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Atopic dermatitis (AD) is a chronic skin disease with relapses that are frequently encountered in infants. The relationship between AD and infant sleep is not clearly known, but it is an essential area of research because sleep plays a vital role in infant development. In this study, we aimed to evaluate the sleep quality of infants with AD and their mothers admitted to the pediatric allergy and immunology outpatient clinic and to examine the relationship with disease severity. Methods: Eighty patients diagnosed with AD between 1-12 months of age and their mothers constituted the patient group. A control group was formed with 80 healthy infants of the same age group. The BISQ-R (Brief Infant Sleep Questionnaire-Revised) was used to assess the sleep quality of the infants in the patient and control groups, and the Pittsburgh Sleep Quality Index (PSQI) was used to determine the mothers' sleep quality. Results: There was no statistically significant difference between the patient and control groups regarding age, gender, and maternal age. There was a statistically significant difference between the BISQ-R and PSQI scores of the patient and control groups (p=0.002, p=0.001, respectively). Infants and their mothers in the patient group had worse sleep quality compared to the control group. A moderate positive linear relationship was found between the objective SCORAD scores of the patients and the PSQI scores of the mothers (p: 0.04, r: 0.32). A highly negative linear relationship was found between the objective SCORAD scores of the patients and the BISQ-R scores (p < 0.001 r: -0.78). It was found that the presence of food allergy had a negative effect on infant and maternal sleep quality, whereas breastfeeding had a positive effect. Conclusion: In this study, the presence of AD was found to negatively affect the sleep quality of the infant and the mother. As the severity of AD increases, the sleep quality of the infant and the mother is more negatively affected. AD patients with food allergies and their mothers should be monitored more closely for sleep disturbance. Encouraging mothers to breastfeed may positively affect infant and maternal sleep quality. [ABSTRACT FROM AUTHOR]

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Objective: There has been an increase in the number of cases as pediatricians mistakenly refer scabies to an allergy clinic, misdiagnosing it as allergic illnesses, particularly atopic dermatitis (AD), because of the presence of symptoms such as itching and eczematous lesions. The objective of our study was to examine the prevalence of scabies in children who were referred to the pediatric allergy clinic after being misdiagnosed with AD. We also aimed to determine the clinical and demographic distinctions between individuals with AD and scabies. Methods: The files of 610 patients those referred to Sakarya Training and Research Hospital Pediatric Allergy Clinics between February -December 2022 with complaints of 'itching and rash' were documented retrospectively. Cases of acute urticaria, chronic urticaria, mastocytosis, insect bite, maculopapular rash with viral infection, drug-induced reactions were excluded. Patients whose final diagnosis was AD and who were diagnosed with 'definite scabies' were included in the study. Results: A total of 404 patients were included in the study. The rate of definite diagnosis of scabies was 18.5% (n:75/404). The median age at presentation was 19 months (IQR 8-51) in patients diagnosed with AD and 53 months (IQR 17-117) in patients diagnosed with scabies (p<0.005). The median time from symptom onset to diagnosis was seven months (IQR 2.5-24) in the AD group and two months (IQR 1-4) in the scabies group (p<0.005). Only 20% (n:15/75) of patients with scabies had family history, 16% of patients (n:12/75) had received one or more treatments before. Pruritis was present in only 72% (54/75) of children. Hospitalization rate was 0.05% (n:4/75). Conclusion: We recommend that scabies should be considered as a potential diagnosis for patients who visit to any clinic with symptoms of itching and a skin rash. Timely identification and medical intervention for scabies in children is crucial in order to minimize the spread of the disease throughout the community and prevent potential complications. [ABSTRACT FROM AUTHOR]

An estimated 2-8% of children have either probable or confirmed food allergy; this corresponds to an average of 1-2 children in a classroom. Food-allergy training for teachers ranges from national-level guidance to variable levels of training, or even none. An estimated 8% to 18% of all food-induced anaphylaxis occurs in school settings. Adrenalin or epinephrine, the first-line medication for the treatment of anaphylaxis, is much more commonly used when reactions occur at school (including childcare centres), but compared to the use when reactions occur elsewhere adrenalin is underused. Individual health plans should be available in schools to help prevent allergic reactions and to serve as support for the use of adrenalin if a reaction does occur. To promote the psychological safety of children with food allergy at schools, a shared decision-making model may be appropriate. The family (and child, when appropriate) and teachers are encouraged to have timely discussions about food-allergy management. But at no time should children be systematically excluded because of their food allergy and zero-tolerance policies about bullying, including food-allergy bullying, are strongly encouraged. This article offers some guidance about managing food allergy in schools, which is intended to promote the physical and psychological safety of children with a food allergy. [ABSTRACT FROM AUTHOR]

Objective • To analyze specific immunotherapy and followup management for respiratory allergic diseases in children. Methods • A total of 100 children with allergic bronchial asthma admitted to our hospital from November 2020 to October 2021 were selected. Based on different treatment schemes, they were divided into two groups: the routine treatment group and the immunotherapy group, with 50 cases in each group. The routine treatment group received standard care, while the immunotherapy group underwent specific immunotherapy. Assessment parameters included asthma symptom control score, pulmonary function, immune function, levels of inflammatory factors, clinical efficacy, and adverse reactions. Results • After treatment and during follow-up, the immunotherapy group showed significantly lower scores for daytime and nighttime symptoms compared to the routine treatment group (P < .05). The immunotherapy group also exhibited higher FEV1/FVC and PEF% values compared to the routine therapy group after treatment and at follow-up (P<.05). Furthermore, the immunotherapy group showed higher levels of CD3+, CD4+, and CD4+/ CD8+ and lower levels of CD8+ compared to the routine therapy group (P<.05). Additionally, the immunotherapy group demonstrated lower levels of IL-4 and IL-12 compared to the routine therapy group after treatment and during follow-up (P < .05). The total effective rate of the immunotherapy group was higher than that of the routine therapy group (P < .05). The incidence of adverse reactions in the immunotherapy group was similar to that in the routine therapy group (P>.05). Conclusions • Specific immunotherapy is a significantly effective approach to managing children’s allergic bronchial asthma. It effectively controls asthma symptoms, improves lung function and immune response, and reduces inflammatory factors. It showed superior clinical efficacy and minimal adverse reactions; specific immunotherapy, therefore, is a safe and beneficial treatment option that warrants further promotion and application. [ABSTRACT FROM AUTHOR]

Objective: The prevalence of food allergy (FA) has gradually increased. Bloody stool is among the symptoms associated with non-immunoglobulin E (IgE) mediated FA in infants. In our study, we shared the clinical characteristics of the patients who applied to our clinic with bloody stool. Material and Methods: The data of the patients with bloody stool were reviewed. Patients' characteristics and the time of onset of tolerance in patients with FA were recorded, retrospectively. Results: The 110 patient files were reviewed. 68% of the patients were diagnosed with FA (63 proctocolitis/12 enterocolitis), 22% with an anal fissure, and 9% with nonspecific colitis. The most common causative food was cow milk (57%), the second was the combination of egg and milk (24.2%), and the third was egg (18.2%). The presence of atopic dermatitis (AD) and eosinophil count at the time of admission did not affect tolerance development time but it was shown that skin prick test (SPT) positivity and the high level of total IgE at the time of admission delayed the development of tolerance [(p=0.02), (r=0.510, p=0.009)]. Conclusion: Bloody stool is one of the common complaints in infants. It does not always indicate a FA. The clinic is mild when the underlying disease is non-IgE mediated FA. However, accompanying IgE-type sensitivities negatively affect the prognosis. Elevated total IgE and SPT positivity at the time of diagnosis may give an impression that tolerance of baked products could be delayed in this type of allergy. [ABSTRACT FROM AUTHOR]

Copyright of Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: With the approval of the use of COVID-19 vaccines for children, their administration has started in many countries. However, families have some hesitations about vaccinating their children with the COVID-19 vaccines. The aim of this study was to determine the COVID-19 vaccination rates in allergic children aged 12-19 years and to evaluate contributing factors to vaccine hesitation. Materials and Methods: This cross sectional study was carried out in a Pediatric Allergy Department of a university-affiliated hospital between 15th December 2021 and 15th February 2022. Parents of allergic children who agreed to participate in this study constituted the study population (n=261). Results: Of the 261 children with allergic diseases, 137 (52.4%) had two doses of the COVID-19 vaccine, and 89.3% of the mothers and 92.3% of the fathers had at least two doses of the COVID-19 vaccine. Among children who were not vaccinated (n=124), the leading reason was the novelty of the vaccine, and the second reason was the side effects. The perceived stress scale score of the parents in the vaccinated group was significantly (p <0.05) higher than in the unvaccinated group. Conclusion: Although there is an effective and safe vaccine for children during the pandemic, vaccination rates are not yet at the desired level. [ABSTRACT FROM AUTHOR]

According to official WHO statistics, giardiasis ranks third in the structure of childhood parasitic diseases. Constant parasitism of the Giardia pathogen in the small and large intestines leads to disruption of the functional state of the intestinal mucosa and the progression of a nonspecific clinical picture of the disease. On the other hand, with giardiasis, the occurrence of an inadequate immune response to microorganisms leads to skin itching, allergic reactions of various forms and localization on the skin of the face and body. In most cases, the clinical signs of giardiasis in children are masked under various clinical variants of other gastroenterological pathologies and symptoms of allergic diseases, which creates some difficulties in clarifying the diagnosis. For this reason, giardiasis continues to remain one of the pressing medical and social problems facing pediatricians. The study we presented presents the results of a study of the clinical signs and characteristics of the course of giardiasis in 18 children aged 3 to 15 years, accompanied by allergic symptoms. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between socioeconomic status (SES) and healthcare utilization by children with allergic diseases. We determined SES based on parental occupation and household income. A cross-sectional study was conducted using the Korean National Health and Nutritional Examination Survey (KNHANES) between 2015 and 2019 with participants who were under 18 years of age. The presence of allergic conditions was determined by a self-reported survey of parental response and healthcare utilization data (such as inpatient and outpatient visits). Moreover, we categorized SES into four quantiles (Q1–Q4) based on household income per annum. Then, the data were analyzed using chi-square tests and multivariate logistic regression analysis with confidence intervals (CIs) of 95%, and p < 0.05 was considered significant. A total of 3250 participants were involved in this study. The percentage of allergic diseases was 67.9% for allergic asthma and 32.1% for atopic dermatitis. It was found that the participants who were over 13 years old had atopic dermatitis and were more likely to visit the hospital than younger children. Additionally, the highest SES group in Q4 demonstrated higher healthcare utilization (OR = 1.58; 95% CI, 1.14–1.76) than other SES groups. Our study reveals that parental socioeconomic characteristics are related to the use of healthcare services for children with allergic disorders in Korea. These results highlight the need for public health actions and research to overcome the SES gap among children with allergic diseases. [ABSTRACT FROM AUTHOR]

Objective: Acute urticaria is one of the most common causes of admission to hospitals in children. The aim of the study is to evaluate the etiology of acute urticaria in patients who admitted to pediatric allergy outpatient clinics. Material and Methods: The patients who were diagnosed as acute urticaria in pediatric allergy outpatient clinics between January 1, 2016 and December 31, 2016 were included in the study. Patient information was recorded retrospectively from medical files. Results: In this study, 469 patients with acute urticaria were evaluated. The median (min-max) age of the patients was 7 years (2 months-18 years), and 48.8 % of them were male. Angioedema was accompanying in 20 % of the patients. Recurrent acute urticaria was seen in 33.5 % (n = 157) of the patients. In the history, infections were the triggers in 37.5 % (n=176) of the patients, drugs in 17.9 % (n=84), food in 10.9 % (n=51), insect bites in 3.2 % (n=15), and 0.2 % (n=1) of them had the vaccine. When the patients were evaluated with the medical histories, physical examination and laboratory findings; triggers could not be detected in 59 % (n=276) and these patients were diagnosed as idiopathic acute urticaria. Infections (37.5 %; n=176) were in the first place in patients with triggers. Food and drug allergies were confirmed in only one patient each. Considering the etiological distribution according to age groups, it was seen that idiopathic acute urticaria was more common in the 12-18 age group and infection-associated acute urticaria in the group under 2 years old (p=0.009). Conclusion: Mostly, triggers cannot be found in children who apply to the allergy clinic due to acute urticaria. In patients who can be identified triggers, infections are in the first place. However, patients' clinical histories may also include food or drug(s) as a suspected trigger, and it is important to evaluate these patients with diagnostic allergy tests. Thus, misdiagnosis of patients and unnecessary food or drug restrictions would be prevented. [ABSTRACT FROM AUTHOR]

Objective: Allergic rhinitis and asthma share an immunoglobulin E-mediated inflammatory reaction following exposure to the causal allergen. Asthma control is associated with rhinitis control. Glycyrrhetic acid is extracted from the licorice and has an anti-inflammatory property. Mannitol is an anti-edema molecule. A medical device contains these components. This study evaluated the medical device efficacy on symptoms and asthma control in children with allergic rhinitis and mild controlled asthma. Methods: The children took 2 puffs of the medical device for each nostril twice a day for 4 weeks. Symptom severity was evaluated considering the total symptom score and nasal obstruction. Symptom perception was assessed by children and doctors using the visual analog scale. Asthma severity and control were also evaluated. Parents judged the efficacy. Results: The study included 38 children: 18 (47.4%) females and 20 (52.6%) males; the mean age was 10.2 (±2.15) years. The treatment significantly reduced the severity of all symptoms, including nasal obstruction (P < .001). Both children and doctors perceived a reduction of symptom intensity (P < .001). Parents judged the treatment as effective. Asthma remained mild and controlled. Conclusions: This pilot study, conducted in clinical practice, showed that intranasal glycyrrhetic acid plus mannitol could reduce nasal symptoms, including obstruction, and maintain asthma control. Therefore, this multicomponent medical device could represent a potential option in children with allergic rhinitis and mild controlled asthma. [ABSTRACT FROM AUTHOR]

Asthma is the most common chronic respiratory condition affecting children in the UK. There is no single gold standard test to confirm the diagnosis and both overdiagnosis and underdiagnosis are common. Asthma should be suspected in any child presenting with episodes of wheeze, especially recurrent episodes of wheeze. Clinical diagnosis alone often results in misdiagnosis; all children from the age of five years under investigation for asthma in primary care should have access to spirometry, bronchodilator reversibility and FeNO testing. Abnormal spirometry with bronchodilator reversibility ≥12% confirms the diagnosis of asthma. Diagnosis should not be based on an abnormal FeNO value alone. A review based on symptoms alone without objective lung function monitoring may miss children at high risk of acute attacks as children with good symptom control often have abnormal lung function. [ABSTRACT FROM AUTHOR]

Food allergy, which is defined as an inverse immune response to food proteins, appears to increase gradually in children as a result of studies. It affects 6% of children and 3-4% of adults. The role of breast milk in preventing the development of allergies in children is controversial. Allergic reactions caused by food in children cause many symptoms and disorders affecting the gastrointestinal tract, respiratory tract and skin. These symptoms occur by immunoglobulin (Ig)E-mediated or non-IgE-mediated mechanisms. The cornerstone of food allergy treatment is removing foods from the diet by strict elimination method. Along with the genetic tendency, environmental factors can eliminate oral tolerance and cause food allergy. Disease results are affected by the immune system and trigger allergen properties. Foods that cause food allergies are a few, mainly milk, eggs, peanuts, nuts, fish and shellfish. In this review, the level of knowledge about the pathogenesis of the immunological response about most allergens, which are special substances in the protein structure found in foods, has been discussed with studies conducted. Thus, this study will shed light on identifying new immunotherapeutic approaches to allergens.

The study explored the associations between maternal exposure to air pollution during different trimesters and allergic diseases including asthma, allergic rhinitis, allergic conjunctivitis or/and eczema. Individual exposure to air pollutants was assessed by an inverse distance weighted (IDW) method using daily concentrations of SO2, NO2, PM10, and PM2.5 from air quality monitoring stations. Multiple logistic regression model was performed to estimate the associations between air pollution during each trimester of pregnancy and childhood allergic diseases. A total of 332 children (51.3%) were reported by their parents having been diagnosed with allergic diseases. After adjusting for covariates, allergic diseases were significantly associated with per interquartile range (IQR) increase in NO2, PM10, PM2.5 during the second trimester with odds ratios (ORs) and 95% confidence intervals (95%CIs) being 1.292 (1.005,1.662), 1.210 (1.042,1,405) and 1.270 (1.004,1.606), respectively. These findings suggest that maternal exposure to certain air pollutants during pregnancy, especially in the second trimester, is associated with childhood allergic diseases. [ABSTRACT FROM AUTHOR]

Background: COVID-19 lockdown caused sudden changes in people's lifestyle, as a consequence of the forced lockdown imposed by governments all over the world. We aimed to evaluate the impact of lockdown on body mass index (BMI) in a cohort of allergic children and adolescents. Methods: From the first of June until the end of October 2020, we submitted a written questionnaire to all the patients who, after lockdown, carried out a visit at the Pediatric Allergy Unit of the Department of Mother-Child, Urological Science, Sapienza University of Rome. The questionnaire was composed by 10 questions, referring to the changes in their daily activities. Data were extrapolated from the questionnaire and then analyzed considering six variables: BMI before and BMI after lockdown, sugar intake, sport, screens, sleep, and anxiety. Results: One hundred fifty-three patients agreed to answer our questionnaire. Results showed a statistically significant increase in the BMI after lockdown (20.97 kg/m2 ± 2.63) with respect to the BMI before lockdown (19.18 kg/m2 ± 2.70). A multivariate regression analysis showed that the two variables that mostly influenced the increase in BMI were sleep and anxiety. Conclusions: For the analyzed cohort of allergic children and adolescents we obtained significant gain in BMI as consequences of lockdown, which can be explained by many factors: high consumption of consolatory food, less sport activities, more time spent in front of screens, sleep alteration associated with increased anxiety. All these factors acted together, although sleep alteration and increased anxiety were the most influential factors that led to the worsening or the onset of weight gain, creating the basis for future health problems. [ABSTRACT FROM AUTHOR]

Asthma is one of the most common chronic diseases in children globally. Previous studies have shown that not attending asthma primary care consultations is associated with poorer treatment adherence and increased risk of loss of asthma control on a short-term basis. Here, we investigated long-term patterns and predictors of not attending scheduled asthma outpatient visits during 5-years of follow-up in 146 children with asthma. Of the 146 children, 67 (46%) did not attend at least one scheduled appointment, amounting to a total of 122 (10.8%) missed of 1133 scheduled appointments. In a multivariate analysis adjusting for total scheduled visits in the 5-year period any allergic sensitization was a significant risk factor for not attending ≥1 scheduled appointment (aOR = 6.6 (95% CI, 1.3–39.7), p = 0.03), which was not the case for asthma treatment step or lung function. Furthermore, atopic predisposition decreased the risk of non-attendance (aOR = 0.36 (0.13–0.92), p = 0.04). We found no association between non-attendance, treatment adherence or loss of asthma control. This study highlights that allergic comorbidity, but not degree of asthma severity, identifies a group of children with asthma who are prone to not attend scheduled outpatient appointments. [ABSTRACT FROM AUTHOR]

Allergic diseases represent a global burden. Although the patho-physiological mechanisms are still poorly understood, epithelial barrier dysfunction and Th2 inflammatory response play a pivotal role. Barrier dysfunction, characterized by a loss of differentiation, reduced junctional integrity, and altered innate defence, underpins the pathogenesis of allergic diseases. Epithelial barrier impairment may be a potential therapeutic target for new treatment strategies Up now, monoclonal antibodies and new molecules targeting specific pathways of the immune response have been developed, and others are under investigation, both for adult and paediatric populations, which are affected by atopic dermatitis (AD), asthma, allergic rhinitis (AR), chronic rhinosinusitis with nasal polyps (CRSwNP), or eosinophilic esophagitis (EoE). In children affected by severe asthma biologics targeting IgE, IL-5 and against IL-4 and IL-13 receptors are already available, and they have also been applied in CRSwNP. In severe AD Dupilumab, a biologic which inhibits both IL-4 and IL-13, the most important cytokines involved in inflammation response, has been approved for treatment of patients over 12 years. While a biological approach has already shown great efficacy on the treatment of severe atopic conditions, early intervention to restore epithelial barrier integrity, and function may prevent the inflammatory response and the development of the atopic march. [ABSTRACT FROM AUTHOR]

Background: Obesity and asthma in childhood often co‐occur. Few studies have examined this relationship using repeated measures of body mass index (BMI) or asthma symptoms (such as wheeze). Objective: We compared two analytic approaches for repeated measures data to investigate this relationship. Methods: Our baseline sample consisted of 1277 children enrolled in a Boston‐area cohort with BMI or wheeze at age 1 year and no missing covariates. We used latent class growth models (LCGM) and inverse probability weighting (IPW) of marginal structural models to examine the extent to which presence of overweight across childhood was associated with early adolescent current asthma, and conversely of repeated measures of wheeze across childhood with early adolescent obesity. Results: Using LCGM, a "persistent" childhood overweight class (vs "never") was associated with higher risk of asthma in early adolescence (RR 1.9; 95% CI 1.1, 3.0), while "persistent" childhood wheeze (vs "never") was associated with higher risk of obesity in early adolescence (RR 2.7; 95% CI 1.0, 6.4) after adjusting for baseline covariates. An IPW analysis treating childhood overweight and wheeze as time‐varying exposures and adjusting for baseline and time‐varying covariates resulted in weaker and less precise associations of "persistent" (vs "never") overweight with adolescent asthma (RR 1.3; 95% CI 0.3, 3.0), and of "persistent" (vs "never") wheeze with adolescent obesity (RR 2.3; 95% CI 0.4, 5.3). Conclusion: Our point estimates from both approaches suggest an association between "persistent" childhood overweight and adolescent asthma, and between "persistent" childhood wheeze and adolescent obesity. LCGM results were stronger and more precise, whereas IPW results were less conclusive with wider 95% confidence intervals containing the null. The precision gained from LCGM may be at the expense of bias, and the use of both approaches helps to shed some light on this tradeoff. [ABSTRACT FROM AUTHOR]

Background Atopic diseases are among the most common chronic conditions in childhood. Causes of allergies are manifold. The aim of this paper is to evaluate risk factors for atopic diseases and unremitting wheeze and to examine if there is an association between measles, mumps and rubella (MMR) vaccination and atopic dermatitis, asthma and unremitting wheeze in Bavarian pre-schoolers. Methods Parents filled out a questionnaire on children's health and environmental and socioeconomic factors. The questionnaire was administered within the Health Monitoring Units in a cross-sectional study in Bavaria, Germany (2014/2015). Data on vaccinations were obtained via the School Entrance Examination, a mandatory examination for pre-school children in Bavaria. Rates of influential factors of atopic diseases and wheeze, MMR and DTP (diphtheria, pertussis and tetanus) vaccination were calculated for all children stratified by health outcomes. To examine if there is an association between MMR vaccination and health outcomes, a multiple logistic regression analysis was performed. Results Data were available for 3237 individuals. Symptoms and diseases were more frequent in boys. Higher parental education was associated with a higher prevalence of atopic dermatitis. There were no significant associations between any of the health outcome groups and MMR vaccination in the multiple logistic regression models with adjustment for potential confounders. Conclusions The present study is in line with the current state of research that MMR vaccination is not associated with atopic diseases. [ABSTRACT FROM AUTHOR]

Copyright of Bezmialem Science is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Allergic sensitization is one of the key components for the development of allergies. Polysensitization seems to be related to the persistence and severity of allergic diseases. Furthermore, allergic sensitization has a predictive role in the development of allergies. The aim of this study was to characterize the pattern of sensitization of atopic patients treated at different pediatric allergy referral centers in Brazil. Methods: A nation-wide transversal multicenter study collected data on patients attended in Brazil. Peripheral blood samples were collected to determine the serum levels of allergenspecific IgE. If allergen-specific IgE was higher than 0.1 kUA/L, the following specific components were quantified. Results: A total of 470 individuals were enrolled in the study. Mite sensitization was the most frequent kind in all participants. A high frequency of sensitization to furry animals and grasses featured in the respiratory allergies. Regarding components, there was a predominance of sensitization to Der p 1 and Der p 2. It has been verified that having a food allergy, atopic dermatitis, or multimorbidity are risk factors for the development of more severe allergic disease. Conclusion: Studies on the pattern of allergic sensitization to a specific population offer tools for the more effectual prevention, diagnosis, and treatment of allergic diseases. Sensitization to dust mites house was the most prevalent in the evaluated sample. High rates of sensitization to furry animals also stand out. Patients with food allergy, atopic dermatitis, or multimorbidity appear to be at greater risk for developing more severe allergic diseases. [ABSTRACT FROM AUTHOR]

Introduction: this review aims to assess the effectiveness of physical exercise or other possible treatments for pediatric respiratory patients with asthma. Material and method: the search was conducted between January and May 2019 in the MedLine, Scopus and PEDro databases with the following keywords: "respiratory physiotherapy, children, asthma" combined with the Boolean operator "AND". This search was based on randomized and controlled clinical trials in Spanish, English and Portuguese. For its election, we took into account the type of study, dealing with respiratory Physiotherapy or a complementary technique to Physiotherapy and a population up to 18 years with asthma problems. If they did not meet these requirements, they were considered excluded. Results: the complete analysis of 9 articles on a pediatric population up to 18 years of age was performed. In these studies, several fields of physiotherapy are opened for the treatment of this pathology: aerobic exercise, respiratory exercises and other alternatives, such as acupuncture, with the study variables of lung function, bronchial response capacity and quality of life. Conclusion: there is strong evidence for the effectiveness of physical exercise on pulmonary function and quality of life variables in asthmatic patients. There is moderate evidence for the effectiveness of inspiratory muscle training on respiratory muscle strength variables in pediatric patients. Similarly, there is moderate evidence for the effectiveness of acupuncture in improving asthma in pediatric patients. [ABSTRACT FROM AUTHOR]

Objectives: Atopic sensitization is important in childhood asthma, however data regarding allergen sensitization patterns in Kenya is unavailable. We sought to determine the prevalence and spectrum of inhalant allergen sensitivity among asthmatic children aged 5-17 years in Nairobi. Methodology: This was a cross sectional study conducted in paediatric outpatient and asthma clinics of two public hospitals in Nairobi, Kenya. An adapted International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was administered, followed by skin prick testing for house dust mite, cat, dog, cockroach and mould. Results: Of the 92 children recruited, 71% had aeroallergen sensitization, with 38% having single allergen sensitization, 27.2% sensitized to two and 6.5 % to three allergens. The most prevalent allergen sensitization was Dust mite (58.7%) followed by indoor mould (37%), dog (15.2%), cockroach (12%) and least cat (5.4%). Dust-mite sensitization was significantly associated with asthma and each of the other associated allergic conditions. Allergic rhinitis was present in 48.9%, eczema in 31.5% and ocular allergy in 16.3% of the participants. Odds of a positive skin prick test increased with asthma-allergic rhinitis co-morbidity OR= 2.2 [(95% CI 0.8,5.8), p=0.08] Conclusion: There is a high prevalence of allergic sensitization among asthmatic children in Nairobi with dust mite followed by mould as the commonest causes. Co-morbidity with asthma and allergic rhinitis was associated with the highest prevalence of allergic sensitization. In a resource constrained setting, asthmatic children with co-existing allergic rhinitis should be prioritized for aeroallergen sensitivity testing. [ABSTRACT FROM AUTHOR]

Asthma and other allergic disorders, such as atopic dermatitis and food allergies, are common chronic health problems in childhood. The rapid rise in the prevalence of these conditions registered over the last few decades has stressed the need to identify the modifiable risk factors associated with the development of these diseases. Breast milk, recognized as the gold standard for healthy growth and development of the newborn, is one of the major factors associated with a lower incidence of allergic and infectious diseases in childhood and young adulthood. Although the underlying mechanisms for these effects are not well understood, breastfeeding leads to immune system maturation. In this narrative review, we summarize existing evidence on breastfeeding and human milk composition in relation to allergic disease prevention or development. [ABSTRACT FROM AUTHOR]

Immunoglobulin E (IgE) is known to play an important role in allergic diseases. Epigenetic traits acquired due to modification of deoxyribonucleic acid (DNA) methylation (DNAm) in early life may have phenotypic consequences through their role in transcriptional regulation with relevance to the developmental origins of diseases including allergy. However, epigenome-scale studies on the longitudinal association of cord blood DNAm with IgE over time are lacking. Our study aimed to examine the association of DNAm at birth with childhood serum IgE levels during early life. Genome-scale DNAm and total serum IgE measured at birth, 5, 8, and 11 years of children in the Taiwan Maternal and Infant Cohort Study were included in the study in the discovery stage. Linear mixed models were implemented to assess the association between cord blood DNAm at ~310K 5′-cytosine-phosphate-guanine-3′ (CpG) sites with repeated IgE measurements, adjusting for cord blood IgE. Identified statistically significant CpGs (at a false discovery rate, FDR, of 0.05) were further tested in an independent replication cohort, the Isle of Wight (IoW) birth cohort. We mapped replicated CpGs to genes and conducted gene ontology analysis using ToppFun to identify significantly enriched pathways and biological processes of the genes. Cord blood DNAm of 273 CpG sites were significantly (FDR = 0.05) associated with IgE levels longitudinally. Among the identified CpGs available in both cohorts (184 CpGs), 92 CpGs (50%) were replicated in the IoW in terms of consistency in direction of associations between DNA methylation and IgE levels later in life, and 16 of the 92 CpGs showed statistically significant associations (P <.05). Gene ontology analysis identified 4 pathways (FDR = 0.05). The identified 16 CpG sites had the potential to serve as epigenetic markers associated with later IgE production, beneficial to allergic disease prevention and intervention. [ABSTRACT FROM AUTHOR]

Objective: To explore the mechanism that miR-29b and B7H3 regulate the polarization of macrophages and thus affect the differentiation of CD4+T. Methods: 1. PBMC was extracted from peripheral blood mononuclear cells of children with asthma and normal children in the affiliated Children's Hospital of Soochow University, and RNA was extracted and reverse transcribed. The expression of miR-29b and B7H3mRNA was determined by real-time quantitative polymerase chain reaction (Q-PCR). The family history of asthma and history of allergic diseases were collected. 2.THP-1 cells were induced into macrophages, miR-29b interference, miR-29b overexpression and normal control were induced by LV526, LV527 and NC virus infection. After 24 hours of culture, the cells were collected to detect the expression of STAT3 and B7H3 genes and proteins. 3. It was verified that STAT3 was the target gene of miR-29b: after inoculating THP-1 cells and culturing with PMA with final concentration of 50ng/ml for 6 hours, the macrophages without PMA were cultured for 24 hours, then the macrophages infected by LV528, LV529 and NC virus were induced to form miR-29b interference, miR29b overexpression and normal control group. Luciferase analysis was performed at 48 hours to verify that STAT3 was the target gene of miR-29b. STAT3-3'UTR luciferase reporter gene plasmids were constructed and divided into three groups: "miR-29b+ STAT3-3'UTR", "miR-29b+STAT3-mut-3'UTR" and "miR-29b+luciferase empty load". 4. Macrophages with different treatments were co-cultured with initial T cells for 3 days. The relative expressions of T-bet, GATA3 and ROR-γt were detected by Q-PCR. Result: 1. The incidence of allergic disease in the acute attack group (68%) was higher than that in the other two groups (34.8%, 33.3%), and the family history of asthma in the normal group (0%) was much lower than that in the other two groups (52%, 60.9%). The difference was statistically significant (P<0.05). 2.The expression of B7H3 in PBMC in acute attack group was higher than that in non-acute attack group and normal group. The expression of miR-29b in PBMC in normal group was significantly higher than that in non-acute attack group and acute attack group (P< 0.0001). The expression of miR-29b in non-acute attack group was significantly higher than that in acute attack group (P= 0.007). 3. After silencing the expression of miR-29b, IL-4Ra, IL-4, IL-5, IL-13 and CD206 of macrophages increased significantly, while IFN-γ decreased, suggesting that miR-29b can promote the polarization of macrophages to M2. 4. The overexpression of miR-29b, STAT3 and B7H3 gene and protein level in macrophages decreased, while the increase of miR-29b, STAT3 and B7H3 gene and protein expression was inhibited. 5. There was a significant positive correlation between the expression of STAT3 and B7H3mRNA in macrophages (r = 0.9737, P< 0.0001). 6. STAT3 is the target gene of miR-29b. 7. Co-culture of macrophages with CD4+T cells can promote the differentiation of primary T cells, namely Th 0 cells, into Th2, and the promoting effect of macrophages with downregulation of miR-29b is more obvious. Conclusion: The expression of miR-29b in PBMC of children with asthma is lower than that of normal children, while the expression of B7H3 is higher than that of normal children. It is speculated that miR-29b has a protective effect on children with asthma, while B7H3 aggravates the inflammatory response. Down-regulation of miR-29b, in macrophages can promote macrophages to M2 polarization, increase the expression of B7H3 and STAT3 in macrophages, make Th0 cells differentiate into Th2 cells, and aggravate the inflammatory response in patients with asthma. [ABSTRACT FROM AUTHOR]

Introduction: Children with allergic diseases and their parents may not only be affected physically but also socially and psychologically. Aim: To search the parents' opinions of allergic diseases and how they are affected by their children's allergic diseases. Material and methods: This was a cross-sectional study of allergic children's parents who were followed by an allergy clinic for more than 6 months. One hundred and two children participated in the study. One of each child's parents (either father or mother) filled out a questionnaire form, which included questions about demographic characteristics and 20 multiple-choice questions about parents' opinions regarding allergic diseases and how they are affected by their children's allergic diseases. Results: Forty percent of the parents thought that their children had an allergic disease because their bodies were weak and one third thought it was genetic. Sixteen percent of the parents' quality of life was highly affected because of their children's allergic disease whereas 6% were not affected. Parents who had a child with more than one allergic disease were significantly more affected (p < 0.05). The most influential problem was children's symptoms of allergic diseases (42%) and secondly allergen avoidance (32%). Forty-eight percent of the parents reported work absenteeism. Almost half (46%) of the parents expected their physician to completely cure their children's allergic disease. Conclusions: Significantly the most affected parents were those whose children had multiple allergic diseases. These parents may need psychological support. [ABSTRACT FROM AUTHOR]

Genistein has been shown to have a broad spectrum of health advantages. Only legumes were reported to have a significant amount of genistein with the highest concentration in Soybean. Soybean was found to cause allergies in children with atopic dermatitis and in adults. Limited food sources have hindered the use of genistein in daily diets, medications, and nutraceuticals. The main objective of the current research work was to discover the novel source for genistein by the simple method of extraction and quantification. Genistein was extracted by solid-liquid extraction technique. Extraction parameters were optimized by a single factor test. Identification and quantification of genistein from the selected seeds of Apiaceae were carried out using UPLC-APCI-TOF-MS. UPLC-APCI-TOF-MS method was successfully developed, validated (linearity ( R 2 = 0.999), precision (R.S.D. <5%), and accuracy (107.23%)), and used for the study. Remarkably, a high concentration of the genistein (811.57 μg/g) was found in the Cuminum cyminum. Solvent mixture (50 mL Methanol+25 mL Dimethyl sulphoxide+25 mL Water (v / v / v)), temperature (80°C), and time (1 h) were found to be the optimum extraction conditions. The concentration of genistein before optimization was 226.67 μg/g and after optimization is 811.57 μg/g. This shows the efficiency of the extraction method in the extraction of genistein without the need for hydrolysis. Novel source for genistein is identified in regular human food can be consumed in a regular diet which increases wellness of human health along with enhancing the taste of the food. The developed extraction method coupled with high throughput, sensitive, and selective UPLC-APCI-TOF-MS technique facilitates rapid quantification (8 minutes of run time) without primary purification of complex extract. [ABSTRACT FROM AUTHOR]

Maternal mental disorder and a negative family emotional climate are a great source of stress for many children, yet their role in the childhood development or expression of asthma and allergies remains poorly understood, particularly beyond the first 1–2 years of life. The current study tested whether childhood allergy onset and symptomatology would be predicted by (1) perinatal and any time exposure to maternal depression or anxiety and (2) current family emotional strain (whole family, mother-child). UK mothers of children aged 2–12 years (N = 328) living with them completed an online survey of measures. Children exposed to maternal depression were almost twice as likely to be diagnosed and almost five times as likely to screen positive for an allergic disorder. Perinatal depression was linked to childhood allergies, but more moderately. Any anxiety exposure, and not specific to the perinatal period, predicted allergy status. Family emotional strain contributed independently to variance in concurrent child allergic symptomatology. All results were independent of potential confounders and current mental distress. The findings highlight the importance of maternal mental health and family function in the child’s neuro-immune development, and that these factors need to be addressed in the treatment of childhood allergic disorders. [ABSTRACT FROM AUTHOR]

Introduction: Seasonal allergic rhinitis (SAR) and bronchial asthma are typical manifestations of pollen-food sensitization in adults. There is limited information regarding the sensitization patterns of pollen-food allergy in children. Aim: To evaluate the prevalence of SAR in children with pollen-food sensitization and assess the impact of food allergens on nasal symptoms. Material and methods: Forty-three children with pollen-food sensitization aged 2--14 years were evaluated for evidence of SAR. The inclusion criteria was IgE-mediated sensitization to pollen and homologous food allergens. The control group consisted of 19 children with SAR caused by pollen without sensitization to homologous food allergens. Results: Allergic rhinitis was the main symptom in 65.1% of children; in 25.6% an association between ingestion of pollen-related foods and nasal symptoms was observed. The simultaneous sensitization to animal origin food allergens was stated in 63.3% of children with SAR. In 25.6% anaphylactic reactions to foods were registered. 37.2% of children were asymptomatic to pollen origin foods despite pollen-food sensitization. The statistically significant differences between values were noticed in comparison to the control group. Conclusions: Allergic rhinitis is a common manifestation of pollen-food sensitization in children and this type of immunological hyperreactivity should be taken into account regardless of age. The lack of association of symptoms with plant origin foods in the majority of cases and the asymptomatic course of food sensitization in more than one third of patients indicates the need for follow-up and being careful in routine recommending the avoidance diet. [ABSTRACT FROM AUTHOR]

Introduction: There is still lack of knowledge of drug allergy in children. Proper knowledge and management of drug hypersensitivity reactions is important to physicians. Aim: To evaluate the approach of primary care doctors regarding drug allergy in children. Material and methods: A total of 195 primary care doctors were questioned in various parts of Lithuania from 2015 to 2016. An original questionnaire was used. The incidence of a suspected drug allergy, culprit drugs, the clinical pattern and management of the suspected drug hypersensitivity were analysed. Results: The majority of primary care doctors (74.4%) reported a suspected drug allergy. The main suspected drugs were antibiotics (95.2%) and nonsteroidal anti-inflammatory drugs (32.4%). Skin symptoms (skin rash (100%) and itching (82.1%)) were the main symptoms of the suspected drug allergy. The vast majority of doctors (93.8%) withdrew the use of a suspected drug and 68.3% of respondents prescribed an alternative drug. The fact that skin tests, blood tests and provocation tests could be used in a drug allergy workup were indicated by 43.6% of doctors. Most doctors (69.2%) knew about the opportunity to test children for drug allergy in Lithuania and 41.4% of doctors referred patients for the further drug allergy workup. Conclusions: The majority of primary care doctors reported a suspected drug allergy in children. The most common suspected drugs were antibiotics and skin symptoms were the main symptoms. Most doctors knew about the possibility to test for the drug allergy but only less than half of them referred patients for the drug allergy workup. [ABSTRACT FROM AUTHOR]

The combination of asthma and allergy is one of the most common chronic diseases in childhood. The aim of this article is to illuminate children's experiences with allergies and asthma through their stories of everyday life. The study is grounded in a phenomenological philosophy of lifeworld and thus employs a qualitative design. The data were collected through qualitative in-depth interviews with four children, aged 9-12 years, with each child interviewed three times. A narrative analysis was conducted from the responses. Four stories, one from each child, were written and later analyzed as one narrative, representing the findings of the study. The main finding is that living with a disease may cause a child to fall out of normal life. This narrative contains three sub-narratives: everyday life with an intrusive disease, supporters in everyday life, and the hope to be included in normal life. Using a narrative analytical approach provided a cohesive story of the children's experiences. In these narratives, the contexts of the children's lives are prominent, yielding stories in which everyday life, the children's lifeworld, emerges. These stories, in turn, offer healthcare professionals insight into the experiences of children living with chronic disease. [ABSTRACT FROM AUTHOR]

Background: Early colonization with a diverse microbiota seems to play a crucial role for appropriate immune maturation during childhood. Breastmilk microbiota is one important source of microbes for the infant, transferred together with maternal IgA antibodies. We previously observed that allergy development during childhood was associated with aberrant IgA responses to the gut microbiota already at 1 month of age, when the IgA antibodies are predominantly maternally derived in breastfed infants. Objective: To determine the microbial composition and IgA‐coated bacteria in breastmilk in relation to allergy development in children participating in an intervention trial with pre‐ and post‐natal Lactobacillus reuteri supplementation. Methods: A combination of flow cytometric cell sorting and 16S rRNA gene sequencing was used to characterize the bacterial recognition patterns by IgA in breastmilk samples collected one month post‐partum from 40 mothers whose children did or did not develop allergic and asthmatic symptoms during the first 7 years of age. Results: The milk fed to children developing allergic manifestations had significantly lower bacterial richness, when compared to the milk given to children that remained healthy. Probiotic treatment influenced the breastmilk microbiota composition. However, the proportions of IgA‐coated bacteria, the total bacterial load and the patterns of IgA‐coating were similar in breastmilk between mothers of healthy children and those developing allergies. Conclusion: Consumption of breastmilk with a reduced microbial richness in the first month of life may play an important role in allergy development during childhood. [ABSTRACT FROM AUTHOR]