International Study Of Asthma And Allergies In Childhood Research Articles

Molecular identification of the main allergens present in household dust of asthmatic patients

Introduction: The main aeroallergens present in house dust are the mites,Dermatophagoidespteronyssinus (Derp) andDermatophagoidesfarinae (Derf), and cockroaches,Periplanetaamericana (Pera). Objective: This work aims to genetically identify the allergens Derp, Derf, and Pera in household dust of asthmatic patients. Materials and methods: 29 patients, aged between 3 and 17 years, were classified as asthmatic or non-asthmatic according to the International Study of Asthma and Allergies in Childhood(ISAAC). Subjectscompleted a complementary questionnaire and skin hypersensitivity tests were performed. House dust was collected from these patients, filtered, and then DNA was extracted. Polymerase chain reactions were performed to identify Derp, Derf, and Pera in the samples. Results: There was an association between Pera sensitization and onset of asthma. There was also an association between the presence of Derp in the home of asthmatic patients and the worsening of symptoms, such as wheezing in the chest and allergic rhinitis. An association between the presence of Derf in house dust of asthmatic patients and the symptoms of allergic rhinitis was found. These data suggest that cockroach sensitization is a predominant factor in asthmatic children and the presence of mite allergens contributesto the worsening of asthma symptoms.

The evolving burden of asthma and contemporary advances in management: Implications for clinical practice in Southern Africa

Asthma is a rising significant global public health burden especially in the developing countries. The annual prevalence of severe asthma episodes is estimated from 1% to 21% for adults and over 20% for children aged 6–7 years. The prevalence of asthma varies widely around the world, ranging from 0.2% to 21.0% in adults and from 2.8% to 37.6% in 6- to 7-year-old children. The International Study of Asthma and Allergies in Children (ISAAC) reports a significant increase in the global prevalence of asthmatic episodes among children. t was estimated that more than 339 million people had Asthma globally in 2016. It is a common disease among children. The common disease asthma is probably not a single disease, but rather a complex of multiple, separate syndromes that overlap. Most asthma-related deaths occur in low- and lower-middle income countries. According to the World Health Organization (WHO) estimates, there were 417,918 deaths due to asthma at the global level and 24.8 million DALYS attributable to Asthma in in 2016. The WHO has estimated that the economic costs associated with asthma have exceeded those of TB and HIV/AIDS combined, and the Global Initiative for Asthma Program forecasted the number of asthma patients to grow globally to greater than 400 million by the year 2025. Since its first description by Hippocrates, asthma remains a treatable yet incurable disease. It is now clear that asthma is a complex syndrome with variable severity, natural history and response to treatment In Namibia a prevalence of Asthma of 11.2 % has been reported in adult populations. The increase in asthmatic episodes, morbidity and mortality among populations in Africa, Latin America and parts of Asia is a rising public health concern. The development of novel asthma phenotyping & endo typing plus better classification of patients using machine learning and big data have markedly improved asthma treatment outcomes in both children and Adults. Several research groups have developed cluster analyses of phenotypes in severe asthma. These clusters support the importance of disease heterogeneity in asthma and suggest differences in pathophysiologic mechanisms that define these clusters. Precision medicine is "an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.

Prevalence of Asthma Symptoms in 13-14-Year-Old Adolescents in Karaj.

Asthma is the most common chronic inflammatory respiratory disorder in children. This study was designed to assess the prevalence of asthma in 13-14-year-old adolescents in Karaj, Alborz province in Iran, using the international study of asthma and allergies in childhood (ISAAC) questionnaire.Totally 950 adolescents attending 40 schools located in 4 regions of Karaj city were enrolled in the survey. The Persian version of the ISAAC questionnaire was filled by 13-14-year-old students. Multi-stage clustered random sampling was used to divide the city of Karaj into four educational districts. Ever wheezing was reported in 22% of the individuals; 10.52% claimed to have wheeze in the last 12 months and 22.73% had during or after exercise. The experience of wheezing in the last 12 months was more prevalent among males (11.73% vs. 9.38%; p<0.05). However, having a history of asthma was higher among males (7.55% vs. 3.47%; p<0.05). History of hospitalization (60.8%), family history of asthma (49.4%), and history of food allergy (42.3%) were found to be the most frequent characteristics significantly associated with" ever wheezing" (p<0.05). The prevalence of wheezing in the last 12 months, as a major index of current asthma, was 10% which was close to the national average. However, nocturnal cough and exercise-induced wheezing were higher in Karaj compared to other cities of Iran; which could be related to the high level of air pollution in this industrial area.

Prevalence and risk factors associated with allergic rhinitis in Mexican school children: Global Asthma Network Phase I

BackgroundThe International Study of Asthma and Allergies in Childhood (ISAAC) showed a wide variability in prevalence and severity of allergic rhinitis (AR) and rhinoconjunctivitis (ARC), in addition to other atopic diseases (Asher et al, 2006).1 The Global Asthma Network (GAN) has continued to study these conditions. ObjectiveTo estimate the prevalence of AR and ARC in children and adolescents in Mexico and to assess their association with different risk factors. MethodsGAN Phase I is a cross-sectional, multicentre survey carried out in 15 centres corresponding to 14 Mexican cities throughout 2016–2019 using the validated Spanish language version of the GAN Phase I questionnaires. The questionnaires were completed by 35 780 parents of 6–7 year old primary school pupils (children) and by 41 399 adolescents, 13–14 years old. ResultsThe current and cumulative prevalence of AR was higher in the adolescents (26.2–37.5%, respectively) in comparison to the children (17.9–24.9%, respectively), especially in female participants. This tendency was also observed in the current prevalence of ARC, where 15.1% of female adolescents reported nasal symptoms accompanied with itchy-watery eyes in the past year. The most important risk factors for AR and ARC were the presence of wheezing in the past 12 months, wheezing in the first year of life, the previous diagnosis of asthma and eczema symptoms. Furthermore, allergic symptoms had a negative tendency concerning altitude. ConclusionThis is the largest AR epidemiological study ever conducted in Mexico. It shows an increase in AR prevalence, as well as significant associations with modifiable risk factors, which could help to establish recommendations to reduce the burden of this condition.

Association between the Concentration and the Elemental Composition of Outdoor PM2.5 and Respiratory Diseases in Schoolchildren: A Multicenter Study in the Mediterranean Area

Abstract: Exposure to outdoor air pollution has been shown to increase asthma symptoms. We assessed the potential role of particulate matter with aerodynamic diameter &lt;2.5 μm (PM2.5) on respiratory condition in schoolchildren in the south Mediterranean area. A total of 2400 children aged 11–14 years were recruited, and data on their symptoms were collected through an ISAAC (International Study of Asthma and Allergies in Childhood)-based questionnaire. Outdoor PM2.5 was collected for 48 consecutive hours in the schoolyards of their schools and selected residential outdoor areas. The levels of PM2.5 were measured, along with its elemental composition. The incidence of an acute respiratory illness within the first 2 years of life was higher amongst Sicilian children when compared to Maltese children (29.7% vs. 13.5% respectively, p &lt; 0.0001). Malta had a significantly higher prevalence of doctor‐diagnosed asthma, when compared to Sicily (18.0% Malta vs. 7.5% Sicily, p &lt;0.0001). Similarly, current asthma (7.8% vs. 2.9%, p &lt; 0.0001) and use of asthma medication in the last 12 months (12.1% vs. 4.9%, p &lt; 0.0001) were more frequent amongst Maltese children. Total median PM2.5 was 12.9 μg/m3 in Sicily and 17.9 μg/m3 in Malta. PM2.5 levels were highest in the Maltese urban town of Hamrun (23.6 μg/m3), while lowest in the rural Sicilian town of Niscemi (10.9 μg/m3, p &lt; 0.0001). Hamrun also exhibited the highest levels of nickel, vanadium, lead, zinc, antimony, and manganese, whilst the Sicilian city of Gela had the highest levels of cadmium, and the highest level of PM2.5 when compared to rural Sicily. Elevated levels of PM2.5 were positively associated with the prevalence of doctor diagnosed asthma (odds ratio (OR) 1.05), current asthma (OR 1.06), and use of asthma medication (OR 1.06). All elements in PM2.5 showed increased OR for doctor diagnosed asthma, while higher concentrations of Cd and Mn were associated with higher prevalence of rhinitis.

Association between Indoor Air Quality Parameters (PM2.5, CO2, and Bioaerosols) in Children Day Care Centres with and without Air Purifier in Bangi.

Introduction: The use of air purifiers have been demonstrated to reduce the level of indoor air quality (IAQ) parameters, thus these may give beneficial effects to the human health. Studies on the effectivity of air purifier in the indoor settings are still limited especially in sensitive environmental settings such as daycare centres. Objective: This study aims to determine the concentration of IAQ parameters between daycare centres with and without the use of an air purifier. Methodology: Purposive sampling was used in selecting the daycare centre with (DC3) and without air purifier (DC1 and DC2) within Bangi areas. The walkthrough inspection was conducted and 5 parameters of IAQ including PM2.5, CO2, bioaerosol (bacterial and fungal), relative humidity and temperature were assessed in this study. A standardized and modified questionnaire adopted from The International Study of Asthma and Allergies in Childhood (ISAAC) was distributed to 46 parents to assess sociodemographic and respiratory symptoms among their children. Result: The result showed that there is a significant difference between PM2.5, CO2, bacteria and fungi concentration in studied areas. Daycare centres with air purifiers (DC3) found the lowest concentration of PM2.5 (18.2 µg/m3) and bacterial count (148 CFU/m3) except for fungal counts and CO2 level. The finding showed that PM2.5 in daycare centres without air purifier (DC1) had the highest (39.1µg/m3). All IAQ parameters not exceed the National Ambient Air Quality (NAAQs) and Department of Occupational, Safety and Health (DOSH) standards. All respiratory symptoms showed no significant difference between daycare with and without air purifier except for asthma symptoms. The higher number of children in the DCs without air purifiers experiences a productive cough and allergic reaction compared to the DC with an air purifier. Conclusion: The finding suggests that the daycare centers with air purifiers can improve IAQ and lower the risk of respiratory symptoms among the centre’s building occupants.

Global Asthma Network Phase I Surveillance: Geographical Coverage and Response Rates.

Background—The Global Asthma Network (GAN) Phase I is surveying school pupils in high-income and low- or middle-income countries using the International Study of Asthma and Allergies in Childhood (ISAAC) methodology. Methods—Cross-sectional surveys of participants in two age groups in randomly selected schools within each centre (2015–2020). The compulsory age group is 13–14 years (adolescents), optionally including parents or guardians. Six to seven years (children) and their parents are also optional. Adolescents completed questionnaires at school, and took home adult questionnaires for parent/guardian completion. Children took home questionnaires for parent/guardian completion about the child and also adult questionnaires. Questions related to symptoms and risk factors for asthma and allergy, asthma management, school/work absence and hospitalisation. Results—53 centres in 20 countries completed quality checks by 31 May 2020. These included 21 centres that previously participated in ISAAC. There were 132,748 adolescents (average response rate 88.8%), 91,802 children (average response rate 79.1%), and 177,622 adults, with >97% answering risk factor questions and >98% answering questions on asthma management, school/work absence and hospitalisation. Conclusion—The high response rates achieved in ISAAC have generally been maintained in GAN. GAN Phase I surveys, partially overlapping with ISAAC centres, will allow within-centre analyses of time-trends in prevalence.

Risk factors associated with rhinitis, allergic conjunctivitis and eczema among schoolchildren in Uganda.

BackgroundThe prevalence of allergy-related diseases (ARDs), including rhinitis, allergic conjunctivitis and eczema, is on the increase globally. The causes of this increase are not well established.ObjectivesTo investigate the risk factors associated with ARDs among schoolchildren in Uganda.MethodsWe conducted a secondary data analysis of a large asthma case–control study involving 1700 schoolchildren, 5–17 years, in urban Uganda. ARDs were defined according to the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Skin prick testing (SPT) was conducted using standard procedures and allergen-specific IgE (asIgE) using ImmunoCAP®. We employed inverse probability weighted analysis to generate estimated prevalence data and weighted odds ratios.ResultsThe lifetime estimated weighted prevalence of reported rhinitis, allergic conjunctivitis and eczema was 43.3%, 39.5% and 13.5%; weighted prevalence in 12 months was 10.1%, 9.1% and 2.3%, respectively. There was overlap of ARDs, with 66.3% of 1193 schoolchildren who reported having ever an ARDs (including asthma) reporting two or more. Risk factors associated with reported rhinitis in the last 12 months were city residence at birth [adjusted odds ratio (95% confidence interval) 2.66 (1.42–4.99) compared to rural]; father’s [2.62 (1.79–3.83)] and mother’s history of allergic disease [2.12 (1.48–3.02)]; frequent de-worming in the last 12 months [2.01 (1.30–3.11), ≥2 versus none]; current high frequency of ‘trucks passing on the street near home’ [2.59 (1.48–4.52), ‘almost all the time’ versus rarely] and positive SPT [1.54 (1.09–2.18)] but not asIgE [1.38 (0.60–3.15)]. The same pattern of risk factors was observed for allergic conjunctivitis and eczema.ConclusionWe found extensive multi-morbidity of, and overlap in the risk factors for, rhinitis, conjunctivitis and eczema—similar to asthma risk factors—among schoolchildren in urban Uganda. This suggests a similar underlying cause for all ARDs, associated with exposure to urban lifestyles and environment in Uganda.

Prevalence of atopic dermatitis, asthma and rhinitis from infancy through adulthood in rural Bangladesh: a population-based, cross-sectional survey

ObjectiveDescribe the pattern of atopic disease prevalence from infancy to adulthood.DesignCross-sectional household survey.SettingCommunity-based demographic surveillance site, Mirzapur, Bangladesh.Participants7275 individuals in randomly selected clusters within 156 villages.Primary and secondary outcome measuresThe...

Prenatal Exposure to Cadmium and Risk of Allergic Diseases in Pre-school Children

Background/Aim: The prevalence of child’s allergic disease has been increased worldwide. Atopic dermatitis is considered to be the first clinical characteristic and the beginning of the atopic march that followed by asthma and allergic rhinitis during the first several years of life. Exposure to metals (such as chromium, cadmium and lead) was reported to associate with immune biomarkers and allergy. Our aim is to investigate the association between prenatal exposure to metals and allergic diseases in children. Methods: A total of 243 pairs of pregnant women and newborns were recruited in central Taiwan during 2012 to 2013, and the questionnaires and specimens were collected from pregnant women. Children were follow-up during 2016 to 2017 to identify their allergic disease by International Study of Asthma and Allergies in Childhood (ISAAC). Metal concentration (cadmium, Cd; lead, Pb) in maternal urine was measured by inductively coupled plasma mass spectrometry (ICP-MS), and child’s blood IgE was quantified using ImmunoCAP total IgE assay system. A few cigarette smokers at pregnancy were excluded from the beginning. Child's sex, allergic status in parents, environmental tobacco smoke at pregnancy, and child’s blood total IgE were adjusted in statistical model. Results: The mean age of children is 3.95 years (SD = 0.56), and approximate 60% is boy. In these children, 30.45% were identified with atopic dermatitis, 3.70% with asthma, and 20.99% with allergic rhinitis. Per doubling increase of prenatal Cd exposure was significantly associated with elevated risk of allergic rhinitis in children (OR = 1.59; 95% CI 1.07, 2.36) even Pb was included in full-adjusted model. Conclusions: Prenatal exposure to cadmium has increased risk of allergic rhinitis in early childhood. Therefore, it is suggested to identify pregnant women at risk of metal exposure and avoid the exposure sources thus might reduce the risk of allergic disease on their children.

Defining asthma in children: how well do parents, doctors and spirometry agree?

BackgroundBecause diagnosing asthma in school-aged children is challenging, a variety of proxies for asthma are used in clinical practice and research settings as indicators of this disease. We aimed to provide insight into the agreement between various asthma indicators based on parental report, medical diagnosis and spirometry.MethodsChildren from the WHISTLER birth cohort performed spirometry and were followed up with parental ISAAC (International Study of Asthma and Allergies in Childhood) questionnaires about asthma at 5 and 8 years of age. Medical data were extracted from primary care records. We compared 15 asthma indicators based on parental report, medical diagnosis and spirometry using positive agreement, κ statistics and latent class cluster analysis.ResultsAt 5 years of age, 1007 children completed a study visit, while 803 children visited at 8 years of age. Depending on the indicator, the responder and child's age, the asthma prevalence ranged from 0.2% to 26.6%. Cluster analysis revealed classes related to the presence of recent symptoms and a decreased lung function. Agreement between parents and doctors was generally low with κ coefficients ranging from 0.07 (recent wheeze) to 0.52 (recent asthma medication). Additionally, parental report showed to be sensitive to recall bias over time.ConclusionsDependent on the asthma indicator, the responder and the age of the child, substantial differences in agreement were observed between commonly used indicators associated with asthmatic disease in school-aged children. Most agreement between parents and doctors was seen for objective and recent indicators such as the recent use of asthma medication. We advocate caution when literature with different asthma indicators is compared.

Trends in worldwide asthma prevalence.

This review of trends in worldwide asthma prevalence starts with defining how asthma prevalence is measured in populations and how it is analysed. Four population studies of asthma across at least two regions are described: European Community Respiratory Health Survey (ECRHS), the International Study of Wheezing in Infants (EISL), the International Study of Asthma and Allergies in Childhood (ISAAC) and the World Health Survey (WHS). Two of these (ISAAC and WHS) covered all the regions of the world; each using its own standardised questionnaire-based methodology with cross-sectional study design, suitable for large populations. EISL (2005 and 2012) and ISAAC (1996-1997 and 2002-2003) have undertaken a second cross-sectional population survey from which trends are available: EISL in three centres in two countries; ISAAC 106 centres in 56 countries (13-14 year olds) and 66 centres in 37 countries (6-7 year olds). Key results from these studies are presented. Unfortunately, there is no new worldwide data outside of EISL since 2003. Global Burden of Disease estimates of asthma prevalence have varied greatly. Recent reliable worldwide data on asthma prevalence and trends is needed; the Global Asthma Network Phase I will provide this in 2021.

Identification and seasonality of rhinovirus and respiratory syncytial virus in asthmatic children in tropical climate.

Introduction: Asthma is a disease that has been associated with the presence of different genetic and socio-environmental factors.Objective: To identify and evaluate the seasonality of respiratory syncytial virus (RSV) and human rhinovirus (RV) in asthmatic children and adolescents in tropical climate, as well as to assess the socioeconomic and environmental factors involved.Methods: The study was conducted in a referral hospital, where a total of 151 children were recruited with a respiratory infection. The International Study of Asthma and Allergies in Childhood (ISAAC) protocol and a questionnaire were applied, and a skin prick test was performed. The nasal swab was collected to detect RV and RSV through molecular assay. National Meteorological Institute (INMET) database was the source of climatic information.Results: The socio-environmental characterization of asthmatic children showed the family history of allergy, disturbed sleep at night, dry cough, allergic rhinitis, individuals sensitized to at least one mite. We identified RV in 75% of children with asthma and 66.7% of RSV in children with asthma. There was an association between the presence of RV and the dry season whereas the presence of the RSV was associated with the rainy season. Contributing to these results, a negative correlation was observed between the RSV and the wind speed and the maximum temperature (T. Max) and a positive correlation with precipitation.Conclusions: The results suggest a high prevalence of RV and RSV in asthmatic children and the seasonality of these viruses were present in different climatic periods. This has significant implications for understanding short- and long-term clinical complications in asthmatic patients.

Impact of Prematurity and Severe Viral Bronchiolitis on Asthma Development at 6-9 Years.

BackgroundPremature birth is associated with increased susceptibility for viral infections and chronic airway morbidity. Preterm children, even moderate and late, may be at risk for short- and long-term respiratory morbidities.ObjectiveOur main goal was to compare the burden of two conditions, severe bronchiolitis and prematurity (early and moderate-late), on asthma development at 6–9 years.Patients and MethodsA retrospective cohort of all preterm (<37weeks gestational age) and full-term children hospitalized for bronchiolitis, with current age between 6 and 9 years, was created. A second cohort was made up of preterm children, without admission for bronchiolitis, randomly chosen from the hospital premature births database. Prevalence and risk factors for asthma were analysed. Parents completed the International Study of Asthma and Allergies in Childhood (ISAAC) Questionnaire for asthma symptoms for children 6–7 years. Lung function and aeroallergen sensitization were evaluated.ResultsOf the 480 selected children, 399 could be contacted and agreed to participate: 133 preterm and 114 full-term cases with admission for bronchiolitis and 146 preterm control children without admission for bronchiolitis. The frequency of current asthma at 6–9 years was higher in preterm cases (27%) compared with full-term-cases (15%) and preterm controls (14%) (p=0.04). Among hospitalized-bronchiolitis children, prematurity (p=0.04), rhinovirus infection (p=0.03), viral coinfection (p=0.04) and paternal asthma (p=0.003) were risk factors for asthma at 6–9 years. Among premature children, with and without bronchiolitis admission, the risk factors for asthma at 6–9 years were admission for bronchiolitis (p=0.03) and aeroallergen sensitisation (p=0.01). Moderate and late preterm children without admission for bronchiolitis showed similar prevalence of current asthma than full-term ones, previously admitted for bronchiolitis.ConclusionPreterm birth is an important early life risk factor for asthma in childhood. The addition of other risk factors, such as severe bronchiolitis, especially by rhinovirus or viral coinfections, are associated with even higher risk for subsequent asthma.

Maternal psychological distress during and after pregnancy and atopic dermatitis in children

Abstract Background Previous studies reported the association between maternal psychological distress (PD) during or after pregnancy and atopic dermatitis in children. However, studies examining the association from both pre- and post-natal aspects are limited. Methods We analysed data from 6,366 mother-child pairs who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Mothers were categorised into four groups of PD (K6 scores ≥5) during early pregnancy and one year after delivery; no PD in both periods, prenatal PD only, postnatal PD only, and PD in both periods. Mothers reported on their children's atopic dermatitis at age two using the International Study of Asthma and Allergies in Childhood (ISAAC). Multivariate logistic regression analysis was conducted to examine the association between maternal PD and atopic dermatitis in children adjusting for maternal age at delivery, maternal education, maternal smoking during early pregnancy, maternal history of atopic diseases, paternal history of atopic diseases, preterm birth, parity, and child's sex. Results The study population included 51.9% without PD in both periods, 14.6% with prenatal PD only, 14.0% with postnatal PD only, and 19.4% with PD in both periods. The prevalence of atopic dermatitis in children at age two was 18.8%. Mothers with postnatal PD only and mothers with PD in both periods had higher risks of children's atopic dermatitis compared with mothers without PD in both periods; the adjusted odds ratios (95% confidence intervals) were 1.37 (1.14-1.65) and 1.38 (1.17-1.63), respectively. The corresponding odds ratio (95% confidence interval) of mothers with prenatal PD only was 1.08 (0.89-1.31). Conclusions Postnatal PD was associated with an increased risk of atopic dermatitis in children. This finding suggests the importance for monitoring mental health among postpartum women. Key messages Postnatal PD has significant effects on atopic dermatitis in children. This study is a first study to examine the association between maternal PD and children’s atopic dermatitis in Japan. Improvements of postnatal care including social support might be effective in preventing atopic dermatitis in children.

The Effects of Indoor Pollutants Exposure on Allergy and Lung Inflammation: An Activation State of Neutrophils and Eosinophils in Sputum.

Background: To explore the inflammation phenotypes following indoor pollutants exposure based on marker expression on eosinophils and neutrophils with the application of chemometric analysis approaches. Methods: A cross-sectional study was undertaken among secondary school students in eight suburban and urban schools in the district of Hulu Langat, Selangor, Malaysia. The survey was completed by 96 students at the age of 14 by using the International Study of Asthma and Allergies in Children (ISAAC) and European Community Respiratory Health Survey (ECRHS) questionnaires. The fractional exhaled nitric oxide (FeNO) was measured, and an allergic skin prick test and sputum induction were performed for all students. Induced sputum samples were analysed for the expression of CD11b, CD35, CD63, and CD66b on eosinophils and neutrophils by flow cytometry. The particulate matter (PM2.5 and PM10), NO2, CO2, and formaldehyde were measured inside the classrooms. Results: Chemometric and regression results have clustered the expression of CD63 with PM2.5, CD11b with NO2, CD66b with FeNO levels, and CO2 with eosinophils, with the prediction accuracy of the models being 71.88%, 76.04%, and 76.04%, respectively. Meanwhile, for neutrophils, the CD63 and CD66b clustering with PM2.5 and CD11b with FeNO levels showed a model prediction accuracy of 72.92% and 71.88%, respectively. Conclusion: The findings indicated that the exposure to PM2.5 and NO2 was likely associated with the degranulation of eosinophils and neutrophils, following the activation mechanisms that led to the inflammatory reactions.

Impact of the COVID-19 pandemic in children with allergic asthma

Impact of the COVID-19 pandemic in children with allergic asthma

Association of diabetes-related autoantibodies with the incidence of asthma, eczema and allergic rhinitis in the TRIGR randomised clinical trial.

This paper presents the relationship between islet autoantibodies, precursors of type 1 diabetes, and the development of persistent asthma, allergic rhinitis and atopic eczema. A total of 2159 newborns who had a first-degree relative with type 1 diabetes and selected HLA genotypes were followed until the youngest participant reached 10years of age. Islet cell antibodies (ICA) were detected using indirect immunofluorescence. Autoantibodies to insulin (IAA), GAD (GADA), the tyrosine phosphatase-related insulinoma-associated 2 molecule (IA-2A) and zinc transporter 8 (ZnT8A) were quantified with the use of specific radiobinding assays. As an ancillary study, the incidence of asthma, allergic rhinitis and eczema was assessed in 1106 of these children using the International Study of Asthma and Allergies in Childhood (ISAAC) core questionnaire when the children were 9-11years old. HRs with 95% CIs were calculated to depict the incidence of these diseases following seroconversion to autoantibody positivity. The cumulative incidence of atopic eczema, allergic rhinitis and persistent asthma were 22%, 9% and 7.5%, respectively, by 9-11years of age. The occurrence of diabetes-related autoantibodies showed a protective association with subsequently reported incidence of asthma and eczema. The incidence of rhinitis was not significantly related to the occurrence of IAA or GADA (statistical power was limited), but demonstrated the same inverse relationship as did the other diseases with ICA or when multiple autoantibodies first appeared together. The findings add evidence to the relationships between these atopic diseases and diabetes-related autoimmunity and also suggest that, for eczema, the interaction depends upon which autoantibody appeared first. ClinicalTrials.gov NCT00179777 Graphical abstract.

ISAAC written questionnaire versus incorporating videos before the questionnaire for asthma prevalence among middle schools students in Al-Sharkiya Egyptian Governorate

BackgroundAsthma is the most common chronic respiratory disorder in childhood with worldwide increasing in its prevalence and global burden. The International Study of Asthma and Allergies in Childhood (ISAAC) provides a standardized methodology to describe the prevalence and severity of childhood asthma symptoms all over the world using simple standardized questionnaires that allow comparisons across geographic and linguistic boundaries. This study aimed to find a suitable application of ISAAC asthma questionnaire to improve the perception and response of the middle (preparatory) school students in Al-Sharkiya Governorate as a step to update the Egyptian prevalence of asthma among children through the translation of the ISSAC written questionnaire into Arabic and to compare the student’s response to the translated questionnaire with their response to the same questionnaire after showing ISAAC videos.ResultsThe percentage of student’s positive answers for asthma symptoms in the written questionnaire after watching ISAAC videos was significantly lower when compared to their written questionnaire answers without watching videos with no significant agreement between the student’s answers in the two methods.ConclusionUsing ISAAC videos before filling the written questionnaire improved the students’ understanding of and dealing with the written questionnaire.

Impact of swimming school attendance in 3-year-old children with wheeze and rhinitis at age 5 years: A prospective birth cohort study in Tokyo

BackgroundIn Japan, swimming school attendance is promoted as a form of therapy or as a prophylactic measure against asthma in young children. However, the putative beneficial effects have not been sufficiently verified.ObjectiveThe aim of the present study was to clarify whether or not swimming school attendance at age 3 years affects the onset and/or improvement of wheeze and rhinitis at age 5 years.MethodsThis study was a single-center, prospective, general, longitudinal cohort study (T-CHILD Study). Between November 2003 and December 2005, 1776 pregnant women were enrolled, and their offspring were followed up until age 5 years. Swimming school attendance at age 3 years and the presence of wheeze and/or rhinitis in the previous one year were examined using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The relationship between swimming school attendance and wheeze and/or rhinitis was analyzed using multivariable logistic regression analysis.ResultsData on the 1097 children were analyzed. At age 3 years, 126 (11.5%) children attended a swimming school, and at age 5 years, the prevalence of wheeze was 180 (16.4%) while that of rhinitis was 387 (35.3%). Swimming school attendance at age 3 showed no significant relationship with the development of either wheeze (aOR 0.83, 95% CI (0.43–1.60) or rhinitis (aOR 0.80, 95% CI (0.43–1.60) at age 5.ConclusionsSwimming school attendance at age 3 years showed neither a preventive nor therapeutic effect on wheeze or rhinitis at age 5 years. There is thus no scientific evidence yet that swimming school attendance has a positive impact on the development of childhood wheeze or rhinitis.