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Au-Doung PLW, Chan JCH, Kui OYH, Ho MKY, Cheung YT, Lam JKW, Chan HK, Brannan J, Chan KCC, Li AM, Leung SSY. Objective monitoring tools for improved management of childhood asthma. Respir Res 2024; 25:194. [PMID: 38702779 PMCID: PMC11069259 DOI: 10.1186/s12931-024-02817-y] [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: 03/11/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024] Open
Abstract
Asthma is a common chronic disease amongst children. Epidemiological studies showed that the mortality rate of asthma in children is still high worldwide. Asthma control is therefore essential to minimize asthma exacerbations, which can be fatal if the condition is poorly controlled. Frequent monitoring could help to detect asthma progression and ensure treatment effectiveness. Although subjective asthma monitoring tools are available, the results vary as they rely on patients' self-perception. Emerging evidence suggests several objective tools could have the potential for monitoring purposes. However, there is no consensus to standardise the use of objective monitoring tools. In this review, we start with the prevalence and severity of childhood asthma worldwide. Then, we detail the latest available objective monitoring tools, focusing on their effectiveness in paediatric asthma management. Publications of spirometry, fractional exhaled nitric oxide (FeNO), hyperresponsiveness tests and electronic monitoring devices (EMDs) between 2016 and 2023 were included. The potential advantages and limitations of each tool were also discussed. Overall, this review provides a summary for researchers dedicated to further improving objective paediatric asthma monitoring and provides insights for clinicians to incorporate different objective monitoring tools in clinical practices.
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Affiliation(s)
- Phillip L W Au-Doung
- School of Pharmacy, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C H Chan
- School of Pharmacy, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Oliver Y H Kui
- School of Pharmacy, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Marco K Y Ho
- School of Pharmacy, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jenny K W Lam
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, London, WC1N 1AX, UK
| | - Hak-Kim Chan
- Sydney Pharmacy School, University of Sydney, Sydney, NSW, Australia
| | - John Brannan
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Kate C C Chan
- Department of Paediatrics, Prince of Wales Hospital, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Albert M Li
- Department of Paediatrics, Prince of Wales Hospital, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sharon S Y Leung
- School of Pharmacy, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
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Choy CT, Siu PLK, Zhou J, Wong CH, Lee YW, Chan HW, Tsui JCC, Lo CJY, Loo SKF, Tsui SKW. Improvements in Gut Microbiome Composition Predict the Clinical Efficacy of a Novel Synbiotics Formula in Children with Mild to Moderate Atopic Dermatitis. Microorganisms 2023; 11:2175. [PMID: 37764019 PMCID: PMC10536305 DOI: 10.3390/microorganisms11092175] [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: 08/09/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
Atopic dermatitis (AD) is a common chronic inflammatory skin disease with a significant association with various type-2 inflammation-related comorbidities. Ongoing research suggests the crucial involvement of gut microbiome, especially in childhood onset AD, and hence, probiotics have emerged as a potential non-steroid-based therapeutics option to complement existing AD management plans. In order to delineate the impact of probiotics in the gut microbiome of pediatric AD patients from southern China, targeted 16S rRNA sequencing and thorough bioinformatic analysis were performed to analyze the gut microbiome profiles of 24 AD children after taking an orally administered novel synbiotics formula with triple prebiotics for 8 weeks. A notable improvement in Eczema Area and Severity Index (EASI) (p = 0.008) was observed after taking an 8-week course of probiotics, with no adverse effects observed. The relative abundances of key microbial drivers including Bacteroides fragilis and Lactobacillus acidophilus were significantly increased at week 8. We also found that the positive responsiveness towards an 8-week course of probiotics was associated with improvements in the gut microbiome profile with a higher relative abundance of probiotic species. Over-represented functional abundance pathways related to vitamin B synthesis and peptidoglycan recycling may imply the underlying mechanism. In summary, our study suggests how the gut microbial landscape shifts upon probiotic supplementation in AD children, and provides preliminary evidence to support targeted probiotic supplementation for the management of childhood AD.
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Affiliation(s)
- Chi Tung Choy
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong
| | - Pui Ling Kella Siu
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong
| | - Junwei Zhou
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong
| | - Chi Ho Wong
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong
| | - Yuk Wai Lee
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong
| | - Ho Wang Chan
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong
| | | | - Claudia Jun Yi Lo
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong
| | - Steven King Fan Loo
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Dermatology Centre, CUHK Medical Centre, The Chinese University of Hong Kong, Hong Kong
| | - Stephen Kwok Wing Tsui
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Centre for Microbial Genomics and Proteomics, The Chinese University of Hong Kong, Hong Kong
- Hong Kong Bioinformatics Centre, The Chinese University of Hong Kong, Hong Kong
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Wang J, Sun M, Li G, Yin D, Hu C, Sun J. The Spectrum and Age-Sex Patterns Among Outpatients with Allergic Diseases - Yichang City, Hubei Province, China, 2018-2021. China CDC Wkly 2023; 5:681-686. [PMID: 37593139 PMCID: PMC10427338 DOI: 10.46234/ccdcw2023.131] [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: 04/12/2023] [Accepted: 06/25/2023] [Indexed: 08/19/2023] Open
Abstract
What is already known about this topic? Allergic diseases have affected an estimated 40% of the population in China. However, our understanding of the full spectrum of these diseases remains insufficient. What is added by this report? Between 2018 and 2021, Yichang City documented 625,929 outpatient visits mainly related to skin and mucous membrane allergies (77.90%) and allergic respiratory conditions (19.64%). In 2021, the occurrence of outpatient visits for conditions such as allergic rhinitis, acute atopic conjunctivitis, and atopic dermatitis increased. The demographic analysis revealed that male patients comprised the majority of the under 18 age bracket (56.05%), while female patients were predominantly represented in the 18 to 65 age bracket (61.79%). What are the implications for public health practice? This constitutes the first analysis of the spectrum of allergic diseases, utilizing regional outpatient data, which has substantial implications for understanding the disease burden.
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Affiliation(s)
- Jinyi Wang
- Jiangsu Taizhou People’s Hospital, Taizhou City, Jiangsu Province, China
| | - Mingwei Sun
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
| | - Dapeng Yin
- Hainan Center for Disease Control and Prevention, Haikou City, Hainan Province, China
| | - Chi Hu
- Yichang Center for Disease Control and Prevention, Yichang City, Hubei Province, China
| | - Jinfang Sun
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
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Ng CSY, Chan CHY, Fung YL, Chau PSY, Luk DCK, Cheng JWCH, Tsang YP, Lam YY, Chu AKY. Impact of comorbid allergic diseases on health-related quality of life of Hong Kong schoolchildren. Pediatr Allergy Immunol 2023; 34:e13953. [PMID: 37232280 DOI: 10.1111/pai.13953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/20/2023] [Accepted: 04/11/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Studies on the relationship between childhood allergic disease and health-related quality of life (HRQOL) have mostly been confined to a single allergic condition. Therefore, a composite allergic score (CAS) was derived to assess the accumulated effect of eczema, asthma, and allergic rhinitis on HRQOL in Hong Kong schoolchildren. METHODS Parents of grade one/two or grade eight/nine schoolchildren completed a questionnaire assessing the prevalence and severity of eczema (POEM), asthma (C-ACT/ACT), and allergic rhinitis (VAS) and schoolchildren's HRQOL (PedsQL). Three rounds of recruitment were conducted. A total of 19 primary and 25 secondary schools agreed to participate. RESULTS Data from 1140 caregivers of grade one/two schoolchildren and 1048 grade eight/nine schoolchildren were imputed and analyzed. The proportion of female respondents were lower in grade one/two (37.7%) but higher in grade eight/nine (57.3%). 63.8% of grade one/two and 58.1% of grade eight/nine schoolchildren reported having at least one allergic disease. In general, greater disease severity was significantly associated with lower HRQOL. After controlling for age, gender, and allergic comorbidity in hierarchical regressions, CAS significantly predicted all HRQOL outcomes in both grade one/two and grade eight/nine schoolchildren. Female grade eight/nine schoolchildren reported lower HRQOL outcomes. CONCLUSION Composite allergic score may be a practical tool to evaluate allergic comorbidity and the effectiveness of treatments targeting common pathological mechanisms of allergic diseases. Non-pharmaceutical approaches should be considered, especially for patients with more than one allergic disease and greater severity.
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Affiliation(s)
- Christina Sum Yi Ng
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, Pokfulam, Hong Kong
| | - Celia Hoi Yan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, Pokfulam, Hong Kong
- Centre on Behavioral Health, Faculty of Social Sciences, University of Hong Kong, Hong Kong, Pokfulam, Hong Kong
| | - Yat Lui Fung
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, Pokfulam, Hong Kong
| | - Priscilla Sin Ying Chau
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, Pokfulam, Hong Kong
| | - David Chi Kong Luk
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Hong Kong, Hong Kong
| | | | - Yuk Ping Tsang
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Hong Kong, Hong Kong
| | - Ying Yin Lam
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Hong Kong, Hong Kong
| | - Ashleigh Ka Ying Chu
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Hong Kong, Hong Kong
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Lu C, Liu Z, Yang W, Liao H, Liu Q, Li Q, Deng Q. Early life exposure to outdoor air pollution and indoor environmental factors on the development of childhood allergy from early symptoms to diseases. ENVIRONMENTAL RESEARCH 2023; 216:114538. [PMID: 36252839 DOI: 10.1016/j.envres.2022.114538] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The prevalence of childhood allergies has increased during past decades leading to serious hospitalization and heavy burden worldwide, yet the key factors responsible for the onset of early symptoms and development of diagnosed diseases are unclear. OBJECTIVE To explore the role of early life exposure to ambient air pollution and indoor environmental factors on early allergic symptoms and doctor diagnosed allergic diseases. METHODS A retrospective cohort study of 2598 preschool children was conducted at 36 kindergartens in Changsha, China from September of 2011 to February of 2012. A questionnaire was developed to survey each child's early onset of allergic symptoms (wheeze and rhinitis-like symptoms) and doctor diagnosis of allergic diseases (asthma and rhinitis) as well as home environments. Each mother's and child's exposures to ambient air pollutants (PM10, SO2, and NO2) and temperature were estimated for in utero and postnatal periods. The associations of early symptoms and diagnosed diseases with outdoor air pollution and indoor environmental variables were examined by logistic regression models. RESULTS Childhood early allergic symptoms (33.9%) including wheeze (14.7%) and rhinitis-like symptoms (25.4%) before 2 years old were not associated with outdoor air pollution exposure but was significantly associated with maternal exposure of window condensation at home in pregnancy with ORs (95% CI) of 1.33 (1.11-1.59), 1.30 (1.01-1.67) and 1.27 (1.04-1.55) respectively, and was associated with new furniture during first year after birth with OR (95% CI) of 1.43 (1.02-2.02) for early wheeze. Childhood diagnosed allergic diseases (28.4%) containing asthma (6.7%) and allergic rhinitis (AR) (7.2%) were significantly associated with both outdoor air pollutants (mainly for SO2 and NO2) during first 3 years and indoor new furniture, redecoration, and window condensation. We found that sex, age, parental atopy, maternal productive age, environmental tobacco smoke (ETS), antibiotics use, economic stress, early and late introduction of complementary foods, and outdoor air pollution modified the effects of home environmental exposure in early life on early allergic symptoms and diagnosed allergic diseases. CONCLUSION Our study indicates that early life exposure to indoor environmental factors plays a key role in early onset of allergic symptoms in children, and further exposure to ambient air pollution and indoor environmental factors contribute to the later development of asthma and allergic rhinitis.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Zijing Liu
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Wenhui Yang
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Hongsen Liao
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Qin Liu
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Qin Li
- XiangYa School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
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Lee SL, Lau YL, Wong WHS, Tian LW. Childhood Wheeze, Allergic Rhinitis, and Eczema in Hong Kong ISAAC Study from 1995 to 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416503. [PMID: 36554390 PMCID: PMC9779471 DOI: 10.3390/ijerph192416503] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND The prevalence of allergic diseases has been increasing in developing areas but has reached a plateau in many developed areas. Regular surveys are imperative to assess the disease burden for the prioritization of resource allocation. OBJECTIVES We examined the change in the prevalence of wheezing, allergic rhinitis (AR), and eczema in school-aged children with possible associative factors and possible health effects of school air quality. METHODS This was the third repeated cross-sectional study conducted in 2015-2016 using the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. Our first and second surveys were conducted in 1994-1995 and 2000-2001, respectively. Regarding the third survey, we recruited 3698 children aged 6-7 from 33 local schools in 18 districts. Air quality, temperature, and humidity were also measured. The changes in prevalence, multiple regression, and GLIMMIX procedure were analyzed. RESULTS From our first survey to our third survey, the increased prevalences for lifetime wheeze, current wheeze, lifetime rhinitis, current rhinitis, current rhinoconjunctivitis, lifetime chronic rash, and current chronic rash were 4.2%, 2.1%, 12.5%, 12.6%, 14.2%, 3.9%, and 4.1%, respectively. Increased prevalence of parental atopy had the strongest association with an increased prevalence of each of these seven health outcomes. There was no significant association between school air pollutant levels and the prevalence of health outcomes. CONCLUSIONS There was an increase in the prevalence of wheezing, allergic rhinitis, and eczema across the surveys. The most important associated risk factor identified was the increased prevalence of a parental history of atopy.
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Affiliation(s)
- So-Lun Lee
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong
- Department of Paediatrics, Duchess of Kent Children’s Hospital, Hong Kong
| | - Yu-Lung Lau
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - Wilfred Hing-Sang Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - Lin-Wei Tian
- School of Public Health, The University of Hong Kong, Hong Kong
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Liu W, Cai J, Sun C, Zou Z, Zhang J, Huang C. Time-trends for eczema prevalences among children and adults from 1985 to 2015 in China: a systematic review. BMC Public Health 2022; 22:1294. [PMID: 35790959 PMCID: PMC9254617 DOI: 10.1186/s12889-022-13650-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/06/2022] [Indexed: 04/11/2023] Open
Abstract
Abstract
Background
Several studies have reported that childhood prevalence of eczema has been increasing worldwide. However, none study quantitatively evaluated prevalence trends of eczema among children and adults in the last 30 years in China.
Methods and Findings
Via a systematic review of literature databases in English and Chinese, we summarized all studies reporting eczema prevalences from 1985 to 2015 in China as well as diagramed prevalence and eczematous population trends against year for different age groups. A total of 93 studies and 17 studies (16 for children and one for adults) were selected for qualitative and quantitative synthesis, respectively. Childhood lifetime-ever eczema prevalences ranged from 10.0% to 30.0%. Prevalences among 3-12-year-olds children showed increasing trends in most specific cities, but national lifetime-ever eczema prevalences among 13-14-year-olds children decreased from 10.6% in 2001 to 8.6% in 2009 in mainland China. We estimated that about 1.5 million children aged 13-14-year-olds in 2009 and 15.5 million children aged 3-6-year-olds in 2012 had lifetime-ever eczema in mainland China. Similar studies were too few to ascertain time-trends of eczema prevalence among adults. About 39.4, 20.0, and 11.6 million adults aged 15-86-year-olds in 2010 had contact dermatitis, seborrheic dermatitis, and atopic dermatitis in the mainland China, respectively.
Conclusions
The burden of eczema became heavier in young children, whereas perhaps had been reduced in adolescent in China. More studies for eczema prevalence in adults are warranted.
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Chen T, Norback D, Deng Q, Huang C, Qian H, Zhang X, Sun Y, Wang T, Zhang Y, Li B, Kan H, Wei L, Liu C, Xu Y, Zhao Z. Maternal exposure to PM 2.5/BC during pregnancy predisposes children to allergic rhinitis which varies by regions and exclusive breastfeeding. ENVIRONMENT INTERNATIONAL 2022; 165:107315. [PMID: 35635966 DOI: 10.1016/j.envint.2022.107315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/02/2022] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Increasing prevalence of childhood allergic rhinitis(AR) needs a deeper understanding on the potential adverse effects of early life exposure to air pollution. OBJECTIVES The main aim was to evaluate the effects of maternal exposure to PM2.5 and chemical constituents during pregnancy on preschool children's AR, and further to explore the modification effects of regions and exclusive breastfeeding. METHODS A multi-center population-based study was performed in 6 cities from 3 regions of China in 2011-2012. Maternal exposure to ambient PM2.5 and main chemical constituents(BC, OM, SO42-, NO3-, NH4+) during pregnancy was assessed and a longitudinal prospective analysis was applied on preschool children's AR. The modification effects of regions and exclusive breastfeeding were investigated. RESULTS A total of 8.8% and 9.8% of children reported doctor-diagnosed allergic rhinitis(DDAR) and current hay fever, respectively, and 48.6% had less than 6 months of exclusive breastfeeding. The means of PM2.5 during pregnancy were 52.7 μg/m3, 70.3 μg/m3 and 76.4 μg/m3 in the east, north and central south of China, respectively. Multilevel log-binomial model regression showed that each interquartile range(IQR) increase of PM2.5 during pregnancy was associated with an average increase in prevalence ratio (PR) of DDAR by 1.43(95% confidence interval(CI): 1.11, 1.84) and current hay fever by 1.79(95% CI: 1.26, 2.55), respectively. Among chemical constituents, black carbon (BC) had the strongest associations. Across 3 regions, the eastern cities had the highest associations, followed by those in the central south and the north. For those equal to or longer than 6 months of exclusive breastfeeding, the associations were significantly reduced. CONCLUSIONS Children in east of China had the highest risks of developing AR per unit increase of maternal exposure to PM2.5 during pregnancy, especially BC constituent. Remarkable decline was found in association with an increase in breastfeeding for ≥6 months, in particular in east of China.
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Affiliation(s)
- Tianyi Chen
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - Dan Norback
- Department of Medical Sciences, Uppsala University, Uppsala SE-751, Sweden
| | - Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha 410083, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Hua Qian
- School of Energy & Environment, Southeast University, Nanjing 210096, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan 030006, China
| | - Yuexia Sun
- Tianjin Key Lab of Indoor Air Environmental Quality Control, Tianjin University, Tianjin 300072, China
| | - Tingting Wang
- School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing 100084, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing 400030, China
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China; WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai 200438, China
| | - Lan Wei
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - Cong Liu
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Yanyi Xu
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China; WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai 200438, China.
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China; WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai 200438, China.
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Han M, Choi SJ, Jeong Y, Lee K, Lee TH, Lee SH, Kim TH. Association between Concentration of Air Pollutants and Prevalence of Inflammatory Sinonasal Diseases: A Nationwide Cross-sectional Study. Am J Rhinol Allergy 2022; 36:649-660. [PMID: 35535390 DOI: 10.1177/19458924221099373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Air pollution is a serious health concern and affects inflammatory sinonasal diseases such as allergic rhinitis (AR) and chronic rhinosinusitis (CRS). Clarifying the relationship between air pollutants and upper respiratory diseases could help the patients. OBJECTIVE To evaluate the association between the concentration of air pollutants and the prevalence of AR and CRS among South Koreans. METHODS In this cross-sectional study, nationwide data were reviewed for participants of the Korean National Health and Nutrition Examination Survey (KNHANES) 2008 to 2012. Participants were surveyed with health questionnaires, examined with endoscopies by otolaryngologists, and tested with serum immunoglobulin E levels. The concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and particulate matter with aerodynamic diameters ≤10 µm (PM10) were measured in 16 areas of South Korea. Air pollutant concentrations of geographic districts were matched to each participant's residence. Logistic regression analysis was performed. RESULTS Among 27 863 eligible adults, 3359 and 1606 participants had AR or CRS, respectively. In multivariable logistic regression analysis for AR, PM10 showed statistically significant results (odds ratio [OR] = 1.145, 95% confidence interval [CI] = 1.042-1.258). No air pollutants showed statistically significant differences in the prevalence of CRS. In AR, PM10 (OR = 1.458, 95% CI = 1.201-1.770) was associated with endoscopic findings of watery rhinorrhea, whereas SO2 (OR = 1.202, 95% CI = 1.100-1.313) was associated with pale mucosa. CONCLUSION The prevalence of AR was significantly associated with PM10 concentration. In patients with AR, endoscopic findings of watery rhinorrhea were associated with PM10. However, CRS was not associated with the air pollutant concentrations. Lower concentration of PM10 might help managing the clinical symptoms in patients of AR.
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Affiliation(s)
- Munsoo Han
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, 36899Korea University, Seoul, Republic of Korea
| | - Soo Jeong Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, 36899Korea University, Seoul, Republic of Korea
| | - Yujin Jeong
- Department of Biostatistics, 218725Korea University College of Medicine, Seoul, Republic of Korea
| | - Kijeong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, 36899Korea University, Seoul, Republic of Korea
| | - Tae Hoon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, 36899Korea University, Seoul, Republic of Korea
| | - Sang Hag Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, 36899Korea University, Seoul, Republic of Korea
| | - Tae Hoon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, 36899Korea University, Seoul, Republic of Korea
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Fong WCG, Chan A, Zhang H, Holloway JW, Roberts G, Kurukulaaratchy R, Arshad SH. Childhood food allergy and food allergen sensitisation are associated with adult airways disease: A birth cohort study. Pediatr Allergy Immunol 2021; 32:1764-1772. [PMID: 34242424 DOI: 10.1111/pai.13592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/17/2021] [Accepted: 07/05/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Childhood food allergy (FA) and food allergen sensitization (FAS) are associated with allergic airway disease(s) [AAD] (asthma and rhinitis) in childhood. However, the associations between childhood FA/FAS and AAD in adulthood are not well described. METHODS We investigated the longitudinal relationship between childhood FA/FAS to common food allergens and AAD at 18 and 26 years, in the Isle of Wight birth cohort. Study subjects (N = 1456) were followed up at fixed time points from ages 1-26 years for FA/FAS status. AAD were evaluated from 4 years onwards. The associations between FA/FAS and AAD were assessed with univariate analyses and then multivariable logistic regression, adjusting for clinically relevant co-variates. RESULTS Food allergy at 4 years was significantly associated with asthma at 18 years [adjusted odds ratio (aOR): 2.75, 95% CI: 1.53-4.92, p = .001] and 26 years (aOR: 2.62, 95% CI: 1.32-5.20, p = .006). Conversely, childhood FA was not associated with adulthood rhinitis whatsoever. While FAS at ages 4 and 10 were associated with both AAD, the associations between FAS and rhinitis were less robust relative to asthma. CONCLUSION Childhood FA increased the odds of asthma during adulthood by nearly threefold. Additionally, childhood FAS was also associated with increased odds of asthma in adulthood. Conversely, FAS but not FA in childhood was associated with rhinitis in adulthood. We suggest that children with FA/FAS should be followed up to facilitate early detection and intervention of subsequent AAD, particularly asthma.
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Affiliation(s)
- Wei Chern Gavin Fong
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Adrian Chan
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Respiratory Medical Associates, Mount Elizabeth Novena Hospital, Singapore City, Singapore
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,Southampton Biomedical Research Centre, National Institutes of Health Research (NIHR), Southampton, UK
| | - Graham Roberts
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Southampton Biomedical Research Centre, National Institutes of Health Research (NIHR), Southampton, UK
| | - Ramesh Kurukulaaratchy
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Southampton Biomedical Research Centre, National Institutes of Health Research (NIHR), Southampton, UK
| | - Syed Hasan Arshad
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Southampton Biomedical Research Centre, National Institutes of Health Research (NIHR), Southampton, UK
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11
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Han M, Lee D, Lee SH, Kim TH. Oxidative Stress and Antioxidant Pathway in Allergic Rhinitis. Antioxidants (Basel) 2021; 10:antiox10081266. [PMID: 34439514 PMCID: PMC8389336 DOI: 10.3390/antiox10081266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/05/2021] [Accepted: 08/05/2021] [Indexed: 01/18/2023] Open
Abstract
Oxidative stress is the cause and consequence of redox metabolism in various physiological and pathological conditions. Understanding the molecular pathways underlying oxidative stress and the role of antioxidants could serve as the key to helping treat associated diseases. Allergic rhinitis is a condition that deteriorates the daily function and quality of life of afflicted individuals and is associated with a high socioeconomic burden and prevalence. Recent studies have focused on the role of oxidative stress and antioxidants in allergic rhinitis. This review discusses animal and clinical studies on oxidative markers and the potential therapeutic dietary antioxidants for allergic rhinitis.
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12
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Leung ASY, Tham EH, Li J, Pacharn P, Takizawa T, Lee E, Xing Y, Leung TF, Hong SJ, Wong GWK. The role of the environment in shaping the trends of childhood asthma - An Asian perspective. Pediatr Allergy Immunol 2021; 32:1152-1164. [PMID: 33760296 DOI: 10.1111/pai.13508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/14/2021] [Accepted: 03/19/2021] [Indexed: 12/15/2022]
Abstract
Asthma has now become one of the most common atopic disorders not only in developed countries but also in many developing countries. The etiology is likely due to a complex interaction between genetic and environmental factors. In many Asian countries, the prevalence of asthma has also been documented by validated instruments to be increasing rapidly over the past two decades. However, studies in rural areas in Asia with a traditional farming environment revealed markedly lower asthma prevalence when compared with residents in nearby cities despite having similar genetic background. Among the environmental factors implicated in the pathogenesis of asthma, air pollution, dietary patterns, viral infections, and early microbial exposure have been studied extensively around the world. Asia provides many opportunities to study these potential factors as there are many ethnic groups living in distinctly different environments. The understanding of the roles of these factors in affecting the early immune system and subsequent development of asthma will enable us to develop potential primary preventive strategies against a disease which affects millions worldwide.
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Affiliation(s)
- Agnes S Y Leung
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Elizabeth Huiwen Tham
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jing Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Punchama Pacharn
- Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Takumi Takizawa
- Department of Pediatrics, Graduate School of Medicine, Gunma University, Gunma, Japan
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Yuhan Xing
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Ting-Fan Leung
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Soo-Jong Hong
- Childhood Asthma and Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gary W K Wong
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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13
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Unlocking the Non-IgE-Mediated Pseudo-Allergic Reaction Puzzle with Mas-Related G-Protein Coupled Receptor Member X2 (MRGPRX2). Cells 2021; 10:cells10051033. [PMID: 33925682 PMCID: PMC8146469 DOI: 10.3390/cells10051033] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 12/17/2022] Open
Abstract
Mas-related G-protein coupled receptor member X2 (MRGPRX2) is a class A GPCR expressed on mast cells. Mast cells are granulated tissue-resident cells known for host cell response, allergic response, and vascular homeostasis. Immunoglobulin E receptor (FcεRI)-mediated mast cell activation is a well-studied and recognized mechanism of allergy and hypersensitivity reactions. However, non-IgE-mediated mast cell activation is less explored and is not well recognized. After decades of uncertainty, MRGPRX2 was discovered as the receptor responsible for non-IgE-mediated mast cells activation. The puzzle of non-IgE-mediated pseudo-allergic reaction is unlocked by MRGPRX2, evidenced by a plethora of reported endogenous and exogenous MRGPRX2 agonists. MRGPRX2 is exclusively expressed on mast cells and exhibits varying affinity for many molecules such as antimicrobial host defense peptides, neuropeptides, and even US Food and Drug Administration-approved drugs. The discovery of MRGPRX2 has changed our understanding of mast cell biology and filled the missing link of the underlying mechanism of drug-induced MC degranulation and pseudo-allergic reactions. These non-canonical characteristics render MRGPRX2 an intriguing player in allergic diseases. In the present article, we reviewed the emerging role of MRGPRX2 as a non-IgE-mediated mechanism of mast cell activation in pseudo-allergic reactions. We have presented an overview of mast cells, their receptors, structural insight into MRGPRX2, MRGPRX2 agonists and antagonists, the crucial role of MRGPRX2 in pseudo-allergic reactions, current challenges, and the future research direction.
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14
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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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15
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Potential Co-Factors of an Intraoral Contact Allergy-A Cross-Sectional Study. Dent J (Basel) 2020; 8:dj8030083. [PMID: 32756376 PMCID: PMC7559516 DOI: 10.3390/dj8030083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/14/2020] [Accepted: 07/22/2020] [Indexed: 01/07/2023] Open
Abstract
The aim of this cross-sectional study was to evaluate the frequency of dental allergens and potential co-factors, especially hypothyroidism, for patients with an intraoral contact allergy. From 2015 to 2016, patients with confirmed symptoms of an intraoral contact allergy (study group SG n = 50) were recruited in the dental clinic of the University of Leipzig. The participants of the control group (CG n = 103) were patients without oral diseases or intraoral symptoms of a contact allergy. For the data collection, a new "Allergy questionnaire" was developed. Information on allergies and general diseases were collected. The statistical analysis was carried out with SPSS 23.0. Sensitizations/allergies to metals and composites were higher in SG compared to CG. Of all study participants (n = 148), 14.2% (n = 21) had a nickel allergy. In 18% (n = 8) of the SG a cobalt allergy based on all metal allergens could be seen. In addition, an association between a nickel and cobalt allergy was found. Hypothyroidism occurred significantly more frequently (p = 0.049) in SG than in CG. Sensitizations and allergies can occur to metals in dental alloys. Hypothyroidism increased the risk of having an allergy threefold.
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16
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Chen M, Wu Y, Yuan S, Chen J, Li L, Wu J, Zhang J, Yin Y. Research on allergic rhinitis improvement in asthmatic children after dust mite exposure reduction: a randomized, double-blind, cross-placebo study protocol. Trials 2020; 21:686. [PMID: 32727603 PMCID: PMC7392667 DOI: 10.1186/s13063-020-04614-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/15/2020] [Indexed: 11/27/2022] Open
Abstract
Background Allergic rhinitis (AR) in children is a major respiratory inflammatory disease with a high incidence that is increasing yearly. In China, 54.93% of children with asthma have AR, which often requires synchronous treatment. House dust mites (HDMs) are common allergens that often cause attacks of AR and asthma. Reducing allergen exposure is one of the most important measures to control and treat AR and asthma attacks. Hestelia Mite Bait, containing 0.1% emamectin, is a new tool for trapping and killing dust mites, reducing the number of dust mites on mattresses and thereby potentially reducing stimulation by allergens and ultimately improving asthma and rhinitis symptoms. This single-centre, randomized, double-blind, cross-placebo trial will explore the improvement in AR in asthmatic children after dust mite exposure reduction. Methods We will recruit 60 children (aged 3–12 years) who have been diagnosed with AR and asthma and are allergic to dust mites as confirmed by a serum allergen test. Participants will randomly receive the Hestelia Mite Bait intervention for 8 weeks and the placebo intervention for 8 weeks. There will be a 4-week washout period between the two interventions. The primary outcome is the visual analogue scale (VAS) score of AR symptoms; the secondary outcomes include the Rhinitis Control Assessment Test (RCAT) score, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score, changes in the dust mite level, drug usage for asthma and AR, Asthma Control Questionnaire-5 (ACQ-5) score, and frequencies of acute asthma attacks, emergency visits, and hospitalizations. Discussion This study aims to scientifically and objectively evaluate the effects of mite bait on rhinitis and asthma improvement after dust mite exposure reduction and provides a convenient means for future prevention and treatment of allergic diseases involving the airways in children. Trial registration www.chictr.org.cn ChiCTR1900024688. Registered on July 21, 2019
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Affiliation(s)
- Ming Chen
- Department of Respiratory Medicine, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University of Medicine, Shanghai, 200127, China
| | - YuFen Wu
- Department of Respiratory Medicine, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University of Medicine, Shanghai, 200127, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University of Medicine, Shanghai, 200127, China
| | - Jiande Chen
- Department of Respiratory Medicine, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University of Medicine, Shanghai, 200127, China
| | - Luanluan Li
- Department of Respiratory Medicine, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University of Medicine, Shanghai, 200127, China
| | - Jinhong Wu
- Department of Respiratory Medicine, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University of Medicine, Shanghai, 200127, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University of Medicine, Shanghai, 200127, China.
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University of Medicine, Shanghai, 200127, China.
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17
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Kim DK, Park YS, Cha KJ, Jang D, Ryu S, Kim KR, Kim SH, Yoon HJ, Cho SH. Cluster Analysis of Inhalant Allergens in South Korea: A Computational Model of Allergic Sensitization. Clin Exp Otorhinolaryngol 2020; 14:93-99. [PMID: 32623852 PMCID: PMC7904440 DOI: 10.21053/ceo.2019.01921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/23/2020] [Indexed: 12/24/2022] Open
Abstract
Objectives. Sensitization to specific inhalant allergens is a major risk factor for the development of atopic diseases, which impose a major socioeconomic burden and significantly diminish quality of life. However, patterns of inhalant allergic sensitization have yet to be precisely described. Therefore, to enhance the understanding of aeroallergens, we performed a cluster analysis of inhalant allergic sensitization using a computational model. Methods. Skin prick data were collected from 7,504 individuals. A positive skin prick response was defined as an allergen-to-histamine wheal ratio ≥1. To identify the clustering of inhalant allergic sensitization, we performed computational analysis using the four-parameter unified-Richards model. Results. Hierarchical cluster analysis grouped inhalant allergens into three clusters based on the Davies-Bouldin index (0.528): cluster 1 (Dermatophagoides pteronyssinus and Dermatophagoides farinae), cluster 2 (mugwort, cockroach, oak, birch, cat, and dog), and cluster 3 (Alternaria tenus, ragweed, Candida albicans, Kentucky grass, and meadow grass). Computational modeling revealed that each allergen cluster had a different trajectory over the lifespan. Cluster 1 showed a high level (>50%) of sensitization at an early age (before 19 years), followed by a sharp decrease in sensitization. Cluster 2 showed a moderate level (10%–20%) of sensitization before 29 years of age, followed by a steady decrease in sensitization. However, cluster 3 revealed a low level (<10%) of sensitization at all ages. Conclusion. Computational modeling suggests that allergic sensitization consists of three clusters with distinct patterns at different ages. The results of this study will be helpful to allergists in managing patients with atopic diseases.
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Affiliation(s)
- Dong-Kyu Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Young-Sun Park
- Department of Mathematics and Institute of Natural Sciences, Hanyang University College of Natural Sciences, Seoul, Korea
| | - Kyung-Joon Cha
- Department of Mathematics and Institute of Natural Sciences, Hanyang University College of Natural Sciences, Seoul, Korea
| | - Daeil Jang
- Department of Mathematics and Institute of Natural Sciences, Hanyang University College of Natural Sciences, Seoul, Korea
| | - Seungho Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Rae Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ho Joo Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Seok Hyun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
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18
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Lin X, Ren X, Xiao X, Yang Z, Yao S, Wong GW, Liu Z, Wang C, Su Z, Li J. Important Role of Immunological Responses to Environmental Exposure in the Development of Allergic Asthma. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2020; 12:934-948. [PMID: 32935487 PMCID: PMC7492518 DOI: 10.4168/aair.2020.12.6.934] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 04/30/2020] [Accepted: 05/02/2020] [Indexed: 12/16/2022]
Abstract
Allergic asthma is a public health problem that affects human health and socioeconomic development. Studies have found that the prevalence of asthma has significantly increased in recent years, which has become particularly pronounced in developed countries. With rapid urbanization in China in the last 3 decades, the prevalence of asthma has increased significantly in urban areas. As changes in genetic backgrounds of human populations are limited, environmental exposure may be a major factor that is responsible for the increased prevalence of asthma. This review focuses on environmental components of farms and rural areas that may have protective effects in reducing the development of asthma. Farm and rural related microorganism- and pathogen-associated molecular patterns are considered to be important environmental factors that modulate host's innate and adaptive immune system to induce protection effects later in life. Environmental microbial-related immunotherapy will also be discussed as the future research direction for the prevention of allergic asthma.
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Affiliation(s)
- Xinliu Lin
- Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xia Ren
- Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaojun Xiao
- Institute of Allergy and Immunology, School of Medicine, Shenzhen University, Shenzhen, China
| | - Zhaowei Yang
- Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Center for Genomics, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Siyang Yao
- Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Gary Wk Wong
- Departments of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, China
| | - Zhigang Liu
- Institute of Allergy and Immunology, School of Medicine, Shenzhen University, Shenzhen, China
| | - Charles Wang
- Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Center for Genomics, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Zhong Su
- Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.
| | - Jing Li
- Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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19
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Ravn NH, Halling AS, Berkowitz AG, Rinnov MR, Silverberg JI, Egeberg A, Thyssen JP. How does parental history of atopic disease predict the risk of atopic dermatitis in a child? A systematic review and meta-analysis. J Allergy Clin Immunol 2019; 145:1182-1193. [PMID: 31887393 DOI: 10.1016/j.jaci.2019.12.899] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/06/2019] [Accepted: 12/11/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Parental history of atopic disease is a well-established risk factor for the development of atopic dermatitis (AD), but several aspects of this association remain unclear. OBJECTIVE We sought to determine the association of parental history of atopic disease with AD in offspring. METHODS We searched PubMed and EMBASE through June 2018 for relevant records and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled odds ratios (ORs) with 95% CI were calculated using random-effects models. RESULTS A total of 163 records covering 149 unique studies were included. Of these, 119 studies were included in the meta-analysis. Individuals with parental history of atopic disease had increased odds of AD (OR, 1.81; 95% CI, 1.65-1.99). Parental asthma (OR, 1.56; 95% CI, 1.18-2.05) and allergic rhinitis (OR, 1.68; 95% CI, 1.34-2.11) had a smaller effect than AD (OR, 3.30; 95% CI, 2.46-4.42). The effect of maternal and paternal history was comparable for all atopic diseases. An increase in odds was observed when comparing the effect of having 1 (OR, 1.30; 95% CI, 1.15-1.47) or 2 atopic parents (OR, 2.08; 95% CI, 1.83-2.36), as well as having a parent with 1 (OR, 1.49; 95% CI, 1.28-1.74) or more atopic diseases (OR, 2.32; 95% CI, 1.92-2.81). CONCLUSIONS This study provides evidence-based risk estimates that may guide physicians who counsel parents with a history of atopic disease about their children's risk of AD. This information is of particular importance for future efforts toward establishing prophylactic interventions for AD on a general population level.
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Affiliation(s)
- Nina H Ravn
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Anne-Sofie Halling
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | | | - Maria R Rinnov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jonathan I Silverberg
- Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; National Allergy Research Centre, Herlev and Gentofte Hospital, Hellerup, Denmark.
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20
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Chan A, Terry W, Zhang H, Karmaus W, Ewart S, Holloway JW, Roberts G, Kurukulaaratchy R, Arshad SH. Filaggrin mutations increase allergic airway disease in childhood and adolescence through interactions with eczema and aeroallergen sensitization. Clin Exp Allergy 2019; 48:147-155. [PMID: 29266469 DOI: 10.1111/cea.13077] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/02/2017] [Accepted: 12/01/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Filaggrin loss-of-function (FLG-LOF) mutations are an established genetic cause of eczema. These mutations have subsequently been reported to increase the risk of aeroallergen sensitization and allergic airway disease. However, it is unclear whether FLG variants require both eczema and aeroallergen sensitization to influence airway disease development long-term outcomes. OBJECTIVE To examine the effects of FLG-LOF mutations on allergic airway disease outcomes, with eczema and aeroallergen sensitization as intermediate variables, using the Isle of Wight birth cohort. METHODS Study participants were evaluated at ages 1, 2, 4, 10 and 18 years to ascertain the development of allergic diseases (eczema, asthma and allergic rhinitis) and aeroallergen sensitization (determined by skin prick tests). FLG-LOF mutations were genotyped in 1150 subjects. To understand the complex associations between FLG mutations, intermediate variables (eczema and aeroallergen sensitization) and airway disease, path analysis was performed. RESULTS There were significant total effects of FLG-LOF mutations on both asthma and allergic rhinitis at all ages as well as on aeroallergen sensitization up till 10 years old. In the filaggrin-asthma analysis, a direct effect of FLG-LOF mutations was observed on early childhood eczema (age 1 and 2 years) (relative risk (RR) 2.01, 95% CI: 1.74-2.31, P < .001), and all significant indirect pathways on asthma outcomes passed through eczema at these ages. In contrast, for the filaggrin-rhinitis model, FLG-LOF mutations exerted significant direct effects on early eczema as well as rhinitis at 10 years (RR 1.99; 95% CI: 1.72-2.29, P = .002). CONCLUSION FLG-LOF mutations are a significant risk factor for later childhood asthma and rhinitis. However, the pathway to asthma is only through early childhood eczema while a direct effect was observed for childhood rhinitis.
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Affiliation(s)
- Adrian Chan
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore City, Singapore
| | - William Terry
- Department of Applied Mathematics and Statistics, Colorado School of Mines, Colorado, SC, USA
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Susan Ewart
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Graham Roberts
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.,Respiratory Biomedical Research Unit, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Ramesh Kurukulaaratchy
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.,Respiratory Biomedical Research Unit, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Syed Hasan Arshad
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
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21
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Sasaki M, Morikawa E, Yoshida K, Adachi Y, Odajima H, Akasawa A. The change in the prevalence of wheeze, eczema and rhino-conjunctivitis among Japanese children: Findings from 3 nationwide cross-sectional surveys between 2005 and 2015. Allergy 2019; 74:1572-1575. [PMID: 30866051 DOI: 10.1111/all.13773] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/19/2019] [Accepted: 03/04/2019] [Indexed: 01/24/2023]
Affiliation(s)
- Mari Sasaki
- Division of AllergyTokyo Metropolitan Children's Medical Center Tokyo Japan
| | - Emi Morikawa
- Division of AllergyTokyo Metropolitan Children's Medical Center Tokyo Japan
| | - Koichi Yoshida
- Division of AllergyTokyo Metropolitan Children's Medical Center Tokyo Japan
| | - Yuichi Adachi
- Department of PediatricsUniversity of Toyama Toyama Japan
| | - Hiroshi Odajima
- Department of PediatricsFukuoka National Hospital Fukuoka Japan
| | - Akira Akasawa
- Division of AllergyTokyo Metropolitan Children's Medical Center Tokyo Japan
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22
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Chan SK, Leung DYM. Dog and Cat Allergies: Current State of Diagnostic Approaches and Challenges. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2018; 10:97-105. [PMID: 29411550 PMCID: PMC5809771 DOI: 10.4168/aair.2018.10.2.97] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 10/11/2017] [Indexed: 12/19/2022]
Abstract
Allergies to dogs and cats affect 10%-20% of the population worldwide and is a growing public health concern as these rates increase. Given the prevalence of detectable dog and cat allergens even in households without pets, there is a critical need to accurately diagnose and treat patients to reduce morbidity and mortality from exposure. The ability to diagnose cat sensitization is good, in contrast to dogs. Component resolved diagnostics of sensitization to individual allergenic proteins will dramatically improve diagnosis. This review focuses on the current state of knowledge regarding allergies to dogs and cats, recent advances, therapies such as subcutaneous immunotherapy, and discusses important areas to improve diagnosis and therapy.
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Affiliation(s)
- Sanny K Chan
- Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, CO. USA
| | - Donald Y M Leung
- Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, CO. USA
- Division of Pediatric Allergy-Immunology, National Jewish Health, Denver, CO, USA.
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23
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Wise SK, Lin SY, Toskala E, Orlandi RR, Akdis CA, Alt JA, Azar A, Baroody FM, Bachert C, Canonica GW, Chacko T, Cingi C, Ciprandi G, Corey J, Cox LS, Creticos PS, Custovic A, Damask C, DeConde A, DelGaudio JM, Ebert CS, Eloy JA, Flanagan CE, Fokkens WJ, Franzese C, Gosepath J, Halderman A, Hamilton RG, Hoffman HJ, Hohlfeld JM, Houser SM, Hwang PH, Incorvaia C, Jarvis D, Khalid AN, Kilpeläinen M, Kingdom TT, Krouse H, Larenas-Linnemann D, Laury AM, Lee SE, Levy JM, Luong AU, Marple BF, McCoul ED, McMains KC, Melén E, Mims JW, Moscato G, Mullol J, Nelson HS, Patadia M, Pawankar R, Pfaar O, Platt MP, Reisacher W, Rondón C, Rudmik L, Ryan M, Sastre J, Schlosser RJ, Settipane RA, Sharma HP, Sheikh A, Smith TL, Tantilipikorn P, Tversky JR, Veling MC, Wang DY, Westman M, Wickman M, Zacharek M. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis. Int Forum Allergy Rhinol 2018; 8:108-352. [PMID: 29438602 PMCID: PMC7286723 DOI: 10.1002/alr.22073] [Citation(s) in RCA: 218] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Critical examination of the quality and validity of available allergic rhinitis (AR) literature is necessary to improve understanding and to appropriately translate this knowledge to clinical care of the AR patient. To evaluate the existing AR literature, international multidisciplinary experts with an interest in AR have produced the International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR). METHODS Using previously described methodology, specific topics were developed relating to AR. Each topic was assigned a literature review, evidence-based review (EBR), or evidence-based review with recommendations (EBRR) format as dictated by available evidence and purpose within the ICAR:AR document. Following iterative reviews of each topic, the ICAR:AR document was synthesized and reviewed by all authors for consensus. RESULTS The ICAR:AR document addresses over 100 individual topics related to AR, including diagnosis, pathophysiology, epidemiology, disease burden, risk factors for the development of AR, allergy testing modalities, treatment, and other conditions/comorbidities associated with AR. CONCLUSION This critical review of the AR literature has identified several strengths; providers can be confident that treatment decisions are supported by rigorous studies. However, there are also substantial gaps in the AR literature. These knowledge gaps should be viewed as opportunities for improvement, as often the things that we teach and the medicine that we practice are not based on the best quality evidence. This document aims to highlight the strengths and weaknesses of the AR literature to identify areas for future AR research and improved understanding.
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Affiliation(s)
| | | | | | | | - Cezmi A. Akdis
- Allergy/Asthma, Swiss Institute of Allergy and Asthma Research, Switzerland
| | | | - Antoine Azar
- Allergy/Immunology, Johns Hopkins University, USA
| | | | | | | | | | - Cemal Cingi
- Otolaryngology, Eskisehir Osmangazi University, Turkey
| | | | | | | | | | | | | | - Adam DeConde
- Otolaryngology, University of California San Diego, USA
| | | | | | | | | | | | | | - Jan Gosepath
- Otorhinolaryngology, Helios Kliniken Wiesbaden, Germany
| | | | | | | | - Jens M. Hohlfeld
- Respiratory Medicine, Hannover Medical School, Airway Research Fraunhofer Institute for Toxicology and Experimental Medicine, German Center for Lung Research, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | - Amber U. Luong
- Otolaryngology, McGovern Medical School at the University of Texas Health Science Center Houston, USA
| | | | | | | | - Erik Melén
- Pediatric Allergy, Karolinska Institutet, Sweden
| | | | | | - Joaquim Mullol
- Otolaryngology, Universitat de Barcelona, Hospital Clinic, IDIBAPS, Spain
| | | | | | | | - Oliver Pfaar
- Rhinology/Allergy, Medical Faculty Mannheim, Heidelberg University, Center for Rhinology and Allergology, Wiesbaden, Germany
| | | | | | - Carmen Rondón
- Allergy, Regional University Hospital of Málaga, Spain
| | - Luke Rudmik
- Otolaryngology, University of Calgary, Canada
| | - Matthew Ryan
- Otolaryngology, University of Texas Southwestern, USA
| | - Joaquin Sastre
- Allergology, Hospital Universitario Fundacion Jiminez Diaz, Spain
| | | | | | - Hemant P. Sharma
- Allergy/Immunology, Children's National Health System, George Washington University School of Medicine, USA
| | | | | | | | | | | | - De Yun Wang
- Otolaryngology, National University of Singapore, Singapore
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Fernandes SDSC, Andrade CRD, Alvim CG, Camargos PAM, Ibiapina CDC. Epidemiological trends of allergic diseases in adolescents. J Bras Pneumol 2018; 43:368-372. [PMID: 29160383 PMCID: PMC5790655 DOI: 10.1590/s1806-37562016000000255] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 05/04/2017] [Indexed: 01/07/2023] Open
Abstract
Objective: To assess the prevalences of asthma, allergic rhinitis, and allergic rhinoconjunctivitis in adolescents in the city of Belo Horizonte, Brazil, in 2012 by administering the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, as well as to compare the observed prevalences with those found in studies performed 10 years earlier and employing the same methodology used here. Methods: This was a cross-sectional study conducted between May and December of 2012 and involving adolescents in the 13- to 14-year age bracket. Participants were randomly selected from among adolescents studying at public schools in Belo Horizonte and completed the ISAAC questionnaire. Proportions were calculated in order to assess the prevalences of asthma, allergic rhinitis, and allergic rhinoconjunctivitis in the sample as a whole, and the chi-square goodness-of-fit test was used in order to compare the prevalences observed in 2012 with those found in 2002. Results: The prevalences of symptoms of asthma, allergic rhinitis, and allergic rhinoconjunctivitis in 2012 were 19.8%, 35.3%, and 16.3%, respectively, being significantly higher than those found in 2002 (asthma, p = 0.006; allergic rhinitis, p < 0.01; and allergic rhinoconjunctivitis, p = 0.002). Conclusions: The prevalences of asthma, allergic rhinitis, and allergic rhinoconjunctivitis among adolescents in 2012 were found to be high, having increased in comparison with those found 10 years earlier, despite efforts in prevention, diagnosis, and treatment.
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Affiliation(s)
| | - Cláudia Ribeiro de Andrade
- . Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
| | - Cristina Gonçalves Alvim
- . Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
| | | | - Cássio da Cunha Ibiapina
- . Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
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25
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Lam SC, Yeung CCY, Chan JHM, Lam DWC, Lam AHY, Annesi-Maesano I, Bousquet J. Adaptation of the Score for Allergic Rhinitis in the Chinese Population: Psychometric Properties and Diagnostic Accuracy. Int Arch Allergy Immunol 2017; 173:213-224. [DOI: 10.1159/000477727] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/23/2017] [Indexed: 12/27/2022] Open
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26
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Lee SL, Lau YL, Wong HS, Tian L. Prevalence of and Risk Factors for Childhood Asthma, Rhinitis, and Eczema in Hong Kong: Proposal for a Cross-Sectional Survey. JMIR Res Protoc 2017; 6:e106. [PMID: 28592396 PMCID: PMC5480011 DOI: 10.2196/resprot.7252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 04/20/2017] [Accepted: 04/24/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Previous studies have shown that particulate matter is a major problem in indoor air quality in Hong Kong schools, but little has been done to assess its relationship with health indicators in the children attending those schools. Our study aims to address this research gap by collecting aerosol data in schools to examine the link between different air pollutants with childhood respiratory health. It is important to explore whether or not the prevalence of asthma, allergic rhinoconjunctivitis, and eczema are increasing in local children. OBJECTIVE Our aim is to (1) examine the prevalence of asthma, allergic rhinitis, and eczema in school children aged 6-7 years in Hong Kong between 2001 and 2017, and (2) measure air quality at primary schools and explore its relationship with health outcomes measured by the International Study of Asthma and Allergies in Childhood (ISAAC) survey. METHODS This is a cross-sectional study consisting of an ISAAC questionnaire and aerosol data collection. We have recruited over 2000 parents of primary school students aged 6-7 years old for the questionnaire, and so far 19 schools have completed aerosol data collection. RESULTS The study is expected to be completed this year. CONCLUSIONS We predict that our study will show a significant change in the prevalence of asthma, allergic rhinitis, and eczema in school children aged 6-7 years old in recent years. In addition, we expect to show a significant association between air quality at school and health outcomes measured by the ISAAC survey.
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Affiliation(s)
- So Lun Lee
- Department of Paediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong).,Department of Paediatrics, The Duchess of Kent Children's Hospital at Sandy Bay, Hong Kong, China (Hong Kong)
| | - Yu Lung Lau
- Department of Paediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong).,The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Hing Sang Wong
- Department of Paediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hing Kong, China (Hong Kong)
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27
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The relationship between allergic status and adenotonsillar regrowth: a retrospective research on children after adenotonsillectomy. Sci Rep 2017; 7:46615. [PMID: 28418014 PMCID: PMC5394537 DOI: 10.1038/srep46615] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 03/22/2017] [Indexed: 11/21/2022] Open
Abstract
Adenotonsillar regrowth in children after adenotonsillectomy (T&A) for obstructive sleep apnea (OSA) is often seen in clinical treatment, however, the relationship between allergic disease and adenotonsillar regrowth remains unclear. In this retrospective study, children were assigned to either the recurrence or control group, and subdivided by age at operation. Among children over 36 months, those in the recurrence group had more allergic disease and higher IgE, IL-4, and IL-5 levels than the same-aged children in control group. The Paediatric Allergic Disease Quality of Life Questionnaire (PADQLQ) scores for nasal symptoms and activity were higher in children older than 36 months in recurrence group. The results of immunohistochemistry and immunofluorescence showed that FoxP3+ cells (Tregs) were less, while GATA3+ cells (Th2 cells) were more in recurrence group for all ages. Allergic status and low levels of FoxP3 were proved as independent risk factors for adenotonsillar regrowth by multivariate logistic regression. These results indicate that allergic disease is a risk factor for adenotonsillar regrowth in children following T&A for OSA, and this risk increases with age. The decreased level of Tregs and subsequent changes in immune function play an important role in the pathogenesis of adenotonsillar regrowth.
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28
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Faraldo-García A, Lopez-Silvarrey A, Pertega S, Cruz MJ, Sampedro M, Sánchez-Lastres J, San-José Gónzalez MA, Bamonde L, Garnelo L, Pérez-Castro T, Valdés-Cuadrado L, Gonzalez-Barcala FJ. Cross-sectional study about impact of parental smoking on rhinitis symptoms in children. Clin Otolaryngol 2017; 42:1275-1280. [PMID: 28306200 DOI: 10.1111/coa.12868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Assess the prevalence of rhinitis and exposure to environmental tobacco smoke (ETS) of children in our community and its relationship with symptoms of rhinitis METHODS (DESIGN, SETTING, PARTICIPANTS, MAIN OUTCOME MEASURES): Cross-sectional study using questionnaire on rhinitis of the International Study of Asthma and Allergies in Childhood, in children (6-7 years) and adolescents (13-14 years). Categories: "rhinitis ever", "recent rhinitis", "recent rhinoconjunctivitis", "severe rhinoconjunctivitis". Parental smoking: (i) neither parent smokes; (ii) only the mother smokes; (iii) only the father smokes; and (iv) both parents smoke. Odds ratio of the prevalence of symptoms of rhinitis according to ETS exposure was calculated using logistic regression. RESULTS 10 690 children and 10 730 adolescents. The prevalence of "rhinitis ever" in children: 29.4%, "recent rhinitis" 24%, "recent rhinoconjunctivitis" 11.5% and "severe rhinoconjunctivitis" 0.1%. In adolescents: 46.2%, 34.5%, 16.2% and 0.2%, respectively. Environmental tobacco smoke exposure in the home occurred in 51% of cases. Parental smoking was associated with a higher prevalence of forms of rhinitis in adolescents when only the mother was a smoker. In children when both parents were smokers. CONCLUSION Rhinitis is highly prevalent in our community. Environmental tobacco smoke exposure is still very common. The relationship between ETS and rhinitis symptoms in children of this community is not as robust as that found for asthma.
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Affiliation(s)
- A Faraldo-García
- Departament of Otorhinolaryngology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - S Pertega
- Clinical Epidemiology and Biostatistics Unit, University Hospital Complex, A Coruña, Spain
| | - M-J Cruz
- Spanish Biomedical Research Networking Centre-CIBERES, Madrid, Spain.,Department of Respiratory Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - M Sampedro
- Departament of Pediatrics, Servicio Galego de Saúde, A Coruña, Spain
| | - J Sánchez-Lastres
- Departament of Pediatrics, Servicio Galego de Saúde, A Coruña, Spain
| | | | - L Bamonde
- Departament of Pediatrics, Servicio Galego de Saúde, A Coruña, Spain
| | - L Garnelo
- Departament of Pediatrics, Servicio Galego de Saúde, A Coruña, Spain
| | - T Pérez-Castro
- Grupo de investigación Cardiovascular (GRINCAR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Instituto Universitario de Ciencias de la Salud, Universidade da Coruña, A Coruña, Spain
| | - L Valdés-Cuadrado
- Department of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - F-J Gonzalez-Barcala
- Spanish Biomedical Research Networking Centre-CIBERES, Madrid, Spain.,Department of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Chuh A, Zawar V, Lee A, Sciallis G. Is Gianotti-Crosti Syndrome Associated with Atopy? A Case-Control Study and a Postulation on the Intrinsic Host Factors in Gianotti-Crosti Syndrome. Pediatr Dermatol 2016; 33:488-92. [PMID: 27339179 DOI: 10.1111/pde.12886] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate whether Gianotti-Crosti syndrome (GCS) in children is associated with atopy. METHODS The setting was two outpatient clinic. Diagnoses of asthma and atopic dermatitis (AD) were made according to internationally accepted diagnostic criteria. Allergic rhinitis, atopic urticaria, and allergic conjunctivitis were diagnosed clinically. Participants were children with GCS diagnosed over the previous 5 years. For any child with GCS, we extracted the record of the subsequent age and sex pair-matched child seen for problems unrelated to the skin as controls. RESULTS We retrieved the records of 37 pairs of study and control subjects; 28 (76%) children with GCS and 9 (24%) controls had AD (risk ratio [RR] = 3.11[95% confidence interval {CI} 1.73, 5.73]), 31 (84%) children with GCS and 19 (51%) controls had at least one atopic condition (RR = 1.63 [95% CI 1.13, 2.18]) and 11 (30%) children with GCS and 2 (5%) controls had at least three atopic conditions (RR = 5.50 [95% CI 1.29, 35.35]). CONCLUSION GCS is significantly associated with AD and the presence of atopic conditions.
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Affiliation(s)
- Antonio Chuh
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong.
| | | | - Albert Lee
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong
| | - Gabriel Sciallis
- Department of Dermatology, College of Medicine, Mayo Clinic, Rochester, Minnesota
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30
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Pau BC, Ng DK. Prevalence of otitis media with effusion in children with allergic rhinitis, a cross sectional study. Int J Pediatr Otorhinolaryngol 2016; 84:156-60. [PMID: 27063773 DOI: 10.1016/j.ijporl.2016.03.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 03/08/2016] [Accepted: 03/11/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Otitis media with effusion (OME) may be caused by various factors including Eustachian tube dysfunction, inflammatory response as well as atopy. Allergic rhinitis (AR), a common chronic disorder in children, is associated with swelling of the mucosa and can therefore result in Eustachian tube dysfunction. This study aims to compare the prevalence of OME in subjects with and without AR. METHOD Children aged 4-12 were recruited from the clinics at Kwong Wah Hospital, Hong Kong. Subjects recruited were interviewed and a questionnaire filled in regarding nasal obstruction, rhinorrhea, sneezing, itching of the nose and/or post nasal discharge (ARIR document). The children were then examined by a doctor using a pneumatic otoscopy and a portable tympanometer. Children found to have OME were offered a follow-up visit 3 months later. RESULTS 12 out of 159 (7.5%) of the AR group were found to have OME compared with 3 out of 185 (1.6%) in the non-AR group, p=0.016. During the 2nd visit at 3 months, 85.7% of the AR subjects showed resolution of their OME. CONCLUSIONS Our data showed a significant difference in the prevalence of OME between AR and non-AR subjects. Of the 185 non AR subjects (Control group), 3 was found to have OME, suggesting a point prevalence of OME of 1.6% in the community in Hong Kong. OME is more likely to occur in children with allergic rhinitis and it may be wiser to manage OME in these individuals differently.
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Affiliation(s)
- Benjamin C Pau
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong SAR, China
| | - Daniel K Ng
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong SAR, China.
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31
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Kim DH, Han K, Kim SW. Relationship Between Allergic Rhinitis and Mental Health in the General Korean Adult Population. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2016; 8:49-54. [PMID: 26540501 PMCID: PMC4695408 DOI: 10.4168/aair.2016.8.1.49] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/26/2015] [Indexed: 12/28/2022]
Abstract
PURPOSE This study was conducted to evaluate the association between AR and mental health status in the general Korean adult population and to investigate the relative burden of AR on mental health using the Allergic Rhinitis and Its Impact on Asthma (ARIA) classification. METHODS A cross-sectional study was performed by using data from 11,154 individuals, 19 years old or older in the Korean National Health and Nutrition Examination Survey 2011-2012. Univariate analysis was conducted in the healthy AR groups with weighted prevalence of demographic characteristics, socioeconomic status, and comorbid diseases. Subanalysis that classified AR severity according to the ARIA classification was carried out to evaluate the relationship of AR severity with mental health. The odds ratios (ORs) for each component representing mental health status were estimated by multiple logistic regression analysis with confounder adjustment. RESULTS Univariate analysis with the chi-square test after adjustment for age, sex, body mass index, smoking status, alcohol use status, and exercise status, components representing mental health status showed a linear relationship with the severity of AR according to the ARIA classification. Stress, depressive mood, suicidal thoughts, and psychological consultation factors were correlated with AR after adjustment for demographic characteristics and socioeconomic status. Even after adjustment for comorbid allergic diseases, the correlation remained significant with stress, depressive mood, and psychological consultation factors (OR [95% CI]; 1.227 [1.042, 1.445], 1.368 [1.095, 1.71], 1.804 [1.096, 2.969], respectively). CONCLUSIONS Patients with AR appear to be at higher risk of mental disorders in the general Korean adult population. Moreover, persistent or severe AR was correlated with poor mental health. Therefore, better control of AR may be conducive to better mental health, and more attention should be paid to the psychological status of AR patients.
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Affiliation(s)
- Do Hyun Kim
- Department of Otorhinolaryngology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, The Catholic University of Korea, Seoul, Korea
| | - Soo Whan Kim
- Department of Otorhinolaryngology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Chen Y, Wong GWK, Li J. Environmental Exposure and Genetic Predisposition as Risk Factors for Asthma in China. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2015; 8:92-100. [PMID: 26739401 PMCID: PMC4713885 DOI: 10.4168/aair.2016.8.2.92] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 04/13/2015] [Indexed: 12/21/2022]
Abstract
Asthma is the most common chronic pulmonary disease worldwide and places a considerable economic burden on society. China is the world's largest developing country and has the largest population. China has undergone dramatic changes in the past few decades. The traditional lifestyle and living environment have changed in ways that directly affect the prevalence of asthma. The prevalence of asthma is lower in Chinese children and adults than in developed countries, but the prevalence has been on the rise during the past 30 years. The prevalence significantly varies among different parts of China. Polymorphisms of multiple genes, outdoor air pollution caused by PM2.5, PM10, SO2, NO2, environmental tobacco smoke, and coal, indoor pollution, and inhaled allergens, such as house dust mites, pollen, and cockroach particles, are risk factors for asthma.
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Affiliation(s)
- Yan Chen
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.,Guangdong Pharmaceutical University, Guangzhou, China
| | - Gary W K Wong
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, China
| | - Jing Li
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
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Luo X, Wang Y, Wang Z, Zhou XH, Zhao J, Suo J, Dong X, Liu M. Effect modification by gender and smoking status on the association between obesity and atopic sensitization in Chinese adults: a hospital-based case-control study. BMC Public Health 2014; 14:1105. [PMID: 25344653 PMCID: PMC4228147 DOI: 10.1186/1471-2458-14-1105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 10/21/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an ongoing debate on the potential association between obesity and atopy. However, no previous studies have investigated whether this relationship depends on sex and smoking status in Chinese adults. METHODS In this hospital-based, case-control study, we recruited 1150 atopic cases aged 18 years or older and 1245 healthy control participants during April 2009 and December 2012 in Harbin, China. We conducted structured questionnaire interviews, anthropometry measurements and serum allergen-specific immunoglobulin E (IgE) testing. Univariate and multivariate logistic regression models were used to explore the relationship between obesity and atopy risk stratified by sex and smoking status. RESULTS There was an association between obesity and an increased risk of atopic sensitization after adjusting for age, educational, family history, smoking and alcohol consumption (OR: 2.61, 3.25; 95% CI: 1.57-4.33,1.91-5.56 in males and females, respectively). The association between BMI and allergic sensitization depended on smoking status. In both genders, the association of obesity with atopic sensitization risk was stronger in non-smokers than in current smokers. In males, ORs of atopic sensitization for obesity were 3.15 (95% CI, 1.46-6.68) for non-smokers and 2.22 (95% CI, 1.10-4.48) for current smokers. The corresponding ORs in females were 3.51 (95% CI, 1.98-6.24) and 2.22 (95% CI, 0.46-10.68) for non-smokers and current smokers, respectively. After excluding those subjects who with pre-existing allergic conditions, the same relationship still remained. CONCLUSIONS Obesity is positively and significantly associated with the risk of atopy in both men and women as well in both smokers and non-smokers in China. In addition, the relationship between obesity and atopic sensitization is stronger in non-smokers than in current smokers.
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Affiliation(s)
- Xiao Luo
- />Public Health College, Harbin Medical University, 157 Baojian Road, Harbin City, Heilongjiang Province Postcode 150081 P.R. China
| | - Yupeng Wang
- />Public Health College, Harbin Medical University, 157 Baojian Road, Harbin City, Heilongjiang Province Postcode 150081 P.R. China
| | - Zhiqiang Wang
- />School of Medicine, the University of Queensland, Room 817, Health Sciences Building, Royal Brisbane & Women’s Hospital, Herston, QLD 4029 Australia
| | - Xiao-hua Zhou
- />Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA 98198 USA
| | - Jing Zhao
- />Public Health College, Harbin Medical University, 157 Baojian Road, Harbin City, Heilongjiang Province Postcode 150081 P.R. China
| | - Jianing Suo
- />Public Health College, Harbin Medical University, 157 Baojian Road, Harbin City, Heilongjiang Province Postcode 150081 P.R. China
| | - Xiaohui Dong
- />Public Health College, Harbin Medical University, 157 Baojian Road, Harbin City, Heilongjiang Province Postcode 150081 P.R. China
| | - Meina Liu
- />Public Health College, Harbin Medical University, 157 Baojian Road, Harbin City, Heilongjiang Province Postcode 150081 P.R. China
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Lin R, Guan R, Liu X, Zhao B, Guan J, Lu L. Significant rise of the prevalence and clinical features of childhood asthma in Qingdao China: cluster sampling investigation of 10,082 children. BMC Public Health 2014; 14:1002. [PMID: 25256616 PMCID: PMC4192336 DOI: 10.1186/1471-2458-14-1002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 08/07/2014] [Indexed: 12/05/2022] Open
Abstract
Background Recent investigations suggested that the trend of childhood asthma has been stabilizing or even reversing in some countries. The observation provides contrast to our experience. Thus, the study aimed to investigate the prevalence and clinical features of asthma in children aged 0–14 years in Qingdao China, determine the changes of childhood asthma in China, and discover evidence that can allow better diagnosis and treatment of childhood asthma. Methods A cluster sampling method was used. We randomly extracted the investigation clusters from schools, kindergartens, and communities in Qingdao. Subsequently, we interviewed the members of the clusters using a questionnaire from the International Study of Asthma and Allergies in Childhood (ISAAC) to find children with asthmatic symptoms. After determination by the doctors, more details on the asthmatic children were obtained by asking questions from the National Epidemiology Study of Asthma and Allergies in China questionnaire to obtain more details. We intended to survey 10,800 children. However, the actual number of children was 10,082. Results The prevalence of asthma in Qingdao children aged 0–14 years was 3.69%. The prevalence among male children was higher than in female (χ2 = 24.53,P < 0.01). Among the asthmatic children, 68.0% had their first attack when they were less than three years old. Moreover, 71.2% once suffered respiratory tract infections. For 95.7% of asthmatic children, the asthma attack was first manifested as cough. Asthmatic children who used inhaled corticosteroids (ICS) only accounted for 46%. Conclusions The prevalence of asthma in children aged 0–14 years in Qingdao China increased significantly based on data obtained ten years ago (2000). Respiratory tract infections were the most important precursors of asthma attack. The attack was most commonly manifested as cough. The treatment, especially the use of ICS, was more rational. However, a certain difference was found, which has yet to be contrasted with the Global Initiative for Asthma (GINA) project.
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Affiliation(s)
- Rongjun Lin
- The Affiliated Hospital of Qingdao University, Qingdao 266003, China.
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Park HJ, Lim HS, Park KH, Lee JH, Park JW, Hong CS. Changes in allergen sensitization over the last 30 years in Korea respiratory allergic patients: a single-center. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2014; 6:434-43. [PMID: 25229001 PMCID: PMC4161685 DOI: 10.4168/aair.2014.6.5.434] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 11/06/2013] [Accepted: 01/24/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE Determining the culprit allergen is important for the diagnosis and management of allergic diseases. The skin prick test (SPT) has been widely used to identify culprit allergens. Skin reactivity to allergens has changed due to changes in lifestyle and outdoor environments. Therefore, the aim of the present paper was to examine changes in allergen sensitization in Korea. METHODS We enrolled 1,135 patients with respiratory allergic diseases who were diagnosed at Severance Hospital from January 2010 to December 2011. SPTs were performed with inhalant allergens, and were compared to our previous studies of the SPTs in the 1980s and the 1990s. RESULTS In the 2010s, the SPT positive rate of allergic rhinitis or allergic conjunctivitis was higher than asthma without allergic rhinitis or allergic conjunctivitis. The SPT positive rate was decreased by increments of age (P value <0.01). Skin reactivity to tree pollens was significantly increased to 36.4% in the 2010s from 19.0% in the 1990s and 8.8% in the 1980s. Among tree pollens, skin reactivity to oak (4.7%->14.4%), birch (7.1%->13.6%), alder (6.3%->13.4%) and pine (2.9%->14.3%) was significantly increased in the 2010s compared with the 1990s, respectively. Current skin reactivity to grass pollens (13.9%) and weed pollens (27.0%) has significantly decreased since the 1990s (20.3%, 40.9%, respectively). Skin reactivity to house dust mites showed no difference between the 1990s (55.2%) and the 2010s (55.6%). Skin reactivity to dog (27.3%->20.7%) and cockroach (25.3%->12.3%) have significantly decreased in the 2010s in comparison with the 1990s. CONCLUSIONS In light of the above results, we revealed the changes in skin reactivity to inhalant allergens that have occurred in Korean allergic patients over the past three decades. Since outdoor environmental factors such as the amount of pollen, global warming and plant distribution causes the changes in skin reactivity, further study and continuous close observation will be needed.
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Affiliation(s)
- Hye Jung Park
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Sun Lim
- Biomedical Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Hee Park
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Hyun Lee
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Jung-Won Park
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Chein-Soo Hong
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
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Duksal F, Becerir T, Ergin A, Akcay A, Guler N. The prevalence of asthma diagnosis and symptoms is still increasing in early adolescents in Turkey. Allergol Int 2014; 63:189-97. [PMID: 24561770 DOI: 10.2332/allergolint.13-oa-0612] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 10/24/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND This study was performed to evaluate the time trends in prevalence of asthma and related factors in Denizli, Turkey. METHODS Two cross-sectional surveys were performed, 6 years apart (2002 and 2008) using the ISAAC protocol, in the 13-14 age groups and comparisons were made between the results. RESULTS Lifetime prevalence of wheeze, 12 month prevalence of wheeze, and the prevalence of wheeze after exercise in the previous 12 months were significantly increased respectively from 10.2% to 13.4% (POR = 1.37, 95%CI = 1.18-1.58, p < 0.001), from 5.0% to 6.2% (POR = 1.26, 95%CI = 1.02-1.55, p = 0.016) and from 9% to 10.2% (POR = 1.15, 95%CI = 0.98-1.35, p = 0.046) in 2008 study. Doctor diagnosed asthma prevalence also increased significantly from 2.1% to 12.9 (POR = 6.80, 95%CI = 5.22-8.85, p < 0.001). Prevalence of sleep disturbed by wheeze in the last 12 months; but, never woken with wheezing (POR = 1.62, 95%CI = 1.26-2.09, p = < 0.001) and less than one night per week (POR = 1.58, 95%CI = 1.06-2.36, p = 0.013) were significantly increased in 2008 study. Severe attacks of wheeze limiting speech in the last year was increased from 1.3% to 2.2% (POR = 1.67, 95%CI = 1.14-2.43, p = 0.004). The number of wheeze attacks in the previous 12 months was increased significantly for 4-to-12 attacks (POR = 1.54, 95%CI = 1.03-2.32, p = 0.02) in 2008 study. However, prevalence of waking with cough in the last 12 months did not change. While history of family atopy and domestic animal at home were found as significant risk factors for asthma in 2002 study, male gender, history of family atopy and stuffed toys were found significant in 2008. CONCLUSIONS The prevalence of asthma symptoms were increased in Denizli. History of family atopy, male gender and stuffed toys were important risk factors for asthma in 2008.
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Affiliation(s)
- Fatma Duksal
- Division of Pediatric Allergy, Department of Pediatrics, Cumhuriyet University, Cumhuriyet School of Medicine, Sivas, Turkey
| | - Tulay Becerir
- Department of Pediatrics, Pamukkale University, Pamukkale School of Medicine, Denizli, Turkey
| | - Ahmet Ergin
- Department of Pediatrics, Pamukkale University, Pamukkale School of Medicine, Denizli, Turkey
| | - Ahmet Akcay
- Division of Pediatric Allergy, Department of Pediatrics, Liv Hospital, Istanbul, Turkey
| | - Nermin Guler
- Division of Pediatric Allergy, Department of Pediatrics, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
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Saulyte J, Regueira C, Montes-Martínez A, Khudyakov P, Takkouche B. Active or passive exposure to tobacco smoking and allergic rhinitis, allergic dermatitis, and food allergy in adults and children: a systematic review and meta-analysis. PLoS Med 2014; 11:e1001611. [PMID: 24618794 PMCID: PMC3949681 DOI: 10.1371/journal.pmed.1001611] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 01/22/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Allergic rhinitis, allergic dermatitis, and food allergy are extremely common diseases, especially among children, and are frequently associated to each other and to asthma. Smoking is a potential risk factor for these conditions, but so far, results from individual studies have been conflicting. The objective of this study was to examine the evidence for an association between active smoking (AS) or passive exposure to secondhand smoke and allergic conditions. METHODS AND FINDINGS We retrieved studies published in any language up to June 30th, 2013 by systematically searching Medline, Embase, the five regional bibliographic databases of the World Health Organization, and ISI-Proceedings databases, by manually examining the references of the original articles and reviews retrieved, and by establishing personal contact with clinical researchers. We included cohort, case-control, and cross-sectional studies reporting odds ratio (OR) or relative risk (RR) estimates and confidence intervals of smoking and allergic conditions, first among the general population and then among children. We retrieved 97 studies on allergic rhinitis, 91 on allergic dermatitis, and eight on food allergy published in 139 different articles. When all studies were analyzed together (showing random effects model results and pooled ORs expressed as RR), allergic rhinitis was not associated with active smoking (pooled RR, 1.02 [95% CI 0.92-1.15]), but was associated with passive smoking (pooled RR 1.10 [95% CI 1.06-1.15]). Allergic dermatitis was associated with both active (pooled RR, 1.21 [95% CI 1.14-1.29]) and passive smoking (pooled RR, 1.07 [95% CI 1.03-1.12]). In children and adolescent, allergic rhinitis was associated with active (pooled RR, 1.40 (95% CI 1.24-1.59) and passive smoking (pooled RR, 1.09 [95% CI 1.04-1.14]). Allergic dermatitis was associated with active (pooled RR, 1.36 [95% CI 1.17-1.46]) and passive smoking (pooled RR, 1.06 [95% CI 1.01-1.11]). Food allergy was associated with SHS (1.43 [1.12-1.83]) when cohort studies only were examined, but not when all studies were combined. The findings are limited by the potential for confounding and bias given that most of the individual studies used a cross-sectional design. Furthermore, the studies showed a high degree of heterogeneity and the exposure and outcome measures were assessed by self-report, which may increase the potential for misclassification. CONCLUSIONS We observed very modest associations between smoking and some allergic diseases among adults. Among children and adolescents, both active and passive exposure to SHS were associated with a modest increased risk for allergic diseases, and passive smoking was associated with an increased risk for food allergy. Additional studies with detailed measurement of exposure and better case definition are needed to further explore the role of smoking in allergic diseases.
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Affiliation(s)
- Jurgita Saulyte
- 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), Barcelona, Spain
| | - Carlos Regueira
- 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), Barcelona, Spain
| | - Agustín Montes-Martínez
- 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), Barcelona, Spain
| | - Polyna Khudyakov
- Departments of Epidemiology and Biostatistics,
Harvard School of Public Health, Boston, Massachusetts, United States of
America
| | - 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), Barcelona, Spain
- * E-mail:
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Passali GC, Bellussi LM, De Corso E, Passali FM, Passali D. The natural course of allergic rhinitis: a 32-year follow-up study. Acta Otolaryngol 2013; 133:1188-95. [PMID: 24125190 DOI: 10.3109/00016489.2013.815362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
CONCLUSION Early intervention may change the natural course of allergic rhinitis, preventing the progression to asthma. In particular, immunotherapy guarantees remission of local symptoms and valid protection against local and bronchial complications. Symptomatic treatment represents a valid alternative; it is always to be preferred to abstention from any treatment. OBJECTIVES Data emerging from various studies on the increase of the prevalence of allergic rhinitis in recent decades appear to be widely dishomogeneous. Another point that needs clarification is the relationship between allergic rhinitis and lower airways pathologies such as asthma or bronchitis. METHODS We followed the evolution of allergic rhinitis in a group of patients for the last 30 years to highlight the efficacy of different treatments in the prevention of complications, specifically asthma. After 32 years (1980-2012), 46/73 (63%) patients completed the follow-up. RESULTS Symptomatic drugs exhibited maximum efficacy from the third to the eighth year, with 13 of 15 patients reporting an improvement of symptoms; immunotherapy achieved the best efficacy starting from the sixth to the tenth year (8 of 10 patients recovered). Subsequently, improvements decreased in the two groups, to a steady level of 11 of 15 and 6 of 10 recovered patients. Asthma developed in 3 of 46 patients and only among patients that were not treated.
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Lu C, Deng Q, Ou C, Liu W, Sundell J. Effects of ambient air pollution on allergic rhinitis among preschool children in Changsha, China. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/s11434-013-5725-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Chen MH, Su TP, Chen YS, Hsu JW, Huang KL, Chang WH, Bai YM. Allergic rhinitis in adolescence increases the risk of depression in later life: a nationwide population-based prospective cohort study. J Affect Disord 2013; 145:49-53. [PMID: 22889525 DOI: 10.1016/j.jad.2012.07.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 07/15/2012] [Accepted: 07/15/2012] [Indexed: 01/09/2023]
Abstract
BACKGROUND Many cross-sectional studies have suggested an association between allergic rhinitis (AR) and depression, but the timing relationship was not determined. Using a nationwide population-based prospective cohort study (1:4, age-/gender-matched), we hypothesized that AR in adolescence would increase the risk of depression in later life. METHODS In all, 1673 adolescents aged 12-15 that had AR between 1996 and 2000 were recruited for our study. Cases of major depressive disorder and any depressive disorder that occurred to the end of follow-up (December 31, 2010) were identified. RESULT Adolescents with AR had a higher prevalence of major depression (2.5% vs. 1.2%, p<0.001) and any depressive disorder (4.9% vs. 2.8%, p<0.001) and an earlier onset of major depression (19.31 ± 2.91 vs. 20.43 ± 2.71 years, p=0.038) and any depressive disorder (19.35 ± 2.63 vs. 20.43 ± 2.62 years, p=0.002) compared with the controls. The Cox regression model showed that adolescents with AR had increased HRs of major depression (HR: 1.59, 95% CI: 1.02-2.50) and any depressive disorder (HR: 1.42, 95% CI: 1.04-1.93) after controlling residence location and comorbid allergic diseases. LIMITATIONS The prevalence of depressive disorder may be underestimated because only those who had medicine-seeking behaviors were enrolled. CONCLUSIONS This first cohort case-control study showed an association between AR in early adolescence and depression in late adolescence and early adulthood. Our results suggested that allergic responses played important roles in the development of depression.
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
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Rasool R, Shera IA, Nissar S, Shah ZA, Nayak N, Siddiqi MA, Sameer AS. Role of skin prick test in allergic disorders: a prospective study in kashmiri population in light of review. Indian J Dermatol 2013; 58:12-7. [PMID: 23372205 PMCID: PMC3555364 DOI: 10.4103/0019-5154.105276] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Skin prick test (SPT) is the most effective diagnostic test to detect IgE mediated type I allergic reactions like allergic rhinitis, atopic asthma, acute urticaria, food allergy etc. SPTs are done to know allergic sensitivity and applied for devising immunotherapy as the therapeutic modality. Materials and Methods: This prospective study was conducted in the department of Immunology and Molecular medicine at SKIMS. A total of 400 patients suffering from allergic rhinitis, asthma and urticaria were recruited in this study. SPT was performed with panel of allergens including house dust mite, pollens, fungi, dusts, cockroach, sheep wool and dog epithelia. Allergen immunotherapy was given to allergic rhinitis and asthmatic patients as therapeutic modality. Results: In our study, age of patients ranged from 6 to 65 years. Majority of patients were in the age group of 20-30 years (72%) with Male to female ratio of 1:1.5. Of the 400 patients, 248 (62%) had urticaria, 108 (27%) patients had allergic rhinitis and 44 (11%) patients had asthma. SPT reaction was positive in 38 (86.4%) with allergic asthma, 74 (68.5%) patients with allergic rhinitis and 4 (1.6%) patient with urticaria, respectively. Allergen immunotherapy was effective in 58% patients with allergic rhinitis and 42% allergic asthma. Conclusion: Identifiable aeroallergen could be detected in 86.4% allergic asthma and 68.5% allergic rhinitis patients by SPT alone. Pollens were the most prevalent causative allergen. There was significant relief in the severity of symptoms, medication intake with the help of allergen immunotherapy.
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Affiliation(s)
- Roohi Rasool
- Department of Immunology and Molecular Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, India
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Lee SL, Cheung YF, Wong HSW, Leung TH, Lam TH, Lau YL. Chronic health problems and health-related quality of life in Chinese children and adolescents: a population-based study in Hong Kong. BMJ Open 2013; 3:bmjopen-2012-001183. [PMID: 23293240 PMCID: PMC3549227 DOI: 10.1136/bmjopen-2012-001183] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE We examined the association of different chronic physical and mental conditions, individually or comorbidly on health-related quality of life (QoL) in Chinese children aged ≤14 years in Hong Kong. DESIGN Population-based cross-sectional survey. PARTICIPANTS Approximately 7500 Chinese children aged <14 years in Hong Kong. INTERVENTIONS Nil. PRIMARY AND SECONDARY OUTCOME MEASURES Various health concepts of validated Chinese version of Child Health Questionnaire (CHQ), a health-related QoL questionnaire in children. RESULT There was significant association of physical and mental health conditions, either individually or comorbidly, on the various concepts of CHQ. Children with mental health problems were apparently more affected than those with physical health problems. Chronic renal disease and congenital malformation were the physical health conditions associated with the lowest scores in CHQ concepts in children aged 5-10 years and aged 10-14 years, respectively. Behavioural problem was the mental health condition associated with the lowest score in CHQ concepts in both age groups. CONCLUSIONS Our study shows important information concerning the prevalence of different health conditions and its association, either individually or comorbidly on the QoL in a representative sample of Chinese children in HK.
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Affiliation(s)
- S L Lee
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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Seo JH, Kim HY, Jung YH, Kwon JW, Kim BJ, Kim HB, Kim WK, Lee SY, Jang GC, Song DJ, Shim JY, Kim EJ, Lee JS, Hong SJ. The association between sibling and allergic rhinitis in adolescents. ALLERGY ASTHMA & RESPIRATORY DISEASE 2013. [DOI: 10.4168/aard.2013.1.1.67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Ju-Hee Seo
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
| | - Hyung Young Kim
- Department of Pediatrics, Kosin University Gospel Hospital, Busan, Korea
| | - Young-Ho Jung
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Byoung-Ju Kim
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - So-Yeon Lee
- Department of Pediatrics, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Eun-Jin Kim
- Department of Immunology and Pathology, Allergy TF, Korea National Institute of Health, Cheongwon, Korea
| | - Joo-Shil Lee
- Department of Immunology and Pathology, Allergy TF, Korea National Institute of Health, Cheongwon, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kim WK, Kwon JW, Seo JH, Kim HY, Yu J, Kim BJ, Kim HB, Lee SY, Kim KW, Kang MJ, Shin YJ, Hong SJ. Interaction between IL13 genotype and environmental factors in the risk for allergic rhinitis in Korean children. J Allergy Clin Immunol 2012; 130:421-6.e5. [PMID: 22846750 DOI: 10.1016/j.jaci.2012.04.052] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 04/19/2012] [Accepted: 04/23/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND The prevalence of allergic rhinitis (AR) is increasing worldwide. Allergic diseases develop in susceptible subjects when they are exposed to specific environmental factors. OBJECTIVE We analyzed changes in the prevalence of AR and identified genetic and environmental factors in early childhood that affect risk. METHODS We used the International Study of Asthma and Allergies in Childhood questionnaire to collect data on AR, allergies, and environmental exposures from 4554 elementary school students from 5 areas of Seoul, Korea, in 2008. We also obtained DNA from 1050 subjects from 1 area of Seoul for genotype analysis of IL13. RESULTS We identified genetic and environmental factors during infancy and early childhood that increased the risk for current AR (resulting in a diagnosis of AR and AR symptoms in the past 12 months) in elementary school-aged children. These included allergic disease in parents and antibiotic use in infants, allergic disease in parents and exposure of infants to mold, and allergic disease in parents and moving an infant to a newly built house. The risk of current AR also increased in subjects with GA or AA at nucleotide 2044 in IL13 who had been exposed to mold in the home during infancy (adjusted odds ratio, 3.27; 95% CI, 1.75-6.11) compared with subjects who had GG at this position and had not been exposed to mold (adjusted odds ratio, 3.27; 95% CI, 1.75-6.11). CONCLUSION The prevalence of AR is increasing in Korean children. Children with a family history of allergic disease and exposure to specific environmental risk factors during infancy are more likely to have AR. Children with GA or AA at IL13(+2044) are at increased risk for AR when exposed to mold in the home during the first year of life.
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Affiliation(s)
- Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea
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Yangzong Y, Shi Z, Nafstad P, Håheim LL, Luobu O, Bjertness E. The prevalence of childhood asthma in China: a systematic review. BMC Public Health 2012; 12:860. [PMID: 23050953 PMCID: PMC3524042 DOI: 10.1186/1471-2458-12-860] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 10/02/2012] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND It is well known that the prevalence of asthma has been reported to increase in many places around the world during the last decades. Therefore, the aim of this study was to identify and review studies of asthma prevalence among children in China and address time trends and regional variation in asthma. METHODS A systematic literature search was performed using PubMed and China National Knowledge Infrastructure (CNKI) databases. Selected articles had to describe an original study that showed the prevalence of asthma among children aged 0-14 years. RESULTS A total of 74 articles met the inclusion criteria. The lifetime prevalence of asthma varied between 1.1% in Lhasa (Tibet) and 11.0% in Hong Kong in studies following the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. The prevalence was 3% or lower in most articles following Chinese diagnostic criteria. One article reported the results from two national surveys and showed that the current average prevalence of asthma for the total study population had increased from 1990 to 2000 (0.9% to 1.5%). The lowest current prevalence was found in Lhasa (0.1% in 1990, 0.5% in 2000). CONCLUSIONS The prevalence of childhood asthma was generally low, both in studies following the ISAAC and Chinese diagnostic criteria. Assessment of time trends and regional variations in asthma prevalence was difficult due to insufficient data, variation in diagnostic criteria, difference in data collection methods, and uncertainty in prevalence measures. However, the findings from one large study of children from 27 different cities support an increase in current prevalence of childhood asthma from 1990 to 2000. The lowest current prevalence of childhood asthma was found in Tibet.
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Affiliation(s)
- Yangzong Yangzong
- Institute of Health and Society, University of Oslo, P.O.Box 1130 Blindern, Oslo 0318, Norway
| | - Zumin Shi
- Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China
- Discipline of Medicine, The University of Adelaide, Adelaide, Australia
| | - Per Nafstad
- Institute of Health and Society, University of Oslo, P.O.Box 1130 Blindern, Oslo 0318, Norway
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo Norway
| | - Lise Lund Håheim
- Norwegian Knowledge Centre for the Health Service, Oslo Norway
- Institute of Basic Medical Sciences, University of Oslo, Oslo Norway
| | - Ouzhu Luobu
- Tibet University Medical College, Tibet Autonomous Region, China
| | - Espen Bjertness
- Institute of Health and Society, University of Oslo, P.O.Box 1130 Blindern, Oslo 0318, Norway
- Tibet University Medical College, Tibet Autonomous Region, China
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Lee SL, Lam TH, Leung TH, Wong WHS, Schooling M, Leung GM, Lau YL. Foetal exposure to maternal passive smoking is associated with childhood asthma, allergic rhinitis, and eczema. ScientificWorldJournal 2012; 2012:542983. [PMID: 22927783 PMCID: PMC3425811 DOI: 10.1100/2012/542983] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 04/14/2012] [Indexed: 11/23/2022] Open
Abstract
Objective. We examined the hypothesis that foetal exposure to maternal passive smoking is associated with childhood asthma, allergic rhinitis, and eczema. Methods. The study was a population-based cross-sectional survey of Hong Kong Chinese children aged ≤14 years carried out in 2005 to 2006. Results. Foetal exposure to maternal passive smoking was significantly associated with wheeze ever (OR 2.05; 95% CI 1.58–2.67), current wheeze (OR 2.06; 95% CI 1.48–2.86), allergic rhinitis ever (OR 1.22; 95% CI 1.09–1.37), and eczema ever (OR 1.61; 95% CI 1.38–1.87). Foetal exposure to maternal active smoking was significantly associated with asthma ever (OR 2.10; 95% CI 1.14–3.84), wheeze ever (OR 2.46; 95% CI 1.27–4.78), and current wheeze (OR 2.74; 95% CI 1.24–6.01) but not with allergic rhinitis ever (OR 1.01; 95% CI 0.70–1.46) or eczema ever (OR 1.38; 95% CI 0.87–2.18). The dose response relationship between wheeze ever and current wheeze with increasing exposure, from no exposure to maternal passive smoking and then to maternal active smoking, further supports causality. Conclusion. There is significant association between foetal exposure to maternal passive smoking and maternal active smoking with childhood asthma and related atopic illnesses. Further studies are warranted to explore the potential causal relationship.
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Affiliation(s)
- S L Lee
- Department of Paediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Deckers IAG, McLean S, Linssen S, Mommers M, van Schayck CP, Sheikh A. Investigating international time trends in the incidence and prevalence of atopic eczema 1990-2010: a systematic review of epidemiological studies. PLoS One 2012; 7:e39803. [PMID: 22808063 PMCID: PMC3394782 DOI: 10.1371/journal.pone.0039803] [Citation(s) in RCA: 363] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 05/30/2012] [Indexed: 02/06/2023] Open
Abstract
The prevalence of atopic eczema has been found to have increased greatly in some parts of the world. Building on a systematic review of global disease trends in asthma, our objective was to study trends in incidence and prevalence of atopic eczema. Disease trends are important for health service planning and for generating hypotheses regarding the aetiology of chronic disorders. We conducted a systematic search for high quality reports of cohort, repeated cross-sectional and routine healthcare database-based studies in seven electronic databases. Studies were required to report on at least two measures of the incidence and/or prevalence of atopic eczema between 1990 and 2010 and needed to use comparable methods at all assessment points. We retrieved 2,464 citations, from which we included 69 reports. Assessing global trends was complicated by the use of a range of outcome measures across studies and possible changes in diagnostic criteria over time. Notwithstanding these difficulties, there was evidence suggesting that the prevalence of atopic eczema was increasing in Africa, eastern Asia, western Europe and parts of northern Europe (i.e. the UK). No clear trends were identified in other regions. There was inadequate study coverage worldwide, particularly for repeated measures of atopic eczema incidence. Further epidemiological work is needed to investigate trends in what is now one of the most common long-term disorders globally. A range of relevant measures of incidence and prevalence, careful use of definitions and description of diagnostic criteria, improved study design, more comprehensive reporting and appropriate interpretation of these data are all essential to ensure that this important field of epidemiological enquiry progresses in a scientifically robust manner.
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Affiliation(s)
- Ivette A G Deckers
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, United Kingdom.
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Peñaranda A, Aristizabal G, García E, Vásquez C, Rodríguez-Martinez CE. Rhinoconjunctivitis prevalence and associated factors in school children aged 6-7 and 13-14 years old in Bogota, Colombia. Int J Pediatr Otorhinolaryngol 2012; 76:530-5. [PMID: 22301354 DOI: 10.1016/j.ijporl.2012.01.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 01/07/2012] [Accepted: 01/08/2012] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Allergic rhinitis is one of the most frequent chronic diseases among children. The objective of the study was to assess the prevalence of rhinoconjunctivitis and determine clinical, social and environmental associated factors, among school children aged 6-7 years and adolescents aged 13-14 years in Bogotá, Colombia. METHODS We used ISAAC (International Study of Asthma and Allergies in Childhood) phase III study methodology and questionnaire for design and data collection, and we did a secondary analysis of these data. The sample consisted of 3830 registers from adolescents between 13 and 14 years old and 3256 registers from children between 6 and 7 years. RESULTS The prevalence of rhinoconjunctivitis symptoms in the last year was 17.2% (95% CI, 15.9-18.5) in children vs. 24.9% (95% CI, 23.6-26.3) in adolescents. In both groups there was a female predominance in children (17.8% vs. 16.5%), and in the teenagers group (28.0% vs. 21.4%), though the differences were not statistically significant. The factors associated with rhinoconjunctivitis in the group of 6-7 years where: asthma [OR 3.9; (95% CI, 2.8-5.4)], atopic dermatitis [OR 2.3; (95% CI, 1.7-3.1)], use of acetaminophen in the last year [OR 2.6; (95% CI, 1.4-4.9)], use of antibiotics in the first year of live [OR 1.7; (95% CI, 1.3-2.3)], higher maternal education [OR 1.5; (95% CI, 1.0-2.3)] and cesarean delivery [OR 1.6; (95% CI, 1.2-2.1)]. Among the 13-14 year age-group, factors associated with rhinoconjunctivitis included: asthma [OR 2.6; (95% CI, 2.0-3.4)], atopic dermatitis [OR 1.8; (95% CI, 1.4-2.3)], use of acetaminophen in the last year [OR 1.8; (95% CI, 1.4-2.4)], consumption of fast-food three times or more per week [OR 1.5; (95% CI, 1.2-2.0), ever smoked [OR 1.4; (95% CI, 1.2-1.7)] and meat consumption was protective factor [OR 0.7; (95% CI, 0.5-0.9)]. CONCLUSION In both studied groups, the estimated prevalence of rhinoconjunctivitis symptoms was relatively high. Future in-depth research is needed to assess the complex interactions between allergic rhinoconjunctivitis symptoms and social and environmental factors.
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Affiliation(s)
- Augusto Peñaranda
- Division of Otolaryngology, Fundación Santafé de Bogotá, Avenida 9 N° 116-20, Second Floor, Bogotá, Colombia.
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Wang QP, Wu KM, Li ZQ, Xue F, Chen W, Ji H, Wang BL. Association between maternal allergic rhinitis and asthma on the prevalence of atopic disease in offspring. Int Arch Allergy Immunol 2011; 157:379-86. [PMID: 22123070 DOI: 10.1159/000328789] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 04/20/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Asthma is a common co-morbidity of allergic rhinitis (AR). The prevalence of these two allergic diseases has increased in China and has been shown to cluster in families independently. This study evaluated the association between maternal AR (presenting with or without asthma) and the allergic conditions in offspring. METHODS Women (n = 592) diagnosed with AR were recruited for this study; 379 patients presented with AR and 213 presented with both AR and asthma. Total serum IgE levels and nasal eosinophil counts were analyzed and correlated with disease presentation. RESULTS The prevalence of allergic conditions in offspring of mothers diagnosed with AR and asthma was significantly higher than the prevalence observed in children born to mothers presenting with AR only. Maternal total serum IgE and eosinophil counts were predictive of atopy in offspring. Children born to mothers presenting with persistent moderate-to-severe AR had the highest risk of developing atopic conditions (OR 6.26, 95% CI 3.26-12.02). Maternal age of 25-30 years at delivery was also associated with a higher risk for the allergic disease in offspring compared to maternal age of 36-40 (OR 2.13, 95% CI 1.31-3.47). CONCLUSIONS The severity of maternal AR, asthma co-morbidity, elevated serum IgE levels and nasal eosinophilia were all associated with an increased risk of offspring developing allergic conditions. Children born to older mothers were protected against developing atopic disease.
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Affiliation(s)
- Qiu-Ping Wang
- Department of Otolaryngology-Head and Neck Surgery, Jinling Hospital, Nanjing, PR China
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Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A, Saffer M, Xu G, Walters RD. Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. Clin Exp Allergy 2011; 42:186-207. [PMID: 22092947 DOI: 10.1111/j.1365-2222.2011.03891.x] [Citation(s) in RCA: 147] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 09/01/2011] [Accepted: 09/02/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is comparatively little information in the public domain on the diversity in prevalence and triggers/factors associated with allergic rhinitis (AR) or allergic rhinoconjunctivitis (AR/C) in countries beyond western-Europe and North America. OBJECTIVE To review the prevalence and the sensitizing agents/triggers and factors associated with AR/C in several countries in Africa, the Asia-Pacific region, Australia, Eastern Europe, Latin America, Middle East and Turkey. METHODS Articles published in English in peer-reviewed journals were assessed and selected for further review, following an extensive literature search using the Medline database. RESULTS This review demonstrated that prevalence of AR and AR/C in these regions has predominantly been investigated in children; with studies indicating wide inter- and intra-regional variations ranging from 2.9% AR and 3.8% AR/C in 10-18-years-old children from one region in Turkey to 54.1% AR and 39.2% AR/C in 13-14-years-old children in one region in Nigeria. Moreover, the prevalence of AR and AR/C has increased markedly over the last decade particularly in some of the more affluent African countries, China-Taiwan and several Middle East countries, likely as a consequence of improved living standards leading to increased exposure to multiple traditional and non-traditional sensitizing agents and risk factors similar to those noted in western-Europe and North America. CONCLUSIONS AND CLINICAL RELEVANCE Our findings suggest that the greater diversity in prevalence of AR or AR/C in populations in these regions is in contrast to the lower diversity of AR or AR/C in the 'western populations (USA and Europe), which tend to be more uniform. This review provides a comprehensive database of the important allergens and triggers which are likely to influence the prevalence of allergic rhinitis in these diverse regions, where the prevalence of allergic rhinitis is increasing and its adverse impact on the quality of life of affected individuals is increasingly recognised.
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Affiliation(s)
- C H Katelaris
- Immunology & Allergy, Campbelltown Hospital, University of Western Sydney, New South Wales, Australia
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