Allergic Diseases In Children Research Articles

Mite allergen levels and fungal counts in children's bedding in four widely separated towns in Japan

We evaluated the relationships between children's housing, earthquake or tsunami damage affecting children, prevalence of allergic diseases, and levels of mite allergens and fungi on children's bedding after the Great East Japan Earthquake in four municipalities in Japan. We surveyed 464 children in Ishinomaki, 254 in Kami, 614 in Iwanuma, and 300 in Oiso whose parents or guardians had completed the International Study of Asthma and Allergies in Childhood questionnaire. We measured the levels of Dermatophagoides 1 allergens (Der 1) (Dermatophagoidespteronyssinus and Dermatophagoides farinae) on children's mattresses or futons and fungal counts (Aspergillus and yeast) between 2016 and 2018. Earthquake damage was significantly greater in Ishinomaki than in the other three municipalities. There were no differences in the prevalence of allergic disease among the four municipalities. Der 1 levels were significantly higher in Ishinomaki than in Iwanuma, but there were no differences among Oiso, Iwanuma, and Kami. Der 1 levels in children with asthma in Iwanuma and with allergic rhinitis in Kami were significantly higher than in those without these conditions. Total fungal counts and Aspergillus counts were highest in Kami and lowest in Oiso. Der 1 levels were significantly correlated with fungal counts in Kami and Iwanuma, but not in Ishinomaki or Oiso. Both Der 1 levels and total fungal counts in Ishinomaki were greater than those in other three municipalities. Housing and allergen-avoidance strategies varied among the four municipalities. Mite allergen and fungal levels in these Japanese municipalities might have been affected by the earthquake and tsunami, and these changes might have affected the prevalence of allergic diseases in children.

Prevalence of Bronchial Asthma in Children in Southern Kyrgyzstan

Background: The aim of this study was to investigate the prevalence of bronchial asthma and other allergic diseases such as allergic rhinitis and atopic dermatitis among 6075 school-aged children in Osh, Jalal-Abad and Batken regions of Kyrgyzstan. Methods: 6075 children were questioned using the ISAAC questionnaire. Bronchial asthma symptoms are frequent – 21.1% of children had difficulty wheezing, and 13.4% had night cough. This indicates a high prevalence of bronchial asthma among children in the study population. The obtained morbidity rates significantly exceed the official statistics for the region. This indicates insufficient diagnosis of allergic diseases in children and substantiates the need to develop a set of measures aimed at optimizing the detection of cases of allergic pathology and increasing the effectiveness of therapeutic and preventive measures. Results: The results of the study demonstrate a high need for the development and implementation of a regional program for the diagnosis, treatment, and prevention of allergic diseases in children of Osh, Jalal-Abad, and Batken regions. Conclusion: Implementing such a program will contribute to better control of bronchial asthma and other allergic pathologies and improve the quality of life of the child population in the region.

Prenatal Exposure to Air Pollutants Associated with Allergic Diseases in Children: Which Pollutant, When Exposure, and What Disease? A Systematic Review and Meta-analysis.

This systematic review aims to identify the association between prenatal exposure to air pollutants and allergic diseases in children, focusing on specific pollutants, timing of exposure, and associated diseases. We searched PubMed, Scopus, and Web of Science for English articles until May 1, 2023, examining maternal exposure to outdoor air pollutants (PM1, PM2.5, PM10, NO, NO2, SO2, CO, and O3) during pregnancy and child allergic diseases (atopic dermatitis (AD), food allergy (FA),asthma (AT)and allergic rhinitis (AR)/hay fever (HF)). The final 38 eligible studies were included in the meta-analysis. Exposure to PM2.5 and NO2 during pregnancy was associated with the risk of childhood AD, with pooled ORs of 1.34 (95% confidence interval (CI), 1.10-1.63) and 1.10 (95%CI, 1.05-1.15) per 10µg/m3 increase, respectively. Maternal exposure to PM1, PM2.5, and NO2 with a 10µg/m3 increase posed a risk for AT, with pooled ORs of 1.34 (95%CI, 1.17-1.54), 1.11 (95%CI, 1.05-1.18), and 1.07 (95%CI, 1.02-1.12), respectively. An increased risk of HF was observed for PM2.5 and NO2 with a 10µg/m3 increase, with ORs of 1.36 (95%CI, 1.17-1.58) and 1.26 (95%CI, 1.08-1.48), respectively. Traffic-related air pollutants (TRAP), particularly PM2.5 and NO2, throughout pregnancy, pose a pervasive risk for childhood allergies. Different pollutants may induce diverse allergic diseases in children across varying perinatal periods. AT is more likely to be induced by outdoor air pollutants as a health outcome. More research is needed to explore links between air pollution and airway-derived food allergies.

Decreased Treg cells induced by bisphenol A is associated with up-regulation of PI3K/Akt/mTOR signaling pathway and Foxp3 DNA methylation in spleen of adolescent mice

The current study aimed to explore whether bisphenol A (BPA) exposure aggravated the decrease in Tregs induced by ovalbumin (OVA) in adolescent female mouse models of asthma, and whether the process was associated with mTOR-mediated signaling pathways and DNA methylation levels. A total of 40 female C57BL/6 mice at the age of four weeks were used and divided into five groups after 1 week of domestication. Each group consisted of eight mice: the control group, OVA group, OVA + BPA (0.1 μg mL−1) group, OVA + BPA (0.2 μg mL−1) group, and OVA + BPA (0.4 μg mL−1) group. Results revealed that Foxp3 protein levels decreased in the spleens of mice exposed to BPA compared to those in the OVA group. After an elevation in BPA dose, the mRNAs of methyltransferases (Dnmt1, Dnmt3a, and Dnmt3b) were gradually upregulated. The mechanism was related to the activity of TLR4/NF-κB and PI3K/Akt/mTOR signaling pathways and the enhancement of Foxp3 DNA methylation. Our results, collectively, provided a new view for studying the mechanisms underlying BPA exposure-induced immune dysfunction. Investigation of the regulatory mechanisms of DNA methylation in the abnormal Th immune response caused by BPA exposure could help reveal the causes and molecular mechanisms underlying the high incidence of allergic diseases in children in recent years.

Preventive allergen immunotherapy with inhalant allergens in children.

The efficacy and safety of preventive allergen immunotherapy (pAIT) in children are currently under investigation. Here, we provide an overview of pAIT with respiratory allergens concerning the prevention of new sensitizations, allergic disease onset and progression as well as further immunomodulatory effects. Three databases were searched for clinical pAIT studies in children. Selected publications were reviewed for preventive outcomes according to prevention level (primary, secondary, and tertiary), allergen type, administration route, dose, and treatment duration. The primary prevention approach appears safe but showed no allergen-specific effect on new sensitizations. Secondary prevention seems feasible and may induce regulatory T cell-mediated immunotolerance. The number of studies at these prevention levels is limited. Tertiary prevention with grass and/or tree pollen-based pAIT has shown efficacy in preventing disease progression from allergic rhinitis/conjunctivitis to asthma. Data on tertiary pAIT with house dust mites and other allergen types are inconclusive. Subcutaneous and sublingual routes appear similarly effective, but head-to-head comparative paediatric studies are scarce. Additionally, there are fewer placebo-controlled studies. Nevertheless, immunomodulatory outcomes of pAIT are encouraging. Currently, limited but favourably suggestive evidence is available for preventing respiratory allergic diseases in children by pAIT. Primary and secondary prevention have potential and warrant further investigation through well-designed studies.

Global, regional and national epidemiology of allergic disorders in children from 1990 to 2019: findings from the Global Burden of Disease study 2019

ObjectiveThis modelling study aimed to estimate the burden for allergic diseases in children during a period of 30 years.DesignPopulation-based observational study.Main outcomes and measuresThe data on the incidence, mortality and...

Epigenetic Responses to Nonchemical Stressors: Potential Molecular Links to Perinatal Health Outcomes.

We summarize the recent literature investigating exposure to four nonchemical stressors (financial stress, racism, psychosocial stress, and trauma) and DNA methylation, miRNA expression, and mRNA expression. We also highlight the relationships between these epigenetic changes and six critical perinatal outcomes (preterm birth, low birth weight, preeclampsia, gestational diabetes, childhood allergic disease, and childhood neurocognition). Multiple studies have found financial stress, psychosocial stress, and trauma to be associated with DNA methylation and/or miRNA and mRNA expression. Fewer studies have investigated the effects of racism. The majority of studies assessed epigenetic or genomic changes in maternal blood, cord blood, or placenta. Several studies included multi-OMIC assessments in which DNA methylation and/or miRNA expression were associated with gene expression. There is strong evidence for the role of epigenetics in driving the health outcomes considered. A total of 22 biomarkers, including numerous HPA axis genes, were identified to be epigenetically altered by both stressors and outcomes. Epigenetic changes related to inflammation, the immune and endocrine systems, and cell growth and survival were highlighted across numerous studies. Maternal exposure to nonchemical stressors is associated with epigenetic and/or genomic changes in a tissue-specific manner among inflammatory, immune, endocrine, and cell growth-related pathways, which may act as mediating pathways to perinatal health outcomes. Future research can test the mediating role of the specific biomarkers identified as linked with both stressors and outcomes. Understanding underlying epigenetic mechanisms altered by nonchemical stressors can provide a better understanding of how chemical and nonchemical exposures interact.

Positive association between chlorinated paraffins and the risk of allergic diseases in children and adolescents

Contaminants may induce immune response polarization, leading to immune diseases, such as allergic diseases. Evidence concerning the effects of chlorinated paraffins (CPs), an emerging persistent organic pollutant, on immune system is scarce, particularly for epidemiological evidence. This study explores the association between CPs exposure and allergic diseases (allergic rhinitis, atopic eczema, and allergic conjunctivitis) in children and adolescents in the Pearl River Delta (PRD) in China. Herein, 131,304 children and adolescents from primary and secondary schools in the PRD were included and completed the questionnaire survey. The particulate matter (PM) samples were collected in the PRD and the PM2.5-bound CP concentrations were analyzed. In the multivarious adjustment mixed effect model (MEM), an IQR increase in ∑CPs was significantly associated with allergic diseases (rhinitis, eczema, and conjunctivitis) with the estimated odds ratios (ORs) for 1.11 (95% CI: 1.10, 1.13), 1.17 (95% CI: 1.15, 1.19), and 1.82 (95% CI: 1.76, 1.88), respectively. Interaction analysis indicated that overweight and obese individuals might have greater risk. Similar effect estimates were observed in several sensitivity analyses. This study provided epidemiological evidence on the immunotoxicity of CPs. More studies to confirm our findings and investigate mechanisms are needed.

Алергічні захворювання в дітей: сучасний погляд на проблему

Aim: review of modern data of scientific medical literature regarding the prevalence, comorbidity, risk factors, features of pathogenesis, diagnosis, principles of treatment and prevention of allergic diseases in children. In recent years, the number of allergic diseases (ADs) has been increasing, especially among children. Approximately 20% of the world's population suffers from these diseases. Comorbid ADs are quite common. Thus, in 67–85% of children, allergic rhinitis is combined with bronchial asthma. Children with atopic dermatitis are diagnosed with allergic rhinitis in 61,8% of cases, and bronchial asthma in 29,4% of cases. The risk of developing bronchial asthma or allergic rhinitis is higher in children with food polysensitization, and infants and young children with atopic dermatitis have a high risk of developing both food allergy and asthma and allergic rhinitis. According to modern data, most ADs have common causal mechanisms. In the development and progression of asthma and allergic rhinitis and atopic dermatitis, the hypotheses of mechanistic damage of the epithelial barrier and biodiversity, related to each other, are considered. In ADs, mechanisms related to allergen-specific immunoglobulin E and non-allergic coexisting mechanisms play an important role. In addition, views on the formation of the sequence of the development of ADs ("allergic march") from the perspective of multimorbidity and phenotyping are increasingly expanding. Pathogenetic treatment of ADs is aimed at controlling the chronic T-helper 2, caused by the inflammatory process in target organs. Secondary and tertiary prevention of ADs in the early stages improves the quality of life of patients and improves the course of atopic conditions. Conclusions. The prevalence of ADs in modern conditions is pandemic in nature. The hypothesis of mechanical damage to the epithelial barrier is significant in the development of ADs. ADs, in particular in children, can be combined, creating multi- and comorbid conditions, and aggravate the course of these diseases. Timely diagnosis of ADs is important, and a personalized approach to the treatment and prevention of ADs is considered the most rational.

Association of factors with childhood asthma and allergic diseases using latent class analysis

We hypothesize that children characterized by deprived factors have poorer health outcomes. We aim to identify clustering of determinants and estimate risk of early childhood diseases. This 1993–2019 longitudinal cohort study combines three Canadian pediatric cohorts and their families. Mothers and children are clustered using latent class analysis (LCA) by 16 indicators in three domains (maternal and newborn; socioeconomic status [SES] and neighbourhood; environmental exposures). Hazard ratios (HR) of childhood asthma, allergic rhinitis (AR), and eczema are quantified with Cox proportional hazard (PH) regression. Rate ratios (RR) of children’s health services use (HSU) are estimated with Poisson regression. Here we report the inclusion of 15,724 mother–child pairs; our LCA identifies four mother-clusters. Classes 1 and 2 mothers are older (30–40 s), non-immigrants with university education, living in high SES neighbourhoods; Class 2 mothers have poorer air quality and less greenspace. Classes 3 and 4 mothers are younger (20–30 s), likely an immigrant/refugee, with high school-to-college education, living in lower SES neighborhoods with poorer air quality and less greenspace. Children’s outcomes differ by Class, in comparison to Class 1. Classes 3 and 4 children have higher risks of asthma (HR 1.24, 95% CI 1.11–1.37 and HR 1.39, 95% CI 1.22–1.59, respectively), and similar higher risks of AR and eczema. Children with AR in Class 3 have 20% higher all-cause physician visits (RR = 1.20, 95% CI 1.10–1.30) and those with eczema have 18% higher all-cause emergency department visits (RR = 1.18, 95% CI 1.09–1.28) and 14% higher all-cause physician visits (RR = 1.14, 95% CI 1.09–1.19). Multifactorial-LCA mother-clusters may characterize associations of children’s health outcomes and care, adjusting for interrelationships.

Early childhood neurodevelopmental milestones in children with allergic diseases: the Japan Environment and Children’s Study (JECS)

This study investigated the potential link between early childhood allergic diseases and neurodevelopmental milestone attainment during the first 3 years of life. Utilizing data from a large-scale prospective birth cohort study in Japan, encompassing 87,986 children, we examined physician-diagnosed and caregiver-reported allergic conditions, including atopic dermatitis (AD), asthma, and food allergy (FA). Neurodevelopmental milestones were assessed using the Ages and Stages Questionnaires at 1, 1.5, 2, 2.5, and 3 years of age. Stabilized inverse probability-weighted generalized estimating equation models were employed to estimate odds ratios (ORs). Our analysis revealed no significant association of AD and asthma with delay in communication, gross motor, fine motor, problem-solving, and personal-social skills during the initial 3 years of life. However, children with FA showed an increased likelihood of experiencing gross motor delay compared with that shown by those without FA (weighted adjusted OR: 1.14). Despite this, no significant association of FA with other developmental domains was observed. Early childhood allergies may not influence neurodevelopmental delays. However, there is a potential association between FA and delays, specifically in gross motor skills, that warrants routine developmental monitoring and additional investigations.

Allergic diseases in children: A continuing challenge for the Allergist-Immunologist.

Allergic diseases in children: A continuing challenge for the Allergist-Immunologist.

Systematic review of the association between short chain fatty acids and allergic diseases.

We performed a systematic review to investigate the current evidence on the association between allergic diseases and short chain fatty acids (SCFAs), which are microbially produced and suggested as one mechanism on how gut microbiome affects the risk of allergic diseases. Medline, Embase and Web of Science were searched from data inception until September 2022. We identified 37 papers, of which 17 investigated prenatal or early childhood SCFAs and the development of allergic diseases in childhood, and 20 assessed SCFAs in patients with pre-existing allergic diseases. Study design, study populations, outcome definition, analysis method and reporting of the results varied between papers. Overall, there was some evidence showing that the three main SCFAs (acetate, propionate and butyrate) in the first few years of life had a protective effect against allergic diseases, especially for atopic dermatitis, wheeze or asthma and IgE-mediated food allergy in childhood. The association between each SCFA and allergic disease appeared to be different by disease and the age of assessment. Further research that can determine the potentially timing specific effect of each SCFA will be useful to investigate how SCFAs can be used in treatment or in prevention against allergic diseases.

Cutaneous mastocytosis and allergic diseases in children: A cross-sectional study

BACKGROUND: Mastocytosis is a heterogeneous group of diseases characterized by abnormal accumulation of clonal mast cells in one or more organs. Comorbidities in patients with mastocytosis include IgE-dependent allergies, psychiatric or psychological disorders, and vitamin D deficiency. Despite the clinical similarities between allergies and mastocytosis, only a few European studies have considered these comorbidities.
 AIM: To analyze the frequency of concomitant-allergic diseases in children with cutaneous mastocytosis.
 MATERIALS AND METHODS: Data of 248 children aged 6 months to 17 years who were diagnosed with cutaneous mastocytosis and received outpatient treatment and observation at the Moscow Scientific and Practical Center for Dermatovenereology and Cosmetology between March 2022 and June 2023 were analyzed. Serum levels of total and allergen-specific IgE were analyzed in children with and without allergic diseases. In addition, a positive history of allergy was analyzed in close relatives of children with cutaneous mastocytosis.
 RESULTS: Every third child (36.7%) with cutaneous mastocytosis had a concomitant allergic disease. Relatives of 27.4% of the examined children had allergic diseases. The process was significantly more often accompanied by allergic diseases in children with mastocytomas than in those with maculopapular cutaneous mastocytosis (χ2=45.46; p=0.001). The level of total IgE was not a statistically significant sign of the presence of allergic diseases in cutaneous mastocytosis (χ2=1.161; p=0.3). Allergen-specific IgE was detected in 47.2% of the children with allergic diseases. Among children without signs of food allergy and pollinosis, asymptomatic low and moderate sensitization to any plant product and birch was detected in 26.5%. Sensitization to respiratory allergens was found in 8% of children with cutaneous mastocytosis without allergic diseases.
 CONCLUSIONS: In Russia, this study demonstrated for the first time a high incidence of allergic diseases in children with cutaneous mastocytosis. The results showed that all clinical forms of mastocytosis in children, including cutaneous mastocytosis, should be subjected to interdisciplinary observation and examination. The timely detection of comorbid allergic diseases contributes to the development of individual techniques for the treatment and prevention of complications and anaphylaxis.

Quantitative and species changes in the local microbiota of the upper respiratory tract in allergic rhinitis

BACKGROUND: The role of local microflora in the pathogenesis of allergic rhinitis has not been sufficiently studied; therefore, the study of changes in the nasal microbiome is of interest from a scientific and practical point of view.
 AIM: To evaluate changes in the local microbiota of the nasal mucosa in patients with seasonal and year-round allergic rhinitis before and after pharmacological and allergen-specific therapy.
 MATERIALS AND METHODS: An observational retrospective single-center case-control study was conducted, which included 182 patients with allergic rhinitis. The groups were randomized according to the diagnosis (seasonal and year-round allergic rhinitis) and the therapy used: basic pharmacotherapy and allergen-specific (sublingual) immunotherapy.
 RESULTS: In total, 182 patients completed the study, of which 50 had seasonal allergic rhinitis, 51 had seasonal allergic rhinitis + atopic asthma (aged 7–42 years), and 81 had year-round allergic rhinitis, which included 29 aged 12–54 years and 52 with year-round allergic rhinitis + atopic asthma, aged 12–39 years. Patients with allergic rhinitis were divided into two subgroups: those who received basic therapy to achieve remission and those who received allergen-specific (sublingual) immunotherapy. After basic therapy, the abundance of Staphylococcus aureus in the local microbiota of the upper respiratory tract in patients with seasonal allergic rhinitis decreased by 1.4 times; in the allergen-specific (sublingual) immunotherapy group, its abundance more significantly decreased (3.9 times; p 0.05). In the group with year-round allergic rhinitis, the same pattern was noted. In the group with seasonal allergic rhinitis and year-round allergic rhinitis and the group with both allergen-specific (sublingual) immunotherapy and atopic asthma who received a full course of allergen-specific (sublingual) immunotherapy, the activation index of blood basophils by rSplA-proteinase S. aureus was reduced by 1.2–1.5 compared with the value in those who received basic pharmacotherapy.
 CONCLUSION: Patients with allergic rhinitis exhibited quantitative and qualitative significant changes in the microbiome of the upper respiratory tract mucosa, one of the consequences of which is the development of IgE-mediated sensitization to S. aureus products. Allergen-specific immunotherapy for patients with allergic rhinitis leads to decreased colonization of the nasal mucosa with S. aureus and decreased sensitization to rSplA proteinase.

Risk of immune-related diseases in childhood after intrapartum antibiotic exposure

Intrapartum antibiotic prophylaxis is effective in preventing early-onset group B streptococcal disease in newborn infants, but it influences gut microbiota development. Gut microbiota composition is, in turn, associated with immune-related diseases in childhood. This study hypothesized that intrapartum antibiotic exposure is associated with immune-related diseases in childhood. We conducted a population-based cohort study of vaginally delivered children. We retrieved data on intrapartum antibiotic exposure from structured electronic medical records and obtained outcome data on childhood autoimmune, allergic, and obstructive airway diseases from comprehensive national registers. We used Cox regression analysis with adjustment for maternal and neonatal covariates and regarded death as a competing risk in the analyses. The study population comprised 45,575 vaginally born children of whom 9733 (21%) had been exposed to intrapartum antibiotics. Intrapartum antibiotic exposure was associated with an autoimmune disease diagnosis (adjusted hazard ratio, 1.28; 95% confidence interval, 1.02-1.62), which corresponds to 22% (95% confidence interval, 6-39) as a theoretical population-attributable fraction. Intrapartum antibiotic exposure was not associated with diagnoses of allergic (adjusted hazard ratio, 1.08; 95% confidence interval, 0.97-1.20) or obstructive airway diseases (adjusted hazard ratio, 1.04; 95% confidence interval, 0.96-1.14). Intrapartum antibiotic exposure may be associated with an increased risk for autoimmune diseases in childhood. This finding supports the efforts to develop more specific group B streptococcal disease prevention strategies in the future.

Farm animal exposure, respiratory illnesses, and nasal cell gene expression

BackgroundFarm exposures in early life reduce the risks for childhood allergic diseases and asthma. There is less information about how farm exposures relate to respiratory illnesses and mucosal immune development. ObjectiveWe hypothesized that children raised in farm environments have a lower incidence of respiratory illnesses over the first two years of life than non-farm children. We also analyzed whether farm exposures or respiratory illnesses were related to patterns of nasal cell gene expression. MethodsThe Wisconsin Infant Study Cohort included farm (n=156) and non-farm (n=155) families with children followed to age 2 years. Parents reported prenatal farm and other environmental exposures. Illness frequency and severity were assessed using illness diaries and periodic surveys. Nasopharyngeal cell gene expression in a subset of 64 children at age two years was compared to farm exposure and respiratory illness history. ResultsFarm vs. non-farm children had nominally lower rates of respiratory illnesses (rate ratio 0.82 [0.69,0.97]) with a stepwise reduction in illness rates in children exposed to 0, 1, or ≥2 animal species, but these trends were non-significant in a multivariable model. Farm exposures and preceding respiratory illnesses were positively related to nasal cell gene signatures for mononuclear cells and innate and antimicrobial responses. ConclusionsMaternal and infant exposure to farms and farm animals was associated with nonsignificant trends for reduced respiratory illnesses. Nasal cell gene expression in a subset of children suggests that farm exposures and respiratory illnesses in early life are associated with distinct patterns of mucosal immune expression.

Association of exposure to indoor molds and dampness with allergic diseases at water-damaged dwellings in Korea

This study aims to characterize levels of molds, bacteria, and environmental pollutants, identify the associations between indoor mold and dampness exposures and childhood allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, using three different exposure assessment tools. A total of 50 children with their parents who registered in Seoul and Gyeonggi-do in Korea participated in this study. We collated the information on demographic and housing characteristics, environmental conditions, and lifestyle factors using the Korean version of the International Study of Asthma and Allergies in Childhood questionnaire. We also collected environmental monitoring samples of airborne molds and bacteria, total volatile organic compounds, formaldehyde, and particulate matter less than 10 µm. We evaluated and determined water damage, hidden dampness, and mold growth in dwellings using an infrared (IR) thermal camera and field inspection. Univariate and multivariate regression analyses were performed to evaluate the associations between prevalent allergic diseases and exposure to indoor mold and dampness. Indoor mold and bacterial levels were related to the presence of water damage in dwellings, and the mean levels of indoor molds (93.4 ± 73.5 CFU/m3) and bacteria (221.5 ± 124.2 CFU/m3) in water-damaged homes were significantly higher than those for molds (82.0 ± 58.7 CFU/m3) and for bacteria (152.7 ± 82.1 CFU/m3) in non-damaged dwellings (p < 0.05). The crude odds ratios (ORs) of atopic dermatitis were associated with < 6th floor (OR = 3.80), and higher indoor mold (OR = 6.42) and bacterial levels (OR = 6.00). The crude ORs of allergic diseases, defined as a group of cases who ever suffered from two out of three allergic diseases, e.g., asthma and allergic rhinitis, and allergic rhinitis were also increased by 3.8 and 9.3 times as large, respectively, with water damage (+) determined by IR camera (p < 0.05). The adjusted OR of allergic rhinitis was significantly elevated by 10.4 times in the water-damaged dwellings after adjusting age, sex, and secondhand smoke. Therefore, a longitudinal study is needed to characterize dominant mold species using DNA/RNA-based sequencing techniques and identify a causal relationship between mold exposure and allergic diseases in the future.

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

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.