1
|
Kamei JM, Maués RD, de Oliveira Silva G, Machado AH, Hoshino EM, Bacchiega FM, Sena LMF, Negrato CA. Prevalence of asthma in people with type 1 diabetes mellitus: a scoping review. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2024; 20:12. [PMID: 38331806 PMCID: PMC10851526 DOI: 10.1186/s13223-024-00869-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/01/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND According to the Th1/Th2 paradigm, the expansion of Th1-type clones in individuals with type 1 diabetes results in reduced Th2-type clones, preventing the development of atopic diseases and vice versa. However, there is no consensus regarding the direct or inverse relationship between autoimmune and atopic diseases. OBJECTIVE The aim of this scoping review was to examine the knowledge gap about the possibility of coexistence of asthma and type 1 diabetes and determine the prevalence of this association. METHODS A scoping review was conducted, following the proposal of the Joanna Briggs Institute. The Population, Concept, and Context strategy was used to formulate the guiding question. The proposed question was: "What is the prevalence of asthma in people with T1DM?" After excluding duplicate articles, analyzing titles and abstracts, and excluding articles that did not answer the guiding question, 17 articles remained and were included in this review. RESULTS Most of the articles selected conformed to the Th1/Th2 hypothesis, as the prevalence of asthma was lower in individuals with T1DM. However, similar or higher prevalence of asthma was found between cases and controls in few articles. CONCLUSION The prevalence of asthma in people with T1DM ranged from 1.7% to 23.1%. Maybe the mechanisms that characterizes the Th1/Th2 paradigm aren't as simple as just the interaction of certain cytokines, since Th1-mediated autoimmune diseases and Th2- mediated atopy can coexist.
Collapse
Affiliation(s)
- Júlia Marchatto Kamei
- University of São Paulo - Bauru Campus (USP-Bauru), Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil.
| | - Raissa Dias Maués
- University of São Paulo - Bauru Campus (USP-Bauru), Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil
| | - Gabriel de Oliveira Silva
- University of São Paulo - Bauru Campus (USP-Bauru), Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil
| | - Alessandra Helena Machado
- University of São Paulo - Bauru Campus (USP-Bauru), Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil
| | - Erika Megumi Hoshino
- University of São Paulo - Bauru Campus (USP-Bauru), Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil
| | - Fabiana Menezes Bacchiega
- University of São Paulo - Bauru Campus (USP-Bauru), Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil
| | - Laís Mota Furtado Sena
- University of São Paulo - Bauru Campus (USP-Bauru), Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil
| | - Carlos Antonio Negrato
- University of São Paulo - Bauru Campus (USP-Bauru), Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, 17012-901, Brazil
| |
Collapse
|
2
|
Xie J, Chen G, Liang T, Li A, Liu W, Wang Y, Wang X, Kuang X, Han D, Liao W, Song L, Zhang X. Childhood asthma and type 1 diabetes mellitus: A meta-analysis and bidirectional Mendelian randomization study. Pediatr Allergy Immunol 2022; 33:e13858. [PMID: 36156818 DOI: 10.1111/pai.13858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/05/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Worldwide incidence and prevalence of both asthma and type 1 diabetes mellitus (T1DM) in children have been increasing in past decades. Association between the two diseases has been found in some but not in other studies. OBJECTIVE We conducted a meta-analysis to verify such an association, and bidirectional Mendelian randomization analysis to examine the potential cause-effect relationships. METHODS Three databases (PubMed, Embase, and Web of Science) were searched from their inception to February 1, 2021. Pooled hazard ratios (HR) or odds ratios (OR), and 95% confidence intervals, were calculated. Associations between single-nucleotide polymorphisms with childhood asthma and T1DM were selected based on genome-wide association studies. The outcome datasets were obtained from FinnGen study. We used the inverse-variance-weighted (IVW), weighted median and MR-Egger methods to estimate causal effects. To assess robustness and horizontal pleiotropy, MR-Egger regression and MR pleiotropy residual sum and outlier test were conducted. RESULTS In meta-analysis, childhood asthma was associated with an increased risk of T1DM (HR = 1.30, 95% CI 1.05-1.61, P = .014), whereas T1DM was not associated with the risk of asthma (HR = 0.98, 95% CI 0.64-1.51, P = .941; OR = 0.84, 95% CI 0.65-1.08, P = .168). MR analysis indicated increased genetic risk of T1DM in children with asthma (OR = 1.308; 95% CI 1.030-1.661; P = .028). Analysis using the IVW method indicated no association between T1DM and genetic risk of asthma (OR = 1.027, 95%CI 0.970-1.089, P = .358). CONCLUSION Both meta-analysis and MR study suggested that childhood asthma was a risk factor for T1DM. No epidemiological or genetic evidence was found for an association of T1DM with asthma incidence. Further studies could be carried out to leverage this newfound insight into better clinical and experimental research in asthma and T1DM.
Collapse
Affiliation(s)
- Junyang Xie
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Gui Chen
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Tianhao Liang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ang Li
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Weixing Liu
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yiyan Wang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaofen Wang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaoxuan Kuang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - DeMin Han
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wenjing Liao
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lijuan Song
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaowen Zhang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Innovation and transformation platform of upper airway disease in Guangdong province, Guangzhou, Guangdong, China.,Department of Allergy and Clinical Immunology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Otolaryngology, Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
3
|
Zeng R, Wang Z, Zhang J, Liang Z, Xu C, Wang J, Dong L. Type 1 diabetes and asthma: a systematic review and meta-analysis of observational studies. Endocrine 2022; 75:709-717. [PMID: 35029744 DOI: 10.1007/s12020-021-02973-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/22/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE Type 1 diabetes (T1D) and asthma are both the top concurrent non-communicable diseases in the world, and the existence of a relationship between the two is an area of debate. METHODS All eligible observational studies in PubMed and EMBASE databases from inception to August 2021 were searched for data extraction and analysis. The pooled odds ratio (OR) with corresponding 95% confidence intervals (95% CI) was evaluated using fixed-effects or random-effects models in RevMan 5.3, and I2 and Cochran Q tests were used to assess the heterogeneity. RESULTS 22 studies with 25,578 T1D and 3,330,901 non-T1D were included in this meta-analysis. After data analysis, there seems to be no apparent connectivity between asthma and T1D as the crude OR (cOR) was 1.07 (95%CI, 0.93-1.23). Nevertheless, after limiting the meta-analysis to 6 studies with adjusted OR (aOR) available, the results suggested a positive association between T1D and asthma (aOR, 1.15; 95%CI, 1.06-1.25). Corresponding with this, a meta-analysis of cohort studies also found a positive association between T1D and asthma with the pooled cOR of 1.27 (95% CI, 1.09-1.49) and aOR of 1.15 (95%CI, 1.05-1.26). Further analysis of 7 studies in which the diagnosis of asthma precedes T1D onset revealed that asthma patients are at increased risk of subsequent T1D with the pooled cOR of 1.23 (95%CI, 1.04-1.44) and aOR of 1.58 (95% CI, 1.11-2.24). CONCLUSION Our meta-analysis suggests a possible association between T1D and asthma, and patients who were previously diagnosed with asthma carried higher odds of developing T1D.
Collapse
Affiliation(s)
- Rong Zeng
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
| | - Zihan Wang
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
| | - Jintao Zhang
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
| | - Ziting Liang
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
| | - Changjuan Xu
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
| | - Jing Wang
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
| | - Liang Dong
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China.
| |
Collapse
|
4
|
Sgrazzutti L, Sansone F, Attanasi M, Di Pillo S, Chiarelli F. Coaggregation of Asthma and Type 1 Diabetes in Children: A Narrative Review. Int J Mol Sci 2021; 22:ijms22115757. [PMID: 34071190 PMCID: PMC8198343 DOI: 10.3390/ijms22115757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/20/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023] Open
Abstract
Asthma and type 1 diabetes mellitus (T1DM) are two of the most frequent chronic diseases in children, representing a model of the atopic and autoimmune diseases respectively. These two groups of disorders are mediated by different immunological pathways, T helper (Th)1 for diabetes and Th2 for asthma. For many years, these two groups were thought to be mutually exclusive according to the Th1/Th2 paradigm. In children, the incidence of both diseases is steadily increasing worldwide. In this narrative review, we report the evidence of the potential link between asthma and T1DM in childhood. We discuss which molecular mechanisms could be involved in the link between asthma and T1DM, such as genetic predisposition, cytokine patterns, and environmental influences. Cytokine profile of children with asthma and T1DM shows an activation of both Th1 and Th2 pathways, suggesting a complex genetic-epigenetic interaction. In conclusion, in children, the potential link between asthma and T1DM needs further investigation to improve the diagnostic and therapeutic approach to these patients. The aim of this review is to invite the pediatricians to consider the potential copresence of these two disorders in clinical practice.
Collapse
|
5
|
Mameli C, Ghezzi M, Mari A, Cammi G, Macedoni M, Redaelli FC, Calcaterra V, Zuccotti G, D’Auria E. The Diabetic Lung: Insights into Pulmonary Changes in Children and Adolescents with Type 1 Diabetes. Metabolites 2021; 11:metabo11020069. [PMID: 33530418 PMCID: PMC7912250 DOI: 10.3390/metabo11020069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/13/2022] Open
Abstract
Historically, the lung was not listed and recognized as a major target organ of diabetic injury. The first evidence of diabetic lung involvement was published fifty years ago, with a study conducted in a population of young adults affected by type 1 diabetes (T1D). In recent years, there has been mounting evidence showing that the lung is a target organ of diabetic injury since the beginning of the disease—at the pediatric age. The deeply branched vascularization of the lungs and the abundance of connective tissue, indeed, make them vulnerable to the effects of hyperglycemia, in a way similar to other organs affected by microvascular complications. In this review, we focus on pulmonary function impairment in children and adolescents affected by T1D. We also cover controversial aspects regarding available studies and future perspectives in this field.
Collapse
Affiliation(s)
- Chiara Mameli
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
- Department of Biomedical and Clinical Science “L. Sacco”, Università di Milano, 20157 Milan, Italy
- Correspondence: ; Tel.: +39-0263635324
| | - Michele Ghezzi
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
- Allergology and Pneumology Unit, V. Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Alessandra Mari
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
| | - Giulia Cammi
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
| | - Maddalena Macedoni
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
| | - Francesca Chiara Redaelli
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
| | - Valeria Calcaterra
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
- Department of Biomedical and Clinical Science “L. Sacco”, Università di Milano, 20157 Milan, Italy
| | - Enza D’Auria
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
- Allergology and Pneumology Unit, V. Buzzi Children’s Hospital, 20154 Milan, Italy
| |
Collapse
|
6
|
Ahmadizar F, Souverein PC, Arets HGM, de Boer A, Maitland-van der Zee AH. Asthma related medication use and exacerbations in children and adolescents with type 1 diabetes. Pediatr Pulmonol 2016; 51:1113-1121. [PMID: 27132537 DOI: 10.1002/ppul.23428] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 02/11/2016] [Accepted: 02/23/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To investigate the use of asthma medication and occurrence of asthma exacerbations up to 5 years before and after the onset of type 1 diabetes mellitus (T1DM) in children and adolescents. METHODS Children and adolescents younger than 19 years with at least 2 insulin prescriptions between 1999 and 2009 classified as T1DM cohort (n = 915) and a 4 times larger reference cohort (n = 3,590) with the same age and gender were identified from the Dutch PHARMO Record Linkage System. The date of first insulin dispensing was selected as the index date. RESULTS The 5-year prevalence rate of asthma medication use in the T1DM cohort (23.2%) was significantly higher than the reference cohort (18.3%) after the onset of diabetes. No statistically significant difference between the two cohorts was observed in the use of specific types of asthma medication except for short acting muscarinic antagonists that were significantly more used in the T1DM cohort (5.5%) compared with the reference cohort (0.62%) after the onset of diabetes. The incidence rate of asthma medication use declined over time with a peak in the T1DM cohort the 1st year after the onset of diabetes. Furthermore, 1 year after the index date there was a peak in incidence rate of asthma exacerbations in both T1DM (7.8 per 1,000 person year) and reference (6.8 per 1,000 person year) cohorts. CONCLUSIONS T1DM is associated with statistically significantly higher asthma medication use after the onset of T1DM, especially in the 1st year after the onset of diabetes. Pediatr Pulmonol. 2016;51:1113-1121. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Fariba Ahmadizar
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Patrick C Souverein
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Hubertus G M Arets
- Division of Paediatrics, Department of Paediatric Pulmonology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Anthonius de Boer
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Anke H Maitland-van der Zee
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.
| |
Collapse
|
7
|
Lumia M, Takkinen HM, Luukkainen P, Kaila M, Lehtinen-Jacks S, Nwaru BI, Tuokkola J, Niemelä O, Haapala AM, Ilonen J, Simell O, Knip M, Veijola R, Virtanen SM. Food consumption and risk of childhood asthma. Pediatr Allergy Immunol 2015; 26:789-96. [PMID: 25693000 DOI: 10.1111/pai.12352] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND The consumption of foods rich in n-3 polyunsaturated fatty acids has been proposed to protect against childhood asthma. This study explores the association of food consumption (including cow's milk (CM)-free diet) in early life and the risk of atopic and non-atopic asthma. METHODS Food intake of 182 children with asthma and 728 matched controls was measured using 3-day food records, within the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study cohort. The diagnoses of food allergies came both from the written questionnaire and from the registers of the Social Insurance Institution. Conditional logistic regression with generalized estimating equations framework was used in the analyses. RESULTS The diagnosis of cow's milk allergy (CMA) led to multiple dietary restrictions still evident at 4 yr of age. Even after adjusting for CMA, higher consumption of CM products was inversely associated with the risk of atopic asthma and higher consumption of breast milk and oats inversely with the risk of non-atopic asthma. Early consumption of fish was associated with a decreased risk of all asthma. CONCLUSIONS Dietary intake in early life combined with atopy history has a clear impact on the risk of developing asthma. Our results indicate that CM restriction due to CMA significantly increases and mediates the association between food consumption and childhood asthma risk.
Collapse
Affiliation(s)
- Mirka Lumia
- Nutrition Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland.,School of Health Sciences, University of Tampere, Tampere, Finland.,Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Hanna-Mari Takkinen
- Nutrition Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland.,School of Health Sciences, University of Tampere, Tampere, Finland
| | - Päivi Luukkainen
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Minna Kaila
- Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | | | - Bright I Nwaru
- Allergy & Respiratory Research Group, Centre for Population Health Sciences, The University Of Edinburgh, Edinburgh, UK
| | - Jetta Tuokkola
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, Seinäjoki, Finland
| | - Anna-Maija Haapala
- Center for Laboratory Medicine, Pirkanmaa Hospital District, Tampere, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, University of Turku, Turku, Finland.,Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Olli Simell
- Department of Pediatrics, University of Turku, Turku, Finland
| | - Mikael Knip
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Folkhälsan Research Institute, University of Helsinki, Helsinki, Finland.,Diabetes and Obesity Research Program, University of Helsinki, Helsinki, Finland
| | - Riitta Veijola
- Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Suvi M Virtanen
- Nutrition Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland.,School of Health Sciences, University of Tampere, Tampere, Finland.,Research Center for Child Health and Science Centre of Pirkanmaa Hospital District, Tampere University Hospital and University of Tampere, Tampere, Finland
| |
Collapse
|
8
|
Klamt S, Vogel M, Kapellen TM, Hiemisch A, Prenzel F, Zachariae S, Ceglarek U, Thiery J, Kiess W. Association between IgE-mediated allergies and diabetes mellitus type 1 in children and adolescents. Pediatr Diabetes 2015; 16:493-503. [PMID: 26189407 DOI: 10.1111/pedi.12298] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 06/10/2015] [Accepted: 06/22/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) is characterized by an immunological reaction that is dominated by type-1 T helper (Th1) cells, whereas immunoglobulin E (IgE)-mediated allergies are associated with Th2 cell. According to the Th1/Th2-hypothesis, the immune system is said to either develop into the direction of Th1 or Th2 cells. This would mean that a child developing T1DM is unlikely to develop an IgE-mediated allergy and vice versa. OBJECTIVE The aim of the study was to investigate the association between the prevalence of T1DM and IgE-mediated allergies. METHODS We designed a prospective case control study with 94 children and adolescents with T1DM and 188 age- and sex-matched control children. The basis of our investigations was a questionnaire concerning the family and children's history as to the presence of IgE-mediated allergies. Moreover, the following blood investigations were done: total serum IgE, specific IgE antibodies to major inhalant allergens, and a multiplex cytokine analysis measuring levels of specific cytokines representing either Th1- or Th2- cytokines. RESULTS Children with T1DM reported the presence of IgE-mediated allergies significantly more often than children of the control group. Children with T1DM had significantly higher tumor necrosis factor alpha (TNFα) levels than healthy controls. Levels of interleukin-2 (IL-2) and IL-6 were higher in the groups of children with the presence of a personal history of allergies, regardless of the presence of T1DM. CONCLUSIONS Our results suggest that T1DM is associated with a higher risk of a self-reported presence of IgE-mediated allergies and that the Th1/Th2-hypothesis may be an oversimplification.
Collapse
Affiliation(s)
- Sabine Klamt
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany.,Centre for Paediatric Research (CPL), University of Leipzig, Leipzig, Germany
| | - Mandy Vogel
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Centre for Paediatric Research (CPL), University of Leipzig, Leipzig, Germany
| | - Thomas M Kapellen
- Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany.,Centre for Paediatric Research (CPL), University of Leipzig, Leipzig, Germany
| | - Andreas Hiemisch
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany.,Centre for Paediatric Research (CPL), University of Leipzig, Leipzig, Germany
| | - Freerk Prenzel
- Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany.,Centre for Paediatric Research (CPL), University of Leipzig, Leipzig, Germany
| | - Silke Zachariae
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Uta Ceglarek
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Joachim Thiery
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Wieland Kiess
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany.,Centre for Paediatric Research (CPL), University of Leipzig, Leipzig, Germany
| |
Collapse
|
9
|
d’Annunzio G, Tosca M, Pistorio A, Silvestri M, Romanisio G, Lorini R, Rossi G, Ciprandi G. Type 1 diabetes mellitus and asthma: A follow-up study. Allergol Immunopathol (Madr) 2015; 43:225-7. [PMID: 24948182 DOI: 10.1016/j.aller.2014.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 01/04/2014] [Accepted: 01/13/2014] [Indexed: 11/26/2022]
|
10
|
The association between asthma and diabetes: does it exist? Allergol Immunopathol (Madr) 2013; 41:285-7. [PMID: 24091031 DOI: 10.1016/j.aller.2013.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 09/02/2013] [Indexed: 02/04/2023]
|
11
|
Tosca MA, Silòvestri M, D’Annunzio G, Lorini R, Rossi GA, Ciprandi G. May T1 diabetes mellitus protect from asthma? Allergol Immunopathol (Madr) 2013; 41:288-91. [PMID: 23265261 DOI: 10.1016/j.aller.2012.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 10/08/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) may be associated with allergy. It was previously reported that >20% of children with T1DM had allergic rhinitis (AR), but none was asthmatic. This finding was surprising as allergic rhinitis is frequently associated with asthma and asthma prevalence is about 10% of the general paediatric population. Thus, it was hypothesized that T1DM could protect from asthma. OBJECTIVES The aim of this preliminary study was to evaluate the pulmonary function and the response to bronchodilation testing in children, suffering from T1DM with associated AR, comparing them with a control group of children with AR alone. METHODS Twenty children with T1DM and AR were compared with 59 children with AR alone; spirometry and bronchodilation testing were performed in all patients. RESULTS There were no statistically significant differences in both "at baseline" and after bronchodilation testing about FVC, FEV1, and FEF25-75 values. However, changes in "post-bronchodilator" values of FEF25-75 (ΔFEF25-75) were significantly higher in children with AR alone than in children with T1DM and AR (p=0.04). CONCLUSIONS This preliminary study could sustain the hypothesis that T1DM in children suffering also from AR might exert a protective effect of preventing the possible evolution in asthma.
Collapse
|
12
|
Lumia M, Luukkainen P, Kaila M, Tapanainen H, Takkinen HM, Prasad M, Niinistö S, Nwaru BI, Kenward MG, Ilonen J, Simell O, Knip M, Veijola R, Virtanen SM. Maternal dietary fat and fatty acid intake during lactation and the risk of asthma in the offspring. Acta Paediatr 2012; 101:e337-43. [PMID: 22578184 DOI: 10.1111/j.1651-2227.2012.02718.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
AIM To explore the association between maternal dietary fat and fatty acid (FA) intake during lactation, and the risk of asthma in the offspring by the age of 5 years. METHODS The subjects comprised 1798 mother-child pairs from the Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study. Dietary intake was assessed by a validated 181-item food frequency questionnaire, which covered the third month of lactation. The cumulative incidence of asthma was assessed at the age of 5 years with a questionnaire modified from the International Study of Asthma and Allergies in Childhood (ISAAC). Cox proportional hazards regression was used for statistical analysis. RESULTS The maternal use of margarines during lactation was associated with a marginally increased risk of asthma [hazard ratio (HR) for user vs. nonuser 1.96, 95% confidence interval (CI) 1.01-3.82, p = 0.047] after adjusting for putative confounders. The maternal intakes of n-3 polyunsaturated FA (PUFA) and fish during lactation were not associated with the risk of asthma. CONCLUSION Maternal use of margarines during lactation was weakly associated with an increased risk of asthma in the offspring at the age of 5 years. Other fats or FAs during lactation were not associated with the risk of asthma. However, the nonadherence to dietary recommendations regarding especially fats of our study population may restrict the generalizability of our results.
Collapse
Affiliation(s)
- M Lumia
- Nutrition Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Tosca MA, Silvestri M, Olcese R, D'Annunzio G, Pistorio A, Lorini R, Ciprandi G, Rossi GA. Allergic sensitization and symptoms, body mass index, and respiratory function in children with type 1 diabetes mellitus. Ann Allergy Asthma Immunol 2012; 108:128-9. [PMID: 22289736 DOI: 10.1016/j.anai.2011.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 12/04/2011] [Accepted: 12/05/2011] [Indexed: 11/16/2022]
|
14
|
Tosca MA, Ciprandi G, Silvestri M, D'Annunzio G, Lorini R, Rossi GA. T1 diabetes and allergic diseases in children: correspondence to the paper of Thomsen et al., Allergy 2011; 66: 645-647. Allergy 2011; 66:1612-3; author reply 1613-4. [PMID: 21797884 DOI: 10.1111/j.1398-9995.2011.02680.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
15
|
Thomsen SF, Duffy DL, Kyvik KO, Skytthe A, Backer V. Type 1 diabetes and allergic diseases in children - response to Tosca et al. Allergy 2011. [DOI: 10.1111/j.1398-9995.2011.02746.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
16
|
Impairment of lung function might be related to IL-10 and IFN-γ defective production in allergic children. Immunol Lett 2011; 140:104-6. [PMID: 21669226 DOI: 10.1016/j.imlet.2011.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 05/09/2011] [Accepted: 05/10/2011] [Indexed: 11/21/2022]
Abstract
A functional defect of T regulatory cells (Tregs) has been proposed as pathogenic mechanism of allergic reaction. Impairment of lung function frequently occurs in children with respiratory allergy. This study aimed at investigating the possible role of IL-10 and IFN-γ on lung function deterioration in allergic children. Forty children with mild asthma, monosensitized to house dust mites, were evaluated and followed-up for 2 years. Spirometry was performed in all children. IL-10 and IFN-γ were evaluated in in vitro experiments. FEV(1), FVC, and FEF(25-75), evaluated as percent of predicted, significantly diminished over time (p<0.0001, p=0.03, and p<0.0001 respectively). There was a strong relationship between changes in spirometric parameters and IL-10 production and between changes in FEV(1) values and IFN-γ production over time. This preliminary study provided evidence that IL-10 and IFN-γ production could be defective in allergic children prone to develop functional impairment.
Collapse
|
17
|
Tozzi AE, Armenio L, Bernardini R, Boner A, Calvani M, Cardinale F, Cavagni G, Dondi A, Duse M, Fiocchi A, Marseglia GL, del Giudice MM, Muraro A, Pajno GB, Paravati F, Peroni D, Tripodi S, Ugazio AG, Indinnimeo L. Pediatric allergy and immunology in Italy. Pediatr Allergy Immunol 2011; 22:267-76. [PMID: 21457333 DOI: 10.1111/j.1399-3038.2011.01157.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In Italy, according to the International Study on Asthma and Allergies in Childhood study, the prevalence of current asthma, allergic rhinoconjunctivitis, and atopic eczema in 2006 was 7.9%, 6.5%, and 10.1% among children aged 6-7 and 8.4%, 15.5%, and 7.75% among children aged 13-14 yr. University education in this field is provided by the Postgraduate Schools of Pediatrics and those of Allergology and Clinical Immunology, as well as several annual Master courses. The Italian Society of Pediatric Allergology and Immunology (SIAIP) was founded in 1996 and counts about 1000 members. SIAIP promotes evidence-based management of allergic children and disseminates information to patients and their families through a quite innovative website and the National Journal 'Rivista Italiana di Allergologia Pediatrica'. In the last decade, four major regional, inter-regional, and national web-based networks have been created to link pediatric allergy centers and to share their clinical protocols and epidemiologic data. In addition, National Registers of Primary Immune-deficiencies and on Pediatric HIV link all clinical excellence centers. Research projects in the field of pediatric allergy and immunology are founded by the Italian Ministry of Education, University and Research (MIUR) and by the National Research Council (CNR), but the overall investments in this research area are quite low. Only a handful Italian excellence centers participate in European Projects on Pediatric Allergy and Immunology within the 7th Framework Program. The European Academy of Allergy and Clinical Immunology currently hosts two Italians in its Executive Committee (EC) and one in the EC of the Pediatric Section; moreover, major European Academy of Allergy and Clinical Immunology meetings and courses in the area of pediatrics (e.g., PAAM, Venice, 2009) have been held in Italy in the last 3 yr. Italian hallmarks in the management of allergic diseases in childhood are a quite alive and spread interest in Molecular Allergology and a remarkable predominance of sublingual (SLIT) compared to the subcutaneous (SCIT) immunotherapy.
Collapse
Affiliation(s)
- Alberto E Tozzi
- Epidemiology Unit, Bambino Gesù Children's Hospital, Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Silvestri M, Tosca MA, Ciprandi G, D'Annunzio G, Lorini R, Rossi GA. Re: Body mass index and allergic sensitization in children with asthma or type 1 diabetes. Clin Exp Allergy 2011; 41:1044-5. [PMID: 21492267 DOI: 10.1111/j.1365-2222.2011.03757.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|