Predicting health-related quality of life in Spanish adolescents with allergic rhinoconjunctivitis and bronchial asthma

This study analyzed the predictive power of sociodemographic (age, sex) and medical variables (months since diagnosis and in treatment, immunotherapy, number of environmental allergens, food allergies or atopic dermatitistypes) on the quality of life of patients with rhinoconjunctivitis and bronchial asthma, using models based on comparative qualitative fuzzy analysis to compare them according to the pathology(s). Retrospective cross-sectional design.Sixty-four adolescents (65.60% boys) diagnosed with rhinoconjunctivitis and/or bronchial asthma aged between 12 and 16 years old (M= 14.02; SD = 1.45). The data were collected between February 2019 and January 2020 using the Brief Disease Perception Questionnaire (B-IPQ), the Adolescent Rhinoconjunctivitis Quality of Life Questionnaire (AdolRQoLQ) and the Respiratory Disease Questionnaire Self-administered and Standardized Chronicle (CRQSAS). Qualitative comparative analysis models (QCA) were used. In the QCA models, the various combinations indicated that the variables that predicted a higher quality of life for both rhinocojuntivitis symptoms and respiratory symptoms were receiving longerterm immunotherapy and a perceived lower threat of the disease. The consistencies of the models vary between 23-29%. In conclusion, the patients' QoL was explained by the presence of longerterm immunotherapy and a less threatening perception of the disease. Therefore, early multidisciplinary diagnosis and treatment is importan

Prevalencia, severidad y factores de riesgo de síntomas de asma, rinitis y eczema en niños de edad escolar en la provincia Oropeza - Bolivia

Background: Asthma and allergies are world-wide common chronic diseases among children and young people. Little is known about prevalence and environmental and dietary risk factors of asthma and allergies among rural and urban school children in Bolivia. The aim of this study was to describe the prevalence, severity and risk factors associated with asthma, rhinoconjunctivitis, and eczema symptoms in children of school age in Oropeza Province – Bolivia. Methods: Overall, 2584 children (response 91%) attending fifth elementary grade in Oropeza province answered the written and the video questionnaire of the International Study on Asthma and Allergies in Childhood. Lifetime, 12 months and severity prevalence were determined for asthma, rhinoconjunctivitis and eczema symptoms. The associations between: environmental and dietary factors and symptoms of asthma, rhinoconjuctivitis and eczema symptoms were analysed using logistic regression analysis with adjustment for age, sex and place of living. Results: Median age of children was 11 years, 52% were female and 26% lived in rural areas. The prevalence of asthma symptoms was higher in the written (18%) than in the video questionnaire (6%). 22% of children reported symptoms of rhinoconjunctivitis and 9% eczema symptoms. Overall, rural children reported more frequently symptoms of asthma and allergies than urban children. Parental smoking (adjusted OR 1.3; 95%IC 1.0-1.6), presence of disease vectors at home (fourth quartile vs. first quartile: 1.5; 1.1-2.2) and farm animals (1.3; 1.0-1.6) were statistically significant predictors of asthma symptoms detected by the written questionnaire. The associations were similar for symptoms of rhinoconjunctivitis and eczema. A greater adherence to the Mediterranean Diet (MD) was inversely related with asthma symptoms in the video questionnaire (reference category: 1st quartile; second quartile 0.6; 0.3-0.9, third quartile 0.7; 0.4-1.2, fourth quartile 0.6; 0.3-1.0) Conclusion: Our results suggest that promoting a healthy diet and reducing exposure to modifiable risk factors like environmental tobacco smoke, precarious housing conditions and certain disease vectors would have a significant positive impact on asthma and allergies morbidity in children in this region

Comparison of physical fitness between healthy and mild‐to‐moderate asthmatic children with exercise symptoms: A cross‐sectional study

.Objective Asthma is a chronic disease that may affect physical fitness, although its primary effects on exercise capacity, muscle strength, functionality and lifestyle, in children and adolescents, are still poorly understood. This study aimed to evaluate the differences in cardiorespiratory fitness, muscle strength, lifestyle, lung function, and functionality between asthmatics with exercise symptoms and healthy children. In addition, we have analyzed the association between clinical history and the presence of asthma. Study Design Cross-sectional study including 71 patients with a diagnosis of asthma and 71 healthy children and adolescents (7–17 years of age). Anthropometric data, clinical history, disease control, lifestyle (KIDMED and physical activity questionnaires), lung function (spirometry), exercise-induced bronchoconstriction test, aerobic fitness (cardiopulmonary exercise test), muscle strength and functionality (timed up and go; timed up and down stairs) were evaluated. Results Seventy-one patients with asthma (mean age 11.5 ± 2.7) and 71 healthy subjects (mean age 10.7 ± 2.5) were included. All asthmatic children had mild to moderate and stable asthma. EIB occurred in 56.3% of asthmatic children. Lung function was significantly (p < .05) lower in the asthmatic group when compared to healthy peers, as well as the cardiorespiratory fitness, muscle strength, lifestyle and functionality. Moreover, asthmatic children were more likely to have atopic dermatitis, allergic reactions, food allergies, and a family history of asthma when compared to healthy children. Conclusions Children with mild-to-moderate asthma presenting exercise symptoms show a reduction in cardiorespiratory fitness, muscle strength, lung function, functionality, and lifestyle when compared to healthy peers. The study provides data for pediatricians to support exercise practice aiming to improve prognosis and quality of life in asthmatic children.S

International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis.

BACKGROUND: Critical examination of the quality and validity of available allergic rhinitis (AR) literature is necessary to improve understanding and to appropriately translate this knowledge to clinical care of the AR patient. To evaluate the existing AR literature, international multidisciplinary experts with an interest in AR have produced the International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR). METHODS: Using previously described methodology, specific topics were developed relating to AR. Each topic was assigned a literature review, evidence-based review (EBR), or evidence-based review with recommendations (EBRR) format as dictated by available evidence and purpose within the ICAR:AR document. Following iterative reviews of each topic, the ICAR:AR document was synthesized and reviewed by all authors for consensus. RESULTS: The ICAR:AR document addresses over 100 individual topics related to AR, including diagnosis, pathophysiology, epidemiology, disease burden, risk factors for the development of AR, allergy testing modalities, treatment, and other conditions/comorbidities associated with AR. CONCLUSION: This critical review of the AR literature has identified several strengths; providers can be confident that treatment decisions are supported by rigorous studies. However, there are also substantial gaps in the AR literature. These knowledge gaps should be viewed as opportunities for improvement, as often the things that we teach and the medicine that we practice are not based on the best quality evidence. This document aims to highlight the strengths and weaknesses of the AR literature to identify areas for future AR research and improved understanding

Enriched mannose glycosylation contributes to Act d 2 allergenicity.

Allergens are responsible for the Th2 response in patients as part of complex mixtures of proteins, fatty acids and other molecules. Plant allergens have hitherto been included in several protein families that share no common biochemical features. Their physical, biochemical and immunological characteristics have been widely studied, but no definite conclusion has been reached about what makes a protein an allergen. N-glycosylation is characteristic of plant allergen sources but is not present in mammals

Allergen Immunotherapy in Children User’s Guide

Allergen immunotherapy is a cornerstone in the treatment of allergic children. The clinical efficiency relies on a well-defined immunologic mechanism promoting regulatory T cells and downplaying the immune response induced by allergens. Clinical indications have been well documented for respiratory allergy in the presence of rhinitis and/or allergic asthma, to pollens and dust mites. Patients who have had an anaphylactic reaction to hymenoptera venom are also good candidates for allergen immunotherapy. Administration of allergen is currently mostly either by subcutaneous injections or by sublingual administration. Both methods have been extensively studied and have pros and cons. Specifically in children, the choice of the method of administration according to the patient's profile is important. Although allergen immunotherapy is widely used, there is a need for improvement. More particularly, biomarkers for prediction of the success of the treatments are needed. The strength and efficiency of the immune response may also be boosted by the use of better adjuvants. Finally, novel formulations might be more efficient and might improve the patient's adherence to the treatment. This user's guide reviews current knowledge and aims to provide clinical guidance to healthcare professionals taking care of children undergoing allergen immunotherapy

Comorbidity in childhood asthma

Dit proefschrift heeft als focus comorbiditeit bij kinderen met astma en de impact hiervan op de astma. Comorbiditeiten in kinderen met astma zijn allergische rhinitis(AR), dysfunctioneel ademen(DA) en depressieve aandoeningen. De prevalentie van AR in kinderen met astma is 76.2%. AR was vastgesteld in maar 56.1%. Ongecontroleerd astma komt vaker voor bij kinderen met AR. De invloed op de astma controle verdwijnt wanner er behandeld wordt met intra-nasale steroïden. DA in kinderen met astma werd in 5.3% vastgesteld met de Nijmegen vragenlijst. DA heeft een associatie met minder astma controle. Er werden geen verschillen gevonden in de totale scores voor angst, depressie of in zelfbeeld tussen kinderen met of zonder astma. Het risico op angst of depressie stijgt met slechtere astma controle. Een oorzaak voor ongecontroleerd astma werd gevonden in 97.2%. De oorzaken waren: slechte therapietrouw(37%), persisterende blootstelling aan omgevingsprikkels(28%), comorbiditeiten(20%), (AR en DA zijn de meest voorkomende). Incorrecte inhalatie techniek(8%). Bij zes(4.2%) was er een andere diagnose dan astma. De prevalentie van therapie resistent astma was 2.8%. De conclusies zijn dat therapie resistent astma zeldzaam is. Comorbiditeiten hebben een belangrijke rol als oorzaak. AR is vaak onderkent maar is belangrijk en goed te behandelen. DA komt minder vaak voor, maar heeft invloed op de astma controle. In goed gecontroleerd astma zijn psychologische comorbiditeiten zeldzaam. Bij minder astma controle is er een associatie met een verhoogd risico op psychologische comorbiditeiten

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Background In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR-Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR-Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence-based findings and recommendation from the full document. Methods ICAR-Allergic Rhinitis 2023 employed established evidence-based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. Results ICAR-Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. Conclusion The ICAR-Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment