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Holmdahl I, Lüning S, Gerdin SW, Asarnoj A, Hoyer A, Filiou A, Sjölander A, James A, Borres MP, Hedlin G, van Hage M, Söderhäll C, Konradsen JR. Rhinovirus-induced wheeze was associated with asthma development in predisposed children. Acta Paediatr 2024. [PMID: 38372208 DOI: 10.1111/apa.17158] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/20/2024]
Abstract
AIM This study explored whether early-life factors, such as rhinovirus-induced wheeze and allergic sensitisation, were related to asthma at 11 years of age. METHODS We focused on 107 children aged 6-48 months, who attended the paediatric emergency department at Astrid Lindgren's Children's Hospital in Stockholm, Sweden, with acute wheeze in 2008-2012. They also attended follow-up visits at 11 years of age and were compared with 46 age-matched healthy controls. Odds ratios (OR) with 95% confidence intervals (CI) were calculated with logistic regression. RESULTS We found that 62.6% of the acute wheeze cases had asthma at 11 years of age. Rhinoviruses at inclusion were the only common airway viruses associated with an increased asthma risk (OR 2.4, 95% CI 1.02-5.6). Other increased risks were parental heredity for asthma and/or allergies (adjusted OR 3.4, 95% CI 1.1-9.9) and allergic sensitisation at 2 years of age (adjusted OR 3.0, 95% CI 1.02-8.7). The highest prevalence of asthma was when children had both rhinovirus-induced wheeze at inclusion and allergic sensitisation at 7 years of age. CONCLUSION Our findings highlight the importance of hereditary factors and allergic sensitisation on the development of asthma and suggest that rhinoviruses are associated with asthma development in predisposed children.
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Affiliation(s)
- Idun Holmdahl
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren's Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Sofia Lüning
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren's Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Sabina Wärnberg Gerdin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren's Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Asarnoj
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren's Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Angela Hoyer
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren's Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anastasia Filiou
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren's Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | | | - Anna James
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Magnus P Borres
- Thermo Fisher Scientific, Uppsala, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Marianne van Hage
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Cilla Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren's Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Jon R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren's Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Farhan AJ, Kothalawala DM, Kurukulaaratchy RJ, Granell R, Simpson A, Murray C, Custovic A, Roberts G, Zhang H, Arshad SH. Prediction of adult asthma risk in early childhood using novel adult asthma predictive risk scores. Allergy 2023; 78:2969-2979. [PMID: 37661293 PMCID: PMC10840748 DOI: 10.1111/all.15876] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 07/30/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Numerous risk scores have been developed to predict childhood asthma. However, they may not predict asthma beyond childhood. We aim to create childhood risk scores that predict development and persistence of asthma up to young adult life. METHODS The Isle of Wight Birth Cohort (n = 1456) was prospectively assessed up to 26 years of age. Asthma predictive scores were developed based on factors during the first 4 years, using logistic regression and tested for sensitivity, specificity and area under the curve (AUC) for prediction of asthma at (i) 18 and (ii) 26 years, and persistent asthma (PA) (iii) at 10 and 18 years, and (iv) at 10, 18 and 26 years. Models were internally and externally validated. RESULTS Four models were generated for prediction of each asthma outcome. ASthma PredIctive Risk scorE (ASPIRE)-1: a 2-factor model (recurrent wheeze [RW] and positive skin prick test [+SPT] at 4 years) for asthma at 18 years (sensitivity: 0.49, specificity: 0.80, AUC: 0.65). ASPIRE-2: a 3-factor model (RW, +SPT and maternal rhinitis) for asthma at 26 years (sensitivity: 0.60, specificity: 0.79, AUC: 0.73). ASPIRE-3: a 3-factor model (RW, +SPT and eczema at 4 years) for PA-18 (sensitivity: 0.63, specificity: 0.87, AUC: 0.77). ASPIRE-4: a 3-factor model (RW, +SPT at 4 years and recurrent chest infection at 2 years) for PA-26 (sensitivity: 0.68, specificity: 0.87, AUC: 0.80). ASPIRE-1 and ASPIRE-3 scores were replicated externally. Further assessments indicated that ASPIRE-1 can be used in place of ASPIRE-2-4 with same predictive accuracy. CONCLUSION ASPIRE predicts persistent asthma up to young adult life.
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Affiliation(s)
- Abdal J. Farhan
- The David Hide Asthma and Allergy Research CentreSt. Mary's HospitalIsle of WightUK
- Clinical and Experimental Sciences, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Dilini M. Kothalawala
- NIHR Biomedical Research CentreUniversity Hospital SouthamptonSouthamptonUK
- Human Development and Health, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Ramesh J. Kurukulaaratchy
- The David Hide Asthma and Allergy Research CentreSt. Mary's HospitalIsle of WightUK
- Clinical and Experimental Sciences, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- NIHR Biomedical Research CentreUniversity Hospital SouthamptonSouthamptonUK
| | - Raquel Granell
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Angela Simpson
- Division of Infection, Immunity and Respiratory Medicine, School of Biological SciencesThe University of Manchester, Manchester Academic Health Science Centre, and Manchester University NHS Foundation TrustManchesterUK
| | - Clare Murray
- Division of Infection, Immunity and Respiratory Medicine, School of Biological SciencesThe University of Manchester, Manchester Academic Health Science Centre, and Manchester University NHS Foundation TrustManchesterUK
| | - Adnan Custovic
- National Heart and Lung InstituteImperial College LondonLondonUK
| | - Graham Roberts
- The David Hide Asthma and Allergy Research CentreSt. Mary's HospitalIsle of WightUK
- Clinical and Experimental Sciences, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- NIHR Biomedical Research CentreUniversity Hospital SouthamptonSouthamptonUK
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public HealthUniversity of MemphisMemphisTennesseeUSA
| | - S. Hasan Arshad
- The David Hide Asthma and Allergy Research CentreSt. Mary's HospitalIsle of WightUK
- Clinical and Experimental Sciences, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- NIHR Biomedical Research CentreUniversity Hospital SouthamptonSouthamptonUK
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3
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Puisto R, Turta O, Rautava S, Isolauri E. Early life exposures and development of allergic disease in infants with familial risk: Results from ongoing probiotic intervention trials. Acta Paediatr 2023; 112:115-121. [PMID: 35989564 DOI: 10.1111/apa.16518] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/03/2022] [Accepted: 08/15/2022] [Indexed: 12/15/2022]
Abstract
AIM We search revision of risk determinants of the ongoing allergy epidemic. METHODS Children numbering 433 born to mothers with allergic disease or sensitisation were selected from the three ongoing probiotic intervention trials for this case-control study. Children who developed atopic eczema or food allergy, had positive skinprick test results or had been prescribed inhaled corticosteroids by the age of 2 years were identified as cases (n = 231), while children without allergic manifestations were the healthy controls (n = 202). The data on early environmental exposures were collected from prospectively documented study records. The statistical analyses were adjusted for potential confounders. RESULTS Determinants associated with the increased risk of atopic eczema were lower maternal prepregnancy BMI (aOR 0.15, 95% CI: 0.037-0.54) and maternal intrapartum antibiotic treatment (aOR 2.21, 95% CI 1.20-4.10), the latter also linked to obstructive respiratory symptoms (aOR 3.87, 95% CI 1.07-14.06). The risk of allergic sensitisation was associated with lower maternal prepegnancy BMI (aOR 0.18, 95% CI 0.43-0.79) and intrapartum antibiotic treatment (aOR 2.13, 95% CI 1.07-4.22). CONCLUSION Based on our demonstrations, interventions such as personalised diets, can be optimised for specific subgroups and definite risk periods.
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Affiliation(s)
- Reetta Puisto
- Department of Pediatrics, Faculty of Medicine, University of Turku, Turku, Finland
| | - Olli Turta
- Department of Pediatrics, Faculty of Medicine, University of Turku, Turku, Finland.,Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Samuli Rautava
- Department of Pediatrics, Faculty of Medicine, University of Turku, Turku, Finland.,Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Erika Isolauri
- Department of Pediatrics, Faculty of Medicine, University of Turku, Turku, Finland.,Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
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Zigante M, Spalj S, Prpic J, Pavlic A, Katic V, Matusan Ilijas K. Immunohistochemical and Histopathological Features of Persistent Gingival Enlargement in Relation to Metal Allergic Sensitisation during Orthodontic Treatment. Materials (Basel) 2022; 16:81. [PMID: 36614420 PMCID: PMC9821443 DOI: 10.3390/ma16010081] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to analyse the immunohistochemical profile of inflammatory infiltrates in the gingival tissue of patients undergoing orthodontic treatment in relation to patients’ titanium and/or nickel allergy status. Patients with gingival enlargement received initial periodontal therapy, followed by external gingivectomy in the case of persistent gingival enlargement. The sample included 44 patients (22 had metal allergic sensitisation). Histopathological changes were assessed, and an immunohistochemical analysis was performed on formalin-fixed and paraffin-embedded gingival samples using antibodies against CD1a, CD3, CD4, CD8, CD20, CD68, and CD138. Computer-assisted image analysis was performed to evaluate the positive cell count in the gingival tissue. The gingiva of the sensitised patients was characterised by the absence of multifocal inflammatory infiltrates (p < 0.05), while pronounced exocytosis and band-like inflammatory infiltrates were more frequently observed in sensitised patients. In addition, there was an increase in Langerhans cells and T-helper lymphocytes and a decrease in naïve T-lymphocytes, cytotoxic T-lymphocytes, macrophages, and plasma cells in the sensitised subjects compared to non-sensitised. However, the differences were only statistically significant for macrophages, with a moderate effect size (82.8 vs. 133.9; p = 0.041; r = 0.308). The absence of multifocal inflammation appears to be the most characteristic histopathological feature of the gingiva of sensitised patients. Although their gingiva presented certain characteristics of late hypersensitivity immune reactions the observed changes imply dominant irritative effect e.
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Affiliation(s)
- Martina Zigante
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Stjepan Spalj
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Department of Dental Medicine, Faculty of Dental Medicine and Health, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Jelena Prpic
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Andrej Pavlic
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Visnja Katic
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Koviljka Matusan Ilijas
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Department of General Pathology and Pathological Anatomy, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
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Lewis G, Milnes L, Adams A, Schwarze J, Duff A. Influences on indoor environmental trigger remediation uptake for children and young people with asthma: A scoping review. Health Expect 2022; 26:87-97. [PMID: 36478049 PMCID: PMC9854302 DOI: 10.1111/hex.13670] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 10/21/2022] [Accepted: 11/06/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Children and young people (CYP) with asthma can benefit from reduced exposure to indoor environmental allergens and triggers but may not consistently have avoidance strategies implemented. To inform future interventions to increase trigger and allergen avoidance and enhance asthma control, a greater understanding of the influences on avoidance behaviours is necessary. METHODS A systematic scoping review was selected to summarize evidence on what influences family uptake of indoor environmental asthma trigger avoidance strategies for CYP with asthma and identify research gaps. Primary studies of any design, including CYP (≤18 years) with asthma, and/or parent-carers, available in English and conducted since 1993, were eligible. Searches included nine databases, hand-searching reference lists and citation searching. FINDINGS Thirty-three articles were included and are summarized narratively due to heterogeneity. Influences appear complex and multifactorial and include barriers to strategy uptake, health beliefs and personal motivation. Research specifically related to family understanding of allergic sensitisation status and exposure risks, and how these may inform avoidance implementation is required. Patient and public involvement (PPI) was not reported in included articles, although two studies used participatory methods. CONCLUSION There is limited research on family asthma trigger management, particularly what influences current management behaviours. Variation in families' ability to identify important triggers, understand exposure risk and consistently reduce exposures warrants further exploratory research to explain how families reach avoidance decisions, and what future interventions should aim to address. Further PPI-informed research to address such gaps, could enable theory-based, person-centred interventions to improve the uptake of asthma trigger remediation. PATIENT OR PUBLIC CONTRIBUTION An asthma-specific PPI group contributed to the decision-making for the funding for the wider project this review sits within. The findings of this scoping review have informed the subsequent phases of the project, and this was discussed with PPI groups (both adult and CYP groups) when proposing the next phases of the project.
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Affiliation(s)
- Grace Lewis
- School of Healthcare, Faculty of Medicine and HealthUniversity of LeedsLeedsUK,Asthma UK Centre for Applied Research, USHER InstituteUniversity of EdinburghEdinburghUK
| | - Linda Milnes
- School of Healthcare, Faculty of Medicine and HealthUniversity of LeedsLeedsUK,Asthma UK Centre for Applied Research, USHER InstituteUniversity of EdinburghEdinburghUK
| | - Alexandra Adams
- Asthma UK Centre for Applied Research, USHER InstituteUniversity of EdinburghEdinburghUK,Paediatric Respiratory UnitLeeds Children's HospitalLeedsUK
| | - Jürgen Schwarze
- Asthma UK Centre for Applied Research, USHER InstituteUniversity of EdinburghEdinburghUK,Child Life and Health, Centre for Inflammation ResearchThe University of EdinburghEdinburghUnited Kingdom
| | - Alistair Duff
- School of Healthcare, Faculty of Medicine and HealthUniversity of LeedsLeedsUK,Asthma UK Centre for Applied Research, USHER InstituteUniversity of EdinburghEdinburghUK,Paediatric Respiratory UnitLeeds Children's HospitalLeedsUK
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de Moira AP, Strandberg-Larsen K, Bishop T, Pedersen M, Avraam D, Cadman T, Calas L, Casas M, de Lauzon Guillain B, Elhakeem A, Esplugues A, Estarlich M, Foong RE, Haakma S, Harris JR, Huang RC, Inskip H, Lertxundi A, Mensink-Bout SM, Nader JLT, Pizzi C, Popovic M, Salika T, Sunyer J, Van Meel ER, Swertz MA, Jaddoe VWV, Burton P, Duijts L, Nybo Andersen AM. Associations of early-life pet ownership with asthma and allergic sensitization: a meta-analysis of >77,000 children from the EU Child Cohort Network. J Allergy Clin Immunol 2022:S0091-6749(22)00149-X. [PMID: 35150722 DOI: 10.1016/j.jaci.2022.01.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Studies examining associations of early-life cat and dog ownership with childhood asthma have reported inconsistent results. Several factors could explain these inconsistencies, including type of pet, timing and degree of exposure. OBJECTIVE To study associations of early-life cat and dog ownership with school-age asthma, including the role of type (cat versus dog), timing (never, prenatal or early childhood) and degree (number) of ownership, and the role of allergic sensitisation. METHODS We used harmonised data from 77,434 mother-child dyads aged 5-11 years from nine birth cohorts in the EU Child Cohort Network. Associations were examined through the DataSHIELD platform using adjusted logistic regression models, fitted separately for each cohort and combined using random-effects meta-analysis. RESULTS Early-life cat and dog ownership ranged between 12-45% and 7-47% respectively, and prevalence of asthma between 2-20%. There was no overall association between either cat or dog ownership and asthma (OR: 0.97 (95% CI: 0.87-1.09) and 0.92 (0.85-1.01), respectively). Timing and degree of ownership did not strongly influence associations. Cat and dog ownership were also not associated with cat- and dog-specific allergic sensitisation (OR: 0.92 (0.75-1.13) and 0.93 (0.57-1.54), respectively). However, cat- and dog-specific allergic sensitisation were strongly associated with school-age asthma (OR: 6.69 (4.91-9.10) and 5.98 (3.14-11.36), respectively). There was also some indication of an interaction between ownership and sensitisation, suggesting that ownership may exacerbate the risks associated with pet-specific sensitisation, but offer some protection against asthma in the absence of sensitisation. CONCLUSION Our findings do not support early-life cat and dog ownership in themselves increasing the risk of school-age asthma, but suggest that ownership may potentially exacerbate the risks associated with cat- and dog-specific allergic sensitisation.
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Burman JI, Remes ST, Mäkelä MJ. Allergic sensitisation did not affect bronchial hyper-responsiveness in children without respiratory tract symptoms. Acta Paediatr 2022; 111:424-431. [PMID: 34586680 DOI: 10.1111/apa.16129] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/24/2021] [Accepted: 09/28/2021] [Indexed: 11/28/2022]
Abstract
AIM The potential for immunotherapy to prevent asthma development has become a hot topic. This prompted us to revisit data from an early study that examined allergic sensitisation on bronchial hyperresponsiveness (BHR) in children with and without respiratory symptoms. Unlike previous studies, it used both indirect and direct test methods. METHODS The study was conducted in Kuopio, Finland, in 1994 and 247 children (55.1% boys) with a mean age 10.5 ± 1.7 years were recruited using a school survey: 165 with lower respiratory symptoms and 82 healthy controls. Each child underwent a 6-min free-running test and a methacholine test with a cumulative dose of 4900 µg. All participants underwent skin-prick tests: 127were sensitised and 120 were non-sensitised. RESULTS There were no significant differences in lung function between the sensitised and non-sensitised children. However, sensitisation was associated with BHR which was measured by both the methacholine test (2400 µg versus >4900 µg, p < 0.001) and the free-running test (-3.5% versus -2.6%, p = 0.042). No such differences were observed among the healthy controls. Sensitisation was a predictor of allergic diseases, and only multisensitisation to a minimum of four allergens increased the incidence of asthma. CONCLUSION Allergic sensitisation did not affect BHR in children without respiratory symptoms.
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Affiliation(s)
- Janne I. Burman
- Skin and Allergy Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Sami T. Remes
- Department of Paediatrics Kuopio University Hospital Kuopio Finland
| | - Mika J. Mäkelä
- Skin and Allergy Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland
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8
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Leth‐Møller KB, Skaaby T, Linneberg A. Allergic rhinitis and allergic sensitisation are still increasing among Danish adults. Allergy 2020; 75:660-668. [PMID: 31512253 DOI: 10.1111/all.14046] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/18/2019] [Accepted: 07/24/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Only a limited number of studies have included objective measures of allergic sensitisation (such as skin-prick test [SPT] and serum specific IgE [sIgE]) when studying time trends in allergic respiratory disease in adults within the current millennium. METHODS Five health examination studies of random samples of individuals aged 18-69 years resident in the Copenhagen region were conducted in 1990-1991, 2006-2008, 2010-2011, 2012-2015, and 2016-2017. Allergic sensitisation was defined by sIgE (in 1990-1991, 2006-2008, and, 2012-2015) or SPT (in 2006-2008, 2010-2011, and 2016-2017) to at least one of the allergens: birch, grass, house dust mite, or cat. Allergic rhinitis was defined as sensitisation and self-reported nasal symptoms. RESULTS The age- and sex-standardised prevalence of sIgE-defined sensitisation increased from 16% in 1990-1991, to 26% in 2006-2008, and to 29% in 2012-2015. The age- and sex-standardised prevalence of SPT-defined sensitisation increased from 27% in 2006-2008, to 28% in 2010-2011, and to 32% in 2016-2017. Changes in sIgE-defined and SPT-defined allergic rhinitis showed similar increasing trends. CONCLUSION The prevalence of allergic sensitisation and allergic rhinitis increased in a general adult Danish population over the last three decades and has thus continued to increase in the current millennium.
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Affiliation(s)
- Katja Biering Leth‐Møller
- Center for Clinical Research and Prevention Bispebjerg and Frederiksberg Hospital Frederiksberg Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
- ALK‐Abelló A/S Hørsholm Denmark
| | - Tea Skaaby
- Center for Clinical Research and Prevention Bispebjerg and Frederiksberg Hospital Frederiksberg Denmark
| | - Allan Linneberg
- Center for Clinical Research and Prevention Bispebjerg and Frederiksberg Hospital Frederiksberg Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
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Dávila I, Domínguez‐Ortega J, Navarro‐Pulido A, Alonso A, Antolín‐Amerigo D, González‐Mancebo E, Martín‐García C, Núñez‐Acevedo B, Prior N, Reche M, Rosado A, Ruiz‐Hornillos J, Sánchez MC, Torrecillas M. Consensus document on dog and cat allergy. Allergy 2018; 73:1206-1222. [PMID: 29318625 DOI: 10.1111/all.13391] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [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: 12/05/2017] [Indexed: 12/16/2022]
Abstract
The prevalence of sensitization to dogs and cats varies by country, exposure time and predisposition to atopy. It is estimated that 26% of European adults coming to the clinic for suspected allergy to inhalant allergens are sensitized to cats and 27% to dogs. This document is intended to be a useful tool for clinicians involved in the management of people with dog or cat allergy. It was prepared from a consensus process based on the RAND/UCLA method. Following a literature review, it proposes various recommendations concerning the diagnosis and treatment of these patients, grounded in evidence and clinical experience. The diagnosis of dog and cat allergy is based on a medical history and physical examination that are consistent with each other and is confirmed with positive results on specific IgE skin tests. Sometimes, especially in polysensitized patients, molecular diagnosis is strongly recommended. Although the most advisable measure would be to avoid the animal, this is often impossible and associated with a major emotional impact. Furthermore, indirect exposure to allergens occurs in environments in which animals are not present. Immunotherapy is emerging as a potential solution to this problem, although further supporting studies are needed.
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Affiliation(s)
- I. Dávila
- Allergy Department University Hospital of Salamanca Salamanca Spain
- Institute for Biomedical Research IBSAL Salamanca Spain
- Department of Biomedical and Diagnostic Sciences University of Salamanca Salamanca Spain
| | - J. Domínguez‐Ortega
- Allergy Department Hospital La Paz Institute for Health Research (IdiPAZ) Madrid Spain
- CIBER de Enfermedades Respiratorias (CIBERES) Madrid Spain
| | - A. Navarro‐Pulido
- Allergology Clinical Management Unit (UGC) El Tomillar Hospital Sevilla Spain
| | - A. Alonso
- Allergy Department Valladolid Medical Alliance Valladolid Spain
| | - D. Antolín‐Amerigo
- Immune System Diseases Department‐Allergy Unit Príncipe de Asturias University Hospital Madrid Spain
- Department of Medicine and medical specialties (IRYCIS) University of Alcalá Madrid Spain
| | | | | | | | - N. Prior
- Allergy Department Severo Ochoa University Hospital Madrid Spain
| | - M. Reche
- Allergy Department Infanta Sofía Hospital Madrid Spain
| | - A. Rosado
- Allergy Unit Alcorcón Foundation University Hospital Madrid Spain
| | | | - M. C. Sánchez
- Allergy Unit Juan Ramón Jiménez Hospital Huelva Spain
| | - M. Torrecillas
- Allergy Department Albacete University General Hospital Complex Albacete Spain
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Ngajilo D, Singh T, Ratshikhopha E, Dayal P, Matuka O, Baatjies R, Jeebhay MF. Risk factors associated with allergic sensitization and asthma phenotypes among poultry farm workers. Am J Ind Med 2018; 61:515-523. [PMID: 29574825 DOI: 10.1002/ajim.22841] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 02/21/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND This study investigated the risk factors for occupational allergic sensitization and various asthma phenotypes in poultry-workers. METHODS A cross-sectional study of 230 workers used a modified ECRHS questionnaire, spirometry, FeNO, Phadiatop, and sIgE to poultry farming related allergens. RESULTS Worker's mean age was 37 ± 9 years, 68% male, 43% current-smokers, 34% atopic, and 5% casual-workers. The prevalence of non-atopic asthma (NAA = 7%) was higher than atopic-asthma (AA = 5%) and probable allergic occupational-asthma (OA = 3%). Sensitization to at least one poultry farming related allergen was 24%. Workers sensitized to chicken-specific-allergens were more likely to be atopic (ORunadj = 20.9, 95%CI: 4.7-93.2) or employed as casual-workers (ORunadj = 6.0, 95%CI: 1.1-35.9). Work-related chest symptoms were associated the rearing-department (ORadj = 3.2, 95%CI: 1.2-8.4) and exposure to high gas/dust/fumes (ORadj = 4.8, 95%CI: 2.4-9.5). Airflow reversibility (ORadj = 10.9, 95%CI: 2.0-60.3) was significantly associated with casual-work status. CONCLUSION Allergic and non-allergic mechanisms play a role in asthma development among poultry-workers with casual workers demonstrating increased risk.
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Affiliation(s)
- Dorothy Ngajilo
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research; School of Public Health and Family Medicine; University of Cape Town; Cape Town Western Cape South Africa
| | - Tanusha Singh
- National Institute for Occupational Health; National Health Laboratory Services; Immunology and Microbiology Section; Johannesburg Gauteng South Africa
- Department of Clinical Microbiology and Infectious Diseases; School of Pathology; University of Witwatersrand; Johannesburg Gauteng South Africa
| | - Edith Ratshikhopha
- National Institute for Occupational Health; National Health Laboratory Services; Immunology and Microbiology Section; Johannesburg Gauteng South Africa
- Department of Clinical Microbiology and Infectious Diseases; School of Pathology; University of Witwatersrand; Johannesburg Gauteng South Africa
| | - Payal Dayal
- National Institute for Occupational Health; National Health Laboratory Services; Immunology and Microbiology Section; Johannesburg Gauteng South Africa
| | - Onnicah Matuka
- National Institute for Occupational Health; National Health Laboratory Services; Immunology and Microbiology Section; Johannesburg Gauteng South Africa
- Department of Clinical Microbiology and Infectious Diseases; School of Pathology; University of Witwatersrand; Johannesburg Gauteng South Africa
| | - Roslynn Baatjies
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research; School of Public Health and Family Medicine; University of Cape Town; Cape Town Western Cape South Africa
- Department of Environmental and Occupational Studies; Faculty of Applied Sciences; Cape Peninsula University of Technology; Cape Town South Africa
| | - Mohamed F. Jeebhay
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research; School of Public Health and Family Medicine; University of Cape Town; Cape Town Western Cape South Africa
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Shaheen SO, Macdonald-Wallis C, Lawlor DA, Henderson AJ. Haemoglobin concentrations in pregnancy and respiratory and allergic outcomes in childhood: Birth cohort study. Clin Exp Allergy 2017; 47:1615-1624. [PMID: 28940397 PMCID: PMC5725736 DOI: 10.1111/cea.13034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 08/31/2017] [Accepted: 09/12/2017] [Indexed: 12/23/2022]
Abstract
Background Limited epidemiological evidence suggests that low maternal iron status and anaemia in pregnancy may increase the risk of childhood respiratory and allergic outcomes. Objectives To investigate the relation between maternal haemoglobin concentrations in pregnancy and childhood respiratory and allergic outcomes. Methods In the Avon Longitudinal Study of Parents and Children (ALSPAC), we examined associations of maternal haemoglobin concentrations (g/dL) in pregnancy with hayfever, eczema, wheezing, doctor‐diagnosed asthma, allergic sensitisation and total IgE at 7 years, and with lung function at 8‐9 years in the offspring, after controlling for potential confounders (N = 3234‐5335). Results Maternal haemoglobin was not associated with offspring hayfever, eczema, wheezing or asthma. However, the first haemoglobin measurement in pregnancy (<18 weeks' gestation) and the last measurement (>28 weeks' gestation) were negatively associated with allergic sensitisation (adjusted odds ratio [95% CI] per g/dL 0.91 [0.83 to 0.99] and 0.90 [0.83 to 0.98], respectively). The last haemoglobin measurement was also negatively associated with total IgE (adjusted geometric mean ratio 0.94 [0.88 to 0.99]). Anaemia (haemoglobin <11 g/dL) in late pregnancy was negatively associated with forced vital capacity (difference in standard deviation score −0.07 [−0.13 to −0.01]). Conclusions and Clinical Relevance Lower maternal haemoglobin in pregnancy may be a risk factor for allergic sensitisation, elevated IgE and lower FVC in childhood, which may reflect effects of lower prenatal iron status. However, maternal haemoglobin was not associated with risk of childhood asthma or other allergic disorders.
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Affiliation(s)
- S O Shaheen
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, London, UK
| | - C Macdonald-Wallis
- School of Social and Community Medicine, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - D A Lawlor
- School of Social and Community Medicine, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - A J Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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12
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Pike KC, Inskip HM, Robinson SM, Cooper C, Godfrey KM, Roberts G, Lucas JSA. The relationship between maternal adiposity and infant weight gain, and childhood wheeze and atopy. Thorax 2013; 68:372-9. [PMID: 23291350 PMCID: PMC3661999 DOI: 10.1136/thoraxjnl-2012-202556] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Obesity and asthma have increased in westernised countries. Maternal obesity may increase childhood asthma risk. If this relation is causal, it may be mediated through factors associated with maternal adiposity, such as fetal development, pregnancy complications or infant adiposity. We investigated the relationships of maternal body mass index (BMI) and fat mass with childhood wheeze, and examined the influences of infant weight gain and childhood obesity. METHODS Maternal prepregnancy BMI and estimated fat mass (from skinfold thicknesses) were related to asthma, wheeze and atopy in 940 children. Transient or persistent/late wheeze was classified using questionnaire data collected at ages 6, 12, 24 and 36 months and 6 years. At 6 years, skin-prick testing was conducted and exhaled nitric oxide and spirometry measured. Infant adiposity gain was calculated from skinfold thickness at birth and 6 months. RESULTS Greater maternal BMI and fat mass were associated with increased childhood wheeze (relative risk (RR) 1.08 per 5 kg/m(2), p=0.006; RR 1.09 per 10 kg, p=0.003); these reflected associations with transient wheeze (RR 1.11, p=0.003; RR 1.13, p=0.002, respectively), but not with persistent wheeze or asthma. Infant adiposity gain was associated with persistent wheeze, but not significantly. Adjusting for infant adiposity gain or BMI at 3 or 6 years did not reduce the association between maternal adiposity and transient wheeze. Maternal adiposity was not associated with offspring atopy, exhaled nitric oxide, or spirometry. DISCUSSION Greater maternal adiposity is associated with transient wheeze but not asthma or atopy, suggesting effects upon airway structure/function but not allergic predisposition.
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Affiliation(s)
- Katharine C Pike
- Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
- NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton, Southampton, UK
| | - Hazel M Inskip
- Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
- Southampton Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Sian M Robinson
- Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
- Southampton Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
- Southampton Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Keith M Godfrey
- Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
- Southampton Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Graham Roberts
- Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
- Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
- NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton, Southampton, UK
| | - Jane SA Lucas
- Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
- NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton, Southampton, UK
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