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Schwarze J, Openshaw P, Jha A, Del Giacco SR, Firinu D, Tsilochristou O, Roberts G, Selby A, Akdis C, Agache I, Custovic A, Heffler E, Pinna G, Khaitov M, Nikonova A, Papadopoulos N, Akhlaq A, Nurmatov U, Renz H, Sheikh A, Skevaki C. Influenza burden, prevention, and treatment in asthma-A scoping review by the EAACI Influenza in asthma task force. Allergy 2017. [PMID: 29105786 DOI: 10.1111/all.13333.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness, and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma. The strongest evidence of an association was seen in studies of children. Countries in the European Union currently recommend influenza vaccination of adults with asthma; however, coverage varied between regions. Coverage was lower among children with asthma. Limited data suggest that good seroprotection and seroconversion can be achieved in both children and adults with asthma and that vaccination confers a degree of protection against influenza illness and asthma-related morbidity to children with asthma. There were insufficient data to determine efficacy in adults. Overall, influenza vaccines appeared to be safe for people with asthma. We identify knowledge gaps and make recommendations on future research needs in relation to influenza in patients with asthma.
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Affiliation(s)
- J Schwarze
- Centre for Inflammation Research, The Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - P Openshaw
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London, London, UK
| | - A Jha
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London, London, UK
| | - S R Del Giacco
- Department of Medical Sciences and Public Health "M. Aresu", University of Cagliari, Cagliari, Italy
| | - D Firinu
- Department of Medical Sciences and Public Health "M. Aresu", University of Cagliari, Cagliari, Italy
| | - O Tsilochristou
- Department of Pediatric Allergology, King's College, London, UK
| | - G Roberts
- Faculty of Medicine, Southampton and David Hide Asthma and Allergy Centre, St Mary's Hospital, University of Southampton, Newport, Isle of Wight, UK
| | - A Selby
- Faculty of Medicine, Southampton and David Hide Asthma and Allergy Centre, St Mary's Hospital, University of Southampton, Newport, Isle of Wight, UK
| | - C Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - I Agache
- Department of Allergy and Clinical Immunology, Faculty of Medicine, Transylvania University Brasov, Brasov, Romania
| | - A Custovic
- Department of Paediatrics, Imperial College London, London, UK
| | - E Heffler
- Personalized Medicine, Asthma and Allergy Clinic, Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - G Pinna
- Department of Medical Microbiology, National Kapodistrian University of Athens, Athens, Greece
| | - M Khaitov
- National Research Center Institute of Immunology of Federal Medicobiological Agency, Moscow, Russia
| | - A Nikonova
- National Research Center Institute of Immunology of Federal Medicobiological Agency, Moscow, Russia
| | - N Papadopoulos
- Division of Infection, Inflammation & Respiratory Medicine, The University of Manchester, Manchester, UK.,Allergy Department, 2nd Paediatric Clinic, National Kapodistrian University of Athens, Athens, Greece
| | - A Akhlaq
- Department of Health and Hospital Management, Institute of Business Management, Korangi Creek, Karachi, 75190, Pakistan
| | - U Nurmatov
- Division of Population Medicine, School of Medicine, Cardiff University, the National Centre for Population Health and Wellbeing Research, Wales, UK
| | - H Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, University Hospital Giessen & Marburg, Marburg, Germany
| | - A Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - C Skevaki
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, University Hospital Giessen & Marburg, Marburg, Germany
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Del Giacco SR, Bakirtas A, Bel E, Custovic A, Diamant Z, Hamelmann E, Heffler E, Kalayci Ö, Saglani S, Sergejeva S, Seys S, Simpson A, Bjermer L. Allergy in severe asthma. Allergy 2017; 72:207-220. [PMID: 27775836 DOI: 10.1111/all.13072] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/20/2022]
Abstract
It is well recognized that atopic sensitization is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term 'Severe Asthma' encompasses a highly heterogeneous group of patients who require treatment on steps 4-5 of GINA guidelines to prevent their asthma from becoming 'uncontrolled', or whose disease remains 'uncontrolled' despite this therapy. Epidemiological studies on emergency room visits and hospital admissions for asthma suggest the important role of allergy in asthma exacerbations. In addition, allergic asthma in childhood is often associated with severe asthma in adulthood. A strong association exists between asthma exacerbations and respiratory viral infections, and interaction between viruses and allergy further increases the risk of asthma exacerbations. Furthermore, fungal allergy has been shown to play an important role in severe asthma. Other contributing factors include smoking, pollution and work-related exposures. The 'Allergy and Asthma Severity' EAACI Task Force examined the current evidence and produced this position document on the role of allergy in severe asthma.
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Affiliation(s)
- S. R. Del Giacco
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - A. Bakirtas
- Department of Pediatric Allergy and Asthma; School of Medicine; Gazi University; Ankara Turkey
| | - E. Bel
- Department of Respiratory Medicine; Academic Medical Centre; University of Amsterdam; Amsterdam The Netherlands
| | - A. Custovic
- Department of Paediatrics; Imperial College London; London UK
| | - Z. Diamant
- Department of General Practice and Department of Clinical Pharmacy & Pharmacology; University Medical Centre Groningen; University of Groningen; Groningen The Netherlands
- Department of Respiratory Medicine and Allergology; Lund University; Lund Sweden
| | - E. Hamelmann
- Klinik für Kinder and Jugendmedizin Kinderzentrum; Bethel Evangelisches Krankenhaus; Allergy Center; Ruhr University Bochum; Bielefeld Germany
| | - E. Heffler
- Respiratory Medicine and Allergology - Department of Experimental and Clinical Medicine; University of Catania; Catania Italy
| | - Ö. Kalayci
- School of Medicine; Hacettepe University; Ankara Turkey
| | - S. Saglani
- National Heart & Lung Institute; Imperial College London; London UK
| | - S. Sergejeva
- Institute of Technology; University of Tartu; Tartu Estonia
| | - S. Seys
- Department of Microbiology and Immunology; Laboratory of Clinical Immunology; KU Leuven Belgium
| | - A. Simpson
- Centre Lead for Respiratory Medicine and Allergy; University Hospital of South Manchester; Education and Research Centre; University of Manchester; Manchester UK
| | - L. Bjermer
- Department of Respiratory Medicine and Allergology; Lund University; Lund Sweden
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Garcia-Larsen V, Del Giacco SR, Moreira A, Bonini M, Charles D, Reeves T, Carlsen KH, Haahtela T, Bonini S, Fonseca J, Agache I, Papadopoulos NG, Delgado L. Asthma and dietary intake: an overview of systematic reviews. Allergy 2016; 71:433-42. [PMID: 26505989 DOI: 10.1111/all.12800] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2015] [Indexed: 12/20/2022]
Abstract
Epidemiological research on the relationship between diet and asthma has increased in the last decade. Several components found in foods have been proposed to have a series of antioxidant, anti-allergic and anti-inflammatory properties, which can have a protective effect against asthma risk. Several literature reviews and critical appraisals have been published to summarize the existing evidence in this field. In the context of this EAACI Lifestyle and asthma Task Force, we summarize the evidence from existing systematic reviews on dietary intake and asthma, using the PRISMA guidelines. We therefore report the quality of eligible systematic reviews and summarize the results of those with an AMSTAR score ≥32. The GRADE approach is used to assess the overall quality of the existing evidence. This overview is centred on systematic reviews of nutritional components provided in the diet only, as a way to establish what type of advice can be given in clinical practice and to the general population on dietary habits and asthma.
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Affiliation(s)
- V. Garcia-Larsen
- Respiratory Epidemiology, Occupational Medicine, and Public Health Group; National Heart and Lung Institute; Imperial College London; London UK
| | - S. R. Del Giacco
- Department of Medical Sciences ‘M Aresu’; University of Cagliari; Cagliari Italy
| | - A. Moreira
- Faculty of Medicine; University of Porto and Hospital São João; Porto Portugal
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine; University of Porto; Porto Portugal
| | - M. Bonini
- Department of Internal Medicine; Lung Function Unit; Sapienza University of Rome; Rome Italy
| | - D. Charles
- Respiratory Epidemiology, Occupational Medicine, and Public Health Group; National Heart and Lung Institute; Imperial College London; London UK
| | - T. Reeves
- Central Library; Imperial College London; London UK
| | - K.-H. Carlsen
- Department of Medicine and Allergology; University of Oslo; Oslo Norway
| | - T. Haahtela
- Skin and Allergy Hospital; Helsinki University Central Hospital; Helsinki Finland
| | - S. Bonini
- Second University of Naples and IFT-CNR; Rome Italy
| | - J. Fonseca
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine; University of Porto; Porto Portugal
| | - I. Agache
- Transylvania University Brasov; Brasov Romania
| | - N. G. Papadopoulos
- Centre for Paediatrics and Child Health; Institute of Human Development; The University of Manchester; Manchester UK
| | - L. Delgado
- Faculty of Medicine; University of Porto and Hospital São João; Porto Portugal
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine; University of Porto; Porto Portugal
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Murgia G, Firinu D, Meleddu R, Lorrai MM, Manconi PE, Del Giacco SR. Systemic lupus erythematosus occurring in a patient with Niemann-Pick type B disease. Lupus 2015. [PMID: 25966928 DOI: 10.1177/0961203315585818.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Niemann-Pick disease is an inherited lipid storage disorder caused by the deficiency of acid sphingomyelinase, which results in accumulation of sphingomyelin within cells of several organs and consequent tissue damage. The broad clinical spectrum of this disorder may overlap with that of systemic lupus erythematosus, hindering differential diagnosis. Herein, we report the case of a patient affected by Niemann-Pick type B disease intertwined with clinical and serological features of systemic lupus erythematosus. Two novel mutations in the SMPD1 gene were found in compound heterozygosity: p.A36V and IVS2 + 8 T > G.
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Affiliation(s)
- G Murgia
- Unit of Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences "M. Aresu", University of Cagliari, Italy
| | - D Firinu
- Unit of Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences "M. Aresu", University of Cagliari, Italy
| | - R Meleddu
- Unit of Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences "M. Aresu", University of Cagliari, Italy
| | - M M Lorrai
- Unit of Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences "M. Aresu", University of Cagliari, Italy
| | - P E Manconi
- Unit of Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences "M. Aresu", University of Cagliari, Italy
| | - S R Del Giacco
- Unit of Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences "M. Aresu", University of Cagliari, Italy
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Moreira A, Bonini M, Garcia-Larsen V, Bonini S, Del Giacco SR, Agache I, Fonseca J, Papadopoulos NG, Carlsen KH, Delgado L, Haahtela T. Weight loss interventions in asthma: EAACI evidence-based clinical practice guideline (part I). Allergy 2013; 68:425-39. [PMID: 23452010 DOI: 10.1111/all.12106] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Asthma and obesity are chronic multifactorial conditions that are associated with gene-environment interaction and immune function. Although the data are not fully consistent, it seems that obesity increases the risk of asthma and compromises asthma control. OBJECTIVE To investigate the impact that weight changes have on asthma. METHODS We carried out a systematic review of three large biomedical databases. Studies were scrutinized and critically appraised according to agreed exclusion and inclusion criteria. Quality assessment of eligible papers was conducted using the GRADE method. Meta-analyses of comparable studies were carried out. RESULTS Thirty studies met the eligibility criteria of the review. Interventions were limited to dietary manipulation in three studies, one of which also used anti-obesity drugs, and bariatric surgery in four. All the other studies reported observational data. Becoming obese increased the odds for incident asthma by 1.82 (95% CI 1.47, 2.25) in adults and 1.98 (95% CI 0.71, 5.52) in children. Weight loss was associated with significant improvement in mean scores for symptoms, rescue medication score, and asthma exacerbations in the only randomized controlled trial. Similarly, evidence gathered from observational studies, with follow-up ranging between 8 weeks to 1 year, and from changes 1 year after bariatric surgery showed improvements in all asthma control-related outcomes. Changes in lung function were reported in one randomized controlled and eight observational studies of asthmatic subjects, with conflicting results. Either improvement after weight loss, decline with weight gain, or no effects at all were reported. Changes in airway inflammation and responsiveness were reported only by observational studies. CONCLUSION Weight increases above the obesity threshold significantly increase the risk of asthma. The available studies show weak evidence of benefits from weight reduction on asthma outcomes.
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Affiliation(s)
- A. Moreira
- Faculty of Medicine; University of Porto and Hospital São João; Porto; Portugal
| | - M. Bonini
- Department of Internal Medicine Lung Function Unit; “Sapienza” University of Rome; Rome; Italy
| | - V. Garcia-Larsen
- National Heart and Lung Institute, Imperial College London; London; UK
| | - S. Bonini
- Department of Internal Medicine; Second University of Naples; Naples
| | - S. R. Del Giacco
- Department of Medical Sciences “M. Aresu”; University of Cagliari; Cagliari; Italy
| | - I. Agache
- Transylvania University; Brasov; Romania
| | - J. Fonseca
- Faculty of Medicine; University of Porto and Hospital São João; Porto; Portugal
| | - N. G. Papadopoulos
- Allergy Department; 2nd Pediatric Clinic; University of Athens; Athens; Greece
| | - K.-H. Carlsen
- Department of Medicine and Allergology; University of Oslo; Oslo; Norway
| | - L. Delgado
- Faculty of Medicine; University of Porto and Hospital São João; Porto; Portugal
| | - T. Haahtela
- Skin and Allergy Hospital; Helsinki University Central Hospital; Helsinki; Finland
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Firinu D, Frau A, Pisanu M, Lorai MM, Meleddu R, Musu F, Manconi PE, Del Giacco SR. An uncommon association of antiphospholipid syndrome, selective IgA deficiency and resistant-to-treatment relapsing polychondritis: efficacy of infliximab. J BIOL REG HOMEOS AG 2012; 26:785-8. [PMID: 23241130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
Abstract
Autoimmune complications in the context of primary immunodeficiency diseases represent a well-known phenomenon, and this is widely recognized also for Selective Immunoglobulin A deficiency (IgAD), the most common primary antibody deficiency (PAD). Relapsing polychondritis (RP) is a rare immune-mediated, difficult to treat, disorder in which the cartilaginous tissues are the target for inflammation and damage. Ocular inflammatory manifestations in RP are frequent and often sight-threatening. Antiphospholipid syndrome (APS) is an acquired prothrombotic state related to circulating autoantibodies against phospholipids and/or their cofactors. Rare reports of APS associated to RP, PAD and APS or PAD and RP are available.
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Firinu D, Barca MP, Serusi L, Lorrai MM, Peralta MM, Manconi PE, Del Giacco SR. Switch to icatibant in a patient affected by hereditary angioedema with high disease activity: a case report. Int J Immunopathol Pharmacol 2012; 25:269-73. [PMID: 22507340 DOI: 10.1177/039463201202500130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Icatibant, an antagonist of the bradykinin B2 receptor, was approved for the treatment of acute attacks of hereditary angioedema in the EU in 2008. This paper presents the case of a 65-year-old woman affected by frequent acute attacks of hereditary angioedema who benefitted from a change of therapy to icatibant, following years of treatment with C1-inhibitor.
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Firinu D, Barca MP, Serusi L, Lorrai MM, Peralta MM, Manconi PE, Del Giacco SR. Switch to icatibant in a patient affected by hereditary angioedema with high disease activity: a case report. Int J Immunopathol Pharmacol 2012. [PMID: 22507340 DOI: 10.1177/039463201202500130.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Icatibant, an antagonist of the bradykinin B2 receptor, was approved for the treatment of acute attacks of hereditary angioedema in the EU in 2008. This paper presents the case of a 65-year-old woman affected by frequent acute attacks of hereditary angioedema who benefitted from a change of therapy to icatibant, following years of treatment with C1-inhibitor.
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Moscato G, Pala G, Barnig C, Blay F, Del Giacco SR, Folletti I, Heffler E, Maestrelli P, Pauli G, Perfetti L, Quirce S, Sastre J, Siracusa A, Walusiak-Skorupa J, Wjik RG. EAACI consensus statement for investigation of work-related asthma in non-specialized centres. Allergy 2012; 67:491-501. [PMID: 22257175 DOI: 10.1111/j.1398-9995.2011.02784.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2011] [Indexed: 11/28/2022]
Abstract
Work-related asthma (WRA) is a relevant problem in several countries, is cause of disability and socioeconomic consequences for both the patient and the society and is probably still underdiagnosed. A correct diagnosis is extremely important to reduce or limit the consequences of the disease. This consensus document was prepared by a EAACI Task Force consisting of an expert panel of allergologists, pneumologists and occupational physicians from different European countries. This document is not intended to address in detail the full diagnostic work-up of WRA, nor to be a formal evidence-based guideline. It is written to provide an operative protocol to allergologists and physicians dealing with asthma useful for identifying the subjects suspected of having WRA to address them to in-depth investigations in a specialized centre. No evidence-based system could be used because of the low grade of evidence of published studies in this area, and instead, 'key messages' or 'suggestions' are provided based on consensus of the expert panel members.
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Affiliation(s)
- G. Moscato
- Allergy and Immunology Unit; Fondazione ‘Salvatore Maugeri’; Institute of Care and Research; Scientific Institute of Pavia; Pavia; Italy
| | - G. Pala
- Allergy and Immunology Unit; Fondazione ‘Salvatore Maugeri’; Institute of Care and Research; Scientific Institute of Pavia; Pavia; Italy
| | - C. Barnig
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital Strasbourg; Strasbourg; France
| | - F. Blay
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital Strasbourg; Strasbourg; France
| | - S. R. Del Giacco
- Department of Medical Sciences ‘M. Aresu’; University of Cagliari; Cagliari; Italy
| | - I. Folletti
- Department of Clinical and Experimental Medicine; Occupational Allergy Unit; Terni Hospital; University of Perugia; Perugia; Italy
| | - E. Heffler
- Allergy and Clinical Immunology; University of Torino; ASO Mauriziano ‘Umberto I’; Torino; Italy
| | - P. Maestrelli
- Department of Environmental Medicine and Public Health; University of Padova; Padova; Italy
| | - G. Pauli
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital Strasbourg; Strasbourg; France
| | - L. Perfetti
- Allergy and Immunology Unit; Fondazione ‘Salvatore Maugeri’; Institute of Care and Research; Scientific Institute of Pavia; Pavia; Italy
| | - S. Quirce
- Department of Allergy; Hospital La Paz-IdiPAZ and CIBER de Enfermedades Respiratorias CIBERES; Madrid; Spain
| | - J. Sastre
- CIBER de Enfermedades Respiratorias; Ciberes and Department of Allergy; Fundación Jiménez Díaz; Madrid; Spain
| | - A. Siracusa
- Department of Clinical an Experimental Medicine; University of Perugia; Perugia; Italy
| | - J. Walusiak-Skorupa
- Department of Occupational Diseases; Nofer Institute of Occupational Medicine; Lodz; Poland
| | - R. Gerth Wjik
- Section of Allergology; Department of Internal Medicine; Erasmus MC; Rotterdam; the Netherlands
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Pitsios C, Del Giacco SR, Grigoreas C. Is Free Running Asthma Screening Test still useful? W INDIAN MED J 2010; 59:287-290. [PMID: 21291108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the usefulness of Free Running Asthma Screening Test (FRAST) as a method that may help the diagnosis of exercise-induced bronchospasm (EIB) in children from a rural area and to compare the results with their history of asthma. METHODS A FRAST challenge took place at 9 schools. It lasted for 6 minutes and pupils performed it properly with the help of an athlete. The best out of three Peak Expiratory Flow Rate (PEFR) efforts was recorded before and after challenge, using a mini-Wright peak-flow-meter. A more than 15% drop in PEFR was considered an indication of EIB. A questionnaire defining asthmatic symptoms had been distributed and already completed by their parents. RESULTS The exercise was successfully performed by 268 children. Eleven children presented a fall of PEFR of at least 15%, five or ten minutes after the exercise; among these, only three boys had a history of asthma, while the remaining 8 children were undiagnosed. No difference regarding age, gender or locations' altitude was found. CONCLUSION FRAST can be of great use in the diagnosis of EIB in areas that lack proper tools and specialized personnel. A poor correlation between self-reported symptoms and the results of exercise challenges was confirmed.
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Affiliation(s)
- C Pitsios
- Simopoulo Health Center, Amaliada's General Hospital, Amalias, Greece.
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Carlsen KH, Anderson SD, Bjermer L, Bonini S, Brusasco V, Canonica W, Cummiskey J, Delgado L, Del Giacco SR, Drobnic F, Haahtela T, Larsson K, Palange P, Popov T, van Cauwenberge P. Treatment of exercise-induced asthma, respiratory and allergic disorders in sports and the relationship to doping: Part II of the report from the Joint Task Force of European Respiratory Society (ERS) and European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA(2)LEN. Allergy 2008; 63:492-505. [PMID: 18394123 DOI: 10.1111/j.1398-9995.2008.01663.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aims of part II is to review the current recommended treatment of exercise-induced asthma (EIA), respiratory and allergic disorders in sports, to review the evidence on possible improvement of performance in sports by asthma drugs and to make recommendations for their treatment. METHODS The literature cited with respect to the treatment of exercise induced asthma in athletes (and in asthma patients) is mainly based upon the systematic review given by Larsson et al. (Larsson K, Carlsen KH, Bonini S. Anti-asthmatic drugs: treatment of athletes and exercise-induced bronchoconstriction. In: Carlsen KH, Delgado L, Del Giacco S, editors. Diagnosis, prevention and treatment of exercise-related asthma, respiratory and allergic disorders in sports. Sheffield, UK: European Respiratory Journals Ltd, 2005:73-88) during the work of the Task Force. To assess the evidence of the literature regarding use of beta(2)-agonists related to athletic performance, the Task Force searched Medline for relevant papers up to November 2006 using the present search words: asthma, bronchial responsiveness, exercise-induced bronchoconstriction, athletes, sports, performance and beta(2)-agonists. Evidence level and grades of recommendation were assessed according to Sign criteria. RESULTS Treatment recommendations for EIA and bronchial hyper-responsiveness in athletes are set forth with special reference to controller and reliever medications. Evidence for lack of improvement of exercise performance by inhaled beta(2)-agonists in healthy athletes serves as a basis for permitting their use. There is a lack of evidence of treatment effects of asthma drugs on EIA and bronchial hyper-responsiveness in athletes whereas extensive documentation exists in treatment of EIA in patients with asthma. The documentation on lack of improvement on performance by common asthma drugs as inhaled beta(2)-agonists with relationship to sports in healthy individuals is of high evidence, level (1+). CONCLUSIONS Exercise induced asthma should be treated in athletes along same principles as in ordinary asthma patients with relevance to controller and reliever treatment after careful diagnosis. There is very high level of evidence for the lack of improvement in athletic performance by inhaled beta2-agonists.
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Affiliation(s)
- K H Carlsen
- Voksentoppen, Department of Paediatrics, Faculty of Medicine, University of Oslo, Rikshospitalet, Norwegian School of Sport Sciences, Oslo, Norway
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Carlsen KH, Anderson SD, Bjermer L, Bonini S, Brusasco V, Canonica W, Cummiskey J, Delgado L, Del Giacco SR, Drobnic F, Haahtela T, Larsson K, Palange P, Popov T, van Cauwenberge P. Exercise-induced asthma, respiratory and allergic disorders in elite athletes: epidemiology, mechanisms and diagnosis: part I of the report from the Joint Task Force of the European Respiratory Society (ERS) and the European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA2LEN. Allergy 2008; 63:387-403. [PMID: 18315727 DOI: 10.1111/j.1398-9995.2008.01662.x] [Citation(s) in RCA: 206] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS To analyze the changes in the prevalence of asthma, bronchial hyperresponsiveness (BHR) and allergies in elite athletes over the past years, to review the specific pathogenetic features of these conditions and to make recommendations for their diagnosis. METHODS The Task Force reviewed present literature by searching Medline up to November 2006 for relevant papers by the search words: asthma, bronchial responsiveness, EIB, athletes and sports. Sign criteria were used to assess level of evidence and grades of recommendation. RESULTS The problems of sports-related asthma and allergy are outlined. Epidemiological evidence for an increased prevalence of asthma and BHR among competitive athletes, especially in endurance sports, is provided. The mechanisms for development of asthma and bronchial hyperresponsiveness in athletes are outlined. Criteria are given for the diagnosis of asthma and exercise induced asthma in the athlete. CONCLUSIONS The prevalence of asthma and bronchial hyperresponsiveness is markedly increased in athletes, especially within endurance sports. Environmental factors often contribute. Recommendations for the diagnosis of asthma in athletes are outlined.
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Affiliation(s)
- K H Carlsen
- Voksentoppen, Department of Paediatrics, Faculty of Medicine, University of Oslo, Rikshospitalet, Norwegian School of Sport Sciences, Oslo, Norway
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14
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Bonini S, Bonini M, Bousquet J, Brusasco V, Canonica GW, Carlsen KH, Corbetta L, Cummiskey J, Delgado L, Del Giacco SR, Haahtela T, Jaeger S, Moretti C, Palange P, Passalacqua G, Passali D, Pedersen BK, Popov T, Rasi G, Ventura MT, Vignola AM. Rhinitis and asthma in athletes: an ARIA document in collaboration with GA2LEN. Allergy 2006; 61:681-92. [PMID: 16677236 DOI: 10.1111/j.1398-9995.2006.01080.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This consensus document is aimed at reviewing evidence that the rhinitis-asthma links have peculiar features in athletes. Beside a review of epidemological data on the high prevalence of rhinitis and asthma in athletes, the effects on intense physical exercise on the immune system and repiratory functions are discussed, with special reference to the role of allergens and pollutants. In extending the Allergic Rhinitis and its Impact on Asthma (ARIA) recommendations to athletes, the issue is addressed of adapting diagnosis and management to criteria set by the International Olympic Committee (IOC) and regulations adopted by the World Anti-Doping Agency (WADA).
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MESH Headings
- Asthma/diagnosis
- Asthma/drug therapy
- Asthma/etiology
- Asthma/physiopathology
- Exercise/physiology
- Humans
- Rhinitis/diagnosis
- Rhinitis/drug therapy
- Rhinitis/etiology
- Rhinitis/physiopathology
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/drug therapy
- Rhinitis, Allergic, Perennial/etiology
- Rhinitis, Allergic, Perennial/physiopathology
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/drug therapy
- Rhinitis, Allergic, Seasonal/etiology
- Rhinitis, Allergic, Seasonal/physiopathology
- Sports
- Sports Medicine
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15
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Bonini S, Brusasco V, Carlsen KH, Delgado L, Del Giacco SR, Haahtela T, Rasi G, van Cauwenberge PB. Diagnosis of asthma and permitted use of inhaled beta2-agonists in athletes. Allergy 2004; 59:33-6. [PMID: 14674930 DOI: 10.1046/j.1398-9995.2003.00355.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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16
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Affiliation(s)
- S R Del Giacco
- Department of Internal Medicine, University of Cagliari, Italy
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17
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Manca E, Arangino V, Lombardini S, Ghiani A, Musu D, Ambrosini B, Del Giacco SR, Del Giacco GS. Triple-labeling cytofluorimetric quantitative and qualitative evaluation of phagocytic activity of monocytes and polymorphonuclear cells. Ann N Y Acad Sci 1997; 832:21-8. [PMID: 9704034 DOI: 10.1111/j.1749-6632.1997.tb46234.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E Manca
- Internal Medicine Department, School of Medicine, Cagliari University, Italy
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