papadopoulos NG, Popov TA, Xepapadaki P, Welsing PMJ, Potts J, Mills ENC, van Ree R, Burney PGJ, Le TM. Prevalence of Food Sensitization and Food Allergy in Children Across Europe. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:2736-2746.e9. [PMID: 32330668 DOI: 10.1016/j.jaip.2020.04.020] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/05/2020] [Accepted: 04/06/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND For adults, prevalence estimates of food sensitization (FS) and food allergy (FA) have been obtained in a standardized manner across Europe. For children, such estimates are lacking. OBJECTIVES To determine the prevalence of self-reported FA, FS, probable FA (symptoms plus IgE sensitization), and challenge-confirmed FA in European school-age children. METHODS Data on self-reported FA were collected through a screening questionnaire sent to a random sample of the general population of 7- to 10-year-old children in 8 European centers in phase I of the EuroPrevall study. Data on FS and probable FA were obtained in phase II, comprising an extensive questionnaire on reactions to 24 commonly implicated foods, and serology testing. Food challenge was performed in phase III. RESULTS Prevalence (95% CI) of self-reported FA ranged from 6.5% (5.4-7.6) in Athens to 24.6% (22.8-26.5) in Lodz; prevalence of FS ranged from 11.0% (9.7-12.3) in Reykjavik to 28.7% (26.9-30.6) in Zurich; and prevalence of probable FA ranged from 1.9% (0.8-3.5) in Reykjavik to 5.6% (3.6-8.1) in Lodz. In all centers, most food-sensitized subjects had primary (non-cross-reactive) FS. However, FS due to birch pollen related cross-reactivity was also common in Central-Northern Europe. Probable FA to milk and egg occurred frequently throughout Europe; to fish and shrimp mainly in the Mediterranean and Reykjavik. Peach, kiwi, and peanut were prominent sources of plant FA in most countries, along with notably hazelnut, apple, carrot, and celery in Central-Northern Europe and lentils and walnut in the Mediterranean. CONCLUSIONS There are large geograhical differences in the prevalence of FS and FA in school-age children across Europe. Both primary and cross-reactive FS and FA occur frequently.
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Affiliation(s)
- Sarah A Lyons
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Michael Clausen
- Children's Hospital, Landspitali University Hospital, Reykjavik, Iceland
| | - André C Knulst
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Barbara K Ballmer-Weber
- Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland; Faculty of Medicine, University of Zürich, Zürich, Switzerland; Clinic for Dermatology and Allergology, Kantonsspital St Gallen, St Gallen, Switzerland
| | | | - Laura Barreales
- Servicio de Medicina Preventiva, Epidemiology Unit, Hospital Clinico San Carlos, UCM, IdISSC, Madrid, Spain
| | - Christian Bieli
- Department of Paediatric Pulmonology, University Children's Hospital, Zürich, Switzerland
| | | | - Cristina Fernandez-Perez
- Servicio de Medicina Preventiva, Epidemiology Unit, Hospital Clinico San Carlos, UCM, IdISSC, Madrid, Spain
| | | | - Marek L Kowalski
- Department of Allergy and Immunology, Medical University of Lodz, Lodz, Poland
| | - Tanya Kralimarkova
- Clinical Centre of Allergology of the Alexandrovska Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Ischa Kummeling
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Tihomir B Mustakov
- Clinical Centre of Allergology of the Alexandrovska Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece; Division of Infection, Immunity and Respiratory Medicine, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom
| | - Todor A Popov
- University Hospital Sv. Ivan Rilski, Sofia, Bulgaria
| | | | - Paco M J Welsing
- Division of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - James Potts
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - E N Clare Mills
- Division of Infection, Immunity and Respiratory Medicine, Manchester Institute of Biotechnology & Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology, Amsterdam University Medical Centers, AMC, Amsterdam, The Netherlands
| | - Peter G J Burney
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Thuy-My Le
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Food allergy in adults in Europe: what can we learn from geographical differences? Curr Opin Allergy Clin Immunol 2020; 20:215-220. [DOI: 10.1097/aci.0000000000000616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Effect of probiotic supplementation in pregnant women: a meta-analysis of randomised controlled trials. Br J Nutr 2019; 123:870-880. [PMID: 31856928 DOI: 10.1017/s0007114519003374] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Probiotics are being used increasingly in pregnant women, whereas the efficiency on pregnancy outcomes is yet lacking. PubMed, Embase and the Cochrane Library were searched. Relative risks (RR) or weighted mean differences (WMD) with 95 % CI were employed to calculate the summary outcomes. A total of eighteen randomised controlled trials (RCT) including 4356 pregnant women were eligible. The summary RR indicated that probiotic supplementation was associated with a significant decrease in the risk of atopic eczema (RR 0·68; 95 % CI 0·58, 0·81; P < 0·001) and eczema (RR 0·79; 95 % CI 0·68, 0·91; P = 0·002) without significant heterogeneity. Probiotic supplementation was associated with a prolonged gestational age (WMD 0·09; 95 % CI 0·04, 0·15; P = 0·001) with insignificant heterogeneity, whereas no significant effect was exerted on birth weight (P = 0·851). The risks of death (RR 0·34; 95 % CI 0·13, 0·91; P = 0·031) and necrotising enterocolitis (NEC) (RR 0·38; 95 % CI 0·18, 0·81; P = 0·012) were significantly reduced in pregnant women receiving probiotics without evidence of heterogeneity. These findings suggested that probiotics in pregnant women were beneficial for atopic eczema, eczema, gestational age, death and NEC.
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Schoos AMM, Chawes BL, Bloch J, Hansen B, Stokholm J, Bønnelykke K, Kristensen B, Bisgaard H. Children Monosensitized to Can f 5 Show Different Reactions to Male and Female Dog Allergen Extract Provocation: A Randomized Controlled Trial. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:1592-1597.e2. [PMID: 31863911 DOI: 10.1016/j.jaip.2019.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/06/2019] [Accepted: 12/06/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Dog dander consists of several allergenic molecules including Can f 5, which is a protein expressed in the prostate of male dogs. OBJECTIVE To investigate whether children monosensitized to Can f 5 show different reactions to provocation tests with male versus female dog dander in a double-blind randomized clinical trial. METHODS Twenty-two children (15-18 years) with a history of dog sensitization were enrolled from the COpenhagen Prospective Studies on Asthma in Childhood2000 mother-child cohort. Skin prick test, specific IgE levels to dog dander (e5), and dog components Can f 1, 2, 3, and 5 were first assessed. We subsequently performed skin prick test and conjunctival allergen provocation test using dog dander collected separately from male and female dogs. RESULTS Seven of the 22 children were monosensitized to Can f 5. Eight were sensitized to a mix of the dog components, and 7 were no longer sensitized to dog. Of the children monosensitized to Can f 5, all had a positive skin prick test result to male dog extract and 1 of 7 was also positive to female dog extract (P = .01). Furthermore, 5 of 7 had a positive conjunctival allergen provocation test result to male dog extract and 1 of 7 also reacted to the female dog extract (P = .03). There was no difference between reactions to male and female dog extract provocation in children sensitized to a mix of the dog components. CONCLUSIONS Children monosensitized to Can f 5 show different reactions to male and female dog extract provocation using both skin prick test and conjunctival allergen provocation test, suggesting tolerance to female dogs.
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Affiliation(s)
- Ann-Marie Malby Schoos
- COpenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Bo Lund Chawes
- COpenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Joakim Bloch
- COpenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Britta Hansen
- COpenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Stokholm
- COpenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Bønnelykke
- COpenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Hans Bisgaard
- COpenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
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Abstract
PURPOSE OF REVIEW Allergic rhinoconjunctivitis is the most common manifestation of allergic disease. This break in the normal natural function of the immune system to ignore harmless molecules such as pollen and pet dander to now aggressively react has lead to a substantial disease burden that is not always recognized and adequately treated. RECENT FINDINGS Individual molecular component testing may increase the predictive value of blood sIgE and clinical symptoms. Defining the most symptoms inducing allergenic protein has led to advances in peptide-based allergen immunotherapy. There have been steady consistent reports that allergy immunotherapy for children with symptomatic allergic rhinitis prevents the onset of asthma. SUMMARY Allergy immunotherapy is an effective disease-modulating treatment that alters the underlying immune dysfunction which is a currently underutilized therapy especially as it is likely effective in preventing the onset of asthma in children, at least in the short term.
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Affiliation(s)
- Sanny K Chan
- Department of Pediatrics, National Jewish Health, Division of Allergy and Immunology, Denver, Colorado, USA
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Gherasim A, Jacob A, Schoettel F, Domis N, de Blay F. Efficacy of air cleaners in asthmatics allergic to cat in ALYATEC ® environmental exposure chamber. Clin Exp Allergy 2019; 50:160-169. [PMID: 31596983 DOI: 10.1111/cea.13511] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/20/2019] [Accepted: 09/25/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Air cleaners have been promoted for respiratory allergic disease prevention, but there is no clear clinical proof of their efficacy in allergic asthma. OBJECTIVE To examine the efficacy of a new air cleaner on early and late asthmatic responses in cat-allergic patients. METHODS This randomized, cross-over, double-blind placebo-controlled study enrolled 24 cat-asthmatic patients with GINA 1 asthma. At baseline, participants were exposed to 40 ng/m3 of airborne cat allergen for a maximum of 2 hours in ALYATEC® environmental exposure chamber (EEC). All participants were subsequently randomized into two groups that were exposed to cat allergen, either with active then placebo air cleaners or with placebo then active air cleaners with a 3-week interval in the EEC. This study was registered under number (NCT03928561). RESULTS Fewer patients experienced an EAR with active air cleaners (seven patients; 29.17%) than placebo (21 patients; 87.50%). The response incidence was lower with active than with placebo air cleaners. A Cox model demonstrated a significant treatment effect (hazard ratio, 0.10; P = .002). Active air cleaners also prevented late asthmatic response: four patients (16.67%) had a late asthmatic response with active air cleaners compared to 11 patients (45.83%) with placebo (Prescott test P = .002). Active air cleaners also decreased the maximal severity of bronchial response (FEV1 decrease of 17.24% with active vs 25.62% with placebo air cleaners; P = .001). CONCLUSIONS Our present results demonstrated that Intense Pure Air XL® air cleaners significantly prevented early and late asthmatic responses among cat-allergic asthmatics during cat allergen exposure in the ALYATEC® EEC.
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Affiliation(s)
- Alina Gherasim
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, Strasbourg, France
| | - Audrey Jacob
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, Strasbourg, France
| | - Florian Schoettel
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, Strasbourg, France
| | - Nathalie Domis
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, Strasbourg, France
| | - Frederic de Blay
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, Strasbourg, France.,Chest Diseases Department, Strasbourg University Hospital, Strasbourg, France.,Federation of translational medicine EA 3070, University of Strasbourg, Strasbourg, France
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Ahmed A, Becker A. Evaluation of eczema, asthma, allergic rhinitis and allergies among the grade-7 children of Iqaluit. Allergy Asthma Clin Immunol 2019; 15:26. [PMID: 31043967 PMCID: PMC6480605 DOI: 10.1186/s13223-019-0341-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 04/15/2019] [Indexed: 12/04/2022] Open
Abstract
Background Little is known about the prevalence of asthma, allergic rhinitis, eczema and allergies among Canadian Inuit children, especially those living in the arctic and subarctic areas. Methods A cross-sectional study among grade seven students attending schools in Iqaluit, the capital city of Nunavut, was conducted during the 2016/2017 school year. We used the International Study of Allergy and Asthma in Children (ISAAC) questionnaire with added questions relevant to the population. In addition, skin prick tests (SPT) were conducted to test for sensitization to common food and environmental allergens. Results The prevalence of current asthma is 5.2%, all of them were males and 2/3 of them were Inuit and all had a previous respiratory hospitalization. Past asthma prevalence is 8.6%, 60% males and 60% Inuit. There was an inverse relationship to crowdedness possibly as a confounding factor because of getting a higher prevalence among the non-Inuit who usually live in less crowded houses. Current allergic rhinitis prevalence is 8.6%, 60% of the cases were among the mixed Inuit/Caucasian ethnicity while no cases among the non-Inuit, there was a female predominance 3:2. Past history of allergic rhinitis prevalence is 10.3%, half of the cases were among the mixed ethnicity (5.2% of that ethnicity) followed by Inuit (3.4%) and non-Inuit (1.7%), female: Male ratio 1:1. Current eczema prevalence was 27.6%, with half of the cases among the mixed ethnicity (13.8% of that group), followed by Inuit (8.6%). There was a female predominance with protective effect of exclusive breastfeeding. Past eczema prevalence 34.5%, with half of the cases were among the mixed ethnicity (17.2% of that group), followed by Inuit (10.3%). There was a female predominance. We noted a high rate of sensitization to Cat at 29.2%, most of the cases were among the mixed ethnicity, while absent sensitization to other common inhalant allergens. Conclusion While being cautious about firm conclusions due to the small sample size and power, the noticed variations in the prevalence and risk factors of asthma, allergic rhinitis and eczema among different ethnicities living at the same subarctic environment might be related to several possible explanations like genetic, gene-environment interaction and/or lifestyle factors, it was out of the scope of this study to determine the causality of such variation in prevalence, which emphasizes the need for further investigation.
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Affiliation(s)
- Ahmed Ahmed
- 1Department of Pediatrics, University of Ottawa, Ottawa, ON Canada
| | - Allan Becker
- 2Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB Canada
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Sensitisation to airborne allergens as a risk factor for allergic rhinitis and asthma in the Polish population. Postepy Dermatol Alergol 2019; 37:751-759. [PMID: 33240016 PMCID: PMC7675083 DOI: 10.5114/ada.2019.84231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 03/24/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction The patterns of sensitisation to airborne allergens and their association with allergic diseases have been analysed in different geographical regions. Aim To analyse the impact of sensitisation to airborne allergens on allergic rhinitis (AR) and asthma in different age groups of the Polish population. Material and methods Completed questionnaires of 18,617 subjects (53.8% females), collected within the ECAP, a cross-sectional multicentre study, were analysed. Three groups of respondents were included: 6-7-year-olds (24.2%), 13-14-year-olds (25.4%), 20-44-year-olds (50.4%). The clinical part (an anamnesis, physical examination, spirometry, skin prick tests and an assay of major airborne allergen-specific IgE) was attended by 25.7% of the respondents. Results The AR was most strongly related to sensitisation to Dermatophagoides pteronyssinus, with the highest odds ratios of 10 in two younger groups and of 16 for persistent AR in children. It was also the most important risk factor for allergic asthma, with odd ratios from 8.34 in children to 6.40 in adolescents. Sensitisation to grass pollen allergens was a major risk factor for both AR, with odds ratios from 9.16 in adults to 7.87 in adolescents, and asthma, with odds ratios from 6.16 in adolescents to 5.67 in adults. Conclusions AR and asthma shared common risk factors, independently of age. Sensitisation to airborne allergens was significantly associated with asthma and, even more strongly, with AR, across all age groups. The AR was the strongest risk factor for allergic asthma in the youngest group. Persistent AR increased asthma risk more than intermittent AR in all age groups.
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Nwaru BI, Suzuki S, Ekerljung L, Sjölander S, Mincheva R, Rönmark EP, Rådinger M, Rönmark E, Borres MP, Lundbäck B, Lötvall J. Furry Animal Allergen Component Sensitization and Clinical Outcomes in Adult Asthma and Rhinitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2019; 7:1230-1238.e4. [PMID: 30594587 DOI: 10.1016/j.jaip.2018.12.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Sensitization to allergen components has been linked to asthma in children, but studies in adults are lacking. OBJECTIVE To study the relation of sensitization to furry animal allergen components to risk of asthma, rhinitis, and markers of asthma severity in adults. METHODS From the West Sweden Asthma Study, a random population-representative sample of adults aged 16 to 75 years, 2006 participants were clinically examined; 1872 were analyzed for serum IgE level to a mix of aeroallergens. Those with an IgE level of more than 0.35 kUA/L to cat, dog, or horse allergen components were analyzed for specific cat (Felis domesticus [Fel d 1, Fel d 2, and Fel d 4]), dog (Canis familiaris [Can f 1, Can f 2, Can f 3, and Can f 5]), and horse (Equus caballus [Equ c 1]) allergen components. We defined monosensitization, double sensitization, and polysensitization (>2 components) patterns and applied cluster analysis to derive distinct sensitization clusters. RESULTS Sensitization to each allergen component, lipocalins, each sensitization pattern, and each sensitization cluster (nonsensitized, Fel d 1-driven sensitized, and multisensitized clusters) was associated with substantial increased risk of asthma, rhinitis, concomitant asthma and rhinitis, and Asthma Control Test-controlled asthma. Fel d 1, Can f 1, Can f 2, Can f 3, polysensitization, and multisensitized cluster were further associated with increased fractional exhaled nitric oxide and eosinophil levels, but with lower PD20 methacoline (provocative dose of methacholine causing a 20% drop in FEV1) values. There was no association with asthma exacerbations, FEV1 predicted values, emergency visits or regular oral steroid use, and neutrophil levels. CONCLUSIONS Sensitization to furry animal allergen components is an important predictor of asthma, rhinitis, and markers of asthma severity with increased blood eosinophils, fractional exhaled nitric oxide, and airway hyperreactivity.
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Affiliation(s)
- Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Shintaro Suzuki
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Division of Allergology and Respiratory Medicine, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Linda Ekerljung
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Roxana Mincheva
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Erik P Rönmark
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Madeleine Rådinger
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Magnus P Borres
- ImmunoDiagnostics, ThermoFisher Scientific, Uppsala, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Bo Lundbäck
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jan Lötvall
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Victor S, Binnmyr J, Lampa E, Rask-Andersen A, Elfman L. Levels of horse allergen Equ c 4 in dander and saliva from ten horse breeds. Clin Exp Allergy 2019; 49:701-711. [PMID: 30716182 PMCID: PMC6850112 DOI: 10.1111/cea.13362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 12/21/2018] [Accepted: 12/29/2018] [Indexed: 12/01/2022]
Abstract
Background Horses are an important source of allergens, but the distribution of horse allergens is poorly understood. Five horse allergens have been identified, Equ c 1‐4 and 6. Equ c 4 seems to be an important allergen, with an IgE‐binding frequency of 77% in horse‐sensitized individuals. Objectives The aim of this study was to investigate levels of horse allergen Equ c 4 in dander, saliva and urine from ten horse breeds. Method The study population included 170 horses (87 mares, 27 stallions, 56 geldings) from ten breeds. Horse dander, saliva and urine samples were collected. Levels of horse allergen Equ c 4 were quantified using a two‐site sandwich ELISA (mAb 103 and 14G4) and were expressed as Equ c 4 U/μg protein. Results The horse allergen Equ c 4 was present in all dander and saliva samples from ten horse breeds, with high within‐breed and inter‐breed variations; GM values were 639 Equ c 4 U/μg protein (range 5‐15 264) for dander and 39.5 (4‐263) for saliva. Equ c 4 was found in 19/21 urine samples. Adjusted for age, sex and changes over time, no differences between breeds could be seen in dander, while in saliva the North Swedish horse showed lower levels of Equ c 4 than any other breed. The levels of Equ c 4 protein in dander and saliva were significantly higher in samples from stallions compared to mares and geldings, independent of breed. Conclusions and Clinical Relevance The results show a high variability in allergen levels of Equ c 4 in dander and saliva both within and between breeds. Significantly higher levels were found in stallions compared to mares and geldings, independent of breed. Results suggest that none of the horse breeds studied can be recommended for individuals allergic to Equ c 4.
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Affiliation(s)
- Susanne Victor
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Jonas Binnmyr
- Department of Clinical Neuroscience, Therapeutic Immune Design Unit, Karolinska Institutet, Stockholm, Sweden
| | - Erik Lampa
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Anna Rask-Andersen
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Lena Elfman
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
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Suzuki S, Nwaru BI, Ekerljung L, Sjölander S, Mincheva R, Rönmark EP, Rönmark E, Lundbäck B, Borres MP, Lötvall J. Characterization of sensitization to furry animal allergen components in an adult population. Clin Exp Allergy 2019; 49:495-505. [PMID: 30697845 DOI: 10.1111/cea.13355] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/25/2018] [Accepted: 12/29/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND There are paucity of data on sensitization to furry animal allergen components in adults. Furry animals are major sensitizers and contributors to asthma burden in northern Europe and North America. OBJECTIVE To characterize sensitization patterns to furry animal allergen components in Swedish adults. METHODS Based on the West Sweden Asthma Study, a random population (n = 1103) and an asthma sample (n = 769) were tested for allergen sensitization using Phadiatop® . Those with IgE ≥ 0.35 kUA /L were tested for cat (Fel d 1, 2, and 4), dog (Can f 1, 2, 3, and 5), and horse (Equ c 1) allergen component sensitization. We defined allergen component poly-sensitization patterns, identified data-driven sensitization clusters, described component sensitization overlaps, and assessed determinants of sensitization patterns. RESULTS The prevalence of allergen component sensitization ranged from 0.8% for Fel d 2 and Can f 3 to 8.9% for Fel d 1. The most common dog component was Can f 5 (3.6%); 2.1% were sensitized to Equ c 1. Those sensitized to Fel d 2 and Fel d 4 were commonly sensitized to Fel d 1. The most common dog component overlap was between Can f 1/Can f 2 and Can f 5. Mono-sensitization was 5.6%, double sensitization 1.5% and poly-sensitization 2.1%. Sensitization was always higher in the asthma than in the random sample. Three sensitization clusters were derived, namely non-sensitized (90% in random vs 66% in asthma sample); Fel d 1-driven sensitized (7% vs 19%); and multi-sensitized (3% vs 15%). Key determinants of sensitization were gender, age, raised on a farm, family history of allergy or asthma, smoking, and occupational exposure to dust or fumes. CONCLUSIONS & CLINICAL RELEVANCE Fel d 1 and Can f 5 are the most common cat and dog components sensitization in this adult Swedish population. Mono-sensitization is more common than poly-sensitization. This detailed characterization highlights the current distribution of furry animal allergen components in Swedish adults, and their impact on clinical outcomes of asthma will be further explored.
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Affiliation(s)
- Shintaro Suzuki
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Division of Allergology and Respiratory Medicine, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Linda Ekerljung
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Roxana Mincheva
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Erik P Rönmark
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Bo Lundbäck
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus P Borres
- ImmunoDiagnostics, Thermo Fisher Scientific, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Jan Lötvall
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Hosoki K, Jaruga P, Itazawa T, Aguilera-Aguirre L, Coskun E, Hazra TK, Boldogh I, Dizdaroglu M, Sur S. Excision release of 5?hydroxycytosine oxidatively induced DNA base lesions from the lung genome by cat dander extract challenge stimulates allergic airway inflammation. Clin Exp Allergy 2018; 48:1676-1687. [PMID: 30244512 DOI: 10.1111/cea.13284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 06/15/2018] [Accepted: 07/15/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Ragweed pollen extract (RWPE) induces TLR4-NFκB-CXCL-dependent recruitment of ROS-generating neutrophils to the airway and OGG1 DNA glycosylase-dependent excision of oxidatively induced 8-OH-Gua DNA base lesions from the airway epithelial cell genome. Administration of free 8-OH-Gua base stimulates RWPE-induced allergic lung inflammation. These studies suggest that stimulation of innate receptors and their adaptor by allergenic extracts initiates excision of a set of DNA base lesions that facilitate innate/allergic lung inflammation. OBJECTIVE To test the hypothesis that stimulation of a conserved innate receptor/adaptor pathway by allergenic extracts induces excision of a set of pro-inflammatory oxidatively induced DNA base lesions from the lung genome that stimulate allergic airway inflammation. METHODS Wild-type (WT), Tlr4KO, Tlr2KO, Myd88KO, and TrifKO mice were intranasally challenged once or repeatedly with cat dander extract (CDE), and innate or allergic inflammation and gene expression were quantified. We utilized GC-MS/MS to quantify a set of oxidatively induced DNA base lesions after challenge of naïve mice with CDE. RESULTS A single CDE challenge stimulated innate neutrophil recruitment that was partially dependent on TLR4 and TLR2, and completely on Myd88, but not TRIF. A single CDE challenge stimulated MyD88-dependent excision of DNA base lesions 5-OH-Cyt, FapyAde, and FapyGua from the lung genome. A single challenge of naïve WT mice with 5-OH-Cyt stimulated neutrophilic lung inflammation. Multiple CDE instillations stimulated MyD88-dependent allergic airway inflammation. Multiple administrations of 5-OH-Cyt with CDE stimulated allergic sensitization and allergic airway inflammation. CONCLUSIONS AND CLINICAL RELEVANCE We show for the first time that CDE challenge stimulates MyD88-dependent excision of DNA base lesions. Our data suggest that the resultant-free base(s) contribute to CDE-induced innate/allergic lung inflammation. We suggest that blocking the MyD88 pathway in the airways with specific inhibitors may be a novel targeted strategy of inhibiting amplification of innate and adaptive immune inflammation in allergic diseases by oxidatively induced DNA base lesions.
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Affiliation(s)
- Koa Hosoki
- Department of Internal Medicine, Division of Allergy and Immunology, University of Texas Medical Branch, Galveston, Texas
| | - Pawel Jaruga
- Biomolecular Measurement Division National Institute of Standards and Technology, Gaithersburg, Maryland
| | - Toshiko Itazawa
- Department of Internal Medicine, Division of Allergy and Immunology, University of Texas Medical Branch, Galveston, Texas
| | | | - Erdem Coskun
- Biomolecular Measurement Division National Institute of Standards and Technology, Gaithersburg, Maryland
| | - Tapas K Hazra
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.,Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Istvan Boldogh
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas.,Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Miral Dizdaroglu
- Biomolecular Measurement Division National Institute of Standards and Technology, Gaithersburg, Maryland
| | - Sanjiv Sur
- Department of Internal Medicine, Division of Allergy and Immunology, University of Texas Medical Branch, Galveston, Texas.,Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston, Texas
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Fernández-Soto R, Navarrete-Rodríguez EM, Del-Rio-Navarro BE, Sienra-Monge JJL, Meneses-Sánchez NA, Saucedo-Ramírez OJ. Fungal Allergy: Pattern of sensitization over the past 11 years. Allergol Immunopathol (Madr) 2018; 46:557-564. [PMID: 29739683 DOI: 10.1016/j.aller.2018.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/15/2018] [Accepted: 01/25/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION AND OBJECTIVES Although the prevalence of sensitization to fungi is not precisely known, it can reach 50% in inner cities and has been identified as a risk factor in the development of asthma. Whereas the prevalence of allergic diseases is increasing, it is unclear whether the same occurs with sensitization to fungi. PATIENTS AND METHODS A retrospective study was performed at the "Hospital Infantil de México Federico Gómez". From skin tests taken between 2004 and 2015, information was gathered about Alternaria alternata, Aspergillus fumigatus, Candida albicans, Cladosporium herbarum, Mucor mucedo and Penicillium notatum. The participating patients were 2-18 years old, presented some type of allergic condition, and underwent immediate hypersensitivity tests to the fungi herein examined. Descriptive analysis and chi-squared distribution were used. RESULTS Of the 8794 patients included in the study, 14% showed a negative result to the entire panel of environmental allergens. The remaining 7565 individuals displayed sensitization to at least one fungus, which most frequently was Aspergillus, with a rate of 16.8%. When the patients were divided into age groups, the same trend was observed. The highest percentage of sensitization (58%) toward at least one type of fungus was found in 2014, and the lowest percentage (49.8%) in 2008. CONCLUSION The rate of sensitization to at least one type of fungus was presently over 50%, higher than that detected in other medical centers in Mexico. This rate was constant over the 11-year study, and Aspergillus exhibited the greatest frequency of sensitization among the patients.
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Affiliation(s)
- R Fernández-Soto
- Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - E M Navarrete-Rodríguez
- Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
| | - B E Del-Rio-Navarro
- Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - J J Luis Sienra-Monge
- Subdirección de Pediatria Ambulatoria. Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - N A Meneses-Sánchez
- Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - O J Saucedo-Ramírez
- Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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Wojtalewicz N, Kabrodt K, Goseberg S, Schellenberg I. Evaluation of the manufacturer-dependent differences in specific immunoglobulin E results for indoor allergens. Ann Allergy Asthma Immunol 2018; 121:490-495. [PMID: 30025909 DOI: 10.1016/j.anai.2018.07.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Even though allergies are an important health issue, the detected amount of allergen-specific IgE (sIgE) has differed widely between manufacturers in the past, and even as recently as this year. These discrepancies hinder diagnostics and can even impact allergen immunotherapy. OBJECTIVE The aim of this study was to evaluate the development and status quo of the quality of in vitro diagnostic testing for house dust mites (HDM) and cat epithelium, 2 important indoor allergen sources. METHODS We analyzed data on the allergen sources European HDM, American HDM, and cat epithelium, which were collected by the Society for Promoting Quality Assurance in Medical Laboratories (INSTAND e.V.) during 7 years as part of External Quality Assessment schemes (EQAs). A pseudoanonymized comparison was made of the semiquantitative data and allergen-class results of the 4 main suppliers of in vitro diagnostic sIgE tests. Coefficients of variation (CV) were determined in order to evaluate interlaboratory comparability. RESULTS In vitro allergy diagnostic testing for the major allergen sources HDM and cat epithelium still reveals manufacturer-dependent differences. Despite this, a cautious trend was found towards an alignment of the results and interlaboratory comparability, with the exception of 1 supplier. CONCLUSION Even though these results are promising, future EQAs have to be closely monitored to ensure this positive trend is not just a snapshot.
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Affiliation(s)
- Nathalie Wojtalewicz
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Düsseldorf, Germany
| | - Kathrin Kabrodt
- Institute of Bioanalytical Sciences (IBAS), Center of Life Sciences, Anhalt University of Applied Sciences, Bernburg, Germany
| | - Sabine Goseberg
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Düsseldorf, Germany
| | - Ingo Schellenberg
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Düsseldorf, Germany; Institute of Bioanalytical Sciences (IBAS), Center of Life Sciences, Anhalt University of Applied Sciences, Bernburg, Germany.
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45
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Santos AF, Lack G. Is the Prevalence of Food Allergy Not on the Rise After All? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 4:721-2. [PMID: 27393781 DOI: 10.1016/j.jaip.2016.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Alexandra F Santos
- Division of Asthma, Allergy & Lung Biology, Department of Pediatric Allergy, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Gideon Lack
- Division of Asthma, Allergy & Lung Biology, Department of Pediatric Allergy, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
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Wang X, Ma T, Wang X, Zhuang Y, Wang X, Ning H, Shi H, Yu R, Yan D, Huang H, Bai Y, Shan G, Zhang B, Song Q, Zhang Y, Zhang T, Jia D, Liu X, Kang Z, Yan W, Yang B, Bao X, Sun S, Zhang F, Yu W, Bai C, Wei T, Yang T, Ma T, Wu X, Liu J, Du H, Zhang L, Yan Y, Wang D. Prevalence of pollen-induced allergic rhinitis with high pollen exposure in grasslands of northern China. Allergy 2018; 73:1232-1243. [PMID: 29322523 PMCID: PMC6033040 DOI: 10.1111/all.13388] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND The aim of this study was to investigate the prevalence of epidemiologic and physician-diagnosed pollen-induced AR (PiAR) in the grasslands of northern China and to study the impact of the intensity and time of pollen exposure on PiAR prevalence. METHODS A multistage, clustered and proportionately stratified random sampling with a field interviewer-administered survey study was performed together with skin prick tests (SPT) and measurements of the daily pollen count. RESULTS A total of 6043 subjects completed the study, with a proportion of 32.4% epidemiologic AR and 18.5% PiAR. The prevalence was higher in males than females (19.6% vs 17.4%, P = .024), but no difference between the two major residential and ethnic groups (Han and Mongolian) was observed. Subjects from urban areas showed higher prevalence of PiAR than rural areas (23.1% vs 14.0%, P < .001). Most PiAR patients were sensitized to two or more pollens (79.4%) with artemisia, chenopodium, and humulus scandens being the most common pollen types, which were similarly found as the top three sensitizing pollen allergens by SPT. There were significant regional differences in the prevalence of epidemiologic AR (from 18.6% to 52.9%) and PiAR (from 10.5% to 31.4%) among the six areas investigated. PiAR symptoms were positively associated with pollen counts, temperature, and precipitation (P < .05), but negatively with wind speed and pressure P < .05). CONCLUSION Pollen-induced AR (PiAR) prevalence in the investigated region is extremely high due to high seasonal pollen exposure, which was influenced by local environmental and climate conditions.
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Affiliation(s)
- X.‐Y. Wang
- Department of AllergyBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - T.‐T. Ma
- Department of AllergyBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - X.‐Y. Wang
- Department of AllergyBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - Y. Zhuang
- Department of AllergyBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - X.‐D. Wang
- Department of Otolaryngology Head and Neck SurgeryBeijing TongRen HospitalBeijing Key Laboratory of Nasal DiseasesBeijing Institute of OtolaryngologyCapital Medical UniversityBeijingChina
| | - H.‐Y. Ning
- Department of AllergyBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - H.‐Y. Shi
- Department of AllergyBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - R.‐L. Yu
- Department of AllergyBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - D. Yan
- Department of PharmacyBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - H.‐D. Huang
- Department of NephrologyBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - Y.‐F. Bai
- State Key Laboratory of Vegetation and Environmental ChangeInstitute of BotanyChinese Academy of SciencesBeijingChina
| | - G.‐L. Shan
- Department of Epidemiology and StatisticsInstitute of Basic Medical Sciences Chinese Academy of Medical SciencesSchool of Basic Medicine PekingUnion Medical CollegeBeijingChina
| | - B. Zhang
- Department of Epidemiology and StatisticsInstitute of Basic Medical Sciences Chinese Academy of Medical SciencesSchool of Basic Medicine PekingUnion Medical CollegeBeijingChina
| | - Q.‐K. Song
- Department of Science and TechnologyBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - Y.‐F. Zhang
- Tongliao HospitalTongliao, Inner MongoliaChina
| | - T.‐J. Zhang
- Jarud People's HospitalJarud Banner, Tongliao, Inner MongoliaChina
| | - D.‐Z. Jia
- Kailu People's HospitalKailu County, Tongliao, Inner MongoliaChina
| | - X.‐L. Liu
- Kailu People's HospitalKailu County, Tongliao, Inner MongoliaChina
| | - Z.‐X. Kang
- Erenhot Community Health Service CenterErenhot, Inner MongoliaChina
| | - W.‐J. Yan
- Duolun People's HospitalDuolun, Inner MongoliaChina
| | - B.‐T. Yang
- Xiwu People's HospitalXiwu BannerInner MongoliaChina
| | - X.‐Z. Bao
- Kailu People's HospitalKailu County, Tongliao, Inner MongoliaChina
| | - S.‐H. Sun
- Jarud People's HospitalJarud Banner, Tongliao, Inner MongoliaChina
| | - F.‐F. Zhang
- Tongliao HospitalTongliao, Inner MongoliaChina
| | - W.‐H. Yu
- Jarud People's HospitalJarud Banner, Tongliao, Inner MongoliaChina
| | - C.‐L. Bai
- Xilingol Mongolian HospitalXilinhot, Inner MongoliaChina
| | - T. Wei
- Xilingol Mongolian HospitalXilinhot, Inner MongoliaChina
| | - T. Yang
- Xilingol Mongolian HospitalXilinhot, Inner MongoliaChina
| | - T.‐Q. Ma
- Erenhot Community Health Service CenterErenhot, Inner MongoliaChina
| | - X.‐B. Wu
- Erenhot Community Health Service CenterErenhot, Inner MongoliaChina
| | - J.‐G. Liu
- Duolun People's HospitalDuolun, Inner MongoliaChina
| | - H. Du
- Duolun People's HospitalDuolun, Inner MongoliaChina
| | - L. Zhang
- Department of Otolaryngology Head and Neck SurgeryBeijing TongRen HospitalBeijing Key Laboratory of Nasal DiseasesBeijing Institute of OtolaryngologyCapital Medical UniversityBeijingChina
| | - Y. Yan
- Department of UrologyBeijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - D.‐Y. Wang
- Department of OtolaryngologyYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
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Mitre E, Susi A, Kropp LE, Schwartz DJ, Gorman GH, Nylund CM. Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy and Allergic Diseases in Early Childhood. JAMA Pediatr 2018; 172:e180315. [PMID: 29610864 PMCID: PMC6137535 DOI: 10.1001/jamapediatrics.2018.0315] [Citation(s) in RCA: 166] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE Allergic diseases are prevalent in childhood. Early exposure to medications that can alter the microbiome, including acid-suppressive medications and antibiotics, may influence the likelihood of allergy. OBJECTIVE To determine whether there is an association between the use of acid-suppressive medications or antibiotics in the first 6 months of infancy and development of allergic diseases in early childhood. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study was conducted in 792 130 children who were Department of Defense TRICARE beneficiaries with a birth medical record in the Military Health System database between October 1, 2001, and September 30, 2013, with continued enrollment from within 35 days of birth until at least age 1 year. Children who had an initial birth stay of greater than 7 days or were diagnosed with any of the outcome allergic conditions within the first 6 months of life were excluded from the study. Data analysis was performed from April 15, 2015, to January 4, 2018. EXPOSURES Exposures were defined as having any dispensed prescription for a histamine-2 receptor antagonist (H2RA), proton pump inhibitor (PPI), or antibiotic. MAIN OUTCOMES AND MEASURES The main outcome was allergic disease, defined as the presence of food allergy, anaphylaxis, asthma, atopic dermatitis, allergic rhinitis, allergic conjunctivitis, urticaria, contact dermatitis, medication allergy, or other allergy. RESULTS Of 792 130 children (395 215 [49.9%] girls) included for analysis, 60 209 (7.6%) were prescribed an H2RA, 13 687 (1.7%) were prescribed a PPI, and 131 708 (16.6%) were prescribed an antibiotic during the first 6 months of life. Data for each child were available for a median of 4.6 years. Adjusted hazard ratios (aHRs) in children prescribed H2RAs and PPIs, respectively, were 2.18 (95% CI, 2.04-2.33) and 2.59 (95% CI, 2.25-3.00) for food allergy, 1.70 (95% CI, 1.60-1.80) and 1.84 (95% CI, 1.56-2.17) for medication allergy, 1.51 (95% CI, 1.38-1.66) and 1.45 (95% CI, 1.22-1.73) for anaphylaxis, 1.50 (95% CI, 1.46-1.54) and 1.44 (95% CI, 1.36-1.52) for allergic rhinitis, and 1.25 (95% CI, 1.21-1.29) and 1.41 (95% CI, 1.31-1.52) for asthma. The aHRs after antibiotic prescription in the first 6 months of life were 2.09 (95% CI, 2.05-2.13) for asthma, 1.75 (95% CI, 1.72-1.78) for allergic rhinitis, 1.51 (95% CI, 1.38-1.66) for anaphylaxis, and 1.42 (95% CI, 1.34-1.50) for allergic conjunctivitis. CONCLUSIONS AND RELEVANCE This study found associations between the use of acid-suppressive medications and antibiotics during the first 6 months of infancy and subsequent development of allergic disease. Acid-suppressive medications and antibiotics should be used during infancy only in situations of clear clinical benefit.
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Affiliation(s)
- Edward Mitre
- Department of Microbiology and Immunology, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Apryl Susi
- Department of Pediatrics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Laura E. Kropp
- Department of Microbiology and Immunology, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - David J. Schwartz
- Division of Allergy and Immunology, Department of Medicine, Dwight D. Eisenhower Army Medical Center, Ft Gordon, Georgia
| | - Gregory H. Gorman
- Department of Pediatrics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Cade M. Nylund
- Department of Pediatrics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Käck U, Asarnoj A, Grönlund H, Borres MP, van Hage M, Lilja G, Konradsen JR. Molecular allergy diagnostics refine characterization of children sensitized to dog dander. J Allergy Clin Immunol 2018; 142:1113-1120.e9. [PMID: 29852259 DOI: 10.1016/j.jaci.2018.05.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 04/23/2018] [Accepted: 05/18/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sensitization to dog dander is an important risk factor for rhinoconjunctivitis and asthma but is not sufficient for diagnosing dog allergy. Molecular allergy diagnostics offer new opportunities for refined characterization. OBJECTIVES We sought to study the association between sensitization to all presently known dog allergen components and clinical symptoms of dog allergy in children evaluated by using nasal provocation tests (NPTs). METHODS Sixty children (age, 10-18 years) sensitized to dog dander extract underwent NPTs with dog dander extract. Measurement of IgE levels to dog dander and to Can f 1, Can f 2, Can f 3, and Can f 5 was performed with ImmunoCAP, and measurement of IgE levels to Can f 4 and Can f 6 was performed with streptavidin ImmunoCAP. An IgE level of 0.1 kUA/L or greater was considered positive. RESULTS There was an association between sensitization to an increasing number of dog allergen components and a positive nasal challenge result (P = .01). Sensitization to lipocalins (odds ratio [OR], 6.0; 95% CI, 1.04-34.5), in particular Can f 4 (OR, 6.80; 95% CI 1.84-25.2) and Can f 6 (OR, 5.69; 95% CI, 1.59-20.8), was associated with a positive NPT result. Monosensitization to Can f 5 was related to a negative NPT result (OR, 5.78; 95% CI, 1.01-33.0). CONCLUSION Sensitization to an increasing number of dog allergen components and to lipocalins is associated with dog allergy. Monosensitization to Can f 5 should not be regarded primarily as a marker for dog allergy.
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Affiliation(s)
- Ulrika Käck
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
| | - Anna Asarnoj
- Department of Medicine Solna Immunology and Allergy Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Hans Grönlund
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Magnus P Borres
- Thermo Fisher Scientific, Uppsala, Sweden; Department of Women's & Children's Health, Uppsala University, Uppsala, Sweden
| | - Marianne van Hage
- Department of Medicine Solna Immunology and Allergy Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Gunnar Lilja
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Jon R Konradsen
- Department of Medicine Solna Immunology and Allergy Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Oncham S, Udomsubpayakul U, Laisuan W. Skin prick test reactivity to aeroallergens in adult allergy clinic in Thailand: a 12-year retrospective study. Asia Pac Allergy 2018; 8:e17. [PMID: 29732293 PMCID: PMC5931924 DOI: 10.5415/apallergy.2018.8.e17] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 04/23/2018] [Indexed: 11/30/2022] Open
Abstract
Background The global prevalence of allergic rhinitis, asthma, and atopic dermatitis has risen significantly over the last 2 decades. Allergic sensitization to aeroallergen is a major risk factor in developing the allergic disease. The prevalence of aeroallergen sensitization varies in different regions and countries. Objective To determine the prevalence of common aeroallergen sensitization and the atopic status among adult patients. Methods A cross-sectional, retrospective study. The data were collected from medical records and database of the result of skin prick test of patients who had the allergic symptoms or chronic urticaria in adult allergy clinic, Ramathibodi hospital from January 2004 to December 2015. Results A total of 1,516 of patients (female, 1,118 [73.7%]) were enrolled. The mean ages of participants were 41.34 (standard deviation, ±16.5) years. Fifty-eight percent (58%) of patients were diagnosed with allergic rhinitis, 19.7%, 3.2%, and 9.2% with asthma, atopic dermatitis, and chronic urticaria respectively. In the chronic urticaria group, 57.4% underwent the positive skin prick test to common aeroallergens. Mites were responsible for the most common inhaled allergen sensitization in this study as 50.1% of Dermatophagoides pteronyssinus, 32% of Dermatophagoides farinae, and 31.5% of house dust. Cockroach was the second most common aeroallergen sensitization as 32.3% followed by grass pollen, Bermuda (21.1%) and timothy (13.6%). The animal dander, cat and dog, occupied 12.9 and 10% respectively. Conclusion Mites were the most common cause of aeroallergen sensitization in all patients followed by cockroach, grass pollen, and animal dander. However, Bermuda sensitization has increased significantly in the last 6 years.
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Affiliation(s)
- Supa Oncham
- Division of Allergy Immunology and Rheumatology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Umaporn Udomsubpayakul
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Wannada Laisuan
- Division of Allergy Immunology and Rheumatology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
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Andersson M, Backman H, Nordberg G, Hagenbjörk A, Hedman L, Eriksson K, Forsberg B, Rönmark E. Early life swimming pool exposure and asthma onset in children - a case-control study. Environ Health 2018; 17:34. [PMID: 29642932 PMCID: PMC5896097 DOI: 10.1186/s12940-018-0383-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 04/03/2018] [Indexed: 05/26/2023]
Abstract
BACKGROUND Trichloramine exposure in indoor swimming pools has been suggested to cause asthma in children. We aimed to investigate the risk of asthma onset among children in relation to individual trichloramine exposure. METHODS A longitudinal nested case-control study of 337 children with asthma (cases) and 633 controls aged 16-17 years was performed within a population-based cohort from The Obstructive Lung Disease in Northern Sweden studies (OLIN). Year of asthma onset and exposure time at different ages were obtained in telephone interviews. Trichloramine concentrations in the pool buildings were measured. Skin prick test results for inhalant allergens were available from previous examinations of the cohort. The risk for asthma was analyzed in relation to the cumulative trichloramine exposure before onset of asthma. RESULTS The participation rate was high in the original cohort (88 to 96%), and in the case-control study (80%). Trichloramine concentrations ranged from 0.020 to 0.55 mg/m3 (mean 0.15 mg/m3). Swimming pool exposure in early life was associated with a significantly higher risk of pre-school asthma onset. A dose-response relationship between swimming pool exposure and asthma was indicated in children with asthma onset at 1 year of age. Children who were both sensitized and exposed had a particularly high risk. CONCLUSIONS Early life exposure to chlorinated swimming pool environments was associated with pre-school asthma onset.
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Affiliation(s)
- Martin Andersson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187 Umeå, Sweden
- The OLIN studies, S-97189 Luleå, Sweden
| | - Helena Backman
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187 Umeå, Sweden
- The OLIN studies, S-97189 Luleå, Sweden
| | - Gunnar Nordberg
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187 Umeå, Sweden
| | - Annika Hagenbjörk
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187 Umeå, Sweden
| | - Linnea Hedman
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187 Umeå, Sweden
- The OLIN studies, S-97189 Luleå, Sweden
| | - Kåre Eriksson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187 Umeå, Sweden
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187 Umeå, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187 Umeå, Sweden
- The OLIN studies, S-97189 Luleå, Sweden
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