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Hossny E, Adachi Y, Anastasiou E, Badellino H, Custovic A, El-Owaidy R, El-Sayed ZA, Filipovic I, Gomez RM, Kalayci Ö, Le Souëf P, Miligkos M, Morais-Almeida M, Nieto A, Phipatanakul W, Shousha G, Teijeiro A, Wang JY, Wong GW, Xepapadaki P, Yong SB, Papadopoulos NG. Pediatric asthma comorbidities: Global impact and unmet needs. World Allergy Organ J 2024; 17:100909. [PMID: 38827329 PMCID: PMC11141278 DOI: 10.1016/j.waojou.2024.100909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 06/04/2024] Open
Abstract
Real-world data on the range and impact of comorbid health conditions that affect pediatric asthma are scant, especially from developing countries. Lack of data hinders effective diagnosis, treatment, and overall management of these complex cases. We, hereby, describe the common pediatric asthma comorbid conditions in terms of evidence for association, potential mechanisms of impact on asthma control, and treatment benefit. Obesity, upper airway allergies, dysfunctional breathing, multiple sensitizations, depressive disorders, food allergy, and gastro-esophageal reflux are common associations with difficult-to-treat asthma. On the other hand, asthma symptoms and/or management may negatively impact the well-being of children through drug adverse effects, worsening of anaphylaxis symptoms, and disturbing mental health. Awareness of these ailments may be crucial for designing the optimum care for each asthmatic child individually and may ultimately improve the quality of life of patients and their families. A multidisciplinary team of physicians is required to identify and manage such comorbidities aiming to mitigate the over-use of asthma pharmacotherapy. Asthma research should target relevant real-world difficulties encountered at clinical practice and focus on interventions that would mitigate the impact of such comorbidities. Finally, policymakers and global healthcare organizations are urged to recognize pediatric asthma control as a healthcare priority and allocate resources for research and clinical interventions. In other words, global asthma control needs support by compassionate scientific partnership.
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Affiliation(s)
- Elham Hossny
- Pediatric Allergy, Immunology, and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Yuichi Adachi
- Pediatric Allergy Center, Toyama Red Cross Hospital, Japan
| | - Eleni Anastasiou
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Héctor Badellino
- Faculty of Psychology, UCES University, San Francisco, Argentina
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Rasha El-Owaidy
- Pediatric Allergy, Immunology, and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Zeinab A. El-Sayed
- Pediatric Allergy, Immunology, and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | | | | | - Ömer Kalayci
- Hacettepe University School of Medicine, Ankara, Turkey
| | - Peter Le Souëf
- School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Michael Miligkos
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Antonio Nieto
- Pediatric Pulmonology and Allergy Unit, Hospital Universitari i Politècnic La Fe, Health Research Institute La Fe, Valencia, Spain
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ghada Shousha
- Pediatric Allergy, Immunology, and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Alvaro Teijeiro
- Respiratory Department, Pediatric Hospital, Córdoba, Argentina
| | - Jiu-Yao Wang
- Allergy, Immunology and Microbiome Research Center, China Medical University Children's Hospital, Taichung, Taiwan
| | - Gary W.K. Wong
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Su Boon Yong
- Department of Allergy and Immunology, China Medical University Children's Hospital, Taichung, Taiwan
| | - Nikolaos G. Papadopoulos
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
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2
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Chen C, Zhang W, Zheng X, Jiang C, Zhang W. Analysis of the potential molecular mechanisms of asthma and gastroesophageal reflux disease. J Asthma 2024:1-13. [PMID: 38517701 DOI: 10.1080/02770903.2024.2334361] [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: 11/27/2023] [Accepted: 03/20/2024] [Indexed: 03/24/2024]
Abstract
OBJECTIVE Asthma and gastroesophageal reflux disease (GERD) often occur simultaneously, with GERD being a comorbidity of asthma. This study aimed to explore the biological markers related to asthma and GERD by bioinformatics analysis. METHODS Initially, gene expression datasets for asthma and GERD were obtained from the Gene Expression Omnibus database, and subsequent differential expression analysis yielded 620 differentially expressed genes (DEGs) for asthma and 2367 DEGs for GERD. The intersection of these two gene sets yielded a total of 84 DEGs. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses revealed that these genes may be involved in steroid hormone secretion and cellular stress response. Five hub genes (PTGDR2, CPA3, FCER1A, TPSAB1, and IL1RL1) were identified by a protein-protein interaction (PPI) network analysis and topological algorithm. RESULTS Enrichment analysis results indicated that hub genes may be involved in hormone secretion and disease development, particularly in regulating the renin-angiotensin system and systemic arterial blood pressure. PTGDR2, CPA3, TPSAB1, and IL1RL1 were upregulated in both asthma and GERD patient groups, while FCER1A was upregulated in asthma patients but downregulated in GERD patients. Through drug prediction, 22 drugs targeting hub genes PTGDR2, FCER1A, and TPSAB1 were identified. By constructing a transcription factor (TF)-target gene network, we found that eight TFs may regulate the expression of PTGDR2, FCER1A, and IL1RL1. CONCLUSION Hence, Asthma and GERD were related to steroid hormone secretion and the renin-angiotensin system.
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Affiliation(s)
- Changdan Chen
- Department of Gastroenterology Medicine, Ningde Municipal Hospital of Ningde Normal University, Ningde, Fujian, China
| | - Wei Zhang
- Department of Gastroenterology Medicine, Ningde Municipal Hospital of Ningde Normal University, Ningde, Fujian, China
| | - Xiujin Zheng
- Department of Gastroenterology Medicine, Ningde Municipal Hospital of Ningde Normal University, Ningde, Fujian, China
| | - Chenglin Jiang
- Department of Gastroenterology Medicine, Ningde Municipal Hospital of Ningde Normal University, Ningde, Fujian, China
| | - Wen Zhang
- Department of Pulmonary and Critical Care Medicine, Ningde Municipal Hospital of Ningde Normal University, Ningde, Fujian, China
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McDonald VM, Hamada Y, Agusti A, Gibson PG. Treatable Traits in Asthma: The Importance of Extrapulmonary Traits-GERD, CRSwNP, Atopic Dermatitis, and Depression/Anxiety. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:824-837. [PMID: 38278324 DOI: 10.1016/j.jaip.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/14/2023] [Accepted: 01/02/2024] [Indexed: 01/28/2024]
Abstract
Treatable traits is a personalized medicine approach to the management of airway disease. Assessing traits within the 3 domains of pulmonary, extrapulmonary, and behavioral/lifestyle/risk factor traits, and applying targeted treatments to effectively manage these traits, enables a holistic and personalized approach to care. Asthma is a heterogeneous and complex airway disease that is frequently complicated by several extrapulmonary traits that impact asthma outcomes and predict future outcomes. We propose that the identification of extrapulmonary and behavioral risk factor traits and the implementation of targeted therapy will lead to improved management of people with asthma. Furthermore, many extrapulmonary traits present as "connected comorbidities"; that is, they coexist with asthma, have an impact on asthma, and effective treatment improves both asthma and the comorbidity or the comorbidities may share a similar mechanism. In this review, we explore this concept and look at atopic dermatitis, chronic rhinosinusitis with nasal polyps, gastroesophageal reflux disease, anxiety, and depression as treatable traits of asthma and how these can be managed using this approach.
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Affiliation(s)
- Vanessa M McDonald
- Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia.
| | - Yuto Hamada
- Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Alvar Agusti
- Respiratory Institute, Hospital Clinic, Universitat de Barcelona, IDIBAPS, CIBERES, Barcelona, Spain
| | - Peter G Gibson
- Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia
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Daidone C, Carper S. Differential Diagnosis and Interdisciplinary Workup of a Pediatric Patient With an Unknown Immune Condition: Chronic Respiratory Distress Secondary to Viral Illness and Developmental Consequences. Cureus 2024; 16:e53109. [PMID: 38414706 PMCID: PMC10898650 DOI: 10.7759/cureus.53109] [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: 12/02/2023] [Accepted: 01/28/2024] [Indexed: 02/29/2024] Open
Abstract
We present a case of a three-year-old African American male, born at term, who initially presented with bronchiolitis at six months and has since experienced recurrent episodes of respiratory distress and hospitalizations. The patient also has severe eczema, developmental delays, and recurrent viral illnesses. Despite thorough evaluations from various specialists, such as pulmonology, allergy, and gastroenterology, the underlying cause remained elusive. The differential diagnosis for this case is as follows: severe persistent asthma with a possible link to genetic mutations such as CDHR3, hyper-IgE syndrome, atypical presentation of Wiskott-Aldrich syndrome, and severe gastroesophageal reflux disease (GERD) with aspiration pneumonitis. This patient's chronic condition has contributed to several developmental consequences, including failure to gain weight and possible hypoxic encephalopathy, leading to delays in cognitive and motor milestones and speech delays. Aggressive medical management, especially long-term systemic steroids, raises concerns about future complications. Through this case, we highlight the importance of thorough workups and an interdisciplinary approach to diagnosing and managing an unknown immune condition, as well as consistent pediatric primary care follow-up to assess development and coordinate necessary support. Here, we aim to address a gap in research on the unique presentations of pediatric respiratory distress symptoms by formulating a comprehensive differential diagnosis and exploring the various ways that chronic respiratory illness can contribute to developmental deficits such as speech and cognitive delays in pediatric patients. This study calls for further research into genetic contributions to asthma, diverse presentations of GERD, prevention of viral illnesses, alternative treatments minimizing steroid use, and an understanding of the impact of chronic respiratory distress on cognitive and language development in children. Thorough workups and interdisciplinary approaches are essential for effective diagnosis and management.
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Affiliation(s)
- Camryn Daidone
- Research, Edward Via College of Osteopathic Medicine, Shreveport, USA
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Scaramozzino MU, Festa M, Levi G, Plastina UR, Sapone G. Correlation between gastroesophageal reflux disease lung volumes and exacerbation of bronchial asthma: Italian pilot observational retrospective study GERDAS. Monaldi Arch Chest Dis 2023; 94. [PMID: 37325973 DOI: 10.4081/monaldi.2023.2640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023] Open
Abstract
Reflux asthma is an entity characterized by typical symptoms and, in some cases, is "silent"; it is more dangerous when associated with obesity and sleep apnea syndrome. Numerous studies demonstrate its high prevalence in the general population, particularly in the pediatric population, where, despite medical specialists' treatment, asthma symptoms remain poorly controlled with a high risk of acute exacerbations. This clinical study aims to show how the addition of a particular type of alginate (Deflux Plus sachets) containing hyaluronic acid and melatonin at low doses administered over a prolonged period of 6 months causes a reduction in vagal reflex stimulation of the esophagus and pulmonary microaspiration reflexes by regulating lower esophageal sphincter motility in asthmatic patients, improving the asthma control test (ATC) score. In the reported statistical analysis, receiver operating characteristic curves were performed for sensitivity and specificity for the analyzed parameters, including the ACT score, with statistically significant data p<0.0001. We conclude that combining conventional therapy for reflux asthma with alginates may improve the risk of acute asthma exacerbations and dynamic lung volumes.
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Affiliation(s)
- Marco Umberto Scaramozzino
- Outpatient Clinic of Pulmonology "La Madonnina", Reggio Calabria; Thoracic Endoscopy, Tirrenia Hospital, Belvedere Marittimo.
| | - Maurizia Festa
- Human Nutrition Sciences, Outpatient Clinic of Pulmonology "La Madonnina", Reggio Calabria.
| | - Guido Levi
- Pulmonology Department, ASST Spedali Civili di Brescia; Department of Clinical and Experimental Sciences, University of Brescia.
| | | | - Giovanni Sapone
- Cardiology Department, Nursing Polyclinic M.d.c., Reggio Calabria.
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Ahn K, Penn RB, Rattan S, Panettieri RA, Voight BF, An SS. Mendelian Randomization Analysis Reveals a Complex Genetic Interplay among Atopic Dermatitis, Asthma, and Gastroesophageal Reflux Disease. Am J Respir Crit Care Med 2023; 207:130-137. [PMID: 36214830 PMCID: PMC9893317 DOI: 10.1164/rccm.202205-0951oc] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/07/2022] [Indexed: 02/02/2023] Open
Abstract
Rationale: Gastroesophageal reflux disease (GERD) is commonly associated with atopic disorders, but cause-effect relationships remain unclear. Objectives: We applied Mendelian randomization analysis to explore whether GERD is causally related to atopic disorders of the lung (asthma) and/or skin (atopic dermatitis [AD]). Methods: We conducted two-sample bidirectional Mendelian randomization to infer the magnitude and direction of causality between asthma and GERD, using summary statistics from the largest genome-wide association studies conducted on asthma (Ncases = 56,167) and GERD (Ncases = 71,522). In addition, we generated instrumental variables for AD from the latest population-level genome-wide association study meta-analysis (Ncases = 22,474) and assessed their fidelity and confidence of predicting the likely causal pathway(s) leading to asthma and/or GERD. Measurements and Main Results: Applying three different methods, each method revealed similar magnitude of causal estimates that were directionally consistent across the sensitivity analyses. Using an inverse variance-weighted method, the largest effect size was detected for asthma predisposition to AD (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.34-1.59), followed by AD to asthma (OR, 1.34; 95% CI, 1.24-1.45). A significant association was detected for genetically determined asthma on risk of GERD (OR, 1.06; 95% CI, 1.03-1.09) but not genetically determined AD on GERD. In contrast, GERD equally increased risks of asthma (OR, 1.21; 95% CI, 1.09-1.35) and AD (OR, 1.21; 95% CI, 1.07-1.37). Conclusions: This study uncovers previously unrecognized causal pathways that have clinical implications in European-ancestry populations: 1) asthma is a causal risk for AD, and 2) the predisposition to AD, including asthma, can arise from specific pathogenic mechanisms manifested by GERD.
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Affiliation(s)
- Kwangmi Ahn
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, NIH, Bethesda, Maryland
| | | | - Satish Rattan
- Division of Gastroenterology & Hepatology, Department of Medicine, Center for Translational Medicine, Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Benjamin F. Voight
- Department of Systems Pharmacology and Translational Therapeutics and
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Steven S. An
- Rutgers Institute for Translational Medicine and Science, New Brunswick, New Jersey
- Department of Pharmacology, Rutgers–Robert Wood Johnson Medical School, The State University of New Jersey, Piscataway, New Jersey
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7
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Ronco L, Folino A, Goia M, Crida B, Esposito I, Bignamini E. Do not forget asthma comorbidities in pediatric severe asthma! Front Pediatr 2022; 10:932366. [PMID: 35967579 PMCID: PMC9372496 DOI: 10.3389/fped.2022.932366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/28/2022] [Indexed: 11/18/2022] Open
Abstract
Asthma is the most common chronic respiratory disease in childhood. The long-term goals in managing asthma aim to control symptoms and prevent exacerbations, as well as to reduce side effects of therapy and mortality disease-related. Most of patients have mild to moderate asthma and respond well to standard therapies. However, a minor proportion of children with asthma has severe disease that remains uncontrolled despite optimal adherence to prescribed therapy and treatment of contributory factors, including trigger exposures and comorbidities, which can mimic or worsen asthma and contribute to exacerbations and poor quality of life. Evaluation of comorbidities is fundamental to optimize the management of the disease in a subgroup of patients with poor responder asthma. The overall aim of this article is to describe characteristics of main pediatric severe asthma comorbidities reported in literature, giving clinicians tools to recognize and manage properly these conditions.
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Affiliation(s)
- Lucia Ronco
- Department of Pediatric Science, School of Medicine, University of Turin, Turin, Italy
| | - Anna Folino
- Department of Surgical Science, University of Turin, Turin, Italy
| | - Manuela Goia
- Pediatric Pulmonology Unit, Regina Margherita Children Hospital, AOU Cittá Della Salute e Della Scienza, Turin, Italy
| | - Benedetta Crida
- Pediatric Pulmonology Unit, Regina Margherita Children Hospital, AOU Cittá Della Salute e Della Scienza, Turin, Italy
| | - Irene Esposito
- Pediatric Pulmonology Unit, Regina Margherita Children Hospital, AOU Cittá Della Salute e Della Scienza, Turin, Italy
| | - Elisabetta Bignamini
- Pediatric Pulmonology Unit, Regina Margherita Children Hospital, AOU Cittá Della Salute e Della Scienza, Turin, Italy
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8
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Mallah N, Turner JM, González-Barcala FJ, Takkouche B. Gastroesophageal reflux disease and asthma exacerbation: A systematic review and meta-analysis. Pediatr Allergy Immunol 2022; 33:e13655. [PMID: 34448255 DOI: 10.1111/pai.13655] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/05/2021] [Accepted: 08/19/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Gastroesophageal reflux disease (GORD) is highly prevalent and often coexists with asthma exacerbation. Divergent findings about the association between the two diseases were reported. We conducted a systematic review and meta-analysis to determine whether there exists an association between GORD and asthma. METHODS We searched MEDLINE, EMBASE, and other databases and then performed a manual search, to identify eligible studies. Pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using fixed- and random-effect models. We evaluated the quality of included studies, explored heterogeneity between studies, undertook subgroup analyses, assessed publication bias, and performed sensitivity analyses. RESULTS We identified 32 eligible studies, conducted in 14 countries and including a total of 1,612,361 patients of all ages. Overall, GORD shows a weak association with asthma exacerbation (OR = 1.27; 95% CI 1.18-1.35). This association was observed in cohort, case-control, and cross-sectional designs and in European as well as non-European populations. Subgroup analyses show that GORD is associated with frequent asthma exacerbations (≥3 exacerbations, OR = 1.59; 95% CI 1.13-2.24) and with exacerbations needing oral corticosteroid therapy (OR = 1.24; 95% CI 1.09-1.41). GORD pediatric patients are at higher odds of asthma exacerbation than adults. We did not detect any evidence of publication bias and the association between GORD and asthma exacerbation held in all undertaken sensitivity analyses. CONCLUSIONS Gastroesophageal reflux disease and asthma exacerbation are weakly associated.
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Affiliation(s)
- Narmeen Mallah
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Methodology and Statistics Unit, Galicia Sur Health Research Institute (IISGS), Vigo, Spain
| | - Julia May Turner
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Francisco-Javier González-Barcala
- Department of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain.,Department of Respiratory Medicine, University Hospital of Santiago de Compostela (CHUS), Santiago de Compostela, Spain
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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9
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Lang JE. Contribution of comorbidities to obesity-related asthma in children. Paediatr Respir Rev 2021; 37:22-29. [PMID: 32828671 DOI: 10.1016/j.prrv.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 01/21/2023]
Abstract
Children with obesity are at increased risk for developing asthma that is difficult to control. A complicating factor to asthma management among these children is likely the commonplace co-morbidities that also result from obesity. We discuss three common obesity-related comorbidities which appear to complicate the effective management of asthma, including hypovitaminosis D, obstructive sleep apnea and gastro-esophageal reflux. Each conditions requires more research to understand their effects on asthma management.
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Affiliation(s)
- J E Lang
- Duke University School of Medicine, Duke Clinical Research Institute, 301 West Morgan Street, Durham, NC 27701, USA.
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Energy-drink consumption is associated with asthma, allergic rhinitis, and atopic dermatitis in Korean adolescents. Eur J Clin Nutr 2020; 75:1077-1087. [PMID: 33257845 DOI: 10.1038/s41430-020-00812-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 10/28/2020] [Accepted: 11/10/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND/OBJECTIVES Few studies have evaluated the effects of energy drinks on allergic diseases. The purpose of this investigation was to evaluate the association between energy drinks and various allergic diseases, including asthma, allergic rhinitis, and atopic dermatitis, in a large representative Korean adolescent population. SUBJECTS/METHODS This cross-sectional study used data from the Korea Youth Risk Behavior Web-based Survey collected from 2015 to 2016. A total of 129,809 participants (n = 67,056 for males; n = 62,753 for females) aged 12-18 years were included and were asked about their frequency of consumption of energy drinks such as Hot6®, Redbull®, and Bacchus®. Their history of asthma, allergic rhinitis, and atopic dermatitis throughout life and in the last 12 months were obtained. The association between the frequency of energy-drink consumption and allergic diseases was analyzed using multiple logistic regression with adjustment for various covariates. RESULTS Age, sex, physical activity, obesity, region of residence, economic level, paternal and maternal educational level, smoking, and alcohol consumption differed significantly according to the frequency of energy-drink consumption (each P < 0.001). Frequent energy-drink consumption (≥7 times a week) was significantly associated with asthma throughout life (odds ratio [OR] = 1.30, 95% confidence interval (CI) = 1.03-1.64, P = 0.025), asthma within the last 12 months (OR = 1.65, 95% CI = 1.16-2.35, P = 0.006), allergic rhinitis within the last 12 months (OR = 1.21, 95% CI = 1.02-1.44, P = 0.030), and atopic dermatitis within the last 12 months (OR = 1.49, 95% CI = 1.17-1.90, P = 0.001) compared to no energy-drink consumption in the full-adjusted model. CONCLUSIONS Frequent energy-drink consumption is associated with allergic diseases, including asthma, allergic rhinitis, and atopic dermatitis, in Korean adolescents.
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