EARLY CHILDHOOD ALLERGY LINKED WITH DEVELOPMENT OF ATTENTION DEFICIT HYPERACTIVITY DISORDER AND AUTISM SPECTRUM DISORDER

Background: Previous studies reported controversial results regarding the association between allergic disorders and ADHD/ASD. The aim of this article is to investigate whether allergic disorders are associated with ADHD/ASD in a large cohort of pediatric patients. Methods: A retrospective study using the pediatric (0-18 year) database (ICD-9-CM codes) of Clalit Health Services during the years (2000-2018). Diagnosis of all disorders was made by specialist physicians. Results: 117,022 consecutive non-selective allergic children diagnosed with one or more allergic disorder (asthma, rhinitis. conjunctivitis, skin, food, or drug allergy) and 116,968 non-allergic children were enrolled to our study. The mean follow-up period was 11±6 years. The presence of allergic disorders in early childhood (mean age of allergic diagnosis 4.5± 4.3 years) in boys as well as in girls, significantly increased the risk to develop ADHD (O.R 2.45, CI 2.39-2.51; P<0.0001), ASD (O.R 1.17, CI 1.08-1.27; P<0.0001) or both ADHD+ASD (O.R 1.5, CI 1.35-1.79; P<0.0001). Children with more than one allergic comorbidity revealed a much higher risk. In a multivariable analysis (adjusted for age at study entry, number of yearly visits and gender) the risk of allergic children to develop ADHD and ADHD+ASD, but not ASD alone, remained significantly higher. Conclusion: Allergic disorder in early childhood significantly increased the risk to develop ADHD, and to a less extend ASD, in later life.

Eosinophilic Esophagitis in 2021

Eosinophilic esophagitis also known as asthma of the esophagus is a food-related allergic disorder of the esophagus widely distributed all over the world. The incidence and prevalence of eosinophilic esophagitis have been increasing over the last few decades. The pathogenesis of this entity is now better understood and three distinct endotypes have been defined for better management strategy. Diagnosis is made on the basis of clinical symptoms followed by endoscopy with biopsy. Drugs, diet and endoscopic dilation are the current modalities of treatment. IL-4 and IL-13 inhibitors have been found to be promising in clinical trials.

CLINICAL STUDY OF KANTKARI AVLEHA AND VASA AVLEHA IN THE MANAGEMENT OF TAMAK SHWASA W.S.R TO BRONCHIAL ASTHMA

Asthma is a chronic inflammatory disease which causes the lining of the airways to become swollen and inflamed, which further leads to production of thick, sticky mucous. These changes further cause the airways to become narrow, making it difficult for the patient to breathe properly. In this study, efficacy of formulations like Vasavaleha and Kantakari Avaleha are studied in the patients of Tamaka Shwasa w.s.r to bronchial asthma. Tamaka Shwasa is a Yapya Vyadhi. The etiopathogenesis, signs, and symptoms of Tamaka Shwasa may be correlated with Bronchial Asthma. Each patient reacts differently to the factors that trigger asthma and are treated symptomatically. Asthma is the most common chronic allergic disorder in childhood and third leading cause of hospitalization under the age of 15 years. As it is a Kapha-Vata predominant disorder, Ayurvedic medicine may help to decrease the recurrence, improve immunity, and check symptoms naturally. With this aim, a clinical study was undertaken on two groups for a duration of 6 weeks. The Kantakari Avaleha and Vasa Avaleha were given orally, separately in both the groups. All the patients were kept under strict dietary control during the treatment. The observation on the effect of therapy was encouraging and showed less recurrence.

Role of a modern laboratory in the diagnosis of allergic disorder

Use of modern certified methods makes it possible to identify the type of allergic reaction. Possibilities of laboratory diagnosis of allergic disorder using immunodiagnostic methods and molecular diagnostic technologies are presented. Examples of using analysis of the results in therapeutic practice, laboratory technologies for in vitro diagnosis of allergy are considered. Features of preanalytical stage of laboratory testing are presented.

Biochemical Characteristics and Allergenic Activity of Common Fungus Allergens

Fungi form a large kingdom with more than 1.5 million species. Fungal spores are universal atmospheric components and are generally recognized as important causes of allergic disorders, including allergic rhinitis, allergic rhinosinusitis, asthma, and allergic bronchopulmonary aspergillosis. The 4 genera which have the closest connection with allergic disorder are Cladosporium, Alternaria, Aspergillus and Penicillium. The cDNA sequences of many fungi allergens and the amino acids involved in their immunoglobulin E binding and T-cell activation have already been elucidated. Until now, 111 allergens from 29 fungal genera have been approved by the International Allergen Nomenclature Sub-committee. This review mainly focuses on the biochemical characteristics and allergenic activity of important allergens from common environmental fungi.

Eosinophilic oesophagitis: a systematic review for otolaryngologists

Background:Eosinophilic oesophagitis is a chronic, immune/antigen-mediated oesophageal disease, only recently, but increasingly, recognised in the world literature. It is diagnosed and managed primarily by medical gastroenterologists and allergy specialists, and is a distinct disease entity, affecting both children and adults. Few studies have been published in otolaryngology journals, although otolaryngologists will encounter patients with undiagnosed eosinophilic oesophagitis. Patients may present with dysphagia, bolus obstruction or with other ENT disorders, such as atopic rhinitis, reflecting the underlying systemic allergic disorder.Objective:This paper systematically reviews the evidence base published on the epidemiology, clinical presentation, diagnosis, treatment and prognosis of eosinophilic oesophagitis, particularly as it relates to otolaryngology practice.

Genetic markers of bronchial asthma in children with atopic dermatitis

The aim of the study was to evaluate the usefulness of the -703С/Т polymorphism in IL-5 gene, Q551R polymorphism in IL-4RA gene, and GSTM1 and GSTТ1 gene polymorphism as biological markers of bronchial asthma (BA) in children with atopic dermatitis (AD). We genotyped children with AD (n = 72; mean age, 9.4 ± 0.28 years), children with AD in combination with BA (n = 68; mean age, 7.5 ± 0.7 years) and control subjects (n = 147; mean age, 9.9 ± 0.42 years). We found the associations between BA and the -703С allele of the interleukin-5 (IL-5) gene (OR = 1.73, p = 0.013) and -703СС / 551RR genotype combination (OR = 3.15; p = 0.015) in children with AD; between the 551RR genotype of the IL-4RA gene and atopy (p < 0.05). -703CT / GSТТ1 0/0 genotype combination was found rarer in children with BA than in controls (OR = 0.15; p = 0.049). Thus, -703С/Т allele of the IL-5 gene and -703СС / 551RR genotype combination were associated with BA and could be used as valuable markers of the disease in children with AD, whereas the Q551R polymorphism in the IL-4RA gene was associated with predisposition to atopic disease and could be used for administration of preventive therapy of allergic disorder in early childhood. The -703CT / GSТТ1 0/0 genotype combination can prevent BA occurrence in children with AD.