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Objectives To find possible relationship between asthma exacerbation and metabolomic profile of airways, assessed by non-invasive method – free volatile organic compounds (VOCs) in exhaled air in children. Material and Methods The study included 80 children aged 4–18 years with asthma: 42 children with a min. 3 asthma exacerbations in the past 12 months, and 38 children without a history of exacerbations in the past year. During the study visit, each patient was examined, medical history (including information regarding atopy and eosinophil blood count) was taken, spirometry and fractional exhaled nitric oxide (FeNO) were tested, an exhaled air sample was taken to test for the presence of VOCs, and the patient also completed standardized form – Asthma Control Questionnaire . Volatile organic compounds were measured by combined gas chromatography coupled to mass spectrometry. Results The obtained results of VOCs were correlated with the history of the disease. The 2 gas profiles were defined and they formed 2 clinically distinct clusters (p = 0.085). Cluster 2 was characterized for children with a higher number of bronchial asthma exacerbations and worse lung function parameters (predicted percentage forced expiratory volume in 1 s [FEV 1 ] [p = 0.023], FEV 1 / forced vital capacity ratio [FVC] [p = 0.0219]). The results were independent of the age, sex, BMI, atopy (house dust mite allergy) and eosinophil blood count. Conclusions The study findings suggest that a relative group of gases may be a useful predictor of having asthma exacerbations in children. Additionally, a single FeNO value was unlikely to be clinically useful in predicting asthma exacerbations in children. The VOCs profile reflecting the metabolism of the airway epithelium and local microbiota was associated with the course of asthma, which strongly justifies further prospective validation studies. Int J Occup Med Environ Health. 2024;37(3):351–59

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%).