High Risk Of Atopy Research Articles

Features of the parietal and cavity intestinal microbiota in infants born to mothers with bronchial asthma, depending on the mode of delivery

Introduction. Intestinal microbiota is a complex and unique system in its composition, performing a huge number of diverse functions in the body. Its formation begins in utero.Aim. To study the features of the parietal and cavity intestinal microbiota in children born to mothers suffering from moderate bronchial asthma, depending on the mode of delivery.Material and methods. A prospective longitudinal study was carried out, which included children from the first day of life to 12 months. A total of 68 children at high risk of atopy (HRA) from mothers with asthma were included, of whom 22 were born by cesarean section and 46 were born through the vaginal birth canal. Qualitative and quantitative analysis of GM was carried out by real-time PCR with group- and species-specific primers: in the examined children, the dynamics of 4 phylums including 31 microorganisms was assessed. The child’s feces and brush-biopsy were taken from the rectum at 7 control points of measurement.Results and discussion. The data obtained showed that the method of delivery has an impact on the formation of the intestinal microbiota: in children born by cesarean section, in the parietal microbiota, starting from the age of 1–2 months, and in the cavity microbiota – 3–4 months, representatives of phylum Firmicutes (Clostridium leptum gr m.). In children born through the vaginal birth canal, all the first 8 months of life in the cavity and parietal microbiota were dominated by representatives of phylum Bacteroidetes (Bacteroides spp., Prevotella spp.). Clostridium leptum can be a marker of an inflammatory process in the intestinal mucosa in children at high risk of atopy. The research conducted over the past few years has found that Clostridium leptum promotes the secretion of anti-inflammatory (IL-10 and IL-12) and inhibition of the production of pro-inflammatory (IL-8) cytokines, and also boosts the number of Treg cells.Conclusion. The mode of delivery in children with a high risk of atopy is an additional epigenetic factor that influences the nature of both the parietal and cerebrospinal microbiota.

Derangement of the infant microbiome development: what a pediatrician needs to know. A review

The research on the microbiome and microbiota of different human ecological niches and their impact on human health showed a significant breakthrough in the last decade. It is known that minor microbial contamination is present even in the fetus in utero, inducing immunological resistance. Immediately after birth, the baby rapidly becomes colonized by maternal and environmental microorganisms. The mode of delivery impacts the number of microbes and species composition and subsequent changes in the infant's immune response. A high risk of early onset of atopic march has been reported in children born by cesarean section and treated with antibacterial drugs in early life. This paper reviews the results of recent studies of the effect of the probiotic based on the two most studied strains of Lactobacillus rhamnosus GG and Bifidobacterium lactis BS01 (Probielle Baby) on intestinal microbiota development and the prospects of its use for correcting disorders in children at high risk of atopy.

The Role of Dietary Fiber or Prebiotics in Atopic Dermatitis

Introduction: Atopic Dermatitis (AD) is a chronic inflammatory skin condition with itchy eczematous lesions, mostly found in children, and may affect a patient’s quality of life. Individuals with AD were found to have dysbiosis of gut microbial, which may alter the immunologic tolerance of mucosa, causing inflammation and affecting skin conditions. Dietary fiber or prebiotics consumption may have a role in reversing dysbiosis and may affect AD. In this literature review, the authors would like to further explore the role of dietary fiber or prebiotics in the prevention and severity of AD/
 Methods: Relevant literature research was conducted in several sources: Pubmed, EBSCOHOST, Proquest, and Google Scholar, using keywords “atopic dermatitis, atopic eczema, dietary fiber, prebiotic, nutrition.” Studies published within the last 10 years were included.
 Discussions: Dietary fiber, particularly soluble fibers and those which can be fermented by gut bacteria (including prebiotics), plays a role in maintaining homeostasis of normal gut flora by producing SCFA, which increases the gut barrier, has anti-inflammatory properties, balances Th1/Th2 ratio, increases lymphocytes in gut-associated lymphoid tissues (GALT) system, and increases secretion of intestinal IgA. The role of dietary fiber/prebiotics in the prevention or decreasing rate of AD is still a matter of debate. Several studies showed no effect or correlation of prebiotic supplementation in decreasing the AD rate in pregnant women or babies with a high risk of atopy. On the other hand, several studies on prebiotic supplementation for babies and children have shown the benefits of prebiotic supplementation in preventing allergies (AD, rhinoconjunctivitis, and urticaria).
 Conclusion: The role of dietary fiber/prebiotics in preventing or treating AD is still a matter of debate. Different study results make it difficult to conclude the clinical effect of prebiotics in allergy prevention, particularly AD. This may be caused by the heterogeneous studies and the limited number of studies on humans. Further studies (RCT) involving large-scale respondents are needed to define the effects of prebiotic supplementation in the prevention or alternative therapy for AD.

Premature Infants have no Higher Risk of Atopy and Respiratory Functions Compared to Control at 4-6 Years of Age.

This study aimed to evaluate the respiratory functions and atopy conditions of preterm infants treated with aminophylline or caffeine for apnea in NICU in early childhood. This is a retrospective cohort study. In this study, 27 patients aged 4 to 6 years hospitalized in NICU for prematurity and 26 healthy children were included. The subjects were evaluated for fx5, phadiatope, total IgE levels, skin tests, and respiratory function tests. There was no statistically significant difference among groups in terms of fx5, phadiatope, total IgE levels, and skin test results. Moreover, no statistically significant difference was found among the groups in terms of FVC, FEV1, FEV1/ FVC, PEF, MEF75, MEF50, MEF25, and MEF25-75 values in respiratory function tests. Preterm neonates with bronchopulmonary dysplasia (BPD) had higher FEV1 values compared to ones without BPD (p=0.02). Preterm infants treated with aminophylline or caffeine did not have a higher risk of atopy and had similar respiratory function tests compared to healthy infants at 4-6 years old. However, FEV1 values were higher in infants with BPD. These results suggested that respiratory functions could be affected in the long-term follow-up of premature infants with BPD.

Пристеночная и полостная кишечная микробиота у детей первого года жизни, рожденных от матерей с бронхиальной астмой

Objective. To study the luminal and mucosal-associated intestinal microbiota (IM) in children at high risk of atopy during the first year of life depe nding on the type of feeding in the early neonatal period. Patients and methods. This prospective, longitudinal, randomized study included pairs of pregnant women and their children. They were divided into two groups: the study group, which consisted of patients with high risk of atopy (39 full-term infants born through vaginal delivery to mothers with bronchial asthma), and the control group, which enrolled patients with low risk of atopy (26 full-term infants born through vaginal delivery to healthy mothers). Depending on the type of feeding in the early neonatal period, subgroups A (exclusively breastfed infants) and B (formula-fed infants) were identified. The intestinal microbiota was examined on day 2-3 and then every 2 months until the child reached the age of 1 year; stool specimens and brushing specimens from the rectum were collected. The luminal and mucosal-associated IM were analyzed using a real-time polymerase chain reaction with group- and species-specific primers in 4 phylums including 31 microorganisms. Results. The IM parameters were influenced by the following: the source of sampling (luminal IM values were higher than that of mucosal-associated IM and increased with the age of children), mass of microorganisms studied (increased with age regardless of the type of feeding in the early neonatal period, but the most diverse IM was noted in children with HRA), the type of infant feeding (had no effect on bacterial mass except for Clostridium dificile, whose mass was higher in exclusively breastfed infants with HRA (F(1.61) = 5.68; p = 0.020; η2 p = 0.09)), and also depended on the child’s age at the time of sampling (F(6.366) = 294.63; p < 0.001 ; η2 p = 0.83) (increased with age) and the source of sampling (higher in mucosal-associated IM) (F(1.61) = 141.12; p < 0.001 ; η2 p = 0.70). The presence of maternal bronchial asthma had the most significant effect on the quantitative and qualitative composition of IM. Conclusion. Children at high risk of atopy had a greater diversity of both the luminal and mucosal-associated intestinal microbiota. The presence of maternal bronchial asthma is the most significant factor modifying the intestinal microbiota of the child. Key words: atopy, bronchial asthma, infants, feeding, luminal and mucosal-associated intestinal microbiota

Indian Academy of Pediatrics Guidelines for Pediatric Skin Care

To develop standard recommendations for skin care in neonates, infants and children to aid the pediatrician to provide quality skin care to infants and children. Though skin is the largest organ in the body with vital functions, skin care in children especially in newborns and infants, is not given the due attention that is required. There is a need for evidence-based recommendations for the care of skin of newborn babies and infants in India. A committee was formed under the auspices of Indian Academy of Pediatrics in August, 2018 for preparing guidelines on pediatric skin care. Three meetings were held during which we reviewed the existing guidelines/ recommendations/review articles and held detailed discussions, to arrive at recommendations that will help to fill up the knowledge gaps in current practice in India. The initial draft of the manuscript based on the available evidence and experience, was sent to all members for their inputs, after which it was finalized. Vernix caseosa should not be removed. First bath should be delayed until 24 hours after birth, but not before 6 hours, if it is not practically possible to delay owing to cultural reasons. Duration of bath should not exceed 5-10 minutes. Liquid cleanser with acidic or neutral pH is preferred, as it will not affect the skin barrier function or the acid mantle. Cord stump must be kept clean without any application. Diaper area should be kept clean and dry with frequent change of diapers. Application of emollient in newborns born in families with high risk of atopy tends to reduce the risk of developing atopic dermatitis. Oil massage has multiple benefits and is recommended. Massage with sunflower oil, coconut oil or mineral oil are preferred over vegetable oils such as olive oil and mustard oil, which have been found to be detrimental to barrier function.

Impaired Lung Functions Using Tidal Breath Analysis in High-risk Infants with Recurrent Wheezing

Objective: We aimed to investigate lung functions using tidal breath analysis (TBA) in high-risk infants with recurrent wheezing. Methods: Lung functions measured using TBA in infants with physician-diagnosed recurrent wheezing (≥3 episodes) who applied our institution between 2018-2020, were retrospectively analyzed. Infants were assigned to two groups: high-risk infants with recurrent wheezing (n=30) and wheezy infants without high risk of atopy (n=33). Results: High-risk infants with recurrent wheezing had lower mean values of tPTEF, tPTEF: tE, VPTEF, and VPTEF: VE than that of wheezy infants without high risk of atopy. There was no significant difference between two groups in terms of Vt/kg and respiratory rate. ROC curve analysis showed that tPTEF: tE ratio <26.5 demonstrated 63.3% sensitivity and 63.6% specificity for detection of high risk of atopy. Conclusion: This study showed that high-risk infants with recurrent wheezing have lower lung function than those of wheezy infants without high risk of atopy. TBA might be useful method to evaluate lung function in wheezy infants.

Supporting a Healthy Microbiome for the Primary Prevention of Eczema.

Eczema is increasing worldwide with associated increases in health costs and decreases in quality of life. There are many factors that are speculated to interact in the development of eczema including genetics and environmental exposures. Prevention of the development of eczema may prevent the further development of food allergies and asthma. This concept has prompted a variety of research into the area of primary prevention of eczema in infants. This exploration includes a growing body of research examining infants supplemented with probiotics, prebiotics, or both (synbiotics) often compared with their breastfed counterparts. The goal of this paper is to examine the evidence for manipulating the microbiome in the prevention of eczema. Several strains of probiotics, compositions of prebiotics, and varied combinations of both are commercially available. Evidence supports altering the microbiome in infants at high risk of atopy who are not able to breastfeed with Lactobacillus strains when given both prenatally followed by prolonged use (greater than 6months) postnatally for the primary prevention of eczema. Prebiotics have also been shown beneficial for primary prevention of eczema in formula-fed infants with prolonged use greater than 6months. These findings are in keeping with the World Allergy Organization (WAO) recommendations that support interventions to manipulate the microbiome with both probiotics and prebiotics.

Galacto-Oligosaccharide/Polidextrose Enriched Formula Protects against Respiratory Infections in Infants at High Risk of Atopy: A Randomized Clinical Trial.

Background: Early nutrition affects the risk of atopy and infections through modifications of intestinal microbiota. The Prebiotics in the Prevention of Atopy (PIPA) study was a 24-month randomised, double-blind, placebo-controlled trial. It aimed to evaluate the effects of a galacto-oligosaccharide/polydextrose (GOS/PDX)-formula (PF) on atopic dermatitis (AD) and common infections in infants who were born to atopic parents and to investigate the relationship among early nutrition, gut microbiota and clinical outcomes. Methods: A total of 201 and 199 infants were randomized to receive a PF and standard formula (SF), respectively; 140 infants remained on exclusive breastfeeding (BF). Results: The cumulative incidence of AD and its intensity and duration were not statistically different among the three groups. The number of infants with at least one episode of respiratory infection (RI) and the mean number of episodes until 48 weeks of age were significantly lower in the PF group than in the SF group. The number of patients with recurrent RIs and incidence of wheezing lower RIs until 96 weeks were lower in the PF group than the SF group, but similar to the BF group. Bifidobacteria and Clostridium cluster I colonization increased over time in the PF group but decreased in the SF and BF groups. Bifidobacteria had a protective role in RIs, whereas Clostridium cluster I was associated with atopy protection. Conclusion: The early administration of PF protects against RIs and mediates a species-specific modulation of the intestinal microbiota. Trial registration: clinicaltrial.gov Identifier: NCT02116452.

Elevated blood eosinophils in early infancy are predictive of atopic dermatitis in children with risk for atopy.

Accessible markers to predict the development of atopic diseases are highly desirable but yet matter of debate. We investigated the role of blood eosinophils at 4 weeks and 7 months of life and their association with developing atopic dermatitis (AD) in a birth cohort of children with atopic heredity. Infant blood samples for eosinophil counts were taken from 559 infants at 4 weeks and from 467 infants at 7 month of life with at least one atopic parent. Elevation of blood eosinophils was defined as ≥ 5% of total leukocytes and the asscociation for the occurrence of AD was assessed by entering 2 × 2 tables and the odds ratios were estimated followed by hypothesis testing against the alternate working hypothesis: odds ratio < > 1. Survival analysis was carried out estimating the Kaplan-Meier product limit estimator from the life-time table of AD score and time to AD manifestation stratified by the eosinophil binary score. Elevated blood eosinophils observed at 4 weeks were significantly associated with the occurrence of AD in the whole cohort at the age of 7 months (p = 0.007), 1 year (p = 0.004), 2 years (p = 0.007) and 3 years (p = 0.006) of life. AD occurred app. 12 weeks earlier in infants with elevated blood eosinophils at 4 weeks of life. Blood eosinophil counts ≥5% at 7 months of life failed to show significance for AD; for eosinophils at 4.5% a significant association at 7 months (p = 0.005), and 1 year of life (p = 0.039), 2 years (p = 0.033) and 3 years (p = 0.034) was observed. Elevated blood eosinophils at age 4 weeks have a predictive value for the onset of atopic dermatitis in infancy and early childhood in children with high risk for atopy. Early eosinophil counts may therefore be helpful for counseling parents to provide infant skincare but furthermore identify individuals for interventional trials aiming at allergy prevention.

A clinical reading on “World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Probiotics”

To the Editor Since the immunomodulatory properties of probiotics have been described, the effect of probiotic supplementation has been investigated in several trials and it has been also proposed as a preventive intervention for the development of allergic diseases. Recently two important evidence-based recommendations about the use of probiotics in the prevention of allergy were published [1, 2] with conflicting conclusions, in particular the most recent guideline [1] seems to be partially in contradiction with the previous statements about prevention of eczema. For these reasons, we tried to analyze the evidences leading to these recommendations [1] to highlight the aspects that can be more directly related or correlated with clinical practice. This clinical reading was addressed to offer some reflections about the methods used to formulate such recommendations, and the possibility to adopt in the clinical practice the proposed conclusions. We tried to retraces the path proposed by the Authors to analyse three important questions about the efficacy of probiotics in preventing allergic diseases if administrated to pregnant women (first question), to breastfeeding mothers (second question) and in healthy infants (third question). These questions have been investigated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach [3], to perform a systematic review of randomized controlled trials and formulate recommendations. In summary, the GRADE method aims to define a rigorous and explicit method for the production of clinical recommendations. According to this method, the knowledge of advantages and disadvantages, benefits and risks of an intervention is necessary to make decisions in the health field. The GRADE approach also provides a three-phases decisional framework: a) formulation of a clinical question, with the choice and the formal evaluation of its related outcomes, and systematic evaluation of the scientific literature and the quality of the evidence; b) evaluation of the benefits and risks associated to the intervention, taking also in consideration its feasibility, the necessary resources and the patients’ preferences; c) formal definition of the strength of the recommendation. From a methodological point of view, it should be noted that the recommendations are directed to patients, clinicians and other health care professionals with different objectives, as clearly explained in the guidelines introduction. Each recommendation can have different levels of strength: strong recommendation indicates that patients would like to receive the intervention and that clinicians should actuate it. Conditional or weak recommendation indicates that the majority of patients would like to receive the intervention, but many other not, as well as they hope that clinicians would recognize that different choices may be appropriate for different patients, by taking advantage of decision-making tools to help patients to make consistent choices. In the results section of the guidelines we can read that “Currently available evidence does not indicate that probiotic supplementation reduces the risk of developing * Correspondence: giampaolo.ricci@unibo.it Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital, Pad 16, via Massarenti 11, 40138 Bologna, Italy Full list of author information is available at the end of the article

Randomized controlled trial of primary prevention of atopy using house dust mite allergen oral immunotherapy in early childhood

Children born to atopic parents are at increased risk of sensitization to environmental allergens. We sought to demonstrate proof of concept for oral immunotherapy to high-dose house dust mite (HDM) allergen in infancy in the prevention of allergen sensitization and allergic diseases. This was a prospective, randomized, double-blind, placebo-controlled, proof-of-concept study involving 111 infants less than 1 year of age at high risk of atopy (≥ 2 first-degree relatives with allergic disease) but with negative skin prick test responses to common allergens at randomization. HDM extract (active) and appropriate placebo solution were administered orally twice daily for 12 months, and children were assessed every 3 months. Coprimary outcomes were cumulative sensitization to HDM and sensitization to any common allergen during treatment, whereas development of eczema, wheeze, and food allergy were secondary outcomes. All adverse events were recorded. There was a significant (P = .03) reduction in sensitization to any common allergen (16.0%; 95% CI, 1.7% to 30.4%) in the active (5 [9.4%]) compared with placebo (13 [25.5%]) treatment groups. There was no treatment effect on the coprimary outcome of HDM sensitization and the secondary outcomes of eczema, wheeze, and food allergy. The intervention was well tolerated, with no differences between active and placebo treatments in numbers or nature of adverse events. Prophylactic HDM oral immunotherapy is well tolerated in children at high heredity risk. The results met the trial's prespecified criteria for proof of concept in reducing sensitization to any allergen; however, no significant preventive effect was observed on HDM sensitization or allergy-related symptoms.

Early-life antibiotic use is associated with wheezing among children with high atopic risk: a prospective European study

Background: Little is known about the relationship between antibiotic use and asthma in the children with a higher risk of allergic sensitization. We examine the association between the use of specific therapeutic antibiotics in the first year of life and development of wheezing by 36 months among children with a higher risk of allergic sensitization. Methods: A multi-center prospective cohort study was conducted among children at high risk for allergic sensitization. A validated questionnaire was used to prospectively collect information on antibiotic use and potential risk factors for wheezing from parents or guardians of 606 children from three European countries at 6, 12, 24 and 36 months of age. Multivariate linear and logistic regression models were used to adjust for potential confounders and effect modifiers and to estimate the association of antibiotic use with the development of early childhood wheezing. Results: Of the antibiotics assessed, only macrolide use in the first year of life was associated with increasing risk for wheezing by 36 months, after adjusting for gender, socioeconomic status, breast feeding >6 months, tobacco smoke exposure, family history of asthma, and respiratory infection (RR = 1.09; 95% CI 1.05–1.13). To avoid a bias by indication, we analyzed children with and without respiratory infection separately. Similar associations were observed for macrolides use in children who had no respiratory infection. Conclusions: In European children with a familial risk for allergic sensitization, we found a positive association between macrolide use in the first year of life and wheezing until 36 months old which was independent of the effect of respiratory infection.

IL-4 and IL-13 regulate TLR expression and eosinophil-basophil differentiation of cord blood CD34+ progenitor cells

Background Intrauterine environmental exposures have been shown to influence neonatal immunity and subsequent allergic disease development [1]. We have previously shown that cord blood (CB) progenitor cells of high atopic risk infants have reduced toll-like receptor (TLR) expression and produce fewer lipopolysaccharide (LPS)-stimulated eosinophil-basophil (Eo/B) colonies, compared to lowatopic risk infants. In the present study, we investigated whether a surrogate ex vivo TH2 milieu (i.e., either IL-4 or IL-13), could represent an underlying mechanism to explain our previous findings.

IL-4 and IL-13 differentially regulate TLR-induced eosinophil-basophil differentiation of cord blood CD34+ progenitor cells.

Intrauterine environmental exposures have been shown to influence neonatal immunity and subsequent allergic disease development. We have previously shown that fewer lipopolysaccharide (LPS)-stimulated eosinophil-basophil (Eo/B) colonies grow from cord blood (CB) of high-atopic risk infants, compared to low-atopic risk infants. In the present study, we investigated whether a surrogate ex vivo TH2 milieu (i.e., either IL-4 or IL-13) could represent an underlying mechanism to explain our previous findings. CB CD34+ cells from healthy donors were cultured with IL-4 or IL-13 (in combination with LPS) and assessed for Eo/B differentiation using methylcellulose cultures and flow cytometry for related intracellular signalling pathways. Pharmacological inhibitors were added to the methylcellulose cultures to determine the effect of blocking intracellular signalling in CB CD34+ cells in relation to Eo/B colony forming unit (CFU) formation. Stimulation of CD34+ cells with IL-4, but not IL-13, reduced Eo/B CFU formation in the presence of LPS; this was found to be dependent on IL-4Rα and not IL-13Rα1. Additionally, IL-4 reduced the expression of ERK 1/2 after LPS stimulation, which was recovered by inhibition of IL-4Rα. While IL-13 did not have an inhibitory effect on ERK 1/2 expression, inhibition of ERK 1/2 significantly reduced Eo/B CFU formation. Thus, the responsiveness of CB CD34+ progenitor cells to LPS is differentially regulated by the TH2 cytokines, IL-4 and IL-13. This may have implications for in utero interactions between placental-derived pro-allergic cytokines and neonatal progenitor cells influencing Eo/B-mediated inflammatory responses in early life.

Effect of maternal ω3 fatty acid supplementation on infant allergy

The prevalence of atopic disease has steadily increased during the past half century, reaching epidemic proportions in the last several years. The underlying cause is unknown but is likely due to a complex interaction of many factors. 1 Priftis K.N. Mantzouranis E.C. Anthracopoulos M.B. Asthma symptoms and airway narrowing in children growing up in an urban versus rural environment. J Asthma. 2009; 46: 244-251 Crossref PubMed Scopus (17) Google Scholar , 2 Kang B.C. Johnson J. Veres-Thorner C. Atopic profile of inner-city asthma with a comparative analysis on the cockroach-sensitive and ragweed-sensitive subgroups. J Allergy Clin Immunol. 1993; 92: 802-811 Abstract Full Text PDF PubMed Scopus (97) Google Scholar , 3 Martino D. Prescott S. Epigenetics and prenatal influences on asthma and allergic airways disease. Chest. 2011; 139: 640-647 Crossref PubMed Scopus (178) Google Scholar , 4 Dunstan J.A. Mori T.A. Barden A. et al. Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial. J Allergy Clin Immunol. 2003; 112: 1178-1184 Abstract Full Text Full Text PDF PubMed Scopus (432) Google Scholar , 5 Martinez F.D. Cline M. Burrows B. Increased incidence of asthma in children of smoking mothers. Pediatrics. 1992; 89: 21-26 PubMed Google Scholar The increase seems to follow a geographic pattern of industrialization and is inconsistent with an underlying genetic cause. Because the prevalence of diabetes, cardiovascular disease, and other inflammatory disorders has increased in parallel with that of atopic disease, we hypothesize that nutritional intake is also influencing the development of allergic sensitization. [6] Watson P.E. McDonald B.W. Subcutaneous body fat in pregnant New Zealand women: association with wheeze in their infants at 18 months. Matern Child Health J. 2013; 17: 959-967 Crossref PubMed Scopus (7) Google Scholar Because it has drastically changed during the past 20 years, the consumption of dietary fatty acids has been studied as a cause of many of these inflammatory disorders; however, the effect on the development of atopic disease remains unclear.

IL-4 and IL-13 Differentially Regulate TLR-Induced Eosinophil-Basophil Differentiation Of Cord Blood CD34+ Progenitor Cells

Intrauterine environmental exposures have been shown to influence neonatal immunity and subsequent atopy. The effect of “pro-allergic” TH2 cytokines on neonatal cord blood (CB) hematopoietic progenitor cells, the phenotype and differentiation of which are associated with atopic risk, is currently unknown. Since we have previously shown that high-atopic risk infants have decreased eosinophil-basophil (Eo/B) differentiation after stimulation with LPS, we investigated whether a TH2 milieu (IL-4 or IL-13) could influence LPS-induced Eo/B colony forming units (CFU), and the mechanism(s) through which this might occur.

Modern therapeutic approaches in food allergy

Food allergy has a growing prevalence in children (6-8%) and represents a worrying public health problem. Despite the numerous controversies regarding the feeding in high atopic risk infants and children with food allergy, there are safe and effective drug therapies, some of them already in clinical trial phase (immunotherapy, anti-IgE agents, recombinant vaccines, Toll-like receptors agonists, chemokine and chemokine receptor antagonists)

Early-life antibiotic use is associated with wheezing among children with high atopic risk: a prospective European study

Background: Deliberate antibiotic use (AU) in early life may contribute to asthma. Although a number of published studies have tested AU in conjuction with the hygiene hypothesis, the results have been conflicting and little is known about the relationship between AU and asthma in the children with high atopic risk. Aims: To examine the association between the use of specific therapeutic antibiotics in the first year of life and wheezing by 36 months among high atopic risk children. Methods: A multi-center prospective cohort study was conducted among children at high-risk for atopic sensitization. A validated questionnaire was used to prospectively collect information on antibiotic use and potential risk factors for wheezing from parents or guardians of 606 children from 3 European countries at 6, 12, 24, and 36 months of age. Linear logistic regression model was used to adjust for potential confounders and estimate odds ratios (OR) with 95% confidence interval (CL) associated with antibiotic use for development of wheezing Results: Only macrolides’ use in the first year of life was associated with increasing risk for wheezing, after adjusting for gender, socioeconomic status, breast feeding, tobacco smoke exposure of the infants, family history of asthma, and respiratory infection (OR=3.24; 95%CI 1.47-7.30). Among the children with respiratory infection, similar associations were observed for macrolides use (OR=3.42; 95%CI 1.46-8.01) and lower respiratory tract infection (OR=4.60; 95%CI 2.19-9.66). Conclusions: In European children with a familial risk for allergic disease, we found a positive association between macrolides use in the first year of life and wheezing until 36 months. Key words: antibiotic use, wheezing, prospective cohort

Prevalence of atopic disorders in rheumatic diseases

Objectives The aim of this study was to assess the point prevalences of hay fever, asthma, and atopic dermatitis in OA, RA, and AS, and to compare with healthy controls.Methods A total of 935 patients and healthy controls were included. Demographic and clinical features were recorded, and a questionnaire assessing the existence of atopic disorders like asthma, hay fever, and atopic dermatitis in all groups was applied. “Either atopy” implied that an individual was either diagnosed with or had symptoms of one or more of these disorders, such as asthma, hay fever, or atopic dermatitis.Results When compared to the controls, only patients with AS had an increased risk for hay fever (OR 1.52, 95 % CI 1.00–2.41). Patients with RA had increased risks for hay fever, atopic dermatitis, and either atopy compared to the patients with OA (2.14, 95 % CI 1.18–3.89; 1.77, 95 % CI 1.00–3.18; and 3.45, 95 % CI 1.10–10.87, respectively). Steroid use had no effect on the prevalence of atopic disorders in patients with RA.Conclusions Patients with OA, RA, and AS seem to have similar risks for asthma, atopic dermatitis, and either atopy to healthy controls. However, the prevalence of hay fever may increase in AS. Patients with RA have a higher risk of atopy than patients with OA.