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Eposse Ekoube C, Abba S, Endale Mangamba M, Mandeng Ma Linwa E, Tchouamo Pokem A, Mbonjo Bitsie D, Disso Massako J, Heles Nsang E, Ngo Linwa EE, Kedy Mangamba Koum DC. Factors associated with sensitisation to selected aero-allergens in children and adolescents with asthma followed up at Laquintinie Hospital Douala, Cameroon. Pediatr Pulmonol 2024; 59:1207-1216. [PMID: 38289059 DOI: 10.1002/ppul.26883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/16/2023] [Accepted: 01/11/2024] [Indexed: 04/30/2024]
Abstract
INTRODUCTION In spite of the substantial impact of pediatric asthma on healthcare resources, there is a notable dearth of research focusing on allergen sensitization specifically in children and adolescents with asthma in Cameroon, with existing studies primarily concentrating on adult populations. We, therefore, set out to determine factors associated with sensitization to selected aero-allergens in children and adolescents with asthma followed up at Laquintinie Hospital Douala, Cameroon. METHODOLOGY We conducted a cross-sectional analytical study on patients aged 2-17 years followed up for pediatric asthma at Laquintinie Hospital Douala for 8 months (January to August 2023). Skin prick tests were performed using selected standardized aeroallergens extracts. Factors associated with sensitization were determined using multivariable logistic regression analysis. The threshold for significance was set at p < .05. RESULTS In total, 126 children and adolescents with asthma were recruited, 50.79% of whom were male with an average age of 8.00 ± 3.99 years. Eight out of 10 patients (83.52%) were sensitized to common aero-allergens (20.59% monosensitized and 79.41% polysensitized). The most common aero-allergens found were the dust mites Dermatophagoïdes pteronyssinus (81.37%), Blomia tropicalis (67.64%) and Dermatophagoïdes farinae (52.94%) followed by Blatella species (25.49%). The factors independently associated with sensitization in our population were the personal history of allergic rhinitis in the patient [adjusted odds ratio, aOR: 4.07 (95% confidence interval, CI: 1.41-11.76), b = 0.54, p = .009], chest tightness at rest [aOR: 5.92 (95% CI: 1.08-32.38), b = 0.87, p = .040), and age above 5 years [aOR: 4.65 (95% CI: 1.47-14.69), b = 0.59, p = .009). CONCLUSION Sensitization to multiple aeroallergens is common in children and adolescents with asthma, especially for dust mites and cockroaches. Factors associated with sensitization are patients aged >5 years, chest tightness at rest, and a personal history of allergic rhinitis.
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Affiliation(s)
- Charlotte Eposse Ekoube
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- Department of Paediatrics, General Paediatrics Unit, Douala Laquintinie Hospital, Douala, Cameroon
| | - Soumaiyatou Abba
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Mireille Endale Mangamba
- Department of Internal Medicine and Paediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Edgar Mandeng Ma Linwa
- Department of Internal Medicine and Paediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Annick Tchouamo Pokem
- Department of Paediatics, Child and Adolescent Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Dora Mbonjo Bitsie
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Jeannette Disso Massako
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Emmanuel Heles Nsang
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Esther Eleonore Ngo Linwa
- Department of Clinical Sciences, Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon
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Wu L, Luo W, Hu H, Zheng X, Cheng ZJ, Huang D, Huang X, Zhang H, Liu Y, Zhang R, Yang H, Sun Y, Wang Y, Ma J, Liu J, Sun X, Wu H, Wei C, Zhang S, Li X, Ren S, Hao C, Sun B. A Multicenter Study Assessing Risk Factors and Aeroallergens Sensitization Characteristics in Children with Self-Reported Allergic Rhinitis in China. J Asthma Allergy 2021; 14:1453-1462. [PMID: 34908846 PMCID: PMC8665874 DOI: 10.2147/jaa.s342495] [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: 10/02/2021] [Accepted: 11/16/2021] [Indexed: 01/30/2023] Open
Abstract
Background Up to now, epidemiological studies on allergy rhinitis (AR) have primarily focused on determining the risk of disease in Chinese adults, with the majority of them designed by single centers, while cross-sectional and epidemiological data describing allergic sensitization in children with self-reported AR are scarce. Objective This study was estimating of the latest information about the sensitization patterns and risk factors of clinical AR to develop effective strategies for the prevention and treatment of AR. Methods We conducted a cross-sectional survey between January 2020 and June 2021 involving children from seven cities in China who reported AR. A total of 762 children participated in this survey. To evaluate the risk factors and specific sensitization patterns of clinical AR through questionnaires and specific immunoglobulin E to 11 aeroallergens. Results Of the 762 patients, 593 (77.8%) had at least one positive IgE level. Aged 7–14 years (OR 1.503, (95% CI 1.058–2.136), P = 0.023); With allergic conjunctivitis (OR 1.843, (95% CI 1.297–2.620), P = 0.001) and living in the Eastern (OR 1.802, (95% CI 1.263–2.573), P = 0.001) all elevated the risk of clinical AR associated with aeroallergens. The sensitization rates of D. pteronyssinus and D. farinae were higher than those of other allergens in the 0–6 and 7–14 years old age groups. The most common aeroallergens among self-reported children with AR in the eastern were D. farinae (74.9%) and D. pteronyssinus (74.3%), while in the western were mugwort (60.0%) and marguerite (56.6%). Majority of sIgE-positive subjects were sensitized to three or more of the tested pollen allergens in the Western (52.1%), compared with 5.7% in the Eastern. Conclusion There was an apparent geographic variation in childhood allergies in China. Age factors also had strong impacts on the allergen sensitization rate of children, but these impacts differed across regions.
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Affiliation(s)
- Liting Wu
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Wenting Luo
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Haisheng Hu
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Xianhui Zheng
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Zhangkai J Cheng
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Dongming Huang
- Department of Pediatrics, Boai Hospital of Zhongshan City, Zhongshan, 528400, People's Republic of China
| | - Xiaowen Huang
- Department of Pediatrics, Boai Hospital of Zhongshan City, Zhongshan, 528400, People's Republic of China
| | - Hong Zhang
- Gansu Provincial Hospital, Lanzhou, 730000, People's Republic of China
| | - Yang Liu
- Gansu Provincial Hospital, Lanzhou, 730000, People's Republic of China
| | - Rongfang Zhang
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, 730000, People's Republic of China
| | - Hui Yang
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, 730000, People's Republic of China
| | - Yun Sun
- Yinchuan Maternal and Child Health Care Hospital, Yinchuan, 750000, People's Republic of China
| | - Yi Wang
- Yinchuan Maternal and Child Health Care Hospital, Yinchuan, 750000, People's Republic of China
| | - JinHai Ma
- Ningxia Medical University General Hospital, Yinchuan, 750000, People's Republic of China
| | - Jing Liu
- Ningxia Medical University General Hospital, Yinchuan, 750000, People's Republic of China
| | - Xin Sun
- Department of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xian, 710032, People's Republic of China
| | - Huajie Wu
- Department of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xian, 710032, People's Republic of China
| | - Chunhua Wei
- Weifang Weien Hospital, Weifang, 261000, People's Republic of China
| | - Shuping Zhang
- Weifang Weien Hospital, Weifang, 261000, People's Republic of China
| | - Xiaoluan Li
- The First Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China
| | - Shuang Ren
- The First Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China
| | - Chuangli Hao
- Department of Respirology, Children's Hospital, Soochow University, Suzhou, 215025, People's Republic of China
| | - Baoqing Sun
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
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AL-Iede M, Al-Ani A, Mafrachi B, Alkhulaifat D, Hassan K, Elhussieni M, Salah N, Al-Somadi H, Ali E, Al-Zayadneh E, Khreesha L. Sensitization to Inhaled Allergens in Atopic Children in Jordan Capital, Amman: A Cross-sectional Study. CURRENT RESPIRATORY MEDICINE REVIEWS 2021. [DOI: 10.2174/1573398x17666210301123802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
As the prevalence of allergic diseases is increasing all over the world, it is
vital to identify the specific allergens, which contribute to the development and persistence of such
conditions.
Objectives:
This study aims to assess the prevalence of aeroallergen sensitization and, to evaluate
the profile of skin prick test among atopic Jordanian children who are visiting Jordan University
Hospital (JUH).
Methods:
A retrospective analysis of all Skin Prick Test (SPT) and results of atopic children and
adolescents aged (1.5-18 years) who visited the pediatrics clinics at JUH from January 2018 until
December 2019.
Results:
Over two years, a total of 171 children (male: female ratio of 1.9) with a median age of
6.2 years (1.5-18) were subjected to SPT. One hundred and seven children (62.5%) were found to
be sensitized to at least one of the ten aeroallergen extracts tested. The most common sensitizations
were to olive pollen (45.6%), Mites Dermatophagoides Petronyssinus (42.0%), and Dog Dander
(38.6%). The highest sensitization rate was among the age group 2-4 years (28.1%). The sensitization
rates increased in conjunction with an increase in age in the first age groups (preschool and
school-age groups).
Conclusion:
The study’s findings provide an understanding of the locally prevalent aeroallergens,
yet a multi-center review would be more useful for creating an optimized SPT panel specific to the
Jordanian pediatric population.
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Affiliation(s)
| | | | - Baraa Mafrachi
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | | | - Kamal Hassan
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | | | - Neveen Salah
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | | | - Elnagi Ali
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | | | - Lubna Khreesha
- Ear, Nose, and Throat Department, Jordan University Hospital, Amman, Jordan
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Haarala AK, Sinikumpu SP, Vaaramo E, Jokelainen J, Timonen M, Auvinen J, Pekkanen J, Lampi J, Huilaja L. Incidence and remission of aeroallergen sensitization in adults in Northern Finland: 15 years longitudinal study. Sci Rep 2021; 11:4249. [PMID: 33608620 PMCID: PMC7895822 DOI: 10.1038/s41598-021-83326-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/02/2021] [Indexed: 01/21/2023] Open
Abstract
Studies on the longitudinal changes in sensitization to aeroallergens in adult populations are sparse. The aim was to evaluate changes in sensitization to aeroallergens [birch, timothy, cat and house dust mite (HDM)] in an unselected adult population aged from 31 to 46 years. Data were gathered from a cohort of adults (Northern Finland Birth Cohort 1966) who had been skin prick tested (SPT) with birch, timothy, cat and HDM allergens at the age of 31 years and at age 46 (n = 5484 and 5373 respectively). Data from both time points were available for 3409 participants, who made up the cohort of the longitudinal study. The overall prevalence of sensitization to any of the selected allergens was 30.3% (n = 1661) in 31-year-olds and 30.7% (n = 1649) in 46-year-olds. In general, men were more sensitized (P < 0.001) and also had more polysensitization (P < 0.001) compared to women. In longitudinal sub-population incidence of sensitization was 7.1%. Birch was the most prevalent new sensitizer, however, the difference was not statistically significant when compared to cat. We conclude that new sensitization, demonstrated by positive findings in SPT, can still occur in middle age and this should be taken into account when managing allergic manifestations in adults as sensitization can be considered the first step in developing clinical allergy.
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Affiliation(s)
- Anna Karoliina Haarala
- PEDEGO Research Unit, PEDEGO Research Group, Department of Dermatology, University Hospital of Oulu and Medical Research Center, University of Oulu, Aapistie 5A, 90029, Oulu, Finland
| | - Suvi-Päivikki Sinikumpu
- PEDEGO Research Unit, PEDEGO Research Group, Department of Dermatology, University Hospital of Oulu and Medical Research Center, University of Oulu, Aapistie 5A, 90029, Oulu, Finland
| | - Eeva Vaaramo
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jari Jokelainen
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Markku Timonen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Juha Pekkanen
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jussi Lampi
- Department of Health Security, Environmental Health, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Laura Huilaja
- PEDEGO Research Unit, PEDEGO Research Group, Department of Dermatology, University Hospital of Oulu and Medical Research Center, University of Oulu, Aapistie 5A, 90029, Oulu, Finland.
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Sabit M, Wong C, Andaya A, Ramos JD. Pollen allergen skin test and specific IgE reactivity among Filipinos: a community-based study. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2020; 16:74. [PMID: 32922458 PMCID: PMC7477877 DOI: 10.1186/s13223-020-00471-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/05/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Despite the clinical importance of pollen allergens among Filipinos, few studies delve into the sensitization profiles of Filipinos against pollen allergens. This study determined the sensitization profile of Filipinos to pollen using skin prick test (SPT) and pollen-specific ELISA. METHODS Pollen from fifteen selected plant sources was collected and extracted for use in sensitization tests. Volunteers were interviewed for their clinical history prior to blood sampling and SPT. The blood samples collected were assessed using Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS The best panel of pollen allergens for the skin prick test was Mangifera indica (64%), Acacia auriculiformis (28%), Mimosa spp. (25%) Amaranthus spinosus (22%), Lantana camara (20%), Pilea microphylla (16%) and Dichanthium aristatum (15%). Young adults had more sensitizations to pollen than among early childhood and elderly. There were more allergic subjects that have rhinitis (61%) than asthma (42%) and atopic dermatitis (35%). Pollen-specific IgE levels show low percent reactivity as compared to the skin test with Cocos nucifera obtaining the highest IgE reactivity (21%). CONCLUSIONS Pollen allergens from both arboreal and herbaceous plants used in this study yielded positive reactivities for both skin tests and specific IgE tests.
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Affiliation(s)
- Maureen Sabit
- The Graduate School, University of Santo Tomas, 1008 Manila, Philippines
- Research Center for the Natural and Applied Sciences, Thomas Aquinas Research Complex, University of Santo Tomas, 1008 Manila, Philippines
- Department of Biological Sciences, College of Science, University of Santo Tomas, 1008 Manila, Philippines
| | - Cecil Wong
- Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Santo Tomas Hospital, 1008 Manila, Philippines
| | - Agnes Andaya
- Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Santo Tomas Hospital, 1008 Manila, Philippines
| | - John Donnie Ramos
- The Graduate School, University of Santo Tomas, 1008 Manila, Philippines
- Research Center for the Natural and Applied Sciences, Thomas Aquinas Research Complex, University of Santo Tomas, 1008 Manila, Philippines
- Department of Biological Sciences, College of Science, University of Santo Tomas, 1008 Manila, Philippines
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Indoor environmental factors associated with pulmonary function among adults in an acid rain-plagued city in Southwest China. Wien Klin Wochenschr 2017; 129:259-268. [PMID: 28160097 DOI: 10.1007/s00508-016-1156-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 12/15/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess the association of indoor environmental risk factors with respiratory function among adults in an acid rain-plagued city in China where coal use is frequent. METHODS The subjects were randomly selected in the winter season. Information on selected home environmental factors was collected through administered questionnaires. Additionally, pulmonary function tests, including Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 s (FEV1), FEV1/FVC and Peak Expiratory Flow Rate (PEFR) were also performed in participants. RESULTS This study showed that, among a variety of risk factors, coal fuel use, cooking oil fumes and active and passive smoking exposure together with asthma in childhood were important factors for deterioration of pulmonary function among adults in the winter season (p < 0.05). Additionally, subjects whose kitchen was located in the living room or bedroom, who opened their windows only occasionally or never, who noted the presence of cooking oil fumes and pests, whose bedroom was shared by 3 or more residents and who kept pets tended to exhibit lower values of FVC, FEV1 and PEFR values compared with non-exposed counterparts (p < 0.05). CONCLUSIONS This study demonstrated impaired pulmonary function among adults who were exposed to indoor risk factors, such as coal fires and cigarette smoking compared to non-users in the winter season and emphasizes the need for public health efforts to decrease exposure to indoor air pollution.
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Navarrete-Rodríguez EM, Fernández-Soto JR, Del Rio-Navarro BE, Saucedo-Ramírez OJ, Sienra-Monge JJL. Dermatophagoides pteronyssinus: Changes in sensitisation in the past 11 years and comparison with other centres in Mexico. Allergol Immunopathol (Madr) 2017; 45:11-17. [PMID: 27914830 DOI: 10.1016/j.aller.2016.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 09/20/2016] [Accepted: 09/21/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND House dust mites are a ubiquitous air allergen in the human habitat. It has been shown that exposure to them is a fundamental factor in sensitisation and development of atopic disease. The objective of the study was to analyse changes in sensitisation to Dermatophagoides pteronyssinus (Der p.) in children treated in a tertiary level care hospital in Mexico City for a period of 11 years and compare with other studies carried out in Mexico. METHODS A retrospective study was performed at the Hospital Infantil de México Federico Gómez (HIMFG). Information was gathered from skin tests for Der p. performed in the Allergy Laboratory from January 2004 to April 2015. Patients 2-18 years old who presented for examination of some type of allergic condition and who had immediate hypersensitivity tests to Der p. were included in the study. Results were compared with prior reports from other institutions. Descriptive analysis and χ2 statistics were used. RESULTS A total of 8794 patients were included in the study; 49.3% of the tests (95% CI 48-50) were positive for Der p. The percentage of monosensitised to mites was 2.7% for Der p. (95% CI 2-3). A significant difference was found between the results of older patients and those <6 years old. The frequency of sensitisation had a tendency to decrease during the 11 years analysed in all age groups. CONCLUSIONS AND CLINICAL RELEVANCE The frequency of sensitisation to Der p. increased with age until reaching adolescence. In the last 11 years a decrease in sensitisation to this air allergen was observed.
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Affiliation(s)
- E M Navarrete-Rodríguez
- Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Infantil de México Federico Gómez, México, DF, Mexico
| | - J R Fernández-Soto
- Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Infantil de México Federico Gómez, México, DF, Mexico
| | - B E Del Rio-Navarro
- Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Infantil de México Federico Gómez, México, DF, Mexico.
| | - O J Saucedo-Ramírez
- Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Infantil de México Federico Gómez, México, DF, Mexico
| | - J J L Sienra-Monge
- Subdirección de Pediatria Ambulatoria, Hospital Infantil de México Federico Gómez, México, DF, Mexico
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Garcia-Larsen V, Potts JF, Del Giacco S, Bustos P, Diaz PV, Amigo H, Oyarzun M, Rona RJ. Changes in symptoms of asthma and rhinitis by sensitization status over ten years in a cohort of young Chilean adults. BMC Pulm Med 2016; 16:116. [PMID: 27503476 PMCID: PMC4977698 DOI: 10.1186/s12890-016-0273-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 06/10/2016] [Indexed: 11/11/2022] Open
Abstract
Background We investigated the net changes in prevalence of symptoms of asthma and rhinitis over 10 years in a cohort of young by baseline sensitization status. Methods One thousand one hundred ninety three Chilean adults subjects aged 22–28 living in a semi-rural area of central Chile answered a lifestyle and the European Community Respiratory Health Survey (ECRHS) questionnaires. Bronchial hyper-responsiveness (BHR) and skin prick test (SPT) to eight allergens were measured at baseline in 2001. Ten years later, 772 participants completed the questionnaires again. Estimates of adjusted net changes in prevalence of symptoms by sensitization status at baseline and association between sensitization status at baseline and respiratory symptoms ten years later were assessed. Results A quarter of the participants were sensitized to at least one allergen in 2001. Prevalence of wheeze had a net change per year of −0.37 % (95 % Confidence Interval −0.71 to 0.02 %; p = 0.067). Self-reported nasal allergies in the last 12 months increased by 0.83 % per year (95 % CI 0.49 to 1.17 %; p < 0.001). Those sensitized to either cat fur (OR 1.76; CI 1.01 to 3.05), cockroach, (OR 2.09; 1.13 to 3.86) blend of grass and pollens (1.78; 95 % CI 1.08 to 2.92), or weeds (OR 1.77; 95 % CI 1.01 to 3.12) in 2001 were more likely to have wheeze in the last 12 months 10 years later. Conclusion Symptoms of asthma remained stable or slightly changed over 10 years in adults, whilst rhinitis and nasal allergies greatly increased. Being sensitized to at least one allergen is a risk factor for persistent symptoms of asthma and rhinitis, but not for determining net changes of symptoms over time. The underlying causes for the contrasting trends between asthma and nasal allergy are unknown. Electronic supplementary material The online version of this article (doi:10.1186/s12890-016-0273-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vanessa Garcia-Larsen
- Respiratory Epidemiology, Occupational Medicine, and Public Health Group, National Heart & Lung Institute, Imperial College London, Emmanuel Kaye Building, Manresa Road, London, SW3 6LR, UK.
| | - James F Potts
- Respiratory Epidemiology, Occupational Medicine, and Public Health Group, National Heart & Lung Institute, Imperial College London, Emmanuel Kaye Building, Manresa Road, London, SW3 6LR, UK
| | - Stefano Del Giacco
- Department of Medical Sciences "M Aresu", University of Cagliari, Asse Didattico "E1" - Cittadella Universitaria, Monserrato, Cagliari, 09042, Italy
| | - Patricia Bustos
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Santiago, Chile
| | - Patricia V Diaz
- Institute of Bio-Medical Science, Faculty of Medicine, University of Chile, Independencia 1027, Santiago, Chile
| | - Hugo Amigo
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Santiago, Chile
| | - Manuel Oyarzun
- Institute of Bio-Medical Science, Faculty of Medicine, University of Chile, Independencia 1027, Santiago, Chile
| | - Roberto J Rona
- Department of Psychological Medicine, Weston Education Centre, King's College London, Cutcombe Road, London, SE5 9RJ, UK
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Mbatchou Ngahane BH, Noah D, Nganda Motto M, Mapoure Njankouo Y, Njock LR. Sensitization to common aeroallergens in a population of young adults in a sub-Saharan Africa setting: a cross-sectional study. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2016; 12:1. [PMID: 26734065 PMCID: PMC4700563 DOI: 10.1186/s13223-015-0107-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 12/17/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Sensitization to aeroallergens increases the risk of developing asthma or allergic rhinitis. Data on sensitization to airborne allergens in the general population in sub-Saharan Africa are lacking. The aim of this study was to determine the prevalence and determinants of sensitization to common aeroallergens in a population of young adults. METHODS A cross-sectional study was conducted among students of the Faculty of Medicine and Pharmaceutical Sciences of the University of Douala between 1st February and 30th April 2014. We consecutively recruited all the students present in class or in hospital during our visit. They filled an anonymous questionnaire and underwent skin prick tests with common aeroallergens. A logistic regression model of the SPSS.20 software was used to investigate factors associated with sensitization to common aeroallergens. RESULTS Of the 600 students included in the study, 305 (50.8 %) were female. The mean age of participants was 22.6 ± 2.7 years. The prevalence of sensitization to aeroallergens was 42.8 % (95 % CI 38.8-46.8). Dermatophagoides pteronyssimus (24.2 %), Dermatophagoides farinae (22.8 %), Blomia tropicalis (23.3 %) and Blatella germanica (15.2 %) were the most common allergens found. Allergic rhinitis, asthma symptoms and family atopy were independently associated to sensitization to common aeroallergens. CONCLUSION A significant proportion of young adults are sensitized to common aeroallergens. Dust mites and cockroach should be included in the panel of aeroallergens in Cameroon.
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Affiliation(s)
- Bertrand Hugo Mbatchou Ngahane
- />Department of Internal Medicine, Douala General Hospital, PO Box 4856, Douala, Cameroon
- />Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Diane Noah
- />Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Malea Nganda Motto
- />Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Yacouba Mapoure Njankouo
- />Department of Internal Medicine, Douala General Hospital, PO Box 4856, Douala, Cameroon
- />Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Louis Richard Njock
- />Department of Ear Nose and Throat, Douala General Hospital, Douala, Cameroon
- />Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
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10
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Amaral AFS, Newson RB, Abramson MJ, Antó JM, Bono R, Corsico AG, de Marco R, Demoly P, Forsberg B, Gislason T, Heinrich J, Huerta I, Janson C, Jõgi R, Kim JL, Maldonado J, Martinez-Moratalla Rovira J, Neukirch C, Nowak D, Pin I, Probst-Hensch N, Raherison-Semjen C, Svanes C, Urrutia Landa I, van Ree R, Versteeg SA, Weyler J, Zock JP, Burney PGJ, Jarvis DL. Changes in IgE sensitization and total IgE levels over 20 years of follow-up. J Allergy Clin Immunol 2015; 137:1788-1795.e9. [PMID: 26586040 PMCID: PMC4889785 DOI: 10.1016/j.jaci.2015.09.037] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 08/21/2015] [Accepted: 09/30/2015] [Indexed: 11/29/2022]
Abstract
Background Cross-sectional studies have reported a lower prevalence of sensitization in older adults, but few longitudinal studies have examined whether this is an aging or a year-of-birth cohort effect. Objective We sought to assess changes in sensitization and total IgE levels in a cohort of European adults as they aged over a 20-year period. Methods Levels of serum specific IgE to common aeroallergens (house dust mite, cat, and grass) and total IgE levels were measured in 3206 adults from 25 centers in the European Community Respiratory Health Survey on 3 occasions over 20 years. Changes in sensitization and total IgE levels were analyzed by using regression analysis corrected for potential differences in laboratory equipment and by using inverse sampling probability weights to account for nonresponse. Results Over the 20-year follow-up, the prevalence of sensitization to at least 1 of the 3 allergens decreased from 29.4% to 24.8% (−4.6%; 95% CI, −7.0% to −2.1%). The prevalence of sensitization to house dust mite (−4.3%; 95% CI, −6.0% to −2.6%) and cat (−2.1%; 95% CI, −3.6% to −0.7%) decreased more than sensitization to grass (−0.6%; 95% CI, −2.5% to 1.3%). Age-specific prevalence of sensitization to house dust mite and cat did not differ between year-of-birth cohorts, but sensitization to grass was most prevalent in the most recent ones. Overall, total IgE levels decreased significantly (geometric mean ratio, 0.63; 95% CI, 0.58-0.68) at all ages in all year-of-birth cohorts. Conclusion Aging was associated with lower levels of sensitization, especially to house dust mite and cat, after the age of 20 years.
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Affiliation(s)
- André F S Amaral
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, United Kingdom.
| | - Roger B Newson
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, United Kingdom; Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Josep M Antó
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Angelo G Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation-University of Pavia, Pavia, Italy
| | - Roberto de Marco
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - Pascal Demoly
- Department of Pulmonology, Division of Allergy, Arnaud de Villeneuve Hospital, CHU Montpellier, and EPAR Team-UMR-S 1136 INSERM, Paris, France
| | - Bertil Forsberg
- Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Thorarinn Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Respiratory Medicine and Sleep, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum, Munich, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital Munich, Ludwig-Maximilians-Universität of Munich, Munich, Germany
| | - Ismael Huerta
- Epidemiological Surveillance Section, Directorate General of Public Health, Department of Health of Asturias, Oviedo, Spain
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Rain Jõgi
- Tartu University Hospital, Lung Clinic, Tartu, Estonia
| | - Jeong-Lim Kim
- Department of Publich Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - José Maldonado
- Unit of Clinical Management of Pneumology and Allergy, University Hospital of Huelva, Huelva, Spain
| | | | - Catherine Neukirch
- INSERM UMR1152, Paris, France; Université Paris Diderot Paris 7, UMR1152, Paris, France
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital Munich, Ludwig-Maximilians-Universität of Munich, and the German Center for Lung Research, Munich, Germany
| | - Isabelle Pin
- Pédiatrie, Pole Couple Enfants, CHU de Grenoble, Grenoble, France; INSERM U823, Institut Albert Bonniot, Grenoble, France; Université Joseph Fourier, Grenoble, France
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | | | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | | | - Ronald van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Serge A Versteeg
- Department of Experimental Immunology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Joost Weyler
- Epidemiology and Social Medicine and the StatUA Statistics Centre, University of Antwerp, Antwerp, Belgium
| | - Jan-Paul Zock
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Peter G J Burney
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Deborah L Jarvis
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, United Kingdom
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Simons E, Kwon S, Yang C, Dell SD. Prediction of childhood atopy by questionnaire. Clin Exp Allergy 2015; 45:835-7. [PMID: 25678339 DOI: 10.1111/cea.12510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E Simons
- Clinical Epidemiology and Health Services Research, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
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Yang SI, Lee E, Jung YH, Kim HY, Seo JH, Kwon JW, Kim BJ, Kim HB, Lee SY, Jang GC, Kim WK, Shim JY, Kang MJ, Yu HS, Hong SJ. Effect of antibiotic use and mold exposure in infancy on allergic rhinitis in susceptible adolescents. Ann Allergy Asthma Immunol 2014; 113:160-165.e1. [PMID: 24973272 DOI: 10.1016/j.anai.2014.05.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 04/29/2014] [Accepted: 05/21/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Antibiotic use in infancy induces alteration in intestinal microbiota and is associated with the development of allergic diseases. Mold exposure is also associated with allergic diseases. Genetic susceptibility may interact with specific environmental factors in allergic disease development. OBJECTIVE To investigate independent and combined effects of antibiotic use and mold exposure in infancy on the risk of allergic rhinitis (AR) in adolescents. METHODS Data on AR and environmental factors were collected using the International Study of Asthma and Allergies in Childhood questionnaire from 7,389 adolescents from Seoul, Korea. TaqMan genotyping was performed for interleukin 13 (IL-13) (rs20541) and Toll-like receptor 4 (rs1927911) polymorphisms in 1,395 adolescents. RESULTS Age, parental history of AR, antibiotic use in infancy, and pet ownership during pregnancy or infancy were associated with an increased risk of current AR (diagnosis of AR and symptoms of AR within the preceding 12 months). Having older siblings was a protective effect. The adjusted odds ratio (aOR) for current AR for combined antibiotic use and mold exposure in infancy was 1.45 (95% confidence interval [CI], 1.01-2.09). For each factor separately, aORs were 1.25 (95% CI, 1.04-1.50) and 0.99 (95% CI, 0.75-1.31), respectively. Antibiotic and mold exposure in infancy, GA or AA genotypes of IL-13 (rs20541) (aOR 4.53; 95% CI, 1.66-12.38; P for interaction = .05), and CT+TT genotype of Toll-like receptor 4 (rs1927911) (aOR, 3.20; 95% CI, 1.24-8.26; P for interaction = .18) increased the risk of current AR. CONCLUSION Antibiotic use and mold exposure in infancy have additive effects on the risk of current AR in genetically susceptible adolescents. Gene-environment interactions between IL-13 (rs20541) and antibiotics or mold may play a role in AR.
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Affiliation(s)
- Song-I Yang
- Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Ho Jung
- Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seungnam, Korea
| | - Byoung-Ju Kim
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, 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
| | - Woo-Kyung Kim
- Department of Pediatrics and the Allergy and Respiratory Research Laboratory, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi-Jin Kang
- Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho-Sung Yu
- Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Wongkamhaeng K, Poachanukoon O, Koontongkaew S. Dental caries, cariogenic microorganisms and salivary properties of allergic rhinitis children. Int J Pediatr Otorhinolaryngol 2014; 78:860-5. [PMID: 24679591 DOI: 10.1016/j.ijporl.2014.03.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 02/28/2014] [Accepted: 03/03/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to observe the caries activities of allergic rhinitis patients in relation to salivary properties, salivary levels of mutans streptococci (MS) and lactobacillus (LB), oral hygiene and dietary habits. METHODS The study groups composed of 40 allergic rhinitis children and 40 healthy controls aged between 6 and 13 years old. Demographic data, oral hygiene practices and dietary habits were recorded by questionnaire. For permanent teeth, caries experience was expressed as DMFT (D=decayed; M=missing; F=filled; T=teeth) index. The dmft (d=decayed; m=missing; f=filling; t=teeth) index was used for caries prevalence in primary teeth. Unstimulated salivary flow rate, salivary buffering capacity, and salivary MS and LB were also determined in children with allergic rhinitis and controls. RESULTS There were no significant differences in combined DMFT/dmft, salivary flow rate, buffer capacity of saliva, salivary LB levels, and sugary food consumption between cases and controls (p>0.05). However, higher salivary MS levels were observed in allergic rhinitis patients, compared to controls (P<0.05). CONCLUSIONS Our results demonstrated that patients with allergic rhinitis had an increase in the level of salivary MS.
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Affiliation(s)
- Kan Wongkamhaeng
- Faculty of Dentistry, Thammasat University (Rangsit Campus), Pathumthani 12120, Thailand
| | - Orapan Poachanukoon
- Department of Pediatrics, Faculty of Medicine, Thammasat University (Rangsit Campus), Pathumthani 12120, Thailand
| | - Sittichai Koontongkaew
- Faculty of Dentistry, Thammasat University (Rangsit Campus), Pathumthani 12120, Thailand.
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14
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Roberts G, Zhang H, Karmaus W, Raza A, Scott M, Matthews S, Kurukulaaratchy RJ, Dean T, Arshad SH. Trends in cutaneous sensitization in the first 18 years of life: results from the 1989 Isle of Wight birth cohort study. Clin Exp Allergy 2013; 42:1501-9. [PMID: 22994347 DOI: 10.1111/j.1365-2222.2012.04074.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Skin prick testing (SPT) is fundamental to the practice of clinical allergy identifying relevant allergens and predicting the clinical expression of disease. There are only limited data on the natural history of SPT results over childhood and adolescence. OBJECTIVE We aimed to describe the natural history of SPT and patterns of sensitization over childhood and adolescence. METHODS The 1989 Isle of Wight birth cohort (1456 participants) was followed up at 1, 2, 4, 10 and 18 years. SPT was undertaken from 4 years. RESULTS SPT was performed on 980 (80%), 1036 (75%) and 853 (65%) of participants at 4, 10 and 18 years. The prevalence of sensitization to any allergen at these time-points was 19.7%, 26.9% and 41.3% respectively. At each time-point, boys were significantly more likely to be sensitized (P < 0.016) and sensitization significantly increased over childhood and adolescence (average annual increase of 7%). Some children outgrew their sensitization. The rate of sensitization to most individual allergens increased over childhood and adolescence. A configural frequency analysis showed that whether an individual was sensitizated was relatively fixed over childhood and adolescence. Cluster analysis at 4 years demonstrated four major groups of individuals with similar co-sensitization to specific allergens. Children who were sensitized at age 4 years generally went onto become sensitized to additional allergens at 10 and 18 years. CONCLUSIONS AND CLINICAL RELEVANCE Allergic sensitization continues to increase over childhood into adolescence although the majority of children who were not sensitized at 4 years remain non-sensitized throughout childhood and adolescence. The presence of sensitization at 4 years predicted later sensitization to additional allergens.
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Affiliation(s)
- G Roberts
- The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, UK.
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15
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Jie Y, Isa ZM, Jie X, Ju ZL, Ismail NH. Urban vs. rural factors that affect adult asthma. REVIEWS OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2013; 226:33-63. [PMID: 23625129 DOI: 10.1007/978-1-4614-6898-1_2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In this review, our aim was to examine the influence of geographic variations on asthma prevalence and morbidity among adults, which is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity. Asthma is a complex inflammatory disease of multifactorial origin, and is influenced by both environmental and genetic factors. The disparities in asthma prevalence and morbidity among the world's geographic locations are more likely to be associated with environmental exposures than genetic differences. In writing this article, we found that the indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke in both urban and rural areas. Asthma and asthma-related symptoms occurred more frequently in urban than in rural areas, and that difference correlated with environmental risk exposures, SES, and healthcare access. Environmental risk factors to which urban adults were more frequently exposed than rural adults were dust mites,high levels of vehicle emissions, and a westernized lifestyle.Exposure to indoor biological contaminants in the urban environment is common.The main risk factors for developing asthma in urban areas are atopy and allergy to house dust mites, followed by allergens from animal dander. House dust mite exposure may potentially explain differences in diagnosis of asthma prevalence and morbidity among adults in urban vs. rural areas. In addition, the prevalence of asthma morbidity increases with urbanization. High levels of vehicle emissions,Western lifestyles and degree of urbanization itself, may affect outdoor and thereby indoor air quality. In urban areas, biomass fuels have been widely replaced by cleaner energy sources at home, such as gas and electricity, but in most developing countries, coal is still a major source of fuel for cooking and heating, particularly in winter. Moreover, exposure to ETS is common at home or at work in urban areas.There is evidence that asthma prevalence and morbidity is less common in rural than in urban areas. The possible reasons are that rural residents are exposed early in life to stables and to farm milk production, and such exposures are protective against developing asthma morbidity. Even so, asthma morbidity is disproportionately high among poor inner-city residents and in rural populations. A higher proportion of adult residents of nonmetropolitan areas were characterized as follows:aged 55 years or older, no previous college admission, low household income, no health insurance coverage, and could not see a doctor due to healthcare service availability, etc. In rural areas, biomass fuels meet more than 70% of the rural energy needs. Progress in adopting modern energy sources in rural areas has been slow. The most direct health impact comes from household energy use among the poor, who depend almost entirely on burning biomass fuels in simple cooking devices that are placed in inadequately ventilated spaces. Prospective studies are needed to assess the long-term effects of biomass smoke on lung health among adults in rural areas.Geographic differences in asthma susceptibility exist around the world. The reason for the differences in asthma prevalence in rural and urban areas may be due to the fact that populations have different lifestyles and cultures, as well as different environmental exposures and different genetic backgrounds. Identifying geographic disparities in asthma hospitalizations is critical to implementing prevention strategies,reducing morbidity, and improving healthcare financing for clinical asthma treatment. Although evidence shows that differences in the prevalence of asthma do exist between urban and rural dwellers in many parts of the world, including in developed countries, data are inadequate to evaluate the extent to which different pollutant exposures contribute to asthma morbidity and severity of asthma between urban and rural areas.
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Affiliation(s)
- Yu Jie
- Department of Community Health, National University of Malaysia, Kuala Lumpur, Malaysia
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Nyembue TD, Jorissen M, Hellings PW, Muyunga C, Kayembe JM. Prevalence and determinants of allergic diseases in a Congolese population. Int Forum Allergy Rhinol 2012; 2:285-93. [PMID: 22294496 DOI: 10.1002/alr.21017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 11/29/2011] [Accepted: 12/06/2011] [Indexed: 11/06/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) is increasing worldwide, but little is known about AR in Africa. We aimed to establish the prevalence of AR and related allergic diseases, to classify AR according to the Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines, and to determine factors associated with allergy in Congo. METHODS We conducted a cross-sectional clustered survey of the population of 8 randomly chosen health zones of Kinshasa. Information was collected on demographics, home environment, participant characteristics, atopic history, and allergic symptoms. Skin-prick testing (SPT) was done. RESULTS Of 1508 screened individuals, 1412 (5-83 years of age) were interviewed and 1005 underwent SPT. Of the participants, 65.6% and 34.4% lived in urban and rural areas, respectively. Mean (± standard deviation [SD]) of age was 29 (±16) years and 52% were female. The 12-month prevalence of rhinitis, rhinoconjunctivitis, wheeze, and skin itch-rash was 30.8%, 24.4%, 15.4%, and 6.2%, respectively. Rhinoconjunctivitis and wheeze were more prevalent in urban than rural individuals. Of skin-tested respondents, 23.2% showed positive results, with mainly Dermatophagoides pteronyssinus and cockroach being involved. AR and non-AR prevalence was reported in 13.9% and 27.9%, respectively. Of AR individuals, 59.7% and 48.0% expressed moderate to severe and persistent symptoms, respectively. Independent determinants of having any allergic diseases in multivariate analysis were active smoking, presence of cockroach in home, history of atopy in siblings, personal history of atopy, using straw or herb mattress, and positive SPT responses. CONCLUSION This study revealed a high prevalence of allergic diseases in Congolese individuals. It is important to increase awareness toward allergic disorders and to ensure adequate management.
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Warm K, Backman H, Lindberg A, Lundbäck B, Rönmark E. Low incidence and high remission of allergic sensitization among adults. J Allergy Clin Immunol 2012; 129:136-42. [DOI: 10.1016/j.jaci.2011.08.033] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 08/17/2011] [Accepted: 08/24/2011] [Indexed: 11/26/2022]
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Do indoor environments influence asthma and asthma-related symptoms among adults in homes?: a review of the literature. J Formos Med Assoc 2011; 110:555-63. [PMID: 21930065 DOI: 10.1016/j.jfma.2011.07.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 05/16/2011] [Accepted: 06/08/2011] [Indexed: 11/21/2022] Open
Abstract
This review summarizes the results of epidemiological studies focusing on the detrimental effects of home environmental factors on asthma morbidity in adults. We reviewed the literature on indoor air quality (IAQ), physical and sociodemographic factors, and asthma morbidity in homes, and identified commonly reported asthma, allergic, and respiratory symptoms involving the home environment. Reported IAQ and asthma morbidity data strongly indicated positive associations between indoor air pollution and adverse health effects in most studies. Indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke. Environmental exposure may increase an adult's risk of developing asthma and also may increase the risk of asthma exacerbations. Evaluation of present IAQ levels, exposure characteristics, and the role of exposure to these factors in relation to asthma morbidity is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity.
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Bunyavanich S, Shargorodsky J, Celedón JC. A meta-analysis of Th2 pathway genetic variants and risk for allergic rhinitis. Pediatr Allergy Immunol 2011; 22:378-87. [PMID: 21309855 PMCID: PMC3345814 DOI: 10.1111/j.1399-3038.2010.01124.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
There is a significant genetic contribution to allergic rhinitis (AR). Genetic association studies for AR have been performed, but varying results make it challenging to decipher the overall potential effect of specific variants. The Th2 pathway plays an important role in the immunological development of AR. We performed meta-analyses of genetic association studies of variants in Th2 pathway genes and AR. PubMed and Phenopedia were searched by double extraction for original studies on Th2 pathway-related genetic polymorphisms and their associations with AR. A meta-analysis was conducted on each genetic polymorphism with data meeting our predetermined selection criteria. Analyses were performed using both fixed and random effects models, with stratification by age group, ethnicity, and AR definition where appropriate. Heterogeneity and publication bias were assessed. Six independent studies analyzing three candidate polymorphisms and involving a total of 1596 cases and 2892 controls met our inclusion criteria. Overall, the A allele of IL13 single nucleotide polymorphism (SNP) rs20541 was associated with increased odds of AR (estimated OR=1.2; 95% CI 1.1-1.3, p-value 0.004 in fixed effects model, 95% CI 1.0-1.5, p-value 0.056 in random effects model). The A allele of rs20541 was associated with increased odds of AR in mixed age groups using both fixed effects and random effects modeling. IL13 SNP rs1800925 and IL4R SNP 1801275 did not demonstrate overall associations with AR. We conclude that there is evidence for an overall association between IL13 SNP rs20541 and increased risk of AR, especially in mixed-age populations.
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Affiliation(s)
- Supinda Bunyavanich
- Channing Laboratory, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA.
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Abstract
The population of Americans over 65 years of age is growing at an unprecedented rate. Rhinitis is a common and burdensome complaint in this group, and physicians should be aware of the diagnosis and management of the disease. Geriatric rhinitis is a nasal disorder of older persons that presents with a constellation of nasal symptoms. The etiologies of this condition include both inflammatory diseases and the effects of aging on physiology of the upper airway. Possible causes include allergic rhinitis, nonallergic rhinitis (vasomotor rhinitis and gustatory rhinitis), adverse effects of medications, hormonal changes, postnasal drip syndrome, chronic rhinosinusitis and atrophic rhinitis. Nasal symptoms in the older patient present a clinical challenge because of the physiologic effects of the aging nose, the unusual clinical presentation, the presence of multiple comorbidities and the problem of polypharmacy. A number of therapeutic options exist for this disorder, although definitive studies of effective regimens are needed.
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Affiliation(s)
- Cheryl C Nocon
- The Section of Otolaryngology – Head & Neck Surgery, The Department of Surgery, The University of Chicago Medical Center, 5841 S Maryland Ave, MC 1035, Chicago, IL 60637, USA
| | - Jayant M Pinto
- The Section of Otolaryngology – Head & Neck Surgery, The Department of Surgery, The University of Chicago Medical Center, 5841 S Maryland Ave, MC 1035, Chicago, IL 60637, USA
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21
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Abstract
BACKGROUND A significant number of patients present with conjunctivitis that is not strictly speaking of allergic, infectious, or dry eye origin. Patients affected by this pseudo-allergic form of vasomotor or idiopathic conjunctivitis usually live in urban polluted areas and may be affected by a new clinical entity called the 'urban eye allergy syndrome'. SCOPE To identify the incidence, pathogenesis and therapeutic response of this condition by collecting from the literature experimental evidence on the relationship between air pollution, allergy, and conjunctival disease. FINDINGS Allergen susceptibility might be increased in areas with increased air pollutants. Both allergens and pollutants can directly initiate specific and nonspecific mucosal inflammation through several interweaving mechanisms. CONCLUSIONS The present commentary introduces the concept of 'urban eye allergy syndrome' discussing inter-actions between air pollutants and pollens, the increase of allergic signs and symptoms by pollutants, the prevalence of urban allergy, preliminary data from a single restricted geographical area, and proposed mechanisms of action.
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Affiliation(s)
- Andrea Leonardi
- Ophthalmology Unit, Department of Neuroscience, University of Padua, Italy.
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22
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Hu Y, Matsumoto Y, Dogru M, Okada N, Igarashi A, Fukagawa K, Tsubota K, Fujishima H. The differences of tear function and ocular surface findings in patients with atopic keratoconjunctivitis and vernal keratoconjunctivitis. Allergy 2007; 62:917-25. [PMID: 17620070 DOI: 10.1111/j.1398-9995.2007.01414.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The pathogenesis of the ocular surface disease in atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC) has not been fully understood. We tried to clarify the differences in the ocular surface status in patients with AKC, VKC, and healthy control subjects. METHODS Twenty-four eyes of 12 AKC patients, 12 eyes of six VKC patients, and 20 eyes of 10 normal control subjects were studied. The subjects underwent corneal sensitivity measurements, Schirmer test, tear film break-up time (BUT), vital staining of the ocular surface, conjunctival impression and brush cytology. Impression cytology samples underwent periodic acid Schiff staining for goblet cell density, squamous metaplasia grading, and immunohistochemical staining for MUC1, 2, 4, and 5AC. Brush cytology specimens underwent staining for inflammatory cell counting and Real Time PCR for MUC1, 2, 4, and 5AC mRNA expression. RESULTS The mean BUT, corneal sensitivity, and conjunctival goblet cell density values in AKC patients were significantly lower compared with VKC patients and control subjects. The squamous metaplasia grades in eyes with AKC were significantly higher compared to eyes with VKC and controls. The inflammatory cell response in brush cytology specimens was different between patients with AKC and VKC. Eyes with AKC showed significantly higher MUC1, 2 and 4 and lower MUC5AC mRNA expression compared to eyes with VKC. CONCLUSIONS Differences of the infiltrates, higher level of tear instability, lower corneal sensitivity, up-regulation of MUC1, 2, and 4, and down regulation of MUC5AC were important differential features of the ocular surface disease in AKC compared with VKC.
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Affiliation(s)
- Y Hu
- Department of Ophthalmology, Keio University School of Medicine, Shinanomachi, Tokyo, Japan
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