Quoi de neuf en allergologie pédiatrique en 2007–2008 ? Partie 2 : allergie oculaire et respiratoire (une revue de la littérature internationale de septembre 2007–octobre 2008)

Abstract

Numerous studies on pathophysiology, epidemiology, (early) diagnosis, prevention and treatment of respiratory allergy in children have been published since October 2007. Parental atopy and/or asthma and bronchial hyperreactivity, gynecological and obstetrical problems during pregnancy, prematurity, maternal exposure to domestic pollutants during pregnancy, passive smoking in utero and during early life, early exposure to high levels of mites and molds, respiratory infections and a personal history of atopy (atopic dermatitis, food allergy, sensitizations detected by means of prick-tests and/or specific IgE determination) are associated with an increased risk of wheezing and asthma. However, these risk factors are dependent on complex interactions with numerous genes and interactions between genes themselves. In wheezing infants, bronchial and blood eosinophilia, bronchial hyperreactivity and severity of bronchiolitis are significant risk factors for asthma in childhood. Ribavirin treatment of respiratory syncytial virus bronchiolitis in infants significantly reduces the risk of asthma in children. The control of asthma exacerbations is better in children treated with inhaled corticosteroids than in children treated with leukotriene receptor antagonists. However, these drugs may be more effective than inhaled corticosteroids in the control of the bronchial eosinophilic inflammation. Sublingual immunotherapy may be as effective as subcutaneous immunotherapy in the prevention of neosensitizations in children sensitized to one or a low number of allergens. However, adherence to sublingual immunotherapy is far from excellent and a new case of severe anaphylactic reaction to sublingual immunotherapy has been reported recently.