Prevalence Of Atopic Disorders Research Articles

Факторы риска возникновения атопического дерматита у детей и пути персонального прогнозирования

Despite considerable progress in prevention and treatment of atopic dermatitis made in recent years, the issue remains topical, since in recent decades a significant increase in the prevalence of atopic disorders is observed all over the world. The increased incidence of atopic dermatitis results from the human body exposure to the wide range of factors, as well as from the factors’ specificity and mutual activation. Atopic dermatitis is a multifactorial disorder associated with genetic predisposition to atopy, realized under the influence of environmental factors. The risk factors of pediatric atopic dermatitis are divided into endogenous and exogenous factors, which are also affected by genetic susceptibility. It is worth paying attention to the fact that the factors are enhanced by triggers, which both directly and indirectly influence the body in children and adolescents. A combination of multiple factors plays a key role in chronic pediatric atopic dermatitis. Also do not forget about the impact of sanitation, hygiene, environmental factors, urbanization of the area of residence, and the presence of industrial enterprises in the residential area on the health of children and adolescents. Atopic dermatitis has a negative impact on the quality of life of children and their families. There is a clear need for further research. Currently, monitoring the effects of atopic dermatitis becomes relevant, it is aimed at addressing the issues of prevention. For its part, timely identification of the risk factors and concomitant disorders are of inestimable value for the course of the disorder.

The Prevalence of Atopy in Biologically Treated Spondyloarthropathies: A Retrospective Study of 200 Patients.

(1) Background: Recent data shed light on the association between atopic disorders (ADs) (atopic dermatitis, allergic asthma, allergic rhinitis) and spondyloarthropathies (SpAs), underpinning the critical role of T helper (Th)1-Th17/Th2-T regulatory cells disbalance. We evaluated the prevalence of AD in axial SpAs (axSpAs) and psoriatic arthritis (PsA) and explored the potential association between atopic status, disease-related parameters, and biological therapy. (2) Methods: A monocentric, retrospective study was conducted that enrolled 200 patients taking biologics. Demographics, disease, and drug-related variables, along with a screening questionnaire focused on Ads, were systematically collected. (3) Results: Overall, 51 patients (25.5%) had atopy—namely, 24.4% of axSpA and 28% of PsA, with a higher frequency of rhinitis (43%) vs. atopic dermatitis (37.2%) or asthma (21.5%). We failed to demonstrate any statistically significant difference in demographics, SpA-related parameters excepting concomitant inflammatory bowel disease, and biologic drug exposure in patients with and without atopy (p > 0.05). However, significantly more non-atopic patients need only one TNF inhibitor (54%) vs. atopic patients (28%) (p < 0.05) to control active SpA. (4) Conclusions: We successfully demonstrated that AD is associated with one out of four SpA. Irrespective of the SpA subtype, atopic patients require more frequent switching among biologics, as significantly more non-atopic patients remain on their first anti-TNF.

Prevalence of atopic disorders in 10–15 years age group students from Kasaragod district, Kerala: A cross-sectional study

IntroductionAtopic disorders are showing a consistent trend of increasing prevalence. Kasaragod was an endosulfan aerial spray region that caused multiple health issues in the population. The aim of this paper was to a) determine the prevalence of, b) identify socio-environmental determinants (SED) of atopic disorders amongst school children of age 10–15 years in Kasaragod district. MethodologyThe study is a cross-sectional survey of students of class 8 to 10 in 20 schools of Kasaragod educational district. International Study of Asthma and Allergies in Childhood (ISAAC) core questionnaire identified atopic students. A validated, closed-ended 30 questions elicited exposure to SEDs. ResultsIn 20 schools, 5914 students filled questionnaires. ISAAC questionnaire identified 2310 (41.8%) atopic students; 716 (13%) chronic wheezers, 543 (9.8%) eczema and 1813 (32.8%) rhinitis. The study showed a significant relationship between rhinitis mode of going to school, solid biomass fuel, rodents and reptiles infestation in living places. Rhinitis is prevalent in students who lived near the coastal region, tarred roads and footpaths. The chance of getting asthma, when a student had eczema and vice-versa (odds ratio = 2.388, x2 = 66.450, p = 0.000), between asthma to rhinitis (odds ratio = 3.671, x2 = 270.829, p = 0.000) and eczema and rhinitis (odds ratio = 2.852, x2 = 139.485, p = 0.000) showed significant relation. DiscussionAtopy prevalence is higher in Kasaragod and association with other allergic disorders suggestive of atopic march. Further studies required to identify reasons; mainly on environmental pollution, epigenetic changes in students.

Allergic Manifestation in Paediatric Patients with Primary Immunodeficiency Diseases

Introduction. Primary immunodeficiency diseases (PID) are a diverse group of rare genetic disorders that affect the development and/or function of the immune system. Affected individuals are predisposed to an increased rate and severity of infections, allergy, autoimmunity and malignancy. Primary immunodeficiency diseases are considered rare; physicians and general practitioners have little knowledge about the clinical presentation, diagnostic approach and health impact of PID. Many PID patients have a clinical history in favour of allergic diseases. Nevertheless, in these patients, the importance and prevalence of atopic disorders have not been completely explained. Aim. The aim of this study was to evaluate atopic presentations, including atopic dermatitis, allergic rhinitis and asthma in a group of PID patients under the care of our clinic. Material and Methods. Fifty-seven pediatric patients with PID primary immunodeficiency diseases were enrolled from March 2018 to April 2019. Serum IgE levels were measured. Information regarding the patient’s history of allergic diseases, including asthma, allergic rhinitis and atopic dermatitis were analysed. Results and Conclusions. Confirmed allergy/asthma was found in 40 patients (70%). Thirty-eight patients (66.7%) had a diagnosis of asthma, 7 patients (12.3%) of allergic rhinitis and 13 (22.8%) of atopic dermatitis. Serum IgE total level was elevated in 12 patients (21%).

Age Differences in Pet Sensitization by Pet Ownership.

Objectives The association between pet sensitization and pet ownership remains unclear. Therefore, we aimed to elucidate the association between pet sensitization and pet ownership by age.Methods We retrospectively reviewed 2,883 patients who visited our allergy clinic for nasal symptoms from January 2003 to December 2014, of whom 1,957 patients with data on skin-prick tests and questionnaire responses were included and divided into adults (age >19 years) and children (age ≤19 years). The association between pet sensitization and pet ownership was evaluated in both groups.Results Among children, dog and cat sensitization showed no associations with dog and cat ownership, respectively. However, among adults, dog sensitization was significantly associated with dog ownership (odds ratio [OR], 3.283; P<0.001), and cat sensitization with cat ownership (OR, 13.732; P<0.001). After adjustment for age, sex, familial history of allergy, sinusitis, diabetes mellitus, other pet ownership, and non-pet sensitization, significant associations remained between dog sensitization and dog ownership (adjusted OR [aOR], 3.881; P<0.001), and between cat sensitization and cat ownership (aOR, 10.804; P<0.001) among adults. Dog ownership did not show any association with allergic rhinitis, asthma, or atopic dermatitis, whereas atopic dermatitis had a significant association with cat ownership in adults (aOR, 4.840; P<0.001).Conclusion Pet ownership in adulthood increased the risk of pet sensitization. However, pet ownership was not associated with the prevalence of atopic disorders, regardless of age, except for atopic dermatitis and cat ownership in adults.

Reliably estimating prevalences of atopic children: an epidemiological study in an extensive and representative primary care database

Electronic health records stored in primary care databases might be a valuable source to study the epidemiology of atopic disorders and their impact on health-care systems and costs. However, the prevalence of atopic disorders in such databases varies considerably and needs to be addressed. For this study, all children aged 0–18 years listed in a representative primary care database in the period 2002–2014, with sufficient data quality, were selected. The effects of four different strategies on the prevalences of atopic disorders were examined: (1) the first strategy examined the diagnosis as recorded in the electronic health records, whereas the (2) second used additional requirements (i.e., the patient had at least two relevant consultations and at least two relevant prescriptions). Strategies (3) and (4) assumed the atopic disorders to be chronic based on strategy 1 and 2, respectively. When interested in cases with a higher probability of a clinically relevant disorder, strategy 2 yields a realistic estimation of the prevalence of atopic disorders derived from primary care data. Using this strategy, of the 478,076 included children, 28,946 (6.1%) had eczema, 29,182 (6.1%) had asthma, and 28,064 (5.9%) had allergic rhinitis; only 1251 (0.3%) children had all three atopic disorders. Prevalence rates are highly dependent on the clinical atopic definitions used. The strategy using cases with a higher probability of clinically relevant cases, yields realistic prevalences to establish the impact of atopic disorders on health-care systems. However, studies are needed to solve the problem of identifying atopic disorders that are missed or misclassified.

Atopic Manifestations: Dermatitis, Allergic Rhinitis and Asthma in Patients With Hypogammaglobulinemia.

Background:Most of the hypogammaglobulinemic patients have a clinical history in favor of allergic respiratory disease. Nevertheless, in these patients the importance and prevalence of atopic disorders have not been completely explained.Objectives:This study was aimed to evaluate atopic manifestations (dermatitis, allergic rhinitis and asthma) and pulmonary function in patients with hypogammaglobulinemia.Patients and Methods:We used the international study of asthma and allergies in childhood (ISAAC) questionnaire in forty-five patients diagnosed with hypogammaglobulinemia and spirometry was done in 41 patients older than 5 years.Results:Spirometry results were normal in 21 (51%), and showed obstructive in 15 (37%) and restrictive pattern in 5 (12%) of the 41 patients who were evaluated. By the end of the study, asthma was diagnosed in nine (20%) patients and other atopies (rhinitis and dermatitis) identified in 10 (22%), and four (9%), respectively.Conclusions:Atopic conditions should be investigated in the hypogammaglobulinemic patients and the prevalence in these patients may be higher than in normal population. Also, it is recommended to perform a pulmonary function test as a routine procedure in patients with hypogammaglobulinemia and atopy should be assessed in these patients.

Prevalence of atopic diseases in patients with sarcoidosis.

It remains unclear whether atopy is associated with the occurrence of sarcoidosis or affects its severity. The purpose of this study was to compare the lifetime prevalence of atopic eczema, asthma, and hay fever in sarcoidosis patients with controls and to assess whether atopy influences the severity of sarcoidosis. The prevalence of atopic disorders assessed with a validated postal questionnaire in sarcoidosis patients with pulmonary, uveitis, and cutaneous sarcoidosis was compared with that of their domestic partners in a case-control study. The serological parameters, the pulmonary function tests, and the high-resolution computed tomography (HRCT) scans of atopic and nonatopic sarcoidosis patients were compared in a nested cohort. Multivariate logistic regression models were used to calculate the odds ratios (ORs) and the 95% confidence intervals (CIs). Two hundred twenty-five sarcoidosis patients and 177 controls were included. The prevalences of atopic eczema, asthma, and hay fever were comparable between patients and controls (12.4% versus 12.4%, 5.3% versus 5.6%, and 16.9% versus 15.8%, respectively). After adjusting for gender and ethnicity, those with sarcoidosis and a history of atopic eczema were significantly less likely to have uveitis (OR, 0.30; 95% CI, 0.13-0.71). Within the sarcoidosis cohort, the distributions of serological markers, the lung function tests, and the HRCT scans were similar between atopic and nonatopic patients. Atopy is not associated with the occurrence of sarcoidosis, but atopic eczema may decrease the likelihood of eye involvement.

Atopic dermatitis is not a protective factor for melanoma but asthma may be

There is evidence from cohort studies for an inverse association between atopic dermatitis and asthma and cutaneous melanoma. However, these studies have been too heterogeneous and did not show statistically significant results. Also, this association has not been compared to traditional melanoma risk factors. To test for associations between history of atopic disorders and melanoma life-time prevalence, and for associations between atopic disorders and melanoma prognosis. Validated questionnaires from the European Community Respiratory Health Survey and International Study of Asthma and Allergies in Children protocol on life-time prevalence of atopic disorders were sent to 280 patients with histopathologically confirmed melanoma. The control group consisted of their spouses. The skin phototype was also assessed using a validated questionnaire. One hundred and eighty-four melanoma patients and 169 controls responded to the questionnaire. The life-time prevalence of atopic dermatitis and hayfever was not different in melanoma patients (8.7 % vs. 8.2, p = 0.890 and 15.2 vs. 18.3 %, p = 0.432, respectively). Asthma was non-significantly lower in melanoma patients (3.8 vs. 8.2 %, p = 0.075). Atopic melanoma patients did not differ from non-atopic patients in terms of Breslow thickness, metastases and second melanomas. Atopic dermatitis is not a protective factor in cutaneous melanoma but a history of asthma may be.

Lower lifetime prevalence of atopy in rheumatoid arthritis

There is evidence that the prevalence of atopic disorders may be lower in patients with autoimmune conditions [1]. In the past, five studies have looked into the associations between atopy and rheumatoid arthritis (RA). All have found evidence of a lower prevalence of atopy in RA patients. However, they were either only questionnaire based, without serological confirmation of atopy [2–4], or they did not account for all manifestations of atopy [4–6]. We have set out to assess the lifetime prevalence of clinical and serological manifestations of atopy in RA patients in a case control study. The subjects were recruited between July 2010 and July 2011, from outpatient clinic for rheumatology at the Maxima Medical Center, Eindhoven, and the controls were patients with varicosities from our phlebology outpatient clinic. All subjects provided informed consent, and the study protocol was reviewed by the local Medical Ethical Committee. The diagnosis of RA was made according to the criteria of the American Rheumatism Association. The disease activity and course severity in RA patients were assessed with disease activity score 28 (DAS) and Health Assessment Questionnaire Disability Index, respectively (HAQDI) [7, 8]. Manifestations of atopy were assessed using a questionnaire based on the European Community Respiratory Health Survey [9]. Blood samples were taken from all subjects and levels of total serum IgE, and IgE directed against common aeroallergens were measured using Phadiatop; Phadia AB, Uppsala Sweden, according to the manufacturers protocol. One hundred and thirty-three RA patients and 124 controls were included. Eighty-nine (66 %) of the RA patients were anti-CCP positive and 90 (67 %) were currently treated with methotrexate. The average age at onset of RA was 50 years, standard deviation 13. The average age was higher in RA patients than in controls (62 vs. 54 years, p \ 0.001). There were 48 (36 %) and 53 (42 %) males in RA and control group, respectively (p = 0.278). RA patients reported previous symptoms of dermatitis, itching and flexural rash less often (20 vs. 33 %, p = 0.020) and (9 vs. 19 %, p = 0.037) (Table 1). However, dry skin during last year, a measure of current symptomatology of atopic dermatitis, was reported equally in both groups (44 vs. 44 %, p = 0.896). RA patients also reported having had hay fever less often (11 vs. 20 %, p = 0.032). The percentage of patients diagnosed with asthma was lower in the RA group although the difference did not reach statistical significance (8 vs. 14 %, p = 0.086). Current asthma symptomatology expressed as asthma attacks in the last year and inhalator use were equally distributed across both groups (Table 1). Finally, serological evidence of atopy was less often found in RA patients. Twelve per cent of the RA group had a serum IgE level of more than 100 kU/L, and in controls, this was 21 %, p = 0.053. A smaller percentage of the RA group were sensitized to common aeroallergens than controls (22 vs. 33 %, p = 0.043). Having any atopic feature lowered the odds of having RA by roughly 60 % with OR 0.43; 95 % CI [0.25–0.75]. Adjusted for age and sex this was OR 0.51; 95 % CI [0.28–0.92]. The median HAQDI in sensitized RA patients did not differ from the median in non-sensitized patients (1.0; IQR [0.3–1.6] vs. 1.0; IQR [0.4–1.5], p = 0.375). The DAS28 score was equally distributed in sensitized and non-sensitized RA patients as well (2.6; IQR [2.1–3.9] vs. 3.2; IQR [2.2–4.0], p = 0.343). In conclusion, RA patients had a lower prevalence of clinical and serological atopic features. Atopy had no effect E. Hajdarbegovic (&) B. Thio T. Nijsten Rotterdam, The Netherlands e-mail: e.hajdarbegovic@erasmusmc.nl

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.

Prevalence of atopic disorders and immunodeficiency in patients with ectodermal dysplasia syndromes

BackgroundEctodermal dysplasia (ED) syndromes are a diverse group of disorders that affect multiple ectodermally derived tissues. Small studies and case reports suggest an increase in atopy and primary immunodeficiencies (PIDs) among patients with ED syndromes. ObjectiveTo determine the prevalence of clinical symptoms suggestive of atopy or immunodeficiency among a large cohort of children with ED syndromes. MethodsA 9-page questionnaire was mailed to families who were members of the National Foundation for Ectodermal Dysplasias. The surveys were completed by parents of children younger than 18 years with a diagnosis of an ED syndrome or carrier state. Portions of the questionnaire were adapted from previously validated questionnaires developed by the International Study of Asthma and Allergies in Childhood (ISAAC). ResultsWe received 347 completed questionnaires (41%). When compared with the 13- to 14-year-old children surveyed by ISAAC, we found both all-aged and age-matched children with ED syndromes, respectively, had significantly higher rates of asthma (32.2% and 37.2% vs 16.4%), rhinitis symptoms (76.1% and 78.3% vs 38.9%), and eczema (58.9% and 48.9% vs 8.2%). The prevalence of physician-diagnosed food allergies (20.7%) and PIDs (6.1%) in these ED patients also exceeded known rates in the general pediatric population. ConclusionThis large-scale, retrospective study demonstrates a greater reported prevalence of symptoms suggestive of atopic disorders and PIDs among children with ED syndromes than the general pediatric population. A combination of genetic and environmental factors in ED syndromes may contribute to breaches of skin and mucosal barriers, permitting enhanced transmission and sensitization to irritants, allergens, and pathogens.

Prevalence of atopic disorders in rheumatic diseases

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. 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. 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. 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.

Haemophilus influenzae type b combination vaccines and atopic disorders: A prospective cohort study

Epidemiologic evidence for an association between vaccinations and atopy development is inconsistent. We evaluated the influence of Haemophilus influenzae type b (Hib) combination vaccines in 6-month-old infants on the prevalence of atopic disorders in 18-month-old children. We used multistage, stratified systematic sampling to recruit 24,200 mother-newborn pairs from the Taiwan national birth registration in 2005. Vaccination status was ascertained through official vaccine cards, while risk factors for atopic disorders were gathered by questionnaires at 6 months of age. Information about development of atopic dermatitis (AD) and recurrent wheezing was collected at 18 months of age. The relationship between atopic disorders and Hib combination vaccines, diphtheria-pertussis-tetanus-Hib and oral poliomyelitis vaccines (DPT-Hib&OPV) and DPT-Hib-inactivated poliomyelitis vaccines (DPT-Hib-IPV), were estimated by multiple logistic regression. A total of 19,968 children completed the follow-up and participated in the study. AD was noted in 1584 (7.9%) infants while recurrent wheezing was found in 1220 (6.1%) infants. The adjusted odds ratios (ORs) (95% CI) for the development of AD in the DPT-Hib&OPV and DPT-Hib-IPV vaccination groups were given as 1.38 (1.15-1.65) and 1.49 (1.29-1.72), compared to those without Hib vaccination (DTP&OPV vaccination). However, the association between DPT-Hib&OPV and DPT-Hib-IPV vaccinations and recurrent wheezing failed to reach statistical significance. There is a potential risk for AD after receiving Hib combination vaccines. Hib vaccination is important to the public health, and therefore the observation requires further investigations.

Atopic diseases by filaggrin mutations and birth year

The prevalence of atopic disorders has increased in recent years. The pathogenesis is complex with genetic and environmental risk factors. Filaggrin loss-of-function mutations are common and associated with atopic disorders. We investigated whether the prevalence of filaggrin mutations increased in different birth cohorts in adults from the general population in Denmark. Cross-sectional questionnaire and filaggrin gene mutation (R501X and 2282del4) data from 3335 18- to 69-year-old adults were available for analyses. The effect of filaggrin mutations on the prevalence of atopic diseases, albeit not statistically significant, depended mostly on birth year for atopic dermatitis (AD). A nonsignificant increase in the prevalence of filaggrin mutations was noted across birth year groups reporting AD, with 12.9% in adults born in 1936-1949 and 19.0% born in 1976-1988. If confirmed in other populations, the observed increase suggests that mutation carriers have been more susceptible to environmental changes accentuating the rise in AD prevalence.

Maternal fatty acid status in pregnancy and childhood atopic manifestations: KOALA Birth Cohort Study

Prevalence of atopic disorders has increased rapidly, but aetiological factors responsible for this increase are still largely unknown. Prenatal exposure to a pro-inflammatory fatty acid status is hypothesized although little research has been carried out. To investigate whether prenatal fatty acid exposures are associated with atopy in childhood. In the KOALA Birth Cohort Study, maternal blood samples (n=1275) at 34-36 weeks of pregnancy were assayed for n-6 and n-3 long-chain polyunsaturated fatty acids (LCPs). The full spectrum of offspring atopic manifestations (wheeze, asthma, allergic rhinoconjunctivitis, eczema, atopic dermatitis, allergic sensitization, and high total IgE) until the age of 6-7 years was assessed by repeated parental questionnaires and measurements of total and specific IgE. Associations of maternal fatty acid status with child atopic outcomes were analysed using multivariable logistic regression and generalized estimating equations for repeated measurements. High ratio of maternal n-6 vs. n-3 LCPs was associated with a lower risk of eczema in the child (P for trend 0.012). More specifically, we found a decreased risk of eczema in the first 7 months of life with increasing arachidonic acid levels (P for trend 0.013). No associations were found between maternal fatty acids and offspring airway-related atopic manifestations, sensitization, or high total IgE. The development of atopic disorders in early childhood is associated with prenatal exposure to n-6 vs. n-3 fatty acids, but with inconsistencies between different manifestations. Further exploration of associations with maternal diet and genetic variants in genes regulating fatty acid metabolism are required. This study shows that the influence of prenatal exposure to fatty acids on the risk of eczema in the child is limited to the first year of life.

The Influence of the Residential Environment on the Sensitization Rates to Aeroallergens and the Prevalence of Allergic Disorders in the School Children in Jeju

Purpose: This study is to investigate the influence of the residential environment on the sensitization rates to aeroallergens and the prevalences of atopic disorders in the school children. Methods: Two elementary schools in Jeju, Korea were selected according to their distinctive residential environment, one located in the area surrounded by the tangerine farms and Japanese cedar forests (tangerine farming community) and the other rarely with them (non-tangerine farming community). All the school children (1,550 students) from the two school were enrolled in this study. Under their parents` informed consent, surveys based on International Study of Asthma and Allergies in Childhood questionnaire were answered by the parents and skin prick tests with 16 common aeroallergens were performed. Results: The questionnaire is responded from 1,290 parents (83.2%) and the skin test was done in 1,284 students (82.8%). The sensitization rates to more than one aeroallergen was 41.9%, increasing by age. The children residing in the tangerine farming community showed significantly higher sensitization rates than those from non-farming one (47.5% vs. 38.4%, P=0.004). The former were sensitized more frequently to house dust mite, citrus red mite and Japanese cedar pollen, while the others to outdoor moulds. However, the prevalence of atopic disorders had no difference between the two groups. Conclusion: The residential environment might influence the sensitization rates to prevalent aeroallergens in the environment among school children, but there is no difference in the prevalence of the atopic disorders. [Pediatr Allergy Respir Dis(Korea) 2011;21:176-185]

High Prevalence of Skin Test Positivity in Severe or Difficult-to-Treat Asthma

Background: Skin tests are considered the gold standard for detecting allergen-specific immunoglobulin E (IgE) in the clinical setting and are an important tool for diagnosing and managing allergic asthma. Objective: To assess the prevalence of skin testing in patients ≥ 12 years enrolled in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study. Methods: Patients were asked whether they had ever been skin tested and, if so, they were asked to provide the test results. Clinical characteristics were used to compare positive (ST+), negative (ST−), and skin test not done (STND) patients. Results: Of 2,985 patients eligible, 85.8% recalled being skin tested. Of those tested, 93.5% were positive (allergist 95.7%, pulmonologist 87.3%). A high proportion of Whites (93.5%) and non-Whites (94.0%) were ST+; however, more non-Whites had never been skin tested (21.7% vs. 12.3%, respectively; p < 0.0001). Total serum IgE was 104.6 IU/mL for ST+ patients, 87.1 IU/mL for STND patients, and 32.4 IU/mL for ST− patients. Age at asthma onset, duration of asthma, and the prevalence of atopic disorders and asthma triggers differentiated the ST+ from the ST− group. Disease severity appeared similar between the two groups. In general, values for STND patients were closer to the ST+ group, suggesting that those not tested would have been ST+ if administered a test. Conclusions: The prevalence of ST+ patients was high in allergy and pulmonology practices, and in White and non-White patients. These data support the utility of a more complete allergic evaluation in severe asthmatics. Skin testing appears associated with disease pathophysiologies in asthma.

The relationship of tonsillar hyperplasia and asthma in a group of asthmatic children

Background: The decline of infections in childhood may contribute to the rising severity and prevalence of atopic disorders in developed countries. With this regard, we examined the relationship of frequent tonsillitis and consequent tonsillar hyperplasia with the development of asthma. Methods: Sixty-seven asthmatic children (ages 3–14) who had no signs or symptoms of acute tonsillitis were included. The control group consisted of 92 randomly selected children who had no signs or symptoms of asthma or acute tonsillitis. Parents were interviewed about the incidence of tonsillitis diagnosed by physicians and history of tonsillectomy; tonsil sizes were evaluated by oropharyngeal inspection by the same observer using the Brodsky L. Scala. Results: A statistically significant association is found between frequent tonsillitis and consequent tonsillar hyperplasia with the development of asthma. Conclusions: Our data suggests that recurrent tonsillitis is associated with a decline in the prevalence of asthma by inducing a Th 1 predominant immune response. Our findings are compatible with the hygiene hypothesis.

Risk factors and prevalence of asthma or atopic dermatitis in young children by a questionnaire survey.

Little is known about the relation between atopic disorders and altitude of residence. The author investigated the prevalence of asthma and atopic dermatitis, and their relationship with altitude of residence. A total of 24,631 children aged four years and under in Gunma Prefecture, Japan, were surveyed. The ATS-DLD questionnaire for asthma was distributed together with an item on atopic dermatitis. Some confounding variables were also asked. The author judged subjects as having asthma when positive answers were given to all 6 items in the ATS/DLD questionnaire. The prevalence of asthma in subjects with atopic dermatitis was higher than in those without (5.1% vs. 1.8%). Logistic regression analyses for asthma and atopic dermatitis were conducted, and male sex, increasing age, family history of target disease, and living at higher altitude commonly and significantly contributed to an increase in the risk of each allergic disorder. For asthma, not being the eldest child, and past or present history of atopic dermatitis were also selected as risk factors. There was an increase in the prevalence of atopic disorders in groups living at a higher altitude was observed in this area.