Allergic Diseases In Children Research Articles

Blood eosinophil counts as a biomarker for allergen sensitization in childhood allergic diseases in comparison with total IgE

Blood eosinophil counts as a biomarker for allergen sensitization in childhood allergic diseases in comparison with total IgE

The association of phototherapy for neonatal hyperbilirubinemia and childhood allergic disease

The association of phototherapy for neonatal hyperbilirubinemia and childhood allergic disease

Management of evidence and conflict of interest in guidelines on early childhood allergy prevention and child nutrition: study protocol of a systematic synthesis of guidelines and explorative network analysis.

With the rising prevalence of allergic diseases in children, prevention of childhood allergies becomes an important public health issue. Recently, a paradigm shift is taking place in the approach to preventing allergies, and clinical practice guidelines (CPG) and food-based dietary guidelines (FBDG) play an important role in providing practitioners with the latest evidence and reliable guidance. However, concern about the methodological quality of the development of FBDGs and CPGs, including limitations in the systematic reviews, lack of transparency and unmanaged conflicts of interest (COI), reduce the trust in these guidelines. We aim to synthesize the available guidance on early childhood allergy prevention (ECAP) through a systematic search for national and international CPGs and FBDGs concerning ECAP and child nutrition (CN) and to assess the quality of the guidelines and management of COI. Additionally, we will analyse the content and the evidence base of the recommendation statements. We aim to quantify the COI in guideline panellists and explore possible associations between COI and recommendations. Through a social network analysis, we expect to elucidate ties between panellists, researchers, institutions, industry and other sponsors. Guidelines are an important tool to inform healthcare practitioners with the newest evidence, but quality and reliability have to be high. This study will help identify potential for further improvement in the development of guidelines and the management of COI. If the social network analysis proves feasible and reveals more information on COI in comparison to disclosed COI from the previous analyses, the methodology can be developed further to identify undisclosed COIs in panelists. This research does not require ethical approval because no human subjects are involved. Results will be published in international peer-reviewed open access journals and via presentations at scientific conferences.

The role of Helicobacter pylori infection in the development and course of allergic diseases in children with gastroesophageal reflux disease

Objective — to improve the prevention and treatment of esophageal lesions in children based on the study of Helicobacter pylori infection in pediatric patients with allergic diseases.
 Materials and methods. Examination involved 256 children aged 6 to 18 years, from them 118 children without allergic pathology were included in the control group. The diagnosis was verified according to the unified clinical protocols of primary and secondary medical care. H. pylori was determined with biopsy urease test or histologically. Video esophagogastroduodenoscopy with endoscopic determination of pH was used to assess the condition of mucosa of the upper gastrointestinal parts. The results were processed using the methods of non‑parametric statistics.
 Results. Helicobacter pylori infection occurred more often in children with atopic dermatitis (32%), less often and equally often (24%) at bronchial asthma and allergic rhinitis and in 16% of patients with a combination of allergic diseases. Only 2 (1.4%) patients had H. pylori‑associated chronic urticaria, which was related to the specificity of the hospital department. Helicobacter infection was observed more often in patients with allergic rhinitis and atopic dermatitis without atopic changes. When comparing the Helicobacter association in children with allergic diseases depending on age, a significant difference was established in the group of children aged 6—12 years with allergic rhinitis and mainly with atopy. Endoscopic changes in the esophageal mucosa and esophageal motility disorders in association with Helicobacter pylori more often diagnosed in patients with atopic dermatitis (10.3%), less often and equally often in patients with bronchial asthma and allergic rhinitis (7.7%), the lowest frequency of Helicobacter pylori infection was found in patients with combined allergic pathology (5.1%) and no association in patients with urticaria. Endoscopic signs of esophageal inflammation were more often detected in patients with atopic dermatitis who had Helicobacter pylori infection and esophageal motility disorders. Most often, inflammatory changes in esophageal mucosa were found in patients with allergies developed in the presence of motor disorders, the risk of their development increased in case of Helicobacter infection. It has not been proven that the presence of atopy affected the development of inflammation in the esophagus.
 Conclusions. Among allergic diseases, Helicobacter pylori infection was more often revealed in patients with atopic dermatitis (32%), allergic rhinitis (24%) and bronchial asthma (24%) without statistical significance. A significant difference in H. pylori contamination depending on age was found only in patients with allergic rhinitis (H. pylori was determined more often in elementary school age), in the rest of the patients and in the control group, no significant differences were found. Endoscopic lesions of the esophagus were more often detected in atopic dermatitis, in particular esophagitis (in 17.9%), it was Helicobacter‑associated in 10.3% of cases and was combined with moderate motor disorders in 10.3% of observations. Allergic rhinitis (15.4%) was also associated with Helicobacter pylori infection (7.7%) and was accompanied by motility disorders in 15.4% of cases. Motor disorders, which were registered both in patients with allergic diseases and in patients without allergies, played an important role in the esophagus inflammation and formation of gastroesophageal reflux disease.

Atopic March or Atopic Multimorbidity-Overview of Current Research.

The atopic march encompasses a sequence of allergic conditions, including atopic dermatitis, food allergy, allergic rhinitis, and asthma, that frequently develop in a sequential pattern within the same individual. It was introduced as a conceptual framework aimed at elucidating the developmental trajectory of allergic conditions during childhood. Following the introduction of this concept, it was initially believed that the atopic march represented the sole and definitive trajectory of the development of allergic diseases. However, this perspective evolved with the emergence of new longitudinal studies, which revealed that the evolution of allergic diseases is far more intricate. It involves numerous immunological pathological mechanisms and may not align entirely with the traditional concept of the atopic march. The objective of our review is to portray the atopic march alongside other patterns in the development of childhood allergic diseases, with a specific emphasis on the potential for a personalized approach to the prevention, diagnosis, and treatment of atopic conditions.

OFFSPRING: A SPRING Follow-Up Study Assessing the Efficacy of Maternal Probiotics and Allergic Disease in the Child

Introduction: There are a variety of factors that contribute to the development of allergic diseases in children, including environmental exposures during the maternal prenatal period. It has been proposed that probiotic supplementation during pregnancy could be used as a possible preventative measure to target childhood allergic disease. Methods: Participants from a previously conducted prospective double-blind randomised control trial of probiotics versus placebo study (Study of PRrobiotics IN Gestation) were sent electronic questionnaires to complete about their child, who are now between 3 and 7 years of age. Demographic data and rates of allergic diseases were compared between the two groups. Results: One hundred and seven women responded to the questionnaires. Between the two groups, there was no difference in the frequency of allergic diseases, with similar rates of eczema, asthma, and hospital presentations seen. Conclusion: In this follow-up study, infants of mothers who were exposed to probiotics during their pregnancy do not appear to have any paediatric health advantages in terms of allergic diseases.

Association of Sleep Duration and Weekend Catch-Up Sleep with Suicidal Ideation among Adolescents with Atopic Dermatitis.

Atopic dermatitis (AD) is a prevalent allergic disease in children that often causes sleep disturbance and which is associated with diminished quality of life and heightened susceptibility to depression and suicidality. In this study, we investigate the relationship between weekend catch-up sleep (WCUS) and mental health in a sample of 71,434 adolescents with AD and 221,057 without AD using multivariate logistic regression analysis. We hypothesized that adolescents with AD experience shorter total and daytime sleep due to pruritus, with compensatory longer WCUS. We found that the lifetime prevalence of AD was 24.4%, and that adolescents with AD slept less overall, with significantly shorter weekday and weekend sleep durations but longer weekend catch-up sleep (WCUS). Sleep dissatisfaction was markedly higher in the AD group. Interestingly, our results suggest that prolonged WCUS is a protective factor against suicidal ideation in adolescents with AD. The study highlights the importance of addressing sleep patterns in adolescents with AD to enhance mental health. Overall, our findings indicate a need for increased awareness and intervention strategies to ensure sufficient sleep and reduce the risk of suicidal ideation in this population.

Prenatal and Infant Exposure to Acid-Suppressive Medications and Risk of Allergic Diseases in Children.

Prenatal and Infant Exposure to Acid-Suppressive Medications and Risk of Allergic Diseases in Children.

Maternal gestational diabetes mellitus and risk of allergic diseases in offspring

BackgroundGestational diabetes mellitus has been linked to inflammation, immune dysregulation in offspring, and changes in the microbiota. It may have long-term implications for the health of children. The aim of this study was to determine if gestational diabetes mellitus increases the risk of allergic diseases in offspring. MethodsThe data source was the National Health Insurance Research Database (NHIRD) of Taiwan. The pairing of mothers and children was established by connecting the NHIRD with the Taiwan Maternal and Child Health Database. First-time pregnant mothers between 2004 and 2019 were enrolled. The GDM group consisted of 22,741 cases. The control group was selected from individuals without GDM matched by maternal age, neonatal gender, and neonatal birthdate at a ratio of 1–4. The primary endpoint was the incidence of childhood allergic diseases, such as asthma, allergic rhinitis, atopic dermatitis, and urticaria. The secondary endpoint was the risk associated with the development of allergic diseases in offspring, considering the presence or absence of insulin therapy. ResultsThe development of allergic rhinitis, atopic dermatitis, and urticaria were found to be significantly associated with GDM. However, no significant association was observed between GDM and asthma. GDM control without insulin was associated with an increased risk of developing allergic rhinitis, urticaria, and atopic dermatitis. However, in the group receiving insulin treatment, there was no significant elevation in the risk of any allergic diseases. ConclusionGDM may elevate the risk of certain atopic diseases in offspring, such as allergic rhinitis, atopic dermatitis, and urticaria.

Features of Statistical Accounting of Allergic Diseases in Children — Evidence from Moscow

Background. The emergence of new functional capabilities of statistical accounting made it possible to conduct a comparative analysis of the morbidity of allergic pathologies according to the registers of allergists and pediatricians from the Unified Medical Information and Analytical System (UMIAS) of Moscow with data from the Form of Federal Statistical Observation No. 12 (FSO No. 12). The aim of the study is to investigate the potential of using UMIAS for assessing/monitoring the morbidity of allergic diseases, including bronchial asthma in children, using the example of several outpatient clinics (OPCs) in Moscow. Methods. A study of combined design has been carried out. The data of children of several OPCs in Moscow were analyzed — data from UMIAS (observation registers of pediatricians and allergist-immunologists) and from the reporting forms of the FSO No. 12. Results. For a comparative analysis of statistical data from UMIAS and FSO No. 12, we studied the information of 60,851 children under 18 years of age. It was revealed that out of 60,851 children: allergic rhinitis according to FSO No. 12 and UMIAS was established in 1001 and 1059 patients; atopic dermatitis — in 142 and 345; urticaria — in 363 and 33; angioedema — in 4 and 16, respectively; food allergy — in 233 children according (to FSO No. 12) and in none of the children (according to UMIAS). Out of 60,851 children, 619 children were diagnosed with bronchial asthma according to the annual report (FSO No. 12) and 537 according to the pediatrician’s observation registers (UMIAS). At the same time, it was found that the diagnosis of bronchial asthma is not available as a separate nosology in the registry of an allergist-immunologist, and information about children with bronchial asthma is available to this specialist only when analyzing the uploaded information about children with other allergic diseases. Conclusion. A adequate sample ensured a high representativeness of the results obtained. The differences in the incidence rates of allergic diseases revealed by a comparative analysis of data from various sources — UMIAS and FSO No. 12 — indicate the need to improve both the system of statistical registration of incidence and the development of modern algorithms for early diagnosis and dynamic monitoring of children with allergies.

Maternal antibiotic exposure and childhood allergies: The Japan Environment and Children's Study.

The association of maternal antibiotic exposure during pregnancy with childhood allergic diseases remains unclear. We aimed to evaluate the association of maternal exposure to antibiotic use during pregnancy with childhood allergic diseases up to the age of 3 years by using data from a large Japanese birth cohort. We analyzed data on 78,678 pregnant women and their offspring aged 0 to 3 years. Prenatal antibiotic exposure was defined as the use of any antimicrobial agent during pregnancy. Information was collected from maternal interviews and medical record transcripts. The outcome variables in this study included preschool asthma, wheezing, food allergy, atopic dermatitis, eczema, allergic rhinoconjunctivitis, and any allergic disease. We used logistic regression analysis to evaluate the association of antibiotic exposure during pregnancy with childhood allergic diseases. Among the participating mothers, 28.5% used antibiotics during pregnancy. Antibiotic exposure during pregnancy was associated with preschool asthma (adjusted odds ratio [aOR]= 1.12 [95% CI= 1.06-1.19]), wheezing (aOR= 1.11 [95% CI= 1.07-1.15]), allergic rhinoconjunctivitis (aOR= 1.10 [95% CI= 1.03-1.17]) and any allergic disease (aOR= 1.09 [95% CI= 1.05-1.14]) in offspring up to age 3 years. In contrast, maternal antibiotic use was not associated with food allergies, atopic dermatitis, or eczema. Additionally, the significant associations were not influenced by the timing of antibiotic exposure, sex of the infants, or maternal history of allergies. Maternal antibiotic exposure during pregnancy is associated with an increased risk of childhood respiratory allergies.

The re-emerging role of linoleic acid in paediatric asthma.

Asthma is the most common chronic disease within the paediatric population. Although it is multifactorial, its onset may be linked to early-life exposures with subsequent impact on immune system development. Microbial and dietary metabolic products have been implicated in the development and exacerbation of paediatric asthma. Linoleic acid is the most common omega-6 polyunsaturated fatty acid in the Western diet. In this review, we summarise the literature regarding the involvement of linoleic acid in the development of and its impact on existing paediatric asthma. First, we summarise the existing knowledge surrounding the relationship between human microbial metabolism and allergic diseases in children. Next, we examine cellular or animal model-based mechanistic studies that investigated the impact of dietary- and microbial-derived linoleic acid metabolites on asthma. Finally, we review the literature investigating the impact of linoleic acid metabolites on the development and exacerbation of childhood asthma. While there is conflicting evidence, there is growing support for a role of linoleic acid in the onset and pathophysiology of asthma. We recommend that additional cellular, animal, and longitudinal studies are performed that target linoleic acid and its metabolites.

Maternal prepregnancy body mass index, gestational weight gain, and allergic diseases in children: A systematic review and meta-analysis.

Several studies have investigated a link between maternal preconception body mass index, gestational weight gain (GWG), and the risk of childhood allergic diseases, but the conclusions of these studies were inconsistent. This review aimed to evaluate the relationship based on existing studies. We eventually included 18 cohort studies. The findings indicated that both maternal preconception overweight or obesity increased the risk of childhood wheezing (overweight: risk ratio (RR) 1.09, 95% confidence interval (CI) 1.04-1.15; obesity: RR 1.24, 95% CI 1.12-1.38) and asthma (overweight: RR 1.18, 95% CI 1.05-1.32; obesity: RR 1.34, 95% CI 1.13-1.58), and the risk of childhood wheezing increased with continuous prepregnancy BMI changes (per 5kg/m2 increase) (RR 1.10, 95% CI 1.05-1.15). Preconception underweight may elevate the risk of childhood eczema ever (RR 1.05, 95% CI 1.02-1.09) and current eczema (RR 1.20, 95% CI 1.05-1.37), and preconception overweight may reduce the risk of childhood eczema ever (RR 0.98, 95% CI 0.96-0.99). No statistically significant association between GWG and the risk of allergic diseases in children was found. Preconception weight management is encouraged for the prevention of allergic diseases in children.

Exposure to sunlight and allergic morbidity in children (Pollution and Asthma Risk: an Infant Study)

Abstract Background Sunlight relationship with allergies is poorly studied in children. Thus, we examined how early exposure to solar radiation is associated with allergic morbidity in the PARIS birth cohort. Methods This study dealt with children who attended at least one of the two health check-ups: 18 months (n = 2012) and 8/9 years (n = 1080). Early exposure (prenatal and during the first year of life) to solar radiation was assessed using meteorological data (solar radiation, temperature, relative humidity). Children with similar exposure trajectories were grouped by longitudinal and multidimensional cluster analysis. Association of solar radiation exposure with allergic morbidity (i.e. allergic sensitisation at 18 months and 8/9 y., current asthma, rhinitis, and eczema at 8/9 y.) was quantified by multivariable logistic regression models adjusted for potential confounders. The effect modification of maternal vitamin D (VitD) supplementation during pregnancy was also tested. Results Four exposure trajectories were found. The trajectory with the highest exposure to early solar radiation had a reduced risk of sensitisation at 8/9 y. compared to the trajectory with the lowest exposure (p = 0.06). This association was statistically significant in the VitD supplemented subgroup. Solar radiation during pre- and post-natal period was significantly associated with a lower risk of sensitisation at 8/9 y. (for ↗IQR, aOR: 0.47; 95%CI: 0.25-0.87 and 0.84;0.70-1.00, respectively). Increased prenatal exposure to solar radiation was significantly associated with a lower asthma risk at 8/9 y. (for ↗IQR, 0.32; 0.10-0.96). Conclusions Early sunlight exposure may reduce the risk of sensitisation and asthma in school-aged children, especially in those prenatally exposed to VitD intake. These findings highlight the importance of VitD in preventing allergic diseases in children, either through supplementation or sunlight exposure. Key messages • Pre-natal and early postnatal exposure to sunlight could reduce the risk of sensitisation and asthma among school-aged children. • The association may be explained by vitamin D immunomodulatory effect, highlighting its importance in preventing allergic diseases in children through supplementation or sunlight exposure.

Associations between prenatal exposure to outdoor PM2.5 and NO2 and childhood respiratory symptoms

Abstract Background Prenatal and early-life air pollution exposures have shown to play an important role in childhood respiratory and allergic diseases development. Our aim was to assess the effect of prenatal exposure to air pollution on several respiratory outcomes up to 12 years old. Methods We included 2054 children from the PELAGIE mother-child cohort in Brittany, France, followed-up at 2-, 6- or 12-years. Parents reported children's respiratory health history, family lifestyle and children immediate environment. PM2.5 and NO2 mean concentrations throughout the pregnancy were modelled at residential address using land use regression models. Ever asthma, rhinitis, allergic rhinitis and eczema at 12-years follow-up, considered as outcomes of interest, were defined using validated questionnaires. A multimorbidity phenotype was also constructed. We performed adjusted logistic regressions per increase of one interquartile range (IQR). Results Participating mothers’ mean age was 30 years (SD 4.1), 88% did not smoke during pregnancy, and 82% lived in rural areas. Fifty percent of children were boys; 55% of them had parents with history of asthma and/or allergies. Pregnancy concentrations of NO2 were 18.74±7.72μg/m3 (IQR=9.66) and PM2.5 15.11±2.21μg/m3 (IQR=3.38). Prevalence of asthma, rhinitis, allergic rhinitis and eczema was 28%, 11% and 38% respectively at 12-years follow-up. Overall, no significant associations were found with asthma, rhinitis or eczema, nor with the multimorbidity phenotype. Discussion/conclusions Prenatal exposures to ambient PM2.5 and NO2, at relatively low concentrations, did not show any significant associations with children's respiratory and allergic outcomes. Further analysis including logistic models stratified by sex and urban-rural area, and clustering approaches will be performed to assess if specific profiles of environmental exposures during pregnancy and early childhood are associated with childhood respiratory and allergic diseases. Key messages • The prenatal and postnatal periods are major vulnerability windows for children's respiratory health. • An exposome approach provides a better understanding of a larger set of urban/rural exposures and their associations with childhood respiratory and allergic diseases.

Metabolic potential of gut microbiota in helminth infections as a way to achieve bronchial asthma control

The aim of the review was to analyze modern experimental studies and clinical trials aimed at assessing metabolic activity of gut microbiota in bronchial asthma (BA) and helminth infections.Being one of the most common chronic heterogeneous respiratory diseases, bronchial asthma secures its place among global health problems of great socioeconomic importance. In recent years, a lot of data has been accumulated indicating that the state of gut microbiota is an important factor determining the state of human health and affecting immune mechanisms underlying the development of allergic diseases in childhood. Dysbiosis of gut microbiota is due not only to changes in its composition, but also to disturbances in its metabolism. In accordance with the “gut – lung axis” concept, maintaining healthy gut microbiota and correcting its disorders, including strategies aimed at activating synthesis of short-chain fatty acids in the intestine, may become a new way to prevent and treat chronic respiratory diseases in childhood. In turn, experimental and epidemiological studies have shown the immunomodulatory activity of helminths. It is assumed that their impact on the composition and function of gut microbiota is one of the mechanisms by which helminths influence the immune response of the host and the course of BA.

Relationship between prenatal and postnatal exposure to BPA and its analogues (BPS, BPF) and allergic diseases.

Bisphenols, endocrine disrupting chemicals, are widely used in daily life. Continued exposure during key developmental periods of life (pregnancy, infancy and early childhood) can contribute to adverse health consequences such as decreased lung function, wheezing/asthma, the occurrence of allergies or changes in immune system responses. The purpose of this review is to present the current state of knowledge on the effects of prenatal or postnatal exposure to bisphenol A (BPA), bisphenol S (BPS) and bisphenol F (BPF) on the development of allergic diseases in childhood. A com- prehensive and systematic search of PubMed, Scopus and Web of Science databases was conducted. The review is restricted to studies published since 2015, in English in peer-reviewed journals. Based on keywords, 2648 studies were identified and reviewed for eligibility. Finally, 8 epidemio- logical studies were found to be appropriate for inclusion in this publication. The data collected in this review suggests that there is an associa- tion between maternal exposure during pregnancy or childhood to BPA and the development of allergic diseases. Most studies reported positive relationships between BPA exposure and at least one of the types of allergic disease. The paucity of studies and the observed differences in findings regarding the association between prenatal/postnatal exposure to BPS and/or BPF do not allow firm conclusions to be drawn. Further research is needed to identify the vulnerable population and the mechanisms responsible for the development of undesirable health consequences. Int J Occup Med Environ Health. 2023;36(5):575-86.

Alterations of milk oligosaccharides in mothers with gestational diabetes mellitus impede colonization of beneficial bacteria and development of RORγt+ Treg cell-mediated immune tolerance in neonates

ABSTRACT Gestational diabetes mellitus (GDM) is an increasing public health concern that significantly increases the risk of early childhood allergic diseases. Altered maternal milk glycobiome may strongly affect gut microbiota and enteric-specific Treg cell-mediated development of immune tolerance in GDM infants. In this study, we found that, compared with healthy Chinese mothers, mothers with GDM had significantly lower levels of total and specific human milk oligosaccharides (HMOs) in their colostrum that subsequently increased with extension of lactation. This alteration in HMO profiles significantly delayed colonization of Lactobacillus and Bifidobacterium spp. in their breast-fed infants, resulting in a distinct gut microbial structure and metabolome. Further experiments in GDM mouse models indicated that decreased contents of milk oligosaccharides, mainly 3ʹ-sialyllactose (3ʹ-SL), in GDM maternal mice reduced colonization of bacteria, such as L. reuteri and L. johnsonii, in the neonatal gut, which impeded development of RORγt+ regulatory T (Treg) cell-mediated immune tolerance. Treatment of GDM neonates with 3ʹ-SL, Lactobacillus reuteri (L. reuteri) and L. johnsonii promoted the proliferation of enteric Treg cells and expression of transcription factor RORγt, which may have contributed to compromising ovalbumin (OVA)-induced allergic responses. In vitro experiments showed that 3ʹ-SL, metabolites of L. johnsonii, and lysates of L. reuteri stimulated differentiation of mouse RORγt+ Treg cells through multiple regulatory effects on Toll-like receptor, MAPK, p53, and NOD-like receptor signaling pathways. This study provides new ideas for the development of gut microbiota and immune tolerance in GDM newborns.

Sex steroid hormones and allergic diseases in children: a pilot birth cohort study in the Japan Environment and Children’s Study cohort

BackgroundNumerous studies suggest that sex steroids might play a role in sex disparity observed in allergic diseases in adults. However, whether sex hormones influence allergic diseases in children remains unclear. The aim of the present study was to examine the association of sex steroid hormones with allergic disease in Japanese children.MethodsThe present cross-sectional study included 145 6-year-old children participating in a pilot birth cohort study in the Japan Environment and Children’s Study. Data on allergic diseases were obtained from questionnaires, and serum levels of sex steroid hormones and allergen-specific IgE were measured. Logistic regression was performed to evaluate the association of sex hormones with allergic diseases.ResultsAfter adjusted sex, amount of body fat at 6 years, parental history of allergic disease, and exposure to tobacco smoke, serum dehydroepiandrosterone sulfate level was significantly associated with reduced odds of any allergic disease (adjusted odds ratio, 0.58; 95% confidence interval, 0.36–0.93; P = 0.024) and serum follicle-stimulating hormone level was significantly associated with increased odds of any allergic disease (adjusted odds ratio, 2.04; 95% confidence interval, 1.01–4.11, P = 0.046). Dehydroepiandrosterone sulfate level showed a significant association with number of allergic diseases.ConclusionsThe current study findings suggest that sex hormones may play an important role in the development of allergic diseases in prepubertal children.

Effect of residential environment on children's allergic diseases in the Greater Taipei area

Effect of residential environment on children's allergic diseases in the Greater Taipei area