Determinants of Allergic Sensitization, Asthma and Lung Function: Results from a Cross-Sectional Study in Italian Schoolchildren.

Fabio Cibella,Stefania La Grutta,Giuliana Ferrante,Gaspare Drago,Silvia Ruggieri,Giuseppina Cuttitta

doi:10.3390/ijerph17145087

Abstract

Prenatal smoking exposure and early-life respiratory infections are major determinants of asthma during childhood. We investigate the factors influencing allergic sensitization (AS), asthma, and lung function in children and the balance between individual and environmental characteristics at different life stages. 1714 children aged 7–16 years and living in southern Italy were investigated using a parental questionnaire, skin prick tests, and spirometry. We found 41.0% AS prevalence: among children without parental history of asthma, male sex, maternal smoking during pregnancy (MatSmoke), and acute respiratory diseases in the first two years of life (ARD2Y) were significant risk factors for AS. MatSmoke was associated (OR = 1.79) with ARD2Y, and this association was influenced by sex. ARD2Y was, in turn, a significant risk factor (OR = 8.53) for childhood current asthma, along with AS (OR up to 3.03) and rhinoconjuctivitis (OR = 3.59). Forced mid-expiratory flow (FEF25–75%) was negatively affected by ARD2Y, with a sex-related effect. Thus, males exposed to MatSmoke had significantly lower FEF25–75% than unexposed males. Despite the difficulty of discriminating among the complex interactions underlying the development of allergic respiratory diseases, ARD2Y appears to strongly influence both asthma and lung function during childhood. In turn, ARD2Y is influenced by prenatal exposure to tobacco smoke with a sex-dependent effect.

Highlights

Asthma is the most common chronic childhood disease [1], and large variations in the prevalence of asthma and rhinitis symptoms in children have been reported worldwide [2]
Despite the hypothesis that allergic sensitization increases the risk for early-life respiratory infections and not the inverse [15], our results suggest that acute respiratory diseases during the first two years of life produce their effect on future allergic sensitization mainly in subjects with apparently lower genetic predisposition
We confirm that acute respiratory diseases during the first two years of life–which appear to be influenced by a parental history of asthma–strongly influence both asthma and poorer lung function during childhood

Summary

Introduction

Asthma is the most common chronic childhood disease [1], and large variations in the prevalence of asthma and rhinitis symptoms in children have been reported worldwide [2]. In Italy, the SIDRIA (Italian Studies on Respiratory Disorders in Children and the Environment) Study, the largest Italian epidemiological survey of children, on the basis of questionnaire responses, reported a prevalence of. Heterogeneous, chronic respiratory disease affected by genetic, socioeconomic, and environmental factors [4]. Allergic sensitization is highly associated with the risk of respiratory symptoms among asthmatic children [5], and atopy increases the probability of allergic asthma [4]. Pre- and postnatal passive smoking exposure [6,7] along with early. Public Health 2020, 17, 5087; doi:10.3390/ijerph17145087 www.mdpi.com/journal/ijerph

Methods

Results

Discussion

Conclusion