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Havenga H, Gharbi D, Sewry N, Language B, Neumann FH, Finch JM, Hill T, Boulter J, Jordaan E, Piketh SJ, Schwellnus M, Burger RP. Healthy environments for athleTes (HEAT): environmental conditions along a 90 km ultra-marathon event, South Africa. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02703-8. [PMID: 38869702 DOI: 10.1007/s00484-024-02703-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 04/22/2024] [Accepted: 05/09/2024] [Indexed: 06/14/2024]
Abstract
This paper provides an overview of the HEAT (Healthy Environments for AthleTes) project, which aims to understand the impact of environmental conditions on athlete health and performance during major sporting events such as long-distance running, cycling, and triathlons. In collaboration with the SAFER (Strategies to reduce Adverse medical events For the ExerciseR) initiative, the HEAT project carried out a field campaign at the 2022 Comrades Marathon in the KwaZulu-Natal province of South Africa. The measurement campaign deployed seven weather stations, seven PM2.5 monitors and one spore trap along the 90 km route to capture spatially representative measurements of complex micro-climates, allergenic aerospora, and particulate matter exposure. The results indicate that runners were exposed to moderate risk heat stress conditions. Novel findings from this initial campaign shows elevated and potentially harmful PM2.5 levels at spectator areas, possibly coinciding with small fire events around the race day festivities. Our findings show values PM2.5 levels over the WHO 24-h guidelines at all stations, while 2000 µg/m3 at two stations. However, the lack of an acute exposure standard means direct health impacts cannot be quantified in the context of a sport event. The HEAT project highlights important aspects of race day monitoring; regional scale climatology has an impact on the race day conditions, the microclimatic conditions (pollution and meteorology) are not necessarily captured by proximity instruments and direct environmental measurements are required to accurately capture conditions along the route.
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Affiliation(s)
- H Havenga
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa.
| | - D Gharbi
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - N Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee Research Centre, Pretoria, South Africa
| | - B Language
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - F H Neumann
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - J M Finch
- School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - T Hill
- School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - J Boulter
- Comrades Marathon Association (CMA), Medical Director, Pietermaritzburg, South Africa
| | - E Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - S J Piketh
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - M Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee Research Centre, Pretoria, South Africa
| | - R P Burger
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
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Hossny E, Adachi Y, Anastasiou E, Badellino H, Custovic A, El-Owaidy R, El-Sayed ZA, Filipovic I, Gomez RM, Kalayci Ö, Le Souëf P, Miligkos M, Morais-Almeida M, Nieto A, Phipatanakul W, Shousha G, Teijeiro A, Wang JY, Wong GW, Xepapadaki P, Yong SB, Papadopoulos NG. Pediatric asthma comorbidities: Global impact and unmet needs. World Allergy Organ J 2024; 17:100909. [PMID: 38827329 PMCID: PMC11141278 DOI: 10.1016/j.waojou.2024.100909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 06/04/2024] Open
Abstract
Real-world data on the range and impact of comorbid health conditions that affect pediatric asthma are scant, especially from developing countries. Lack of data hinders effective diagnosis, treatment, and overall management of these complex cases. We, hereby, describe the common pediatric asthma comorbid conditions in terms of evidence for association, potential mechanisms of impact on asthma control, and treatment benefit. Obesity, upper airway allergies, dysfunctional breathing, multiple sensitizations, depressive disorders, food allergy, and gastro-esophageal reflux are common associations with difficult-to-treat asthma. On the other hand, asthma symptoms and/or management may negatively impact the well-being of children through drug adverse effects, worsening of anaphylaxis symptoms, and disturbing mental health. Awareness of these ailments may be crucial for designing the optimum care for each asthmatic child individually and may ultimately improve the quality of life of patients and their families. A multidisciplinary team of physicians is required to identify and manage such comorbidities aiming to mitigate the over-use of asthma pharmacotherapy. Asthma research should target relevant real-world difficulties encountered at clinical practice and focus on interventions that would mitigate the impact of such comorbidities. Finally, policymakers and global healthcare organizations are urged to recognize pediatric asthma control as a healthcare priority and allocate resources for research and clinical interventions. In other words, global asthma control needs support by compassionate scientific partnership.
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Affiliation(s)
- Elham Hossny
- Pediatric Allergy, Immunology, and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Yuichi Adachi
- Pediatric Allergy Center, Toyama Red Cross Hospital, Japan
| | - Eleni Anastasiou
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Héctor Badellino
- Faculty of Psychology, UCES University, San Francisco, Argentina
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Rasha El-Owaidy
- Pediatric Allergy, Immunology, and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Zeinab A. El-Sayed
- Pediatric Allergy, Immunology, and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | | | | | - Ömer Kalayci
- Hacettepe University School of Medicine, Ankara, Turkey
| | - Peter Le Souëf
- School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Michael Miligkos
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Antonio Nieto
- Pediatric Pulmonology and Allergy Unit, Hospital Universitari i Politècnic La Fe, Health Research Institute La Fe, Valencia, Spain
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ghada Shousha
- Pediatric Allergy, Immunology, and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Alvaro Teijeiro
- Respiratory Department, Pediatric Hospital, Córdoba, Argentina
| | - Jiu-Yao Wang
- Allergy, Immunology and Microbiome Research Center, China Medical University Children's Hospital, Taichung, Taiwan
| | - Gary W.K. Wong
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Su Boon Yong
- Department of Allergy and Immunology, China Medical University Children's Hospital, Taichung, Taiwan
| | - Nikolaos G. Papadopoulos
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
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Domingo KN, Gabaldon KL, Hussari MN, Yap JM, Valmadrid LC, Robinson K, Leibel S. Impact of climate change on paediatric respiratory health: pollutants and aeroallergens. Eur Respir Rev 2024; 33:230249. [PMID: 39009406 PMCID: PMC11262702 DOI: 10.1183/16000617.0249-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/07/2024] [Indexed: 07/17/2024] Open
Abstract
Paediatric populations are particularly vulnerable to respiratory diseases caused and exacerbated by aeroallergens, pollutants and infectious agents. Worsening climate change is expected to increase the prevalence of pollutants and aeroallergens while amplifying disease severity and causing disproportionate effects in under-resourced areas. The purpose of this narrative review is to summarise the role of anthropogenic climate change in the literature examining the future impact of aeroallergens, pollutants and infectious agents on paediatric respiratory diseases with a focus on equitable disease mitigation. The aeroallergens selected for discussion include pollen, dust mites and mould as these are prevalent triggers of paediatric asthma worldwide. Human rhinovirus and respiratory syncytial virus are key viruses interacting with climate change and pollution and are primary causal agents of viral respiratory disease. Within this review, we present the propensity for aeroallergens, climate change and pollution to synergistically exacerbate paediatric respiratory disease and outline measures that can ameliorate the expected increase in morbidity and severity of disease through a health equity lens. We support shifting from fossil fuels to renewable energy worldwide, across sectors, as a primary means of reducing increases in morbidity.
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Affiliation(s)
- Karyssa N Domingo
- School of Medicine, University of California San Diego, La Jolla, CA, USA
- K.N. Domingo and K.L. Gabaldon contributed equally
| | - Kiersten L Gabaldon
- School of Medicine, University of California San Diego, La Jolla, CA, USA
- K.N. Domingo and K.L. Gabaldon contributed equally
| | | | - Jazmyn M Yap
- School of Medicine, University of California San Diego, La Jolla, CA, USA
| | | | - Kelly Robinson
- Department of Pediatrics, Division of Allergy and Immunology, University of California San Diego, La Jolla, CA, USA
| | - Sydney Leibel
- Department of Pediatrics, Division of Allergy and Immunology, University of California San Diego, La Jolla, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
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Cay E, Karakulak V, Sezer A, Baspinar H, Bahar N, Fidan BH, Serbes M, Bilen S, Yucel SP, Ozcan D, Altintas DU. Clinical characteristics of children with asthma exacerbations: a cross-sectional descriptive study. J Asthma 2024:1-6. [PMID: 38376119 DOI: 10.1080/02770903.2024.2319847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 02/12/2024] [Indexed: 02/21/2024]
Abstract
AIM In this cross-sectional descriptive study, we aimed to determine the clinical characteristics of children admitted to a tertiary hospital with asthma exacerbations in a city in southern Turkey where aeroallergens are common and to determine how these characteristics affect the severity of exacerbations. METHODS Data from a cross-sectional analysis of children with asthma exacerbations who were followed up at the Cukurova University Medical Faculty Pediatric Emergency Department (ED) and Pediatric Allergy & Immunology inpatient clinic were retrospectively analyzed. The study included 106 children who were diagnosed with asthma and did not have any additional comorbidities. In a comparative analysis, the clinical characteristics and laboratory parameters of children with mild/moderate and severe exacerbations were examined. RESULTS While 81.1% of the patients had mild/moderate exacerbation, 18.8% had severe exacerbation. Additional atopic disease, Alternaria positivity in the skin prick test, the frequency of exacerbations in the previous year, Streptococcus pneumoniae infection, and the rate of noncompliance with treatment were significantly higher in children with severe asthma exacerbations. PEF, FEV1, and FEV1/FVC values were considerably lower in patients with severe exacerbations. CONCLUSIONS Bacterial infections, presence of atopic disease, Alternaria exposure, low spirometric measures, number of exacerbations in the previous year, and low rate of treatment adherence may be relevant in predicting the severity of asthma exacerbations.
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Affiliation(s)
- Ezgi Cay
- Department of Pediatrics, Faculty of Medicine, Balcali Hospital, Cukurova University, Adana, Turkey
| | - Veysel Karakulak
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Balcali Hospital, Cukurova University, Adana, Turkey
| | - Ahmet Sezer
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Balcali Hospital, Cukurova University, Adana, Turkey
| | - Huseyin Baspinar
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Balcali Hospital, Cukurova University, Adana, Turkey
| | - Nilgun Bahar
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Balcali Hospital, Cukurova University, Adana, Turkey
| | - Busra Hatice Fidan
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Balcali Hospital, Cukurova University, Adana, Turkey
| | - Mahir Serbes
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Balcali Hospital, Cukurova University, Adana, Turkey
| | - Sevcan Bilen
- Division of Pediatric Emergency Medicine, Faculty of Medicine, Balcali Hospital, Cukurova University, Adana, Turkey
| | - Sevinc Puren Yucel
- Department of Biostatistics, Faculty of Medicine, Balcali Hospital, Cukurova University, Adana, Turkey
| | - Dilek Ozcan
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Balcali Hospital, Cukurova University, Adana, Turkey
| | - Derya Ufuk Altintas
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Balcali Hospital, Cukurova University, Adana, Turkey
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Lee S, Ryu SH, Sul WJ, Kim S, Kim D, Seo S. Association of exposure to indoor molds and dampness with allergic diseases at water-damaged dwellings in Korea. Sci Rep 2024; 14:135. [PMID: 38167981 PMCID: PMC10762174 DOI: 10.1038/s41598-023-50226-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
This study aims to characterize levels of molds, bacteria, and environmental pollutants, identify the associations between indoor mold and dampness exposures and childhood allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, using three different exposure assessment tools. A total of 50 children with their parents who registered in Seoul and Gyeonggi-do in Korea participated in this study. We collated the information on demographic and housing characteristics, environmental conditions, and lifestyle factors using the Korean version of the International Study of Asthma and Allergies in Childhood questionnaire. We also collected environmental monitoring samples of airborne molds and bacteria, total volatile organic compounds, formaldehyde, and particulate matter less than 10 µm. We evaluated and determined water damage, hidden dampness, and mold growth in dwellings using an infrared (IR) thermal camera and field inspection. Univariate and multivariate regression analyses were performed to evaluate the associations between prevalent allergic diseases and exposure to indoor mold and dampness. Indoor mold and bacterial levels were related to the presence of water damage in dwellings, and the mean levels of indoor molds (93.4 ± 73.5 CFU/m3) and bacteria (221.5 ± 124.2 CFU/m3) in water-damaged homes were significantly higher than those for molds (82.0 ± 58.7 CFU/m3) and for bacteria (152.7 ± 82.1 CFU/m3) in non-damaged dwellings (p < 0.05). The crude odds ratios (ORs) of atopic dermatitis were associated with < 6th floor (OR = 3.80), and higher indoor mold (OR = 6.42) and bacterial levels (OR = 6.00). The crude ORs of allergic diseases, defined as a group of cases who ever suffered from two out of three allergic diseases, e.g., asthma and allergic rhinitis, and allergic rhinitis were also increased by 3.8 and 9.3 times as large, respectively, with water damage (+) determined by IR camera (p < 0.05). The adjusted OR of allergic rhinitis was significantly elevated by 10.4 times in the water-damaged dwellings after adjusting age, sex, and secondhand smoke. Therefore, a longitudinal study is needed to characterize dominant mold species using DNA/RNA-based sequencing techniques and identify a causal relationship between mold exposure and allergic diseases in the future.
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Affiliation(s)
- Seokwon Lee
- Environmental Health Research Department, National Institute of Environmental Research, Incheon, 22689, Republic of Korea
| | - Seung-Hun Ryu
- Environmental Health Research Department, National Institute of Environmental Research, Incheon, 22689, Republic of Korea
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Woo Jun Sul
- Department of Systems Biotechnology, College of Biotechnology and Natural Resources, Chung-Ang University, Anseong, Gyeonggi-do, 17546, Republic of Korea
| | - Seunghyun Kim
- Allergy Immunology Center, College of Medicine, Korea University, Seoul, 02841, Republic of Korea
| | - Dohyeong Kim
- School of Economic, Political and Policy Sciences, University of Texas at Dallas, Richardson, TX, 75080-3021, USA
| | - SungChul Seo
- Department of Nano, Chemical and Biological Engineering, College of Engineering, Seokyeong University, Seoul, 02173, Republic of Korea.
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Grewling Ł, Ribeiro H, Antunes C, Apangu GP, Çelenk S, Costa A, Eguiluz-Gracia I, Galveias A, Gonzalez Roldan N, Lika M, Magyar D, Martinez-Bracero M, Ørby P, O'Connor D, Penha AM, Pereira S, Pérez-Badia R, Rodinkova V, Xhetani M, Šauliene I, Skjøth CA. Outdoor airborne allergens: Characterization, behavior and monitoring in Europe. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 905:167042. [PMID: 37709071 DOI: 10.1016/j.scitotenv.2023.167042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/23/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023]
Abstract
Aeroallergens or inhalant allergens, are proteins dispersed through the air and have the potential to induce allergic conditions such as rhinitis, conjunctivitis, and asthma. Outdoor aeroallergens are found predominantly in pollen grains and fungal spores, which are allergen carriers. Aeroallergens from pollen and fungi have seasonal emission patterns that correlate with plant pollination and fungal sporulation and are strongly associated with atmospheric weather conditions. They are released when allergen carriers come in contact with the respiratory system, e.g. the nasal mucosa. In addition, due to the rupture of allergen carriers, airborne allergen molecules may be released directly into the air in the form of micronic and submicronic particles (cytoplasmic debris, cell wall fragments, droplets etc.) or adhered onto other airborne particulate matter. Therefore, aeroallergen detection strategies must consider, in addition to the allergen carriers, the allergen molecules themselves. This review article aims to present the current knowledge on inhalant allergens in the outdoor environment, their structure, localization, and factors affecting their production, transformation, release or degradation. In addition, methods for collecting and quantifying aeroallergens are listed and thoroughly discussed. Finally, the knowledge gaps, challenges and implications associated with aeroallergen analysis are described.
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Affiliation(s)
- Łukasz Grewling
- Laboratory of Aerobiology, Department of Systematic and Environmental Botany, Faculty of Biology, Adam Mickiewicz University, Poznań, Poland.
| | - Helena Ribeiro
- Department of Geosciences, Environment and Spatial Plannings of the Faculty of Sciences, University of Porto and Earth Sciences Institute (ICT), Portugal
| | - Celia Antunes
- Department of Medical and Health Sciences, School of Health and Human Development & ICT-Institute of Earth Sciences, IIFA, University of Évora, 7000-671 Évora, Portugal
| | | | - Sevcan Çelenk
- Department of Biology, Faculty of Arts and Sciences, Bursa Uludag University, Bursa, Turkey
| | - Ana Costa
- Department of Medical and Health Sciences, School of Health and Human Development & ICT-Institute of Earth Sciences, IIFA, University of Évora, 7000-671 Évora, Portugal
| | - Ibon Eguiluz-Gracia
- Allergy Unit, Hospital Regional Universitario de Malaga, Malaga 29010, Spain
| | - Ana Galveias
- Department of Medical and Health Sciences, School of Health and Human Development & ICT-Institute of Earth Sciences, IIFA, University of Évora, 7000-671 Évora, Portugal
| | - Nestor Gonzalez Roldan
- Group of Biofunctional Metabolites and Structures, Priority Research Area Chronic Lung Diseases, Research Center Borstel, Leibniz Lung Center, Member of the German Center for Lung Research (DZL), Airway Research Center North (ARCN), Borstel, Germany; Pollen Laboratory, Department of Biological and Environmental Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Mirela Lika
- Department of Biology, Faculty of Natural Sciences, University of Tirana, Tirana, Albania
| | - Donát Magyar
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | | | - Pia Ørby
- Department of Environmental Science, Danish Big Data Centre for Environment and Health (BERTHA) Aarhus University, Aarhus, Denmark
| | - David O'Connor
- School of Chemical Sciences, Dublin City University, Dublin D09 E432, Ireland
| | - Alexandra Marchã Penha
- Water Laboratory, School of Sciences and Technology, ICT-Institute of Earth Sciences, IIFA, University of Évora. 7000-671 Évora, Portugal
| | - Sónia Pereira
- Department of Geosciences, Environment and Spatial Plannings of the Faculty of Sciences, University of Porto and Earth Sciences Institute (ICT), Portugal
| | - Rosa Pérez-Badia
- Institute of Environmental Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain
| | | | - Merita Xhetani
- Department of Biology, Faculty of Natural Sciences, University of Tirana, Tirana, Albania
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Gerboni G, Comunale G, Chen W, Lever Taylor J, Migliorini M, Picard R, Cruz M, Regalia G. Prospective clinical validation of the Empatica EmbracePlus wristband as a reflective pulse oximeter. Front Digit Health 2023; 5:1258915. [PMID: 38111608 PMCID: PMC10726006 DOI: 10.3389/fdgth.2023.1258915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/14/2023] [Indexed: 12/20/2023] Open
Abstract
Introduction Respiratory diseases such as chronic obstructive pulmonary disease, obstructive sleep apnea syndrome, and COVID-19 may cause a decrease in arterial oxygen saturation (SaO2). The continuous monitoring of oxygen levels may be beneficial for the early detection of hypoxemia and timely intervention. Wearable non-invasive pulse oximetry devices measuring peripheral oxygen saturation (SpO2) have been garnering increasing popularity. However, there is still a strong need for extended and robust clinical validation of such devices, especially to address topical concerns about disparities in performances across racial groups. This prospective clinical validation aimed to assess the accuracy of the reflective pulse oximeter function of the EmbracePlus wristband during a controlled hypoxia study in accordance with the ISO 80601-2-61:2017 standard and the Food & Drug Administration (FDA) guidance. Methods Healthy adult participants were recruited in a controlled desaturation protocol to reproduce mild, moderate, and severe hypoxic conditions with SaO2 ranging from 100% to 70% (ClinicalTrials.gov registration #NCT04964609). The SpO2 level was estimated with an EmbracePlus device placed on the participant's wrist and the reference SaO2 was obtained from blood samples analyzed with a multiwavelength co-oximeter. Results The controlled hypoxia study yielded 373 conclusive measurements on 15 subjects, including 30% of participants with dark skin pigmentation (V-VI on the Fitzpatrick scale). The accuracy root mean square (Arms) error was found to be 2.4%, within the 3.5% limit recommended by the FDA. A strong positive correlation between the wristband SpO2 and the reference SaO2 was observed (r = 0.96, P < 0.001), and a good concordance was found with Bland-Altman analysis (bias, 0.05%; standard deviation, 1.66; lower limit, -4.7%; and upper limit, 4.8%). Moreover, acceptable accuracy was observed when stratifying data points by skin pigmentation (Arms 2.2% in Fitzpatrick V-VI, 2.5% in Fitzpatrick I-IV), and sex (Arms 1.9% in females, and 2.9% in males). Discussion This study demonstrates that the EmbracePlus wristband could be used to assess SpO2 with clinically acceptable accuracy under no-motion and high perfusion conditions for individuals of different ethnicities across the claimed range. This study paves the way for further accuracy evaluations on unhealthy subjects and during prolonged use in ambulatory settings.
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Affiliation(s)
| | | | | | | | | | - Rosalind Picard
- Empatica, Inc., Cambridge, MA, United States
- MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Marisa Cruz
- Empatica, Inc., Cambridge, MA, United States
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8
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Denning DW, Pfavayi LT. Poorly controlled asthma - Easy wins and future prospects for addressing fungal allergy. Allergol Int 2023; 72:493-506. [PMID: 37544851 DOI: 10.1016/j.alit.2023.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 08/08/2023] Open
Abstract
Poorly controlled asthma is especially common in low resource countries. Aside from lack of access to, or poor technique with, inhaled beta-2 agonists and corticosteroids, the most problematic forms of asthma are frequently associated with both fungal allergy and exposure, especially in adults leading to more asthma exacerbations and worse asthma. The umbrella term 'fungal asthma' describes many disorders linked to fungal exposure and/or allergy to fungi. One fungal asthma endotype, ABPA, is usually marked by a very high IgE and its differential diagnosis is reviewed. Both ABPA and fungal bronchitis in bronchiectasis are marked by thick excess airway mucus production. Dermatophyte skin infection can worsen asthma and eradication of the skin infection improves asthma. Exposure to fungi in the workplace, home and schools, often in damp or water-damaged buildings worsens asthma, and remediation improves symptom control and reduces exacerbations. Antifungal therapy is beneficial for fungal asthma as demonstrated in nine of 13 randomised controlled studies, reducing symptoms, corticosteroid need and exacerbations while improving lung function. Other useful therapies include azithromycin and some biologics approved for the treatment of severe asthma. If all individuals with poorly controlled and severe asthma could be 'relieved' of their fungal allergy and infection through antifungal therapy without systemic corticosteroids, the health benefits would be enormous and relatively inexpensive, improving the long term health of over 20 million adults and many children. Antifungal therapy carries some toxicity, drug interactions and triazole resistance risks, and data are incomplete. Here we summarise what is known and what remains uncertain about this complex topic.
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Affiliation(s)
- David W Denning
- Manchester Fungal Infection Group, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK.
| | - Lorraine T Pfavayi
- Institute of Immunology & Infection Research, Ashworth Laboratories, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
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9
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Yarsky E, Banzon TM, Phipatanakul W. Effects of Allergen Exposure and Environmental Risk Factors in Schools on Childhood Asthma. Curr Allergy Asthma Rep 2023; 23:613-620. [PMID: 37651001 PMCID: PMC11262705 DOI: 10.1007/s11882-023-01108-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE OF REVIEW This review aims to assess the prevalence of common allergen exposures and environmental risk factors for asthma in schools, examine the underlying mechanisms of these environmental risk factors, and explore possible prevention strategies. RECENT FINDINGS Cockroach, mouse, dust mites, fungi, viral infections, ozone pollution, and cleaning products are common allergen exposures and environmental risk factors in schools which may affect asthma morbidity. Novel modifiable environmental risk factors in schools are also being investigated to identify potential associations with increased asthma morbidity. While several studies have investigated the benefit of environmental remediation strategies in schools and their impact on asthma morbidity, future studies are warranted to further define the effects of modifiable risk factors in schools and determine whether school mitigation strategies may help improve asthma symptoms in students with asthma.
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Affiliation(s)
- Eva Yarsky
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Tina M Banzon
- Division of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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Moreno-Sabater A, Sterlin D, Imamovic L, Bon F, Normand AC, Gonnin C, Gazzano M, Bensalah M, Dorgham K, Ben Salah E, Acherar A, Parizot C, Rigourd V, Begue H, Dalle F, Bachmeyer C, Hennequin C, Yssel H, Malphettes M, Fieschi C, Fadlallah J, Gorochov G. Intestinal Candida albicans overgrowth in IgA deficiency. J Allergy Clin Immunol 2023; 152:748-759.e3. [PMID: 37169153 DOI: 10.1016/j.jaci.2023.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/20/2023] [Accepted: 03/28/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Secretory IgA interacts with commensal bacteria, but its impact on human mycobiota ecology has not been widely explored. In particular, whether human IgA-deficiency is associated with gut fungal dysbiosis remains unknown. OBJECTIVES Our goal was to study the impact of IgA on gut mycobiota ecology. METHODS The Fungi-Flow method was used to characterize fecal, systemic, and maternal IgA, IgM, and IgG responses against 14 representative fungal strains (yeast/spores or hyphae forms) in healthy donors (HDs) (n = 34, 31, and 20, respectively) and to also compare gut mycobiota opsonization by secretory antibodies in HDs (n = 28) and patients with selective IgA deficiency (SIgAd) (n = 12). Stool mycobiota composition was determined by internal transcribed spacer gene sequencing in HDs (n = 23) and patients with SIgAd (n = 17). Circulating CD4+ T-cell cytokine secretion profiles were determined by intracellular staining. The impact of secretory IgA, purified from breast milk (n = 9), on Candidaalbicans growth and intestinal Caco-2 cell invasion was tested in vitro. RESULTS Homeostatic IgA binds commensal fungi with a body fluid-selective pattern of recognition. In patients with SIgAd, fungal gut ecology is preserved by compensatory IgM binding to commensal fungi. Gut Calbicans overgrowth nevertheless occurs in this condition but only in clinically symptomatic patients with decreased TH17/TH22 T-cell responses. Indeed, secretory IgA can reduce in vitro budding and invasion of intestinal cells by Calbicans and therefore exert control on this pathobiont. CONCLUSION IgA has a selective impact on Calbicans ecology to preserve fungal-host mutualism.
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Affiliation(s)
- Alicia Moreno-Sabater
- Sorbonne Université, Institut national de la santé et de la recherche médicale (INSERM), Centre d'Immunologie et des Maladies Infectieuses, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint Antoine, Paris, France
| | - Delphine Sterlin
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Lejla Imamovic
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses, Paris, France
| | - Fabienne Bon
- UMR PAM Université de Bourgogne Franche-Comté (UBFC), AgroSup Dijon, Équipe Vin, Aliment, Microbiologie, Stress, Groupe Interactions Candida-muqueuses, Dijon, France
| | - Anne-Cecile Normand
- Service de Parasitologie-Mycologie, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Paris, France
| | - Cecile Gonnin
- Département d'Immunologie, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Paris, France
| | - Marianne Gazzano
- Département d'Immunologie, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Paris, France
| | - Merieme Bensalah
- Département d'Immunologie, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Paris, France
| | - Karim Dorgham
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses, Paris, France
| | - Elyes Ben Salah
- Département d'Immunologie, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Paris, France
| | - Aniss Acherar
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Christophe Parizot
- Département d'Immunologie, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, Paris, France
| | - Virginie Rigourd
- Lactarium régional d'Ile de France. AP-HP, Hôpital Necker-Enfants Malades, Paris, France
| | - Hervé Begue
- UMR PAM Université de Bourgogne Franche-Comté (UBFC), AgroSup Dijon, Équipe Vin, Aliment, Microbiologie, Stress, Groupe Interactions Candida-muqueuses, Dijon, France
| | - Frederic Dalle
- UMR PAM Université de Bourgogne Franche-Comté (UBFC), AgroSup Dijon, Équipe Vin, Aliment, Microbiologie, Stress, Groupe Interactions Candida-muqueuses, Dijon, France; Department of Parasitology/Mycology, Dijon Bourgogne University Hospital, Dijon, France
| | - Claude Bachmeyer
- Service de Médecine Interne, AP-HP, Hôpital Tenon, Paris, France
| | - Christophe Hennequin
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Hans Yssel
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses, Paris, France
| | - Marion Malphettes
- Université Paris Cité, Department of Clinical Immunology, Hôpital Saint-Louis, Paris, AP-HP, France
| | - Claire Fieschi
- Université Paris Cité, Department of Clinical Immunology, Hôpital Saint-Louis, Paris, AP-HP, France
| | - Jehane Fadlallah
- Université Paris Cité, Department of Clinical Immunology, Hôpital Saint-Louis, Paris, AP-HP, France
| | - Guy Gorochov
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.
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Agossou M, Inamo J, Ahouansou N, Dufeal M, Provost M, Badaran E, Zouzou A, Awanou B, Dramé M, Desbois-Nogard N. Frequency and Distribution of Broncho-Alveolar Fungi in Lung Diseases in Martinique. J Clin Med 2023; 12:5480. [PMID: 37685550 PMCID: PMC10488106 DOI: 10.3390/jcm12175480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
The microbiota refers to all the microorganisms living in and on the human body; its fungal component is known as the mycobiota. The molecular component (mycobiome) has been linked to certain pulmonary diseases. Morphological fungal examination is still common practice and makes it possible to isolate fungi on direct examination or after sample culture. This study aimed to identify fungi via the genus colonising the respiratory tract in our environment and to evaluate the relationship between identified fungi and underlying diseases. We performed a retrospective study of patients who underwent bronchofiberoscopy and mycological analysis of fluid collected by broncho-alveolar lavage at our centre over a period of 5 years. During the study period, 1588 samples from 1547 patients were analysed (50.7% male, mean age 63.7 ± 14.8 years). Among the 1588 samples, 213 (13.4%) were positive on direct examination, and 1282 (80.8%) were positive after culture. The average number of species detected per sample was 1.4 ± 1.1. For patients with positive fungus, the median was two (ranging from one to seven). At least three fungal species were isolated in 14.4% of samples (17.9% of positive cultures), and at least two were isolated in 41.2% of samples (51.1% of positive cultures). Sterile mycelium was observed in 671 samples (42.28%), while Candida was identified in 607 samples (38.25%), and Geotrichum was identified in 271 samples (17.08%). Moulds were more frequently associated with bronchiectasis, while yeasts were associated with infectious pneumonia. Both moulds and yeasts were less frequent in diffuse interstitial lung disease, and yeast was less frequently present in chronic cough. Although overall, sterile mycelium and Candida were most frequently observed regardless of the underlying disease, there was nonetheless significant variability in the fungal genera between diseases. Fungal spores are highly prevalent in respiratory samples in Martinique. The species present in the samples varied according to the underlying respiratory disease.
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Affiliation(s)
- Moustapha Agossou
- Department of Respiratory Medicine, CHU of Martinique, 97261 Fort-de-France, France; (N.A.); (M.D.); (M.P.); (E.B.); (A.Z.); (B.A.)
| | - Jocelyn Inamo
- Department of Cardiology, CHU of Martinique, 97261 Fort-de-France, France;
| | - Nelly Ahouansou
- Department of Respiratory Medicine, CHU of Martinique, 97261 Fort-de-France, France; (N.A.); (M.D.); (M.P.); (E.B.); (A.Z.); (B.A.)
| | - Marion Dufeal
- Department of Respiratory Medicine, CHU of Martinique, 97261 Fort-de-France, France; (N.A.); (M.D.); (M.P.); (E.B.); (A.Z.); (B.A.)
| | - Mathilde Provost
- Department of Respiratory Medicine, CHU of Martinique, 97261 Fort-de-France, France; (N.A.); (M.D.); (M.P.); (E.B.); (A.Z.); (B.A.)
| | - Elena Badaran
- Department of Respiratory Medicine, CHU of Martinique, 97261 Fort-de-France, France; (N.A.); (M.D.); (M.P.); (E.B.); (A.Z.); (B.A.)
| | - Adel Zouzou
- Department of Respiratory Medicine, CHU of Martinique, 97261 Fort-de-France, France; (N.A.); (M.D.); (M.P.); (E.B.); (A.Z.); (B.A.)
| | - Bérénice Awanou
- Department of Respiratory Medicine, CHU of Martinique, 97261 Fort-de-France, France; (N.A.); (M.D.); (M.P.); (E.B.); (A.Z.); (B.A.)
| | - Moustapha Dramé
- Department of Clinical Research and Innovation, CHU of Martinique, 97261 Fort-de-France, France;
- EpiCliV Research Unit, Faculty of Medicine, University of the French West Indies, 97261 Fort-de-France, France
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12
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Yang L, Li W, Qi S, Jiang Q, Huang N, Yang Y, Ma D, Zhang W, Chen H, Zhu R. A Survey of Airborne Fungi and Their Sensitization Profile in Wuhan, China. Int Arch Allergy Immunol 2023; 184:1153-1164. [PMID: 37611554 DOI: 10.1159/000531245] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/09/2023] [Indexed: 08/25/2023] Open
Abstract
INTRODUCTION Airborne fungi induce allergic symptoms in 3-10% of the population worldwide. To better prevent and manage fungi-related allergic diseases, it is essential to identify the genus and the distribution profile of airborne fungi. METHODS With this purpose in mind, we carried out a 12-month volumetric sampling study to monitor the airborne fungi and retrospectively analyzed the sensitization profile of four dominant fungi (Cladosporium, Alternaria, Aspergillus, and Penicillium) among respiratory allergies during the same study period in Wuhan, China. RESULTS A total of 29 different fungal genuses were identified, and the peak fungal concentration period was found to be in September and October, followed by May and June. The most prevalent fungi in this area were Cladosporium (36.36%), Ustilago (20.12%), and Alternaria (13.87%). In addition, the skin prick test data from 1,365 respiratory allergies patients showed that 202 (14.80%) of them were sensitized to fungi. The sensitization rates to Cladosporium, Alternaria, Aspergillus, and Penicillium were 11.72%, 4.69%, 1.98%, and 4.76%, respectively. The seasonal fluctuation of Alternaria and Aspergillus correlated with their sensitization rates. Among the fungal sensitized patients, 76 (37.62%) were sensitized to two or more kinds of fungi. The serum-specific IgE tests suggested low to high correlations existed between these fungi; however, these correlations were not found between fungi and other allergens. CONCLUSION Our study provides the distribution profile and reveals the clinical significance of the airborne fungi in Wuhan, which will facilitate the precise management of fungal allergy.
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Affiliation(s)
- Lin Yang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,
| | - Wenjing Li
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shanshan Qi
- Department of Allergy, Wuhan No. 1 Hospital, Wuhan, China
| | - Qing Jiang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Huang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaqi Yang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dongxia Ma
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Zhang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Chen
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rongfei Zhu
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Al-Shaarani AAQA, Quach ZM, Wang X, Muafa MHM, Nafis MMH, Pecoraro L. Analysis of Airborne Fungal Communities on Pedestrian Bridges in Urban Environments. Microorganisms 2023; 11:2097. [PMID: 37630657 PMCID: PMC10458245 DOI: 10.3390/microorganisms11082097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/31/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Airborne fungal spores constitute an important type of bioaerosol and are responsible for a number of negative effects on human health, including respiratory diseases and allergies. We investigated the diversity and concentration of culturable airborne fungi on pedestrian bridges in Tianjin, China, using an HAS-100B air sampler. We compared the airborne fungal communities at the top central area of the selected pedestrian bridges and along the corresponding sidewalk, at ground level. A total of 228 fungal strains belonging to 96 species and 58 genera of Ascomycota (68.86%), Basidiomycota (30.26%), and Mucoromycota (0.88%) were isolated and identified using morphological and molecular analysis. Alternaria was the dominant genus (20.61%), followed by Cladosporium (11.48%), Schizophyllum (6.14%), Sporobolomyces (5.70%), and Sporidiobolus (4.82%). Alternaria alternata was the most frequently occurring fungal species (6.58%), followed by Schizophyllum commune (5.26%), Alternaria sp. (4.82%), Sporobolomyces carnicolor (4.39%), and Cladosporium cladosporioides (3.95%). The recorded fungal concentration ranged from 10 to 180 CFU/m3. Although there was no significant difference in the distribution and abundance of the dominant airborne fungal taxa between the two investigated bridges' sites, numerous species detected with a low percentage of abundance belonging to well-known pathogenic fungal genera, including Alternaria, Aspergillus, Aureobasidium, Cladosporium, Penicillium, and Trichoderma, were exclusively present in one of the two sites. The relative humidity showed a stronger influence compared to the temperature on the diversity and concentration of airborne fungi in the investigated sites. Our results may provide valuable information for air quality monitoring and for assessing human health risks associated with microbial pollution.
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Affiliation(s)
| | | | | | | | | | - Lorenzo Pecoraro
- School of Pharmaceutical Science and Technology, Tianjin University, 92 Weijin Road, Tianjin 300072, China; (A.A.Q.A.A.-S.); (Z.M.Q.); (X.W.); (M.H.M.M.); (M.M.H.N.)
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14
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Makrufardi F, Manullang A, Rusmawatiningtyas D, Chung KF, Lin SC, Chuang HC. Extreme weather and asthma: a systematic review and meta-analysis. Eur Respir Rev 2023; 32:32/168/230019. [PMID: 37286218 DOI: 10.1183/16000617.0019-2023] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/03/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Climate change's influence on extreme weather events poses a significant threat to the morbidity and mortality of asthma patients. The aim of this study was to examine associations between extreme weather events and asthma-related outcomes. METHODS A systematic literature search for relevant studies was performed using the PubMed, EMBASE, Web of Science and ProQuest databases. Fixed-effects and random-effects models were applied to estimate the effects of extreme weather events on asthma-related outcomes. RESULTS We observed that extreme weather events were associated with increasing risks of general asthma outcomes with relative risks of 1.18-fold for asthma events (95% CI 1.13-1.24), 1.10-fold for asthma symptoms (95% CI 1.03-1.18) and 1.09-fold for asthma diagnoses (95% CI 1.00-1.19). Extreme weather events were associated with increased risks of acute asthma exacerbation with risk ratios of asthma emergency department visits of 1.25-fold (95% CI 1.14-1.37), of asthma hospital admissions of 1.10-fold (95% CI 1.04-1.17), of asthma outpatient visits of 1.19-fold (95% CI 1.06-1.34) and of asthma mortality of 2.10-fold (95% CI 1.35-3.27). Additionally, an increase in extreme weather events increased risk ratios of asthma events by 1.19-fold in children and 1.29-fold in females (95% CI 1.08-1.32 and 95% CI 0.98-1.69, respectively). Thunderstorms increased the risk ratio of asthma events by 1.24-fold (95% CI 1.13-1.36). CONCLUSIONS Our study showed that extreme weather events more prominently increased the risk of asthma morbidity and mortality in children and females. Climate change is a critical concern for asthma control.
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Affiliation(s)
- Firdian Makrufardi
- International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Amja Manullang
- International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Desy Rusmawatiningtyas
- Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sheng-Chieh Lin
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Allergy, Asthma, and Immunology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Chi Chuang
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Fungal Aeroallergen Sensitization Patterns among Airway-Allergic Patients in Zagazig, Egypt. J Fungi (Basel) 2023; 9:jof9020185. [PMID: 36836300 PMCID: PMC9961027 DOI: 10.3390/jof9020185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Airway allergies such as asthma and allergic rhinitis, as well as their comorbidities, are increasing worldwide, causing significant socioeconomic health burdens to societies. It is estimated that between 3% and 10% of the population is allergic to fungi. The type of fungal sensitization varies from one geographical region to another. The present study aimed to identify the common fungal aeroallergen sensitization patterns among airway-allergic patients residing in the Zagazig locality, Egypt, in order to obtain a better understanding of fungal allergy, in addition to improving the awareness and management strategies for those patients. METHODS The present cross-sectional study included 200 allergic rhinitis and asthma patients. Sensitization to fungal aeroallergens was evaluated by skin prick testing and in vitro measurement of total and specific immunoglobulin E. RESULTS As determined by a skin prick test, 58% of the patients studied were allergic to mixed molds. Alternaria alternata was the predominant fungal aeroallergen among the studied patients (72.2%), which was followed by Aspergillus fumigatus (53.45%), Penicillium notatum (52.6%), Candida albicans (34.5%), and Aspergillus niger (25%). CONCLUSION Mixed mold sensitization ranked fourth among the most frequent aeroallergens in airway-allergic patients, and Alternaria alternata was the most frequently encountered fungal aeroallergen in the Zagazig locality.
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Nageen Y, Wang X, Pecoraro L. Seasonal variation of airborne fungal diversity and community structure in urban outdoor environments in Tianjin, China. Front Microbiol 2023; 13:1043224. [PMID: 36699604 PMCID: PMC9869124 DOI: 10.3389/fmicb.2022.1043224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
Airborne fungi are ubiquitous in human living environments and may be a source of respiratory problems, allergies, and other health issues. A 12 months study was performed to investigate the diversity, concentration and community structure of culturable airborne fungi in different outdoor environments of Tianjin City, using an HAS-100B air sampler. A total of 1,015 fungal strains belonging to 175 species and 82 genera of Ascomycota 92.5%, Basidiomycota 7%, and Mucoromycota 0.3% were isolated and identified using morphological and molecular analysis. The most abundant fungal genera were Alternaria 35%, Cladosporium 18%, Penicillium 5.6%, Talaromyces 3.9%, Didymella 3%, and Aspergillus 2.8%, while the most frequently occurring species were A. alternata (24.7%), C. cladosporioides (11%), A. tenuissima (5.3%), P. oxalicum (4.53%), and T. funiculosus (2.66%). The fungal concentration ranged from 0 to 340 CFU/m3 during the whole study. Environmental factors, including temperature, relative humidity, wind speed, and air pressure exerted a varying effect on the presence and concentration of different fungal taxa. The four analyzed seasons showed significantly different airborne fungal communities, which were more strongly influenced by air temperature and relative humidity in spring and summer, whereas wind speed and air pressure had a stronger effect in autumn and winter. Fungal communities from green and busy sites did not show significant differences over the four analyzed seasons, which may be due to the effect of the surrounding environments characterized by high human activities on the air of the relatively small parks present in Tianjin. The present study provided valuable information on the seasonal dynamics and the environmental factors shaping the diversity and concentration of the analyzed outdoor airborne fungal communities, which can be of help for air quality monitoring, microbial contamination control, and health risk assessment in urban environments.
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Xu X, Ding F, Hu X, Yang F, Zhang T, Dong J, Xue Y, Liu T, Wang J, Jin Q. Upper respiratory tract mycobiome alterations in different kinds of pulmonary disease. Front Microbiol 2023; 14:1117779. [PMID: 37032908 PMCID: PMC10076636 DOI: 10.3389/fmicb.2023.1117779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/08/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction The human respiratory tract is considered to be a polymicrobial niche, and an imbalance in the microorganism composition is normally associated with several respiratory diseases. In addition to the well-studied bacteriome, the existence of fungal species in the respiratory tract has drawn increasing attention and has been suggested to have a significant clinical impact. However, the understanding of the respiratory fungal microbiota (mycobiome) in pulmonary diseases is still insufficient. Methods In this study, we investigated the fungal community composition of oropharynx swab (OS) samples from patients with five kinds of pulmonary disease, including interstitial lung disease (ILD), bacterial pneumonia (BP), fungal pneumonia (FP), asthma (AS) and lung cancer (LC), and compared them with healthy controls (HCs), based on high-throughput sequencing of the amplified fungal internal transcribed spacer (ITS) region. Results The results showed significant differences in fungal composition and abundance between disease groups and HCs. Malassezia was the most significant genus, which was much more abundant in pulmonary diseases than in the control. In addition, many common taxa were shared among different disease groups, but differences in taxa abundance and specific species in distinct disease groups were also observed. Based on linear discriminant analysis effect size (LefSe), each group had its characteristic species. Furthermore, some species showed a significant correlation with the patient clinical characteristics. Discussion Our study deepened our understanding of the respiratory tract mycobiome in some diseases that are less studied and identified the commonalities and differences among different kinds of pulmonary disease. These results would provide the solid basis for further investigation of the association between the mycobiome and pathogenicity of pulmonary diseases.
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Affiliation(s)
- Xingye Xu
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fangping Ding
- Division of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiangqi Hu
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fan Yang
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ting Zhang
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Dong
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Xue
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tao Liu
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Tao Liu,
| | - Jing Wang
- Division of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Jing Wang,
| | - Qi Jin
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Qi Jin,
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Yazar B, Meydanlioglu A. The prevalence and associated factors of asthma, allergic rhinitis, and eczema in Turkish children and adolescents. Pediatr Pulmonol 2022; 57:2491-2501. [PMID: 35809022 DOI: 10.1002/ppul.26065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/14/2022] [Accepted: 06/25/2022] [Indexed: 11/11/2022]
Abstract
AIM We aim to determine the prevalence and related risk factors of asthma and allergic diseases in school children and adolescent in Konya, Turkey, and to compare this prevalence with that of 11 years ago. METHODS This descriptive correlational study also includes the third phase of the International Study of Asthma and Allergies in Childhood protocol. A total of 2220 students aged between 6 and 18 took part in this study. RESULTS In our study, prevalence of wheezing of 21.8%, eczema of 4.3%, and allergic rhinitis of 43.2% were found in students until this age. In the study, student smoking, school location, history of asthma in the family, mold or moisture at home, and mother's smoking now were related factors for wheezing, while eating habits, breastfeeding, and student's gender were determined as related factors for allergic rhinitis symptoms in the past 12 months. In addition, having a pet, eating habits, and school level were determined as related factors for eczema symptoms in the past 12 months (p < 0.05). As a result of comparison of the findings of this study with the results of the study conducted by Güner et al., it was determined that the rates of wheezing and allergic rhinitis had increased, whereas the rate of eczema had decreased (p < 0.05). CONCLUSION It was determined that under the effect of urbanization in Konya, the prevalence of asthma and allergic rhinitis in students had increased, while the prevalence of eczema had decreased.
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Affiliation(s)
- Birgul Yazar
- Ali Kemal Belviranlı Obstetrics and Pediatrics Hospital, Konya, Turkey
| | - Ayse Meydanlioglu
- Department of Community Health Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
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