Role Of Viral Coinfections In Asthma Development In Children With Severe Bronchiolitis In Early Childhood

Abstract BACKGROUND. Severe viral bronchiolitis is associated with a higher risk of developing asthma, but little is known about the medium-term prognosis and the lung function evolution of patients admitted for viral coinfection-associated bronchiolitis. Our main objective was to compare the lung function, the prevalence of asthma and the rate of allergic sensitization at 6-9 years in children hospitalized for bronchiolitis with viral coinfection versus single viral infection.METHODS. Observational, longitudinal study in children previously hospitalized for viral bronchiolitis with current age between 6-9 years. Clinical and epidemiological data were collected. Fraction of exhaled nitric oxide determination, spirometry and skin prick test for common aeroallergens were performed.RESULTS. A total of 244 bronchiolitis-admitted children (52 coinfections and 192 single infections), with current age 6-9 years, accepted to participate by telephone answering the clinical questionnaires. Of them, 181 patients agreed for a medical visit. The overall frequency of asthma was 21%, being this prevalence almost twice as high in the viral coinfection group (p = 0.049). The coinfection cohort had more than twice as many admissions (p = 0.04), was more likely to receive montelukast (p = 0.06) and salmeterol/fluticasone treatment (p = 0.03) than the single-infection one. No differences regarding lung function values or allergic sensitization rate were observed between both groups.The variables independently related to current asthma at 6-9 years were: viral coinfection during bronchiolitis (p = 0.004), allergic rhinitis (p = 0.001), food allergy (p = 0.05) and atopic dermatitis (p = 0.017). CONCLUSIONS. Severe bronchiolitis associated with double or multiple viral detection in the first 24 months is an independent risk factor for higher frequency and greater severity of asthma at 6-9 years, being this risk almost three times higher compared to single infection. This fact is suggested by the higher frequency of current asthma, symptoms in intercrisis periods, maintenance anti-asthma treatment and number of hospitalizations for recurrent wheezing in children with coinfection compared to single infection. Early viral etiology identification in severe bronchiolitis might facilitate the prompt prediction and treatment of asthma in school age.

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Lung Function, Allergic Sensitization and Asthma in School-Aged Children After Viral-Coinfection Bronchiolitis

10.21203/rs.3.rs-969658/v1 ◽

2021 ◽

Author(s):

Sara Ruiz ◽

Cristina Calvo ◽

Francisco Pozo ◽

Inmaculada Casas ◽

María Luz García-García

Keyword(s):

Lung Function ◽

Independent Risk Factor ◽

Allergic Sensitization ◽

Respiratory Morbidity ◽

School Age ◽

Z Score ◽

Prick Test ◽

School Aged Children ◽

Lower Lung ◽

Viral Coinfection

Abstract BACKGROUND. Our main objective was to compare the lung function, the rate of allergic sensitization and the prevalence of asthma at 7-9 years in children hospitalized for bronchiolitis with viral coinfection versus single viral infection.METHODS. Observational study in children with previous bronchiolitis and current age 7-9 years. Clinical data were collected. Fraction of exhaled nitric oxide (FeNO) determination, spirometry and skin prick test for common aeroallergens were performed.RESULTS. A total of 181 children hospitalized for bronchiolitis (40 coinfections and 141 single infections), with median age of 8.3 years (IQR:7.5-9.1) were included. Single-HRV-infections showed lower basal FEV1(%) than coinfections (p=0.04) and lower z-score FEV1 than single-RSV-infections(p=0.04) or coinfections(p=0.02). Also, single-HRV-infections had lower post-bronchodilator FEV1(%) and z-score FEV1 values than coinfections (p=0.03 and p=0.03). Single-HRV-bronchiolitis was an independent risk factor for FEV1<80%(p=0.007). FeNO value >25 ppb was detected in 21(12.5%) cases, without differences between viral groups(p=0.768). The prevalence of allergic sensitization was similar in coinfections (31.4%) versus single infections (38.7%), (p=0.428). The highest frequency of allergic rhinitis was observed in single-HRV patients(p=0.004).The respiratory morbidity at 7-9 years of coinfected patients was similar to the single-HRV ones. In contrast, the likelihood of current asthma was up to 5 times higher in RSV/HRV coinfections than in the single-RSV-infections ones (p=0.012).CONCLUSIONS. The respiratory morbidity at 7-9 years of age after severe bronchiolitis is significantly higher in single-HRV or viral coinfection patients that in single-RSV ones. Single-HRV-bronchiolitis is independently associated with lower lung function at school-age.

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Investigation of Allergic Sensitization Pattern in 4,203 Children in Northern China

International Archives of Allergy and Immunology ◽

10.1159/000511976 ◽

2020 ◽

pp. 1-4

Author(s):

Wei Wang ◽

Xian-hui Zhang ◽

Lei Zhu ◽

Yu-xiang Liu

Keyword(s):

Immunoglobulin E ◽

Allergic Sensitization ◽

Epidemiological Data ◽

Northern China ◽

Allergic Diseases ◽

Egg White ◽

Specific Immunoglobulin E ◽

Sensitization Rate ◽

Positive Rate ◽

Sensitization Pattern

Objective: The objective of this study is to investigate the allergen sensitization pattern among 4,203 children in the Shanxi region of China and to provide guidance for diagnosis and prevention of allergic diseases. Methods: A retrospective analysis was conducted on the allergen-specific immunoglobulin E (sIgE) results of 4,203 children aged 0–12 years from January to December in 2019. SIgE antibodies to 19 allergens in the serum sample were detected by enzyme ALLERGO-SORBENT testing. Results: In total, 49.70% (2,089/4,203) of children with allergic diseases were positive for sIgE, and the top 5 allergens were egg white 18.63% (783/4,203), artemisia 14.47% (608/4,203), milk 13.04% (548/4,203), ragweed 8.66% (364/4,203), and poplar/willow/elm 8.52% (358/4,203). Significant differences in the positive rate of food allergens and aeroallergens in different ages were found (p < 0.05). 50.98% (1,065/2,089) patients were sensitive to 2 or more allergens. The high sensitization rate in the >3-year group was significantly higher than the ≤3-year group (p < 0.05). Conclusion: Egg white and artemisia are the most common allergens in children in northern China. This study provides allergic sensitization pattern of children and clinical epidemiological data in the region.

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Impaired Lung Functions Using Tidal Breath Analysis in High-risk Infants with Recurrent Wheezing

Trends in Pediatrics ◽

10.5222/tp.2020.43153 ◽

2020 ◽

Author(s):

Ayşe Anık ◽

Pınar Uysal

Keyword(s):

High Risk ◽

Lung Function ◽

Breath Analysis ◽

Roc Curve Analysis ◽

Recurrent Wheezing ◽

Mean Values ◽

Significant Difference ◽

Lung Functions ◽

Lower Lung ◽

High Risk Infants

INTRODUCTION: We aimed to investigate lung functions using tidal breath analysis (TBA) in high-risk infants with recurrent wheezing. METHODS: Lung functions measured using TBA in infants with physician-diagnosed recurrent wheezing (≥3 episodes) who applied our institution between 2018-2020, were retrospectively analyzed. Infants were assigned to two groups: high-risk infants with recurrent wheezing (n=30) and wheezy infants without high risk of atopy (n=33). RESULTS: High-risk infants with recurrent wheezing had lower mean values of tPTEF, tPTEF: tE, VPTEF, and VPTEF: VE than that of wheezy infants without high risk of atopy. There was no significant difference between two groups in terms of Vt/kg and respiratory rate. ROC curve analysis showed that tPTEF: tE ratio <26.5 demonstrated 63.3% sensitivity and 63.6% specificity for detection of high risk of atopy. DISCUSSION AND CONCLUSION: This study showed that high-risk infants with recurrent wheezing have lower lung function than those of wheezy infants without high risk of atopy. TBA might be useful method to evaluate lung function in wheezy infants.

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Asthma, allergic sensitization and lung function in sickle cell disease

Allergologia et Immunopathologia ◽

10.1016/j.aller.2019.12.012 ◽

2020 ◽

Vol 48 (5) ◽

pp. 450-457

Author(s):

Andrea Angel ◽

Gustavo Falbo Wandalsen ◽

Dirceu Solé ◽

Fernanda C. Lanza ◽

Carolina L.N. Cobra ◽

...

Keyword(s):

Sickle Cell Disease ◽

Lung Function ◽

Sickle Cell ◽

Allergic Sensitization ◽

Cell Disease

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Effects of Passive Smoking at Work on Respiratory Symptoms, Lung Function, and Bronchial Responsiveness in Never-Smoking Office Cleaning Women

Archives of Industrial Hygiene and Toxicology ◽

10.2478/10004-1254-60-2009-1941 ◽

2009 ◽

Vol 60 (3) ◽

pp. 327-334 ◽

Cited By ~ 3

Author(s):

Jordan Minov ◽

Jovanka Karadžinska-Bislimovska ◽

Kristin Vasilevska ◽

Snežana Risteska-Kuc ◽

Sašo Stoleski

Keyword(s):

Lung Function ◽

Passive Smoking ◽

Respiratory Symptoms ◽

Respiratory Health ◽

Bronchial Hyperresponsiveness ◽

Lung Function Test ◽

Indoor Environments ◽

Cross Sectional ◽

Bronchial Responsiveness ◽

Prick Test

Effects of Passive Smoking at Work on Respiratory Symptoms, Lung Function, and Bronchial Responsiveness in Never-Smoking Office Cleaning WomenThis cross-sectional study compares respiratory symptoms, lung function, and bronchial responsiveness between 27 office cleaning women exposed to environmental tobacco smoke at work and 57 unexposed controls. The age range of both groups was 24 to 56 years, and none of the women had ever smoked. Information on respiratory symptoms, cleaning work history, and passive smoking in the workplace were obtained with a questionnaire. The subjects also took a skin prick test to common inhalant allergens, a lung function test, and a histamine challenge. Despite smoking restriction in indoor environments, we found a high prevalence of passive smokers in the workplace (32.1 %). In these subjects we found a significantly higher prevalence of wheezing with breathlessness (25.9 % vs. 8.8 %; P=0.036), wheezing without cold (25.9 % vs. 7.0 %; P=0.016), and breathlessness after effort (29.6 % vs. 8.8 %; P=0.014) than in control subjects. Objective measurements showed a significantly lower MEF25 (53.6 % vs. 63.7 %; P=0.001) and a significantly higher prevalence of borderline bronchial hyperresponsiveness (22.2 % vs. 7.0 %; P=0.044) in the passive smokers in the workplace. This study provides evidence of adverse respiratory effects in office cleaning women associated with passive smoking in the workplace. Our findings support a stricter implementation of the current national law to protect respiratory health of all workers.

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Predicting the Long-Term Course of Asthma in Wheezing Infants Is Still a Challenge

ISRN Allergy ◽

10.5402/2011/493624 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Flore Amat ◽

Amandine Vial ◽

Bruno Pereira ◽

Isabelle Petit ◽

André Labbe ◽

...

Keyword(s):

Risk Factors ◽

Atopic Dermatitis ◽

Allergic Sensitization ◽

Persistent Asthma ◽

Inclusion Criteria ◽

Recurrent Wheezing ◽

History Of ◽

Airborne Allergens ◽

Term Management

Background. In recurrent wheezing infants, it is important to identify those likely to remain asthmatic in order to propose appropriate long-term management. Objective. To establish predictive factors for persistent asthma at adolescence in a population of recurrent wheezing infants. Methods. Retrospective study of 227 infants. Inclusion criteria were age under 36 months, a history of at least three wheezing episodes assessed via a doctor-led ISAAC questionnaire and a standardized allergy testing programme. At 13 years, active asthma was assessed by questionnaire. Results. Risk factors for asthma persisting into adolescence were allergic sensitization to multiple airborne allergens (OR 4.6, CI-95% (1.9–11.2) ), initial atopic dermatitis (OR 3.4, CI-95% (1.9–6.3) ), severe recurrent wheezing (OR 2.3, CI-95% (1.3–4.2) ), and hypereosinophilia ≥470/mm3 (OR 2.2, CI-95% (1.07–4.7) ). Conclusion. While it is still difficult to predict the long-term course of asthma, atopy remains the major risk factor for persistent asthma.

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Latentna tuberkulozna infekcija u zdravstvenih radnika povezana je s alergijama i senzibilizacijom na uobičajene inhalacijske alergene

Collegium Antropologicum ◽

10.5671/ca.44.3.3 ◽

2020 ◽

Vol 44 (3) ◽

pp. 127-132

Author(s):

Ivana Banić ◽

Mirjana Turkalj ◽

Boro Nogalo ◽

Rajka Lulić Jurjević ◽

Davor Plavec ◽

...

Keyword(s):

Immune Response ◽

Mutual Influence ◽

Allergic Sensitization ◽

Latent Tuberculosis ◽

T Helper ◽

Allergen Sensitization ◽

Prick Test ◽

Increased Risk ◽

History Of ◽

Low Exposure

Health care workers (HCW) are at increased risk of a latent tuberculosis infection (LTBI) due to occupational exposure to Mycobacterium tuberculosis. In order to investigate the mutual influence of a TH1 type immune response caused by LTBI and T helper 2 (TH2) type immune response caused by allergy, we conducted a study examining the prevalence of common inhaled allergen sensitization in the HCW population with different levels of exposure to tuberculosis (high and low). HCW with possible exposure to tuberculosis (TB) were tested with QuantiFERON-TB Gold (QFT-G) and tuberculin skin test (TST), while skin prick test (SPT) was performed for inhaled allergens. The antigen (Ag) response at QFT-G was inversely correlated with participants` allergy anamnesis (p= 0.039). Sensitization to inhaled allergens (positive SPT and number of positive allergens at SPT) was more prominent in the low exposure group (p= 0.006 and p= 0.0065, respectively). Ag response at QFT-G test was significantly higher in participants with no medical history of allergy (p= 0.048). Our results demonstrate that exposure to TB and LTBI are associated with inhaled allergen sensitization in HCW, possibly inhibiting allergic sensitization by mediating the T-helper type 1 (Th1) immune response.

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550Short-term exposure to grass pollen is associated with lower lung function and increased airway inflammation

International Journal of Epidemiology ◽

10.1093/ije/dyab168.307 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

N. Sabrina Idrose ◽

Rachel Tham ◽

Caroline Lodge ◽

Adrian Lowe ◽

Dinh Bui ◽

...

Keyword(s):

Lung Function ◽

Airway Inflammation ◽

Grass Pollen ◽

Hay Fever ◽

Exhaled Breath ◽

Delayed Effect ◽

Cross Sectional ◽

Spore Trap ◽

Current Asthma ◽

Pollen Exposure

Abstract Background The association between grass pollen exposure and lung function changes and airway inflammation is limited. We investigated these associations in a community-based sample, and whether any such associations were modified by current asthma, current hay fever, pollen sensitization and age. Methods Cross-sectional analyses of data from the Melbourne Atopy Cohort Study (MACS) participants (n = 936). Lung function was assessed using spirometry. Airway inflammation was assessed by fractional exhaled nitric oxide (FeNO), and exhaled breath condensate pH and nitrogen oxides (NOx). Daily pollen counts were collected using a volumetric spore trap. The associations were examined by linear regression. Results Higher ambient levels of grass pollen 2 days before (lag 2) were associated with lower mid-forced expiratory flow (FEF25-75%) and FEV1/FVC ratio (Coef. [95% CI] = -119 [-226, -11] mL/s and -1.0 [-3.0, -0.03] %, respectively) and also 3 days before (lag 3). Increased levels of grass pollen a day before (lag 1) was associated with increased FeNO (4.35 [-0.1, 8.7] ppb) and also at lag 2. Adverse associations between pollen and multiple outcomes were greater in adults with current asthma, hay fever and pollen sensitization. Conclusions Grass pollen exposure was associated with eosinophilic airway inflammation 1-2 days after exposure and airway obstruction 2-3 days after exposure. Key messages There is a more delayed effect on lung function compared to airway inflammation. Adults with current asthma, hay fever and grass pollen sensitisation are especially vulnerable.

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Household Environmental Tobacco Smoke and Risk of Allergic Sensitization Among Children with Asthma

Acta Medica Marisiensis ◽

10.2478/amma-2013-0008 ◽

2013 ◽

Vol 59 (1) ◽

pp. 36-39

Author(s):

Brîndușa Căpîlna ◽

Maria Despina Baghiu

Keyword(s):

Cigarette Smoke ◽

Tobacco Smoke ◽

Respiratory Infections ◽

Negative Impact ◽

Allergic Sensitization ◽

Specific Ige ◽

Tobacco Smoke Exposure ◽

Food Allergens ◽

Adjuvant Effect ◽

Recurrent Wheezing

Abstract Background: Exposure to cigarette smoke is causing health problems, its components are known to possess carcinogenic, mutagenic, cytotoxic or irritant properties. Prevalence of smoking in pregnant women is between 17% and 35% worldwide. Passive smoking is identified as a factor with negative impact on health, and children are especially vulnerable. Children raised in families with smokers have a higher incidence of respiratory infections, recurrent wheezing, bronchitis, nocturnal cough and asthma. The aim of this study was determination of sensitization to various allergens in children exposed to cigarette smoke compared with children not exposed to cigarette smoke. Material and method: One-hundred eighty children treated in Pediatric Clinic 1 of Tîrgu Mureș were included in the study between 2008- 2011. The patients were divided into two groups: 50 children exposed to cigarette smoke and 130 children not exposed. Measurement of lung function was performed in children over 4 years using a spirometer. Serum specific IgE was analyzed to inhalatory and food allergens. Wheezing phenotype was determined in children younger than 4 years and exposure to cigarette smoke was evaluated based on parents' responses to questionnaires. Results: There was a significantly greater likelihood of developing sensitivity in children exposed to tobacco smoke than in those not exposed to dermatophagoides pteronissimus, dermatophagoides farinae, milk and grass pollen. Conclusions: During early childhood both pre- and postnatal tobacco smoke exposure has an adjuvant effect on allergic sensitization inhalatory and food allergens.

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Childhood pneumonia, pleurisy and lung function: a cohort study from the first to sixth decade of life

Thorax ◽

10.1136/thoraxjnl-2019-213389 ◽

2019 ◽

Vol 75 (1) ◽

pp. 28-37 ◽

Cited By ~ 2

Author(s):

Jennifer L Perret ◽

Caroline J Lodge ◽

Adrian J Lowe ◽

David P Johns ◽

Bruce R Thompson ◽

...

Keyword(s):

Carbon Monoxide ◽

Lung Function ◽

Lower Limit ◽

Transfer Factor ◽

Study Cohort ◽

Z Score ◽

Lung Volumes ◽

Current Asthma ◽

Childhood Pneumonia ◽

Lower Limit Of Normal

IntroductionAdult spirometry following community-acquired childhood pneumonia has variably been reported as showing obstructive or non-obstructive deficits. We analysed associations between doctor-diagnosed childhood pneumonia/pleurisy and more comprehensive lung function in a middle-aged general population cohort born in 1961.MethodsData were from the prospective population-based Tasmanian Longitudinal Health Study cohort. Analysed lung function was from ages 7 years (prebronchodilator spirometry only, n=7097), 45 years (postbronchodilator spirometry, carbon monoxide transfer factor and static lung volumes, n=1220) and 53 years (postbronchodilator spirometry and transfer factor, n=2485). Parent-recalled histories of doctor-diagnosed childhood pneumonia and/or pleurisy were recorded at age 7. Multivariable linear and logistic regression were used.ResultsAt age 7, compared with no episodes, childhood pneumonia/pleurisy-ever was associated with reduced FEV1:FVC for only those with current asthma (beta-coefficient or change in z-score=−0.20 SD, 95% CI −0.38 to –0.02, p=0.028, p interaction=0.036). At age 45, for all participants, childhood pneumonia/pleurisy-ever was associated with a restrictive pattern: OR 3.02 (1.5 to 6.0), p=0.002 for spirometric restriction (FVC less than the lower limit of normal plus FEV1:FVC greater than the lower limit of normal); total lung capacity z-score −0.26 SD (95% CI −0.38 to –0.13), p<0.001; functional residual capacity −0.16 SD (−0.34 to –0.08), p=0.001; and residual volume −0.18 SD (−0.31 to –0.05), p=0.008. Reduced lung volumes were accompanied by increased carbon monoxide transfer coefficient at both time points (z-score +0.29 SD (0.11 to 0.49), p=0.001 and +0.17 SD (0.04 to 0.29), p=0.008, respectively).DiscussionFor this community-based population, doctor-diagnosed childhood pneumonia and/or pleurisy were associated with obstructed lung function at age 7 for children who had current asthma symptoms, but with evidence of ‘smaller lungs’ when in middle age.

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