Changes in symptoms of asthma and rhinitis by sensitization status over ten years in a cohort of young Chilean adults

Atopy and allergic diseases among college students at a Saudi Public University

Background

Despite its significant prevalence worldwide, atopy and allergic diseases continue to need more studies, with a need for published articles describing the prevalence of atopy and allergic diseases in Saudi society. The study aimed to determine the prevalence of atopic dermatitis diseases among college students at Imam Mohammad Ibn Saud Islamic University.

Methods

The Cross-sectional study was conducted in Saudi Arabia among college students at Imam Mohammed bin Saud Islamic University in Riyadh based on self-report Asthma and Allergies questionnaires (ISSAC questionnaire, atopic dermatitis part).

Results

Seven hundred ninety-seven (797) students from 11 colleges participated in the study. About half (47.6%) aged between 21 and 24, and 73.7% were females. More than one-third (34.8%) had atopic dermatitis during the last six months, while 30.7% of the participants reported having itchy rash in the past 12 months, and 33.8% were diagnosed with eczema in any life interval. Age is not one of the significant factors affecting the prevalence of atopic dermatitis. However, the prevalence of atopic dermatitis slightly increases with age (P = 0.062). Atopic dermatitis was significantly higher among female students (39.7%) than 21.0% among male students (P = 0.000). College level nor GPA had no significant impact on the prevalence of atopic dermatitis (P = 0.238 and 0.884, respectively).

Conclusion

Imam Mohammad Ibn Saud Islamic University students have a high prevalence of atopic dermatitis, which may indicate a higher prevalence of allergens. Females and older participants were more liable to reported atopic dermatitis.

Prevalence of asthma, allergic rhinitis and pollinosis in a city of Brazil: A monitoring study

BACKGROUND

Allergic respiratory diseases such as asthma and allergic rhinitis have increased considerably in the last decades.

OBJECTIVE

The present study estimates prevalence trends of asthma, allergic rhinitis and pollinosis in the population of a city of Southern Brazil, without restriction of age, from 2011 to 2018, using the ISAAC standardized questionnaire.

METHODS

Data was collected from March to June of 2011 and during the same months in 2018, in order to verify trends in the prevalence of these allergic conditions. The total sample consisted of 3132 individuals of both sexes living in the municipality of Santo Ângelo, in the state of Rio Grande do Sul, Brazil.

RESULTS

No differences were observed in the prevalence of asthma diagnosis (15.1% in 2011 and 13.8% in 2018), however the prevalence of current wheeze was significantly reduced from 24.7% in 2011 to 21.2% in 2018 (p<0.05). Regarding allergic conditions in 2011 and in 2018, a significant reduction was observed (p<0.001) in reported current rhinitis (63.3% vs. 50.5%), rhinoconjunctivitis (48.9% vs. 38.8%), hay fever (52.0% vs. 43.3%), and pollinosis (29.0% vs 17.0%). Moreover, we observed an inverse relation between age and rhinoconjunctivitis and hay fever, and all symptoms were more frequent in females. Rhinoconjunctivitis and hay fever, as well as current rhinitis and pollinosis were highly prevalent among 30-39 years-old individuals, whereas current wheeze affected mainly the age group 10-19 years-old.

CONCLUSION

While the prevalence of asthma remained similar after seven years, allergic rhinitis and pollinosis declined between 2011 and 2018.

Measurement of bronchial hyperreactivity: comparison of three Nordic dosimetric methods

Clinical testing of bronchial hyperreactivity (BHR) provides valuable information in asthma diagnostics. Nevertheless, the test results depend to a great extent on the testing procedure: test substance, apparatus and protocol. In Nordic countries, three protocols predominate in the testing field: Per Malmberg, Nieminen and Sovijärvi methods. However, knowledge of their equivalence is limited. We aimed to find equivalent provocative doses (PD) to obtain similar bronchoconstrictive responses for the three protocols. We recruited 31 patients with suspected asthma and health care workers and performed BHR testing with methacholine according to Malmberg and Nieminen methods, and with histamine according to Sovijärvi. We obtained the individual response-dose slopes for each method and predicted equivalent PD values. Applying a mixed-model, we found significant differences in the mean (standard error of mean) response-dose (forced expiratory volume in one second (FEV₁)%/mg): Sovijärvi 7.2 (1.5), Nieminen 13.8 (4.2) and Malmberg 26 (7.3). We found that the earlier reported cut-point values for moderate BHR and marked BHR between the Sovijärvi (PD₁₅) and Nieminen (PD₂₀) methods were similar, but with the Malmberg method a significant bronchoconstrictive reaction was measured with lower PD₂₀ values. We obtained a relationship between slope values and PD (mg) between different methods, useful in epidemiological research and clinical practice.

Atopy and allergic diseases among Saudi young adults: A cross-sectional study

Objective

In this cross-sectional study, we aimed to determine the prevalence of asthma and other allergic diseases among a homogenous group of students attending the health colleges of a Saudi university and to investigate the relationship between their atopy profile and associated clinical symptoms of allergic diseases.

Methods

A total of 222 students completed the International Study of Asthma and Allergies in Childhood questionnaire and underwent skin prick testing (SPT) using a standardized panel of allergenic extracts.

Results

Overall prevalence of physician-diagnosed allergic diseases was 27% for bronchial asthma (BA), 13.1% for atopic dermatitis (AD), and 5% for allergic rhinitis (AR). Atopy was present in 90 (40.5%) students. Students with atopic disease were more likely to have physician-diagnosed BA, AR, and AD. Atopy and polysensitization was more frequent among male than female students. SPT results were positive in 20.8% of participants for Bermuda grass, 18.9% for cat fur, and 12.7% for Dermatophagoides pteronyssinus .

Conclusion

The prevalence of atopy and allergic diseases in Saudi young adults is high and worrisome. Comorbid allergic diseases were more prevalent among our participants with atopic disease. Determination of allergen sensitization patterns in patients with atopic disease is crucial for selecting proper preventive and therapeutic strategies.

History of allergic rhinitis and risk of asthma; a systematic review and meta-analysis

Background

Allergic rhinitis has been suspected to be a risk factor for asthma in several studies but this association is not firmly established. The objective of this study was to synthesize the evidence of the association between allergic rhinitis and the risk of asthma through a systematic review and meta-analysis.

Methods

We performed a search in Medline, Scopus, ISI Proceedings databases and other databases from inception until February 2019, followed by manual search to identify potentially relevant case-control and cohort studies that reported relative risk estimates and confidence intervals of the association between allergic rhinitis and asthma. Cross-sectional studies were excluded. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed and random effects models and quality of studies was assessed through a modified version of the Newcastle-Ottawa scale.

Results

Twenty-nine eligible studies, 22 cohort and 7 case-control studies, with a total of 274489 subjects, were included in the meta-analysis. The results show that history of allergic rhinitis is significantly associated with the occurrence of asthma (OR = 3.82; 95% CI: 2.92–4.99). European studies showed a stronger association (OR = 4.35; (95% CI: 3.12–6.06) than non-European studies (OR = 2.75; 95% CI: 2.16–3.50), and case-control studies showed a stronger association (OR = 4.71; 95% CI: 3.58–6.17) than cohort studies (OR = 3.42; 95% CI: 2.60–4.50).

Conclusions

This meta-analysis shows that allergic rhinitis is strongly associated with asthma. Further prospective studies on the effect of treatment of allergic rhinitis on the development of asthma are needed. Relief of airway allergic manifestations may need dual control of allergic rhinitis and asthma.

Registration

PROSPERO database with registration number CRD42017055156.

Heating-induced contraction in airways smooth muscle: A possible causative factor of exercise-induced bronchoconstriction

Asthmatic patients often suffer from bronchoconstriction or asthma following breathing hot air or exposure to exercise due to raises the core body temperature. However, the direct effect of heating airways has not been studied yet. The aim of this study is to investigate the effect of heating on tracheal and bronchiolar smooth muscles. Isolated ovine tracheal strips and bronchiolar segments preparations were suspended in organ baths containing Krebs' solution for isometric tension recording. Tissues responses were examined during decreasing and elevating baths temperature (20 °C, 40 °C-45 °C and 50 °C). Cooling or heating induced rapid and reproducible contractions proportional with decreasing or increasing temperature respectively in tracheal and bronchiolar preparations. On reset to 37 °C the tone returned rapidly to basal level. Changing the bath's temperature from 37 °C to 20 °C or to 40 °C and 45 °C for tracheal strips or to 45 °C and 50 °C for bronchiolar segments induced contractions in both preparations. Changing the temperature below or above the normal body temperature (37 °C), leads to airways contractions. Heating induced contractions in tracheal and bronchiolar smooth muscle proportional to the heating temperature. Therefore, breathing hot air or elevation of body core temperature due to exercise can be considered possible causative factor of heating- or exercise-induced bronchoconstriction.

Prevalence of asthma-like symptoms with ageing

Background

Change in the prevalence of asthma-like symptoms in populations of ageing adults is likely to be influenced by smoking, asthma treatment and atopy.

Methods

The European Community Respiratory Health Survey collected information on prevalent asthma-like symptoms from representative samples of adults aged 20–44 years (29 centres in 13 European countries and Australia) at baseline and 10 and 20 years later (n=7844). Net changes in symptom prevalence were determined using generalised estimating equations (accounting for non-response through inverse probability weighting), followed by meta-analysis of centre level estimates.

Findings

Over 20 years the prevalence of ‘wheeze’ and ‘wheeze in the absence of a cold’ decreased (−2.4%, 95% CI −3.5 to −1.3%; −1.5%, 95% CI −2.4 to −0.6%, respectively) but the prevalence of asthma attacks, use of asthma medication and hay fever/nasal allergies increased (0.6%, 95% CI 0.1 to 1.11; 3.6%, 95% CI 3.0 to 4.2; 2.7%, 95% CI 1.7 to 3.7). Changes were similar in the first 10 years compared with the second 10 years, except for hay fever/nasal allergies (increase seen in the first 10 years only). Decreases in these wheeze-related symptoms were largely seen in the group who gave up smoking, and were seen in those who reported hay fever/nasal allergies at baseline.

Interpretation

European adults born between 1946 and 1970 have, over the last 20 years, experienced less wheeze, although they were more likely to report asthma attacks, use of asthma medication and hay fever. Decrease in wheeze is largely attributable to smoking cessation, rather than improved treatment of asthma. It may also be influenced by reductions in atopy with ageing.