Sensibilization Spectrum in Preschool Children with Atopic Dermatitis

Background. Atopic dermatitis (AD) is an allergodermathosis that is widespread in children and adult populations. Sensibilization to food allergens prevails in children of early age, and to airborne allergens in older age. Impairments of skin barrier lead to increase in Staphylococcus aureus colonization and finally aggravate the course of AD and the sensibilization level.Objective. The aim of the study is to estimate the sensibilization spectrum in 3-6 years old children with AD and its correlation with severity.Methods. It was cross sectional study with two independent cohorts of 3-6 years old children with and without (healthy) AD. Estimation of sensibilization spectrum and revealing of correlation with disease severity were performed.Results. The study includes 106 children aged 4.4 ± 1.2 year (58.5% boys and 41.5% girls). Polysensibilization was revealed in 28.3% of children. According to our data: 3-6 years old children with AD most often had sensibilization to the cat epithelium (34.9%), cow's milk proteins (22.6%), Dermatophagoides pteronyssinus mite (16.0%). Sensibilization to enterotoxins of Staphylococcus aureus was revealed in 7.5% children. We have recorded weak positive correlation between the AD severity and the level of specific IgE to airborne and food allergens. There was no statistically significant correlation between the AD severity and the level of specific IgE to Staphylococcus aureus enterotoxins A and B. Conclusion. The most common sensibilization type among 3-6 years old children with AD was one to airborne allergens. Sensibilization to the cat epithelium prevails among airborne allergens, to the cow's milk proteins — among food allergens. The weak positive correlation between the AD severity and the level of specific IgE to airborne and food allergens was revealed. The weak negative correlation with the level of specific IgE to Staphylococcus aureus enterotoxins A and B was revealed, thus the data was statistically insignificant.

Early Life Wheeze and Risk Factors for Asthma—A Revisit at Age 7 in the GEWAC-Cohort

One third of all toddlers are in need of medical care because of acute wheeze and many of these children have persistent asthma at school age. Our aims were to assess risk factors for and the prevalence of asthma at age 7 in a cohort of children suffering from an acute wheezing episode as toddlers. A total of 113 children, included during an acute wheezing episode (cases), and 54 healthy controls were followed prospectively from early pre-school age to 7 years. The protocol included questionnaires, ACT, FeNO, nasopharyngeal virus samples, blood sampling for cell count, vitamin D levels, and IgE to food and airborne allergens. The prevalence of asthma at age 7 was 70.8% among cases and 1.9% among controls (p < 0.001). Acute wheeze caused by rhinovirus (RV) infection at inclusion was more common among cases with asthma at age 7 compared to cases without asthma (p = 0.011) and this association remained significant following adjustment for infection with other viruses (OR 3.8, 95% CI 1.4–10.5). Cases with asthma at age 7 had been admitted to hospital more often (p = 0.024) and spent more days admitted (p = 0.01) during the year following inclusion compared to cases without asthma. RV infection stands out as the main associated factor for wheeze evolving to persistent asthma. Cases who developed asthma also had an increased need of hospital time and care for wheeze during the year after inclusion.

Effect of Shadbindu Taila and Haridra Khanda in Pratishyaya (Allergic Rhinitis)

Allergic rhinitis (AR) is an immune response of the nasal mucosa to airborne allergens and involves nasal congestion, watery nasal discharge, itching of the nose, and sneezing. Ayurveda describes Pratishyaya as one of the most important diseases among the 31 Nasarogas. Acharya Sushruta clearly mentioned that Pratishyaya is the condition in which vata kapha dusti was observed. Haridra Khanda is one of the prominent anti allergic drugs mentioned in ayurveda. Pratimarsha nasya has significant role in the prevention of urdhvajatrugata rogas. Ancient acharya has told to try shadbindu taila and Haridra khanda both locally and systematically in the management of pratishyaya. Here 30 patients were selected open randomly in shalakya opd of ayurveda campus kirtipur. They were given pratimarsha nasya with sadhbindu taila and internally haridra khanda for 30 days. The vital sign and symptom of pratishyaya like nasa srava, nasa kandu, kshavatu, nasa kandu and shira shula were studied before and after the treatment. The result of the study indicated that the combined therapy of internally Haridra Khanda and external pratimarsha narsha with sadbindu tail has given significant result in the treatment of Allergic Rhinitis (Pratishyaya).

DNA Methylation Levels in Mononuclear Leukocytes from the Mother and Her Child Are Associated with IgE Sensitization to Allergens in Early Life

DNA methylation changes may predispose becoming IgE-sensitized to allergens. We analyzed whether DNA methylation in peripheral blood mononuclear cells (PBMC) is associated with IgE sensitization at 5 years of age (5Y). DNA methylation was measured in 288 PBMC samples from 74 mother/child pairs from the birth cohort ALADDIN (Assessment of Lifestyle and Allergic Disease During INfancy) using the HumanMethylation450BeadChip (Illumina). PBMCs were obtained from the mothers during pregnancy and from their children in cord blood, at 2 years and 5Y. DNA methylation levels at each time point were compared between children with and without IgE sensitization to allergens at 5Y. For replication, CpG sites associated with IgE sensitization in ALADDIN were evaluated in whole blood DNA of 256 children, 4 years old, from the BAMSE (Swedish abbreviation for Children, Allergy, Milieu, Stockholm, Epidemiology) cohort. We found 34 differentially methylated regions (DMRs) associated with IgE sensitization to airborne allergens and 38 DMRs associated with sensitization to food allergens in children at 5Y (Sidak p ≤ 0.05). Genes associated with airborne sensitization were enriched in the pathway of endocytosis, while genes associated with food sensitization were enriched in focal adhesion, the bacterial invasion of epithelial cells, and leukocyte migration. Furthermore, 25 DMRs in maternal PBMCs were associated with IgE sensitization to airborne allergens in their children at 5Y, which were functionally annotated to the mTOR (mammalian Target of Rapamycin) signaling pathway. This study supports that DNA methylation is associated with IgE sensitization early in life and revealed new candidate genes for atopy. Moreover, our study provides evidence that maternal DNA methylation levels are associated with IgE sensitization in the child supporting early in utero effects on atopy predisposition.

The capacity and effectiveness elimination domestic animals allergens: myths and realities

At present, sensitization to airborne allergens in domestic animals is absolutely rightly considered one of the key risk factors for the development of allergic rhinitis and bronchial asthma, as well as largely determines the development of severe forms of atopic dermatitis and respiratory allergosis. Of particular importance is the fact that, unlike other triggers, the elimination of allergens in domestic animals is often associated with internal resistance from patients. Various aspects of this problem are associated with a large number of baseless statement that lead to inadequate prevention and therapy, as well as negatively affecting the social activity of patients and their families. The article presents the current data on the prevalence of sensitization, the properties and clinical significance of the allergens of domestic animals, outlines approaches to conducting elimination activities.

Early life wheeze and risk factors for subsequent asthma -- a revisit at age 7 years in the GEWAC-cohort

Background: One third of all toddlers are in need of medical care because of acute wheeze and many of these children continue to have asthma at school age. Our aim was to assess the prevalence of asthma among the children in GEWAC at age 7 years. And investigate why some children continue to have recurrent wheeze and asthma at school age. Methods: The study included 156 cases with acute wheeze, recruited from the paediatric emergency ward, Astrid Lindgren’s Children’s Hospital, Stockholm, Sweden and 102 age-matched controls. Cases attended a follow-up visit after 3 months, after one year and at age 7 years. The protocol included questionnaires, ACT, FENO, nasopharyngeal virus samples, blood sampling for cell count, Vitamin D and IgE to food and airborne allergens. Results: A total of 70.8 % of the cases and 1.9 % of the controls had asthma at age 7 (p<0.001). Acute wheeze caused by Rhinovirus (RV) infection at inclusion was more common among cases with asthma at age 7 compared to cases without asthma (p=0.011). When adjusting for other viruses, RV remained significantly associated with asthma at age 7 (OR 3.8 95% CI 1.4-10.5). Cases with asthma at age 7 had been admitted to hospital more often (p=0.024) and spent more days admitted (p=0.01) during the year following inclusion. Conclusion: Rhinovirus induced acute wheeze is a risk factor for asthma by age 7. Cases with asthma at age 7 were hospitalized more frequently and needed more inpatient time during the year after inclusion.

Dendritic Cells: Critical Regulators of Allergic Asthma

Allergic asthma is a chronic inflammatory disease of the airways characterized by airway hyperresponsiveness (AHR), chronic airway inflammation, and excessive T helper (Th) type 2 immune responses against harmless airborne allergens. Dendritic cells (DCs) represent the most potent antigen-presenting cells of the immune system that act as a bridge between innate and adaptive immunity. Pertinent to allergic asthma, distinct DC subsets are known to play a central role in initiating and maintaining allergen driven Th2 immune responses in the airways. Nevertheless, seminal studies have demonstrated that DCs can also restrain excessive asthmatic responses and thus contribute to the resolution of allergic airway inflammation and the maintenance of pulmonary tolerance. Notably, the transfer of tolerogenic DCs in vivo suppresses Th2 allergic responses and protects or even reverses established allergic airway inflammation. Thus, the identification of novel DC subsets that possess immunoregulatory properties and can efficiently control aberrant asthmatic responses is critical for the re-establishment of tolerance and the amelioration of the asthmatic disease phenotype.

An overview of allergic and bacterial conjunctivitis

Conjunctivitis affects many people across the globe, significantly disturbing the quality of life of the people who are affected. Conjunctivitis can be divided into infectious and noninfectious causes. Viruses and bacteria are the most common infectious causes. Some of the most commonly diagnosed allergic diseases include atopic dermatitis, rhinitis, allergic conjunctivitis and sinusitis. Other conditions, such as eosinophilic oesophagitis, the prevalence of which is on the rise, are being diagnosed across all continents, except for Africa. Allergic conjunctivitis is an allergic disease characterised by inflammation of the conjunctiva caused by airborne allergens; it presents as itching, excessive lacrimation, discharge and pink eye. Usually it is associated with other allergic conditions such as allergic rhinitis and bronchial asthma. Allergic conjunctivitis is further divided into acute, seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC). Bacterial conjunctivitis, caused by bacterial and viral pathogens, may include three major categories: hyperacute bacterial conjunctivitis, acute conjuncitivis and chronic conjunctivitis. The diagnosis is primarily clinical. This article provides an overview of these conditions and their current management options.

Male sex is strongly associated with IgE-sensitization to airborne but not food allergens: results up to age 24 years from the BAMSE birth cohort

Background Up to half of the population in high-income countries has allergen-specific IgE antibodies. However, data regarding sex differences of IgE-sensitization from childhood to adulthood is limited. Objective To explore IgE-sensitization to common foods and airborne allergens in relation to sex over time in a population-based birth cohort followed up to young adulthood. Methods The Swedish population-based birth cohort BAMSE includes 4,089 subjects who have been followed regularly with questionnaires and clinical investigations. A recent 24-year follow-up included 3,069 participants (75%). Sera collected at 4, 8, 16 and 24 years were analyzed for IgE-antibodies to 14 common foods and airborne allergens. Results At 24 years sensitization to foods had decreased compared to previous follow-ups affecting 8.4%, while sensitization to airborne allergens was more common, affecting 42.2%. Male sex was associated with IgE-sensitization to airborne allergens at all ages (overall OR: 1.68, 95% CI 1.46 - 1.94) while there was no statistically significant association between sex and sensitization to food allergens (overall OR: 1.10, 95% CI 0.93 - 1.32). Levels of allergen-specific IgE did not differ significantly between males and females for any of the tested foods or airborne allergens at any age, following adjustment for multiple comparisons. Conclusion IgE-sensitization to airborne allergens increases with age up to young adulthood, whereas sensitization to food allergens seems to level off. Male sex is strongly associated with IgE-sensitization to airborne allergens from early childhood up to young adulthood. In contrast, there is little evidence for associations between sex and IgE-sensitization to foods.

Male sex is strongly associated with IgE-sensitization to airborne but not food allergens: results up to age 24 years from the BAMSE birth cohort

Background Up to half of the population in high-income countries has allergen-specific IgE antibodies. However, data regarding sex differences of IgE-sensitization from childhood to adulthood is limited. Objective To explore IgE-sensitization to common foods and airborne allergens in relation to sex over time in a population-based birth cohort followed up to young adulthood. Methods The Swedish population-based birth cohort BAMSE includes 4,089 subjects who have been followed regularly with questionnaires and clinical investigations. A recent 24-year follow-up included 3,069 participants (75%). Sera collected at 4, 8, 16 and 24 years were analyzed for IgE-antibodies to 14 common foods and airborne allergens. Results At 24 years sensitization to foods had decreased compared to previous follow-ups affecting 8.4%, while sensitization to airborne allergens was more common, affecting 42.2%. Male sex was associated with IgE-sensitization to airborne allergens at all ages (overall OR: 1.68, 95% CI 1.46 - 1.94) while there was no statistically significant association between sex and sensitization to food allergens (overall OR: 1.10, 95% CI 0.93 - 1.32). Levels of allergen-specific IgE did not differ significantly between males and females for any of the tested foods or airborne allergens at any age, following adjustment for multiple comparisons. Conclusion IgE-sensitization to airborne allergens increases with age up to young adulthood, whereas sensitization to food allergens seems to level off. Male sex is strongly associated with IgE-sensitization to airborne allergens from early childhood up to young adulthood. In contrast, there is little evidence for associations between sex and IgE-sensitization to foods.