Risk Of Respiratory Allergies Research Articles

Allergic Rhinitis and Asthma: A Profile of Beta-defensins in Serum of Iraqi Patients

Human beta-defenses (hBDs) are antimicrobial peptides involved in innate immune protection, and their association with the risk of respiratory allergy has been proposed. Therefore, this study sought to evaluate this association in allergic rhinitis (AR) and asthma (AS) of Iraqi patients. A case-control study was conducted to investigate serum levels of hBD1, hBD2, hBD3, and hBD4 in 52 AR and 60 AS patients and 61 healthy controls (HC). The hBDs were determined using enzyme-linked immunosorbent assay kits. Results revealed that median levels of hBD1, hBD2, and hBD3 were significantly elevated in the serum of AR and AS patients compared with HC (p < 0.01). Levels of hBD4 were also elevated in AR and AS patients but the differences were not significant. The levels of hBDs showed no significant differences between AR and AS patients. Age, gender, symptoms, and disease duration of patients influenced some of these variations. Logistic regression analysis indicated that hBD3 was the most important marker associated with the risk of AR and AS, and the estimated Odds ratios were 25.31 (95% confidence interval: 2.97-215.78; p = 0.012) and 32.20 (95% confidence interval: 2.49-415.89; pc = 0.032), respectively. Receiver operating characteristic curve analysis revealed that hBD3 occupied a very good area under the curve in AR and AS (0.83 and 0.84, respectively). In conclusion, the role of hBDs in the pathogenesis of AR and AS was indicated. In this context, hBD3 was the most important, and its association with the risk of developing AR and AS was suggested.

Do we need aerobiological air monitoring in desert climates? The Qatar experience.

Knowledge about diurnal, seasonal, and annual fluctuations in airborne pollen and fungal spores in any geographical area is essential for effective diagnosis and treatment of allergies. Aerobiological analysis enables the detection of airborne pollen and spores, thus providing information on plant phenology, plant distribution, related diseases, and the risks for some species in terms of allergies. Although pollen and fungal spores have been widely studied as aeroallergens throughout the world, not much is known about the biological aerosols in countries with a desert environment; and these could be present in much higher concentrations than expected. Arid desert regions (including the region surrounding the Arab Gulf), characterized by hot weather, poor soils, and low biological productivity, have typically been neglected when building ambitious biomonitoring networks for the large-scale monitoring of biological particles; however, few studies in Kuwait, Saudi Arabia, and recently Qatar have aimed to delineate the various botanical families that contribute to inhalant allergens in this region.Understanding the aerobiological features of countries with hot and desert climates may better prepare healthcare providers to assist patients with allergic rhinitis. It may be argued that one of the reasons why aerobiologists have only recently turned their attention to the state of Qatar investigating how pollen and fungal spore records could contribute to evaluating the correlation between different pollen conditions and allergy symptoms.The first aerobiological network of Qatar was monitoring (2017–2020) the atmospheric pollen concentrations of Doha and Al Khor to determine the association between the possible risk of respiratory allergies and the distribution of certain species throughout the region. In the Qatari database, more than 25 native taxa have been recorded, up to 50% of which can be considered allergenic. This includes Amaranthaceae and Poaceae pollen among the major aeroallergens causing allergy symptoms in Qatar. Our study has confirmed a statistically significant association between Amaranthaceae and asthma and allergic rhinitis. To summarize, it is worth considering aerobiological monitoring in desert climate regions when assessing the effectiveness of pollen allergy therapy and planning prevention methods for patients.

Breastfeeding and risk of respiratory allergies and asthma in children: Seeing things from different perspective

None to declare.

Response letter: Breastfeeding and risk of respiratory allergies and asthma in children: Seeing things from a different perspective.

A response to the letter by the author Dimnjakovic Jelena1 . The author stated a general critique on breastfeeding studies that frequently regarded breastfeeding as 'intervention' and not 'control', which might form readers' opinion about breastfeeding as an optional feeding and not as a standard one1,2 . Specifically, this issue was addressed in a recent study published in Acta Paediatrica by Bigman3 . Briefly, Dimnjakovic stressed the analysis, where exclusively formula-fed children were considered as the 'control' implying the author considered it as the optimal feeding while comparing it to those who were exclusively breastfed or as Dimnjakovic defined as the 'intervention' implying it as optional feeding1 .

The natural history of atopic dermatitis and its association with Atopic March.

Atopic dermatitis (AD) is the first manifestation of Atopic March. The natural history of AD and predictive factors for Atopic March have not been widely studied in Asia. To study the natural history and associated factors of disease remission and risk of respiratory allergy in Thai children with AD. Medical records of AD patients attending Allergy clinic at Siriraj hospital from 2004-2014 were reviewed. Patients were further followed-up to obtain current symptoms and treatment. One hundred and two AD patients (60.8% female) were followed for 10.2±4.7 years. The median age at diagnosis was 1.5 (0.1-12.0) years. The most common allergen sensitization was Dermatophagoides pteronyssinus and Dermatophagoides farinae. Forty-four percent of patients had complete remission at the median age of 6.3 (2.0-15.0) years. Forty-seven percent of early AD patients (onset < 2 years) had concomitant food allergy which egg and cow's milk were leading causes. The remission rate of AD was higher in early AD than later onset AD (p=0.02). Allergic rhinitis (AR) and asthma were diagnosed in 61.8% and 29.4% of the patients at the median age of 4.6 and 3.8 years, respectively. Early AD and food allergies were significantly associated with early asthma (onset < 3years) (OR=10.80, p< 0.01 and OR=8.70, p=0.01). Almost half of AD children had complete remission at school age with a better prognosis in early AD. At preschool age, two-thirds and one-third developed AR and asthma, respectively. Early AD and food allergy were risk factors of early asthma.

High levels of both n-3 and n-6 long-chain polyunsaturated fatty acids in cord serum phospholipids predict allergy development.

BackgroundLong-chain polyunsaturated fatty acids (LCPUFAs) reduce T-cell activation and dampen inflammation. They might thereby counteract the neonatal immune activation and hamper normal tolerance development to harmless environmental antigens. We investigated whether fatty acid composition of cord serum phospholipids affects allergy development up to age 13 years.MethodsFrom a population-based birth-cohort born in 1996/7 and followed until 13 years of age (n = 794), we selected cases with atopic eczema (n = 37) or respiratory allergy (n = 44), as well as non-allergic non-sensitized controls (n = 48) based on diagnosis at 13 years of age. Cord and maternal sera obtained at delivery from cases and controls were analysed for proportions of saturated, monounsaturated and polyunsaturated fatty acids among serum phospholipids.ResultsThe cord serum phospholipids from subject who later developed either respiratory allergy or atopic eczema had significantly higher proportions of 5/8 LCPUFA species, as well as total n-3 LCPUFA, total n-6 LCPUFA and total LCPUFA compared to cord serum phospholipids from controls who did not develop allergy (P<0.001 for all comparisons). Conversely, individuals later developing allergy had lower proportion of the monounsaturated fatty acid 18∶1n-9 as well as total MUFA (p<0.001) among cord serum phospholipids. The risk of respiratory allergy at age 13 increased linearly with the proportion of n-3 LCPUFA (Ptrend<0.001), n-6 LCPUFA (Ptrend = 0.001), and total LCPUFA (Ptrend<0.001) and decreased linearly with the proportions of total MUFA (Ptrend = 0.025) in cord serum phospholipids. Furthermore, Kaplan-Meier estimates of allergy development demonstrated that total LCPUFA proportion in cord serum phospholipids was significantly associated with respiratory allergy (P = 0.008) and sensitization (P = 0.002), after control for sex and parental allergy.ConclusionA high proportion of long-chain PUFAs among cord serum phospholipids may predispose to allergy development. The mechanism is unknown, but may involve dampening of the physiologic immune activation in infancy needed for proper maturation of the infant's immune system.

340 Sensitization to Aeroallergens and Risk of Respiratory Allergy in Atopic Dermatitis Children

BackgroundInfants and young children with atopic dermatitis (AD) are at grate risk of developing respiratory allergy later in life with rhinitis, eye symptoms, and sometimes asthma. The aim of our study was to describe the sensitization patterns to inhalants in our young patients with AD and to assess the relation between early sensitization to aeroallergens and the development of respiratory allergy.Methods80 children diagnosed of AD, aged from 11 to 34 months, were included (51 male and 29 female). Seventy two of these 80 were followed up to 7 years of age. Except a clinical examination, total IgE level was investigated by ELISA, and analysis of specific IgE antibodies to aeroallergens was performed with MAST CLA Allergen specific IgE Assay. Nonparametric tests were used in comparative analysis.Results79% of our infants with AD had increased level of total IgE (mean: 387 kU/L). Sensitization to inhalant allergens was determined in 52 atopic dermatitis children (65%). The most relevant results were: 39 patients (48.8%) were sensitized to pets, 36 patients (45.0%) were sensitized to house-dust mites, 25 patients (31.3%) were sensitized to pollen, 17 patients (21.5%) were sensitized to molds. During the follow up, 48% of patients developed asthma and 52% allergic rhinitis. The mean age of respiratory allergy onset was 29.8 ± 3.9 months. At the end of our study the cumulative prevalence of respiratory allergy symptoms was significantly higher in children with inhalant sensitization compared to children without sensitization to aeroallergens (71% vs 18%, P < 0.001). The risk of asthma in that group also was significantly higher (68% vs 14%, P < 0.001).ConclusionsEarly sensitization to aeroallergens in AD children is associated with increased risk of development of respiratory allergic symptoms later in life.