Aspects of eczema in childhood

Eczema (atopic dermatitis) is a common itc hy inflammatory skin disease that often starts in childhood. Having eczema is troublesome and has been shown to reduce quality of life . Eczema is associated with an increased risk for other allergy - related diseases such as asthma and rhinitis. Knowledge co ncerning the natural course of eczema and its association with asthma and rhinitis in childhood is limited . Even though a majority of children with eczema have mild disease, most studies on quality of life and associations with asthma and rhinitis have bee n done in selected populations of children with moderate to severe eczema. New knowledge about eczema genetics and skin barrier function has highlighted the need for longitudinal studies to better understand the natural course of eczema as well as its asso ciation with eczema, asthma and rhinitis . The aim of this epidemiological study was to provide a better understanding of childhood eczema in the gener al population and especially its association with asthma and rhinitis. We used the population - based birth cohort BAMSE , including 4,089 children followed up at age 0, 1, 2, 4, 8 and 12 years with parental questionnaires focusing on symptoms of allergy - related diseases and risk factors. In paper I we showed that allergy - related diseases affect a majority of children during the first 12 years of life and that eczema, asthma and rhinitis develop dynamic ally throughout childhood. In addition we found that comorbidity between allergy - related diseases increase with increasing age and that 7.5% of 12 - year - old child ren have two or three of the diseases eczema, asthma and rhinitis. In paper II we examined eczema severity at 12 years in relation to asthma , rhinitis and Filaggrin mutations. We found that the risk of having asthma and rhinitis was associated with eczem a severity, with the highest risk among boys with moderate to severe eczema. However, no association between Filaggrin mutations and severity of eczema was found. In paper III we show ed that e czema and even mild eczema among pre - adolescent girls is associ ated with impaired self - perceived health. Finally, in paper IV we examined prognosis and risk factors for eczema, asthma and rhinitis in pre - adolescence among children with infantile eczema. We found that a lmost half of the children with infantile eczema will have eczema, asthma or rhinitis in pre - adolescence but in three of four children the eczema will have remitted. We also found that e czema in the first but not the second year of life is associated with a good prognosis for eczema but an increased ris k of asthma and rhinitis in pre - adolescence. In conclusion the results of this thesis stress the importance of allergy - related diseases and in particular eczema among children as a public health concern. This thesis also demonstrates a strong association between eczema, asthma and rhinitis in childhood and emphasizes the importance of considering comorbidities between these diseases both in research and in clinical practice

Development and comorbidity of eczema, asthma and rhinitis to age 12 : data from the BAMSE birth cohort

BACKGROUND: Allergy-related diseases are a public health issue, but knowledge on development and comorbidity among children is scarce. The aim was to study the development of eczema, asthma and rhinitis in relation to sex and parental allergy, in a population-based cohort, during childhood. METHODS: At 1, 2, 4, 8 and 12 years, parental questionnaires were used to obtain data on allergy-related diseases. Complete data for all five follow-up occasions were available from 2916 children. Odds ratios for the risk of any allergy-related disease in relation to heredity and sex were calculated using generalized estimating equations. RESULTS: At 12 years, 58% of the children had had eczema, asthma and/or rhinitis at some time. Disease turnover was high for all three diseases throughout the study. Comorbidity increased with age, and at 12 years, 7.5% of all the children were affected by at least two allergy-related diseases. Parental allergy was associated with increased comorbidity and more persistent disease and increased the risk of having any allergy-related disease (adjusted OR 1.76; 95% CI 1.57-1.97) up to 12 years. Male sex was associated with an increased risk throughout childhood. Boys and girls did not differ in disease persistence, and for comorbidity, the differences were minor. CONCLUSIONS: Allergy-related diseases may affect a majority of children. Eczema, asthma and rhinitis develop dynamically throughout childhood, and allergic comorbidity is common. These findings indicate that allergy-related diseases should be neither seen nor studied as isolated entities.Stockholm County CouncilHjärt- och LungfondenVetenskapsrådetAstma- och allergiförbundetManuscrip

European and multi-ancestry genome-wide association meta-analysis of atopic dermatitis highlights importance of systemic immune regulation

Atopic dermatitis (AD) is a common inflammatory skin condition and prior genome-wide association studies (GWAS) have identified 71 associated loci. In the current study we conducted the largest AD GWAS to date (discovery N = 1,086,394, replication N = 3,604,027), combining previously reported cohorts with additional available data. We identified 81 loci (29 novel) in the European-only analysis (which all replicated in a separate European analysis) and 10 additional loci in the multi-ancestry analysis (3 novel). Eight variants from the multi-ancestry analysis replicated in at least one of the populations tested (European, Latino or African), while two may be specific to individuals of Japanese ancestry. AD loci showed enrichment for DNAse I hypersensitivity and eQTL associations in blood. At each locus we prioritised candidate genes by integrating multi-omic data. The implicated genes are predominantly in immune pathways of relevance to atopic inflammation and some offer drug repurposing opportunities.</p

Novembre-décembre 1993 en France : Chronologie

Cheyron Christiane. Novembre-décembre 1993 en France : Chronologie. In: Hommes et Migrations, n°1172-1173, Janvier-février 1994. Minorités au Proche-Orient. pp. 111-113

Anaphylactic reactions to novel foods:Case report of a child with severe crocodile meat allergy

Availability of "exotic" foods is steadily increasing. In this report, we describe the first case of anaphylaxis to crocodile meat. The patient was a 13-year-old boy with severe immunoglobulin E-mediated allergy to chicken meat. When tasting crocodile meat for the first time, he developed an anaphylactic reaction. Cross-reactivity between chicken and crocodile meat was suspected to have triggered this reaction. Basophil activation and immunoglobulin E testing confirmed the boy's allergic reaction to crocodile meat proteins. Molecular analysis identified a crocodile a-parvalbumin, with extensive sequence homology to chicken a-parvalbumin, as the main cross-reactive allergen. We conclude that crocodile meat can be a potent food allergen and patients with allergy to chicken meat should be advised to avoid intake of meat from crocodile species. Both foods and people travel around the world and accessibility to exotic foods is steadily growing. As a result, novel allergic cross-reactivities are likely to become a challenge in the management of food allergy and, as our report illustrates, cross-reactivity has to be considered even between foods that might not intuitively be perceived as related.</p

Pediatric food allergy-related household costs are influenced by age, but not disease severity

Objective: The economic burden of food allergy on households is poorly understood. We evaluated the household costs associated with specialist-diagnosed pediatric food allergy, with focus on age and disease severity. Study design: A cross-sectional study of 70 Swedish case-control pairs (59% boys) was conducted using Food Allergy Economic questionnaire. Household costs were analyzed between age- and gender-matched cases (children aged 0-17 years, with specialist-diagnosed food allergy) and controls (non-food allergic households). Results: Parents were predominantly university-educated and employed full-time. Most cases had parent-reported previous anaphylaxis. Mean total annual household costs were comparable between cases and controls. However, compared to controls, cases had significantly higher direct medical-, and non-medical related costs; higher indirect medical-related costs, and higher intangible costs (all p amp;lt; 0.05). In a sensitivity analyses of only cases aged 0-12 years, direct household costs, including lost earnings due to childs hospitalization, were significantly higher than controls. Results from only children with severe disease paralleled those of all cases vs. controls. Conclusions: Although pediatric food allergy is not associated with higher total annual household costs, these households have significantly higher direct medical-related, indirect and intangible costs vs. non-food allergic households. Higher household costs were identified amongst younger children, but not disease severity.Funding Agencies|Swedish Asthma and Allergy Foundation [F2015-0004, F2015-0042]</p

Health-related quality of life worsens by school age amongst children with food allergy

Abstract Background Food allergy is negatively associated with health-related quality of life (HRQL). Although differences exist between parents and children, less is known about age-specific differences amongst children. As such, we aimed to identify if age, as well as other factors, are associated with food allergy-specific HRQL in an objectively defined population of children. Methods Overall, 63 children (boys: n = 36; 57.1%) with specialist-diagnosed food allergy to 1 + foods were included. Parents/guardians completed the Swedish version of a disease-specific questionnaire designed to assess overall- and domain-specific HRQL. Descriptive statistics and linear regression were used. Results The most common food allergy was hen’s egg (n = 40/63; 63.5%). Most children had more than one food allergy (n = 48; 76.2%). Nearly all had experienced mild symptoms (e.g. skin; n = 56/63; 94.9%), and more than half had severe symptoms (e.g. respiratory; 39/63; 66.1%). Compared to young children (0–5 years), older children (6–12 years) had worse HRQL (e.g. overall HRQL: B = 0.60; 95% CI 0.05–1.16; p < 0.04.). Similarly, multiple food allergies, and severe symptoms were significantly associated with worse HRQL (all p < 0.05) even in models adjusted for concomitant allergic disease. No associations were found for gender or socioeconomic status. Conclusion Older children and those with severe food allergy have worse HRQL