Prevalence Of Respiratory Allergies Research Articles

Differences in the prevalence of allergy and asthma among US children and adolescents during and before the COVID-19 pandemic

BackgroundThe increasing prevalence of allergies and asthma has led to a growing global socioeconomic burden. Since the outbreak of the COVID-19 pandemic, the health and lifestyles of children and adolescents have changed dramatically. It’s unclear how this shift impacted allergy and asthma, with limited studies addressing this question. We aim to explore the difference of the prevalence of allergies and asthma among US children and adolescents during and before the COVID-19 pandemic using a nationally representative sample of US children and adolescents.MethodsThis cross-sectional study included 31,503 participants in the National Health Interview Survey (NHIS) between 2018 and 2021. Allergies and asthma were defined on an affirmative response in the questionnaire by a parent or guardian. Chi-square tests were used to compare baseline characteristics with allergies and asthma for categorical variables. Differences in prevalence during and before the COVID-19 pandemic were estimated with weighted logistic regression, adjusting for demographic factors. Interaction analyses explored variations across strata.ResultsIn US children and adolescents aged 0 to 17, prevalence of any allergy was 26.1% (95% CI, 24.8%- 27.4%) in 2018 and 27.1% (95% CI, 25.9%- 28.2%) in 2021. Thereinto, in 2018, prevalence of respiratory allergies, food allergies and skin allergies were 14.0% (95% CI, 13.1%- 15.0%), 6.5% (95% CI, 5.8%- 7.1%) and 12.6% (95% CI, 11.6%- 13.5%), respectively, and in 2021, 18.8% (95% CI, 17.8%- 19.9%), 5.8% (95% CI, 5.2%- 6.4%) and 10.7% (95% CI, 9.9%- 11.5%), respectively. And prevalence of asthma was 11.1% (95% CI, 10.5%- 11.7%) in 2018–2019 and 9.8% (95% CI, 9.2%- 10.4%) in 2020–2021. Prevalence of respiratory allergies, skin allergies and asthma during and before the COVID-19 pandemic in children and adolescents had statistically significant differences. The differences persisted after adjusting for demographic and socioeconomic variables.ConclusionPrevalence of respiratory allergies increased and the prevalence of both skin allergies and asthma decreased among US children and adolescents during the COVID-19 pandemic compared with the pre-COVID-19 pandemic. Further research is required to explore the association between allergic diseases and the pandemic, with a particular emphasis on the impact of lifestyle changes resulting from measures to prevent COVID-19 infection.

Therapeutic effect of an Ayurvedic drug in the management of Respiratory Allergic Disorders in children - A comprehensive review

Background: Respiratory allergic disorders (RAD) are the most common allergy symptom seen in children. Respiratory allergies are primarily caused by hyper responsiveness of the respiratory mucosa, which results in histamine release and mast cell activation. In Ayurvedic words, this could be viewed as an abnormality of the body's immune system or Ojus induced by disrupted Vata, Kapha, and Pitta. The prevalence of respiratory allergies in school-aged children in India varies widely, ranging from 5-20%. Methods: This study was completed by gathering the knowledge from classical Ayurvedic literature, research articles, guidelines and PubMed and MedLine databases. Results and Discussion: Dashmoola Katutrayadi drug is mentioned in Sahastra Yogam under Swasa Kasahara Kashaya have Shwas-Kasahar, anti-inflammatory, anti-histaminic and anti-asthmatic effects individually and in combinations. Conclusion: Present review reveals that these drugs have potential to alleviate the severity and frequency of RAD and can be used for the management of the same.

Prevalence of respiratory allergy in the population of our health area

Prevalence of respiratory allergy in the population of our health area

A Questionnaire Survey on the Prevalence and Parents' Perceptions of Respiratory Allergies in a 3- to 16-Year-Old Population in Wuhan, China.

(1) Background: The prevalence of allergic rhinitis (AR) and asthma has increased rapidly in China. However, perceptions of respiratory allergies and barriers to their management have not attracted enough attention. (2) Objective: To investigate the prevalence of, parents’ perceptions of and their unmet needs for information concerning respiratory allergies in a 3- to 16-year-old children population. (3) Methods: A cross-sectional survey was conducted from June to July 2021 in three schools in Wuhan, China. A total of 1963 participants were recruited through cluster sampling for their parents to complete an online questionnaire regarding respiratory allergic symptoms. The diagnosis of respiratory allergies was based on self-reported symptoms and face-to-face physician evaluation. All the participants with respiratory allergies were asked to complete the Brief Illness Perception Questionnaire (B-IPQ), the Asthma Knowledge Questionnaire (AKQ) and a questionnaire regarding their unmet needs for disease management. (4) Results: The prevalence of respiratory allergies was 29.3% (576/1963) in the 3- to 16-year-old population, among whom AR accounted for 25.7%; asthma, 1.8% and AR-complicated asthma (AR&Asthma), 1.9%. The total B-IPQ score was 40.2 ± 10.9 in the participants with respiratory allergies, and there were no differences among the AR, asthma and AR&Asthma groups (all p > 0.05). The B-IPQ score correlated significantly with symptom onset time and a history of atopic dermatitis (p < 0.01). Nearly one fifth, 18.9%, of the participants with respiratory allergies never went to hospital for treatment, but those with higher B-IPQ scores were more likely to seek professional treatment (p < 0.001). The accuracy rates of AKQ were 72.5% in the participants with asthma and 76.7% in those without asthma (p = 0.147). Among the 576 participants with respiratory allergies, 568 (98.6%) had tried to obtain disease-management information from online platforms, and 55.5% (315/568) were dissatisfied with current platforms; the reasons included incomprehensive contents of illness (45.7%), lack of voice from leading experts (40.3%), too many advertisements (37.5%) and similar contents on different platforms (36.8%). (5) Conclusions: The prevalence of respiratory allergies is high in the 3- to 16-years old population in Wuhan, China. Yet the parents’ perceptions of respiratory allergies and knowledge of asthma are insufficient. It is crucial to increase parents’ awareness of the illness and facilitate their access to truly informative and professional platforms.

Climate change, air pollution, and increase of respiratory allergies: just a coincidence or something more?

It is well known that the prevalence of respiratory allergies has increased over time. At the same time, climate change has become part of our everyday life. The resulting question is whether this 'allergic epidemic' is linked to this aspect. It is assumed that the causes of the increase of respiratory allergies are mainly related to environmental factors and lifestyle: first, the improvement of social and health conditions and related hygiene hypothesis; secondly, lifestyle change and anthropogenic activities, which have caused an alteration in the balance normally existing between soil, water, and atmosphere, giving rise to the phenomena of climate change. In fact, it has been demonstrated that they can influence beginning, duration, and intensity of the pollen season, as well as the allergenicity of pollen. The consequence is both an increase in frequency and intensity of allergic symptomatology in subjects previously affected by allergy, and a promotion of the sensitization of the airways to allergens present in the atmosphere in predisposed subjects. Several intervention strategies aiming to mitigate climate change and reduce anthropogenic emissions and, consequently, respiratory allergies are possible and can be implemented on an individual and social level. It follows that the allergist cannot solve the problem of the progressive increase of respiratory allergies on his own. Anyway, his role can have both clinical and educational purposes with a special commitment to reduce health impact due to environmental risk factors. KEYWORDS: respiratory allergies; allergenic potential of pollen; climate change; pollution.

Some features of the prevalence of respiratory allergy in southern Russia

The review article presents data on the prevalence of respiratory allergy - allergic rhinitis and bronchial asthma in southern Russia, published over the past decades. The dominant role of pollen allergy is shown in almost the entire southern region of Russia. In the Chechen Republic, sensitization to house dust mites and grass pollen was found in patients with respiratory allergy equally (51.1 and 52.5%, respectively), whereas ragweed and mugwort sensitization was 3 times less (26.6 and 20.7%, respectively) compared with the neighboring regions of southern Russia. These data demonstrate climate-geographical, environmental and other regional features in the prevalence of respiratory allergies.

Profils de sensibilisation cutanée aux allergènes respiratoires des patients de la ville de Tétouan (Nord Ouest du Maroc)

The prevalence of respiratory allergies is increasing and is a serious global health problem. The objective of the study was to determine the prevalence of skin sensitization to inhalant allergens in patients consulting for respiratory allergy, to identify the main allergens involved and to evaluate the profile of skin prick-test reactivity related to sex, age and season. This retrospective study included 379 patients consulting during 2009-2012 in three private medical offices of Tetouan. Of the 379 patients, 39.6% were monosensitized and 60.4% polysensitized. The percentages of polysensitized patients were higher in patients exhibiting rhinoconjunctivitis and astma-rhinoconjunctivitis than in subjects with asthma. The prevalence of symptoms according to sex showed no significant difference (P=0.64). Regarding age, a significant difference was observed in the case of rhinoconjunctivitis (P<0.01), while asthma and asthma-rhinoconjunctivitis showed no significant difference. Sensitization to house dust mites was the most frequent followed by grasses, olives and Parietaria. The multiple correspondence analyses (ACM) showed that patients under 20-years of age with asthma and asthma-rhinoconjunctivitis profile are more associated with sensitization to mites during the spring and autumn. The 20-49-year age group was represented mainly by polysensitized patients with rhinoconjunctivitis. Sensitization to mites ranks first in Tetouan followed by the percentage of sensitized patients to grass pollen and olive. The ACM showed that the house dust mite asthma seems to affect more children and adolescents while the 20-49 year age of polysensitized group suffers significantly rhinoconjunctivitis.

The Use of Probiotics in Respiratory Allergy

There is a high and steadily increasing prevalence of respiratory allergy throughout the world, especially in paediatric population and in industrialized and developing countries. A complex interplay between genetic and environmental factors has been implicated to explain this dramatic increase in prevalence of allergic diseases. It has been suggested that exposure to microbes plays a critical role in the development of the early immune system and may contribute to allergic diseases through their effect on mucosal immunity. Probiotics, microorganisms exerting beneficial effects on the host, are used in a great number of paediatric and adult diseases, mainly gastrointestinal disorders, but they have been proposed to be beneficial also in allergic diseases. Different trials have been published finding benefits in the use of probiotics in prevention and treatment of atopic dermatitis, but to date, studies have yielded inconsistent findings to support a protective association between their use on prevention of allergic rhinitis or asthma. However, probiotics may be beneficial in improving symptoms and quality of life in patients with allergic rhinitis although it remains limited due to study heterogeneity and variable outcome measures. As a result of these controversies, future investigations with a better standardization are needed. In this review, we summarize recent clinical research to elucidate the mechanisms of probiotics and their effect in respiratory allergy. According to published data, probiotics could emerge as a novel, complementary treatment option for allergic rhinitis but not for asthma.

Immunoglobulin deficiency in patients with chronic rhinosinusitis: Systematic review of the literature and meta-analysis

Several studies have shown a high prevalence of immunoglobulin deficiencies in patients with chronic rhinosinusitis (CRS). We sought to perform a systematic review and meta-analysis to estimate this prevalence more precisely and to identify patients who need substitution treatment. All case series published after 1990 describing patients with CRS, which was defined as symptomatic rhinosinusitis for more than 12 weeks and documented immunoglobulin deficiencies (including deficiencies of IgG with subclasses, IgA, and IgM; specific antibody deficiencies; and potential common variable immunodeficiency), were retrieved. A meta-analysis of the proportion of any combination of common variable immunodeficiency, IgG deficiency, IgA deficiency, and IgM deficiency in patients with CRS was performed by using logit transformation of the prevalence. Recurrent CRS was defined as rhinosinusitis not controlled by appropriate conservative management for 4 months, and difficult-to-treat CRS was defined as noncontrollable rhinosinusitis despite successful sinus surgery and appropriate conservative management for at least 1 year. The meta-analysis revealed a prevalence of pooled IgG, IgA, and IgM deficiencies in 13% of patients with recurrent CRS and 23% of patients with difficult-to-treat CRS. The prevalence of IgG subclass deficiency (5% to 50%) and specific antibody deficiency (8% to 34%) was increased in patients with CRS, as was the prevalence of respiratory allergies in patients with recurrent CRS (31% to 72%). Immunoglobulin deficiency is a frequent condition in patients with CRS. An even higher prevalence of atopy was observed in patients with recurrent CRS. Therefore immunoglobulin titers and accurate allergy diagnostic workups are strongly recommended in these patients to provide specific treatments for symptom alleviation. However, there is a need for larger prospective studies addressing the effect of specific therapeutic interventions for CRS.

Role of Antibiotics and Infection-Host Interactions in the Prevalence of Respiratory Atopy: Experience and Perspective

We have witnessed a dramatic increase in the prevalence of respiratory allergies during the last decades. The role of infections in the prevalence of respiratory allergic diseases is attributed to the antagonism between: a) induction of T helper (Th) 1 immune response by human organism; and b) manipulation of the human immune response toward Th2 profile by common infective agents in order to increase their surviving opportunity. This review proposes an important role of massive antibiotics exposure during neonatal and early childhood on the increasing epidemiological trend. It is believed that the antibiotics exposure during early childhood has also provided better surviving opportunity for atopic individuals with an inadequate immune defense against common infections, deviating therefore the genetic background of general population toward Th2 profile. Taking this into account, we suggest that Th2 profile frequency (and consequently atopic phenotype prevalence) can be increased along an individual lifespan after initial massive antibiotic introduction, until the entire population is exposed to them during childhood. This hypothesis may explain findings on epidemiological surveys, which report a prevalent increase among adults in industrialized countries between 1970s and 2000s, while in recently- developed countries this trend begun only at the end of 1980s. These arguments may lead to the conclusion that infections will manipulate the human immunity along generations, whereas actual antibiotics can increase the prevalence of respiratory allergies among a population only along an individual longevity. These findings may be beneficial in the development of future strategies for management of respiratory allergic or infective pathologies.

Allergies in Children: What’s New?—A Cross-Sectional Descriptive Study

Background: The prevalence of respiratory allergies is increasing worldwide, with important consequences especially for little children. Objective: The aim of this study was to assess the prevalence of respiratory allergies, such as rhinitis and asthma, and to point out the risk factors and their relationship with allergic diseases in a specific area of Northern Italy. Methods: 110 children, male and female, from our outpatient service for allergic children, between 3 and 17 years old, were examined. After a skin prick test and a nasal cytology, the written questionnaire of the International Study of Asthma and Allergies in Childhood was filled by parents together with their children. Results: 110 children were examined. 74% of children had rhinitis and 71% asthma. 88 patients were allergic, grass pollen and house dust mite was the most frequent allergens. A family history of atopy, family background, geographic area, active and passive smoking and home pets were associated to allergies. Older children (6 - 15 years old) had more often rhinitis associated with asthma and conjunctivitis as compared to younger. 21 Children were also affected by non allergic rhinitis. Conclusions: Respiratory allergies are widespread and associated to a low quality of life among little children. Sensitization to Ragweed is increasing with important consequences. Rhinitis precedes the onset of asthmatic symptoms. Moreover non allergic rhinitis is increasing and frequently underdiagnosed.

P03 ‐ Mould allergy in children with allergic rhinitis in a seaside agricultural region

Objective Allergic rhinitis (AR) is a major chronic respiratory disease due to its prevalence, impact on quality of life (QL), economic burden, link with asthma. During the last years, many countries have experienced an increase in the prevalence of respiratory allergy. A significant contribution in development of AR, in addition to house dust mite, cockroaches, dogs, cats, pollen and trees, seems to have mould allergens. Alternaria is predominantly an outdoor allergen favouring damp spots, and most indoor concentrations may derive from outdoor primary sources.

Prevalence of the Respiratory Allergies among Adult Population in the City of Skopje in Relation to Climatic Change and Change in Pollen Micro Flora

Introduction: Climate change may have an impact of prevalence and severity of respiratory allergies causing changes in the concentrations, distribution, dispersion patterns, and allergenic potential of aeroallergens in the environment. Objective: To assess the prevalence of atopy, sensitization to common pollen allergens, and respiratory allergies (allergic rhinitis and asthma) among adult population in the city of Skopje in relation to changes in pollen distributions caused by climate change and particularly maximum temperature, in the period 1996-2010. Methods: Aeropalinological measurements in the city of Skopje were performed by volumetric method in the period 1996-2009. Serial cross-sectional studies on the prevalence of atopy, sensitization to common pollen allergens, allergic rhinitis and asthma in adults by standardized methodology were conducted in defined critical periods (1996, 2003, 2007/2008 and 2009/2010). Evaluation of examined subjects included completion of a questionnaire, skin prick tests (SPT) to common inhalant allergens, and lung function tests. Results: Data from aeropalinological measurements showed differences in the pollen concentrations, as well as in the duration of pollen season for some pollen types. The prevalence of atopics was similar in all critical periods, and the prevalence of sensitization to common pollen allergens was slightly higher in the last study than in the study performed in 1996. We registered increase in the prevalence of allergic rhinitis in the examined period (11.5% in 1996 to 17.4% in 2009/2010) followed by increase in the prevalence of rhinitics sensitized to common pollen allergens. The prevalence of allergic asthma was significantly higher in the study conducted in 2009/2010 than in the study conducted in 1996 (5.1% vs. 2.1%, P = 0.037) followed by slightly higher prevalence of asthmatics sensitized to common pollen allergens in the same period. Conclusions: Registered changes in the prevalence of sensitization to common pollen allergens, as well as in the prevalence of subjects with respiratory allergies sensitized to these allergens, even statistically non-significant, indicate the need of further monitoring and investigation in order to assess the association between climate change with change in pollen micro flora and related allergic disorders.

Prevalence of self-reported food allergy and IgE antibodies to food allergens in Swedish and Estonian schoolchildren

To compare the prevalence of self-reported food allergy and IgE antibodies to food allergens in wheezing and non-wheezing Estonian and Swedish schoolchildren, in the light of the disparities in the standard of living, food consumption and prevalence of respiratory allergies that still exist between Estonia and the Scandinavian countries. As a part of the ISAAC Phase II study, children from a random sample of schools in Tallinn in Estonia and Linköping and Ostersund in Sweden participated in skin prick tests to inhalant allergens and the parents replied to questionnaires. IgE antibodies against a panel of food allergens (egg white, milk, soy bean, fish, wheat and peanut) were taken from children with questionnaire-reported wheezing and a random sample of nonwheezing children. Children aged 10-11 y. The prevalence of self-reported food allergy was similar in Estonia and Sweden and about twice as high in wheezing children than in nonwheezing children. In Estonia, however, 3% of the children with perceived food allergy reported reactions from at least four different foods, as compared to 31% in Sweden. The prevalence of sensitisation to food allergens was similar in wheezing and nonwheezing children in Estonia (8%) while, in Swedish children, IgE antibodies to food allergens were more likely among wheezing children (Linköping 38 vs 11%, crude OR 5.1, 95% CI 2.2-11.6, and Ostersund 24 vs 7%, crude OR 4.1, 95% CI 1.9-8.5). Our study suggests that IgE-mediated food reactions were less likely in Estonian schoolchildren. Moreover, the perception of food allergy and thereby the meaning of self-reported food allergy appears to be different in the two countries.

Nasal lavage as a tool for the assessment of upper-airway inflammation in adults and children

The prevalence of respiratory allergies has increased over the last 20 years, highlighting the need for a simple and noninvasive tool to investigate, in a clinical and epidemiological context, airway-inflammation mechanisms encountered in allergic and inflammatory processes. The nose, as the first region of the respiratory tract to come in contact with airborne pollutants, is easily explored with the use of nasal lavage (NL). We evaluated an NL method for adults and children, along with its reproducibility and capacity to separate different subgroups. NL reproducibility, assessed in 10 healthy, nonsmoking adults on three different occasions, was determined with the use of the intraclass coefficient of correlation for such inflammatory markers as total cell count, albumin, urea, neutrophil elastase, α1-antitrypsin, interleukin-6, and interleukin-8. Using this NL method, we analyzed nasal markers of 50 healthy adults (smokers and nonsmokers) and 12 healthy children. Our NL method demonstrated high reproducibility with regard to total cell count, albumin, urea, and α1-antitrypsin (intraclass correlation coefficient > 0.75). Compared with NL results in nonsmokers, NL in heavy smokers revealed significant increased concentrations of total cell counts and interleukin-8 and significant decreased concentrations of interleukin-6. These findings suggest that NL can be used as a tool in the assessment of inflammation because it has the correct reproducibility and can discriminate between heavy smokers and nonsmokers. Moreover, the use of this standardized method in children is feasible. (J Lab Clin Med 2002;139:173-80)

Quoi de neuf en allergologie pédiatrique en 2000 ?Revue de la littérature internationale dˈoctobre 1999 à octobre 2000

The relation between maternal and childhood atopy may result from an increased intrauterine Th2 environment and high levels of Th2 cytokines in the milk of atopic mothers. The value of in vitro tests for early prediction of atopy is low, but high levels of eosinophil-derived proteins in nasal secretions of neonates may predict respiratory allergy. The prevalence of respiratory allergy has decreased in children living in rural areas, especially on farms. This may be related to exposure to mycobacterias, but the development of allergic conditions is independent of tuberculin reactivity and history of tuberculosis infection; however, the prevalence of asthma is decreased in young adults infected by Mycobacterium tuberculosis during childhood. High levels of eosinophils in the blood of children with bronchiolitis predict the development of persistent wheezing and asthma. Inhaled, oral and intravenous corticosteroids do not prevent relapses of bronchiolitis and persistent wheezing, but early hyposensitization has long-term beneficial effects on asthmatic symptoms. Results of prick-tests and specific IgE determinations are correlated with the severity of food allergy, and several studies confirm the diagnostic value of patch-tests with foods in children with atopic dermatitis associated with food allergy. Interesting cases of unexpected food allergies are reported (carob-induced anaphylaxis, and exercise-induced anaphylaxis to snails). Finally, children with spina bifida demonstrate a progressive sensitization to latex, in spite of a latex-free environment after the first surgical procedure(s), and the gelatin included in vaccines is highly immunogenic and allergenic.

Increasing prevalence of specific IgE to aeroallergens in an adult population: Two cross-sectional surveys 8 years apart: The Copenhagen Allergy Study

Background: There is evidence that the prevalence of respiratory allergy has increased in children in many countries. However, this evidence is largely based on questionnaire data, and little is known about similar trends in adults. Objective: We investigated whether the prevalence of specific IgE to aeroallergens had increased in an adult general population over an 8-year period. Methods: Two cross-sectional surveys were carried out in 1990 and 1998. A mailed screening questionnaire on respiratory symptoms sent to random samples of 15- to 41-year-old subjects living in Copenhagen (Denmark) preceded both surveys. Random samples of responders were invited to a health examination, including assessment of specific IgE to 6 common aeroallergens. Totals of 312 (74.6% of the invited subjects) and 482 (53.4% of the invited subjects) subjects were examined in 1990 and 1998, respectively. Analyses of serum samples from both surveys were performed in 1999. Results: The prevalence of specific IgE to at least one allergen increased significantly from 1990 to 1998 (26.5% vs 33.9%; odds ratio adjusted for sex, age, and season of examination, 1.63; 95% confidence interval, 1.15-2.32; P = .006). This increase remained unexplained after adjustment for changes in questionnaire variables on lifestyle and home environment. The clinical significance of this increase was underlined by a corresponding increase in the prevalence of allergic rhinitis symptoms associated with specific IgE positivity. Conclusion: We found that the prevalence of specific IgE positivity to aeroallergens increased in an adult Danish general population from 1990 and 1998. (J Allergy Clin Immunol 2000;106:247-52.)

Increasing prevalence of allergic rhinitis symptoms in an adult Danish population.

There is evidence that the prevalence of respiratory allergy is increasing. This is mainly based on studies in children and young adults. The aim of the study was to compare the prevalences of self-reported symptoms of respiratory allergy among Danish adults in two surveys 8 years apart. Identical questionnaires were mailed to two random general population samples in 1989 and 1997. The response rates were 86.1% (n = 3603) and 86.4% (n = 817), respectively. The sampling frame and sampling method were identical in both surveys. The changes in the prevalences of symptoms were expressed by sex- and age-adjusted odds ratios comparing 1997 to 1989. We found a significant increase in the prevalence of seasonal rhinitis symptoms (OR=1.6, 95% CI 1.4-1.9), rhinitis symptoms on exposure to pollen (OR =1.6, 95% CI 1.4-1.9), rhinitis symptoms on exposure to furry animals (odds ratio 1.6, 95% CI 1.3-2.0), rhinitis symptoms on exposure to house dust (OR = 1.3, 95% CI 1.1-1.6), and breathlessness on exposure to pollen (OR = 1.5, 95% CI 1.0-2.0). The observed increases were independent of sex and age. The questionnaire was validated in relation to allergen skin test reactivity in a subgroup of the responders to the 1989 survey. When the estimated associations between symptoms and skin test reactivity were considered, the results suggested an increase in allergy to pollen and animal dander. In conclusion, we found evidence of increased prevalence of allergic rhinitis symptoms associated with skin test reactivity.

Lymphoid aggregates in endobronchial biopsies from young elite cross-country skiers.

Observation of bronchus-associated lymphoid tissue (BALT) in whole lung specimens from healthy nonsmoking adults has questioned the hypothesis that BALT is not constitutively present in healthy adult human lungs. In our study, we investigated endobronchial biopsies of the second- and third-generation carinae from 44 cross-country ski athletes and 12 healthy control subjects, all nonsmoking young adults. The skiers had a prevalence of respiratory allergy (18%), asthma-like symptoms (59%), beta2 agonist medication (25%), and methacholine bronchial hyperresponsiveness (79%). Biopsy sections were stained by immunohistochemical and hematoxylin-eosin-saffran methods. Lymphoid aggregates of more than 50 cells were identified in 28 (64%) skiers and three (25%) control subjects (p = 0.02). They were small in comparison to those found in rabbits and rats, contained T and B lymphocytes and macrophages, and were seen more frequently in skiers using beta2 agonists (p = 0.04) and with bronchial hyperresponsiveness to methacholine (p = 0.053). The frequency of these aggregates was not significantly different at the two carinal levels (p = 0.6). The aggregates were not associated with a history of respiratory allergy or asthma-like symptoms. These aggregates share some resemblance with what is usually defined as BALT. However, their exact nature and function await further clarification.

Prevalence of respiratory allergy in a platinum refinery.

In a cross-sectional study, 65 workers in the chemical industry with exposure to platinum salts were investigated with regard to the prevalence to allergic respiratory tract diseases. A respiratory questionnaire, a skin-prick test with K2PtCl6 and environmental allergens, determination of total IgE, platinum-specific IgE and histamine release in basophilic granulocytes and lung function tests were applied before and after a Monday shift and after a Friday shift. Work-related symptoms of respiratory allergy were present in 23% of all workers, but were significantly more frequent in the most exposed group in the platinum refinery (52.4%). Of all workers, 18.7% had a positive skin-prick test with platinum salt. As compared to the other workers, the workers with work-related symptoms of respiratory allergy had significantly more positive skin-prick tests (64.3%) and a higher total IgE and platinum-specific IgE; they did not, however, show higher histamine release. In the course of the week, a significant fall in lung function, namely in FEV1 and FEF25, was recorded in the group of workers with work-related symptoms.