Arnon Elizur, Shirel Rachel-Jossefi, Marianna Rachmiel, Eli Eisenberg, Yitzhak Katz
Background
The effect of the amount of transient cow's milk formula (CMF) consumed during the first days of life on IgE-cow's milk allergy (IgE-CMA) is unknown.
Methods
A cohort of 58 patients with IgE-CMA was identified from a large scale population-based study of 13,019 infants followed from birth. A group of 116 infants matched for sex and breastfeeding only duration (beyond the nursery period), and another random group of 259 healthy infants were used as controls. Parents were interviewed and the infants' medical records were searched to assess CMF consumption in the nursery.
Results
While 96% of the mothers of the 174 infants (58 with Cow's milk allergy and 116 controls) reported on exclusive breastfeeding during the stay in the nursery, CMF consumption was documented in 96 (55%) of the infants. Of those, most (57; 59%) received one to three feedings, 20 (21%) received four to nine feedings, and 19 (20%) received ≥10 feedings. Fewer formula feeds (1–3) were significantly more common in the allergic group than ≥4 feeds (p = 0.0003) and no feeds at all (p = 0.02) compared to controls (n = 116). Of those exclusively breastfed in the nursery, 13/23 allergic infants (57%) introduced CMF at age 105–194 days (the period with highest-risk for IgE-CMA) compared to 33/98 (34%) from the random control group (n = 259) (p = 0.04).
Conclusions
Most infants end up receiving few CMF feeds in the nursery. Transient CMF in the nursery is associated with increased risk of IgE-CMA.
{"title":"Consumption of cow's milk formula in the nursery and the development of milk allergy","authors":"Arnon Elizur, Shirel Rachel-Jossefi, Marianna Rachmiel, Eli Eisenberg, Yitzhak Katz","doi":"10.1002/clt2.12352","DOIUrl":"https://doi.org/10.1002/clt2.12352","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The effect of the amount of transient cow's milk formula (CMF) consumed during the first days of life on IgE-cow's milk allergy (IgE-CMA) is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort of 58 patients with IgE-CMA was identified from a large scale population-based study of 13,019 infants followed from birth. A group of 116 infants matched for sex and breastfeeding only duration (beyond the nursery period), and another random group of 259 healthy infants were used as controls. Parents were interviewed and the infants' medical records were searched to assess CMF consumption in the nursery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>While 96% of the mothers of the 174 infants (58 with Cow's milk allergy and 116 controls) reported on exclusive breastfeeding during the stay in the nursery, CMF consumption was documented in 96 (55%) of the infants. Of those, most (57; 59%) received one to three feedings, 20 (21%) received four to nine feedings, and 19 (20%) received ≥10 feedings. Fewer formula feeds (1–3) were significantly more common in the allergic group than ≥4 feeds (<i>p</i> = 0.0003) and no feeds at all (<i>p</i> = 0.02) compared to controls (<i>n</i> = 116). Of those exclusively breastfed in the nursery, 13/23 allergic infants (57%) introduced CMF at age 105–194 days (the period with highest-risk for IgE-CMA) compared to 33/98 (34%) from the random control group (<i>n</i> = 259) (<i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most infants end up receiving few CMF feeds in the nursery. Transient CMF in the nursery is associated with increased risk of IgE-CMA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140550043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannah Wecker, Stefanie Ziehfreund, Sebastian Sitaru, Emma K. Johansson, Jesper Elberling, Anaïs Doll, Electra Nicolaidou, Emanuele Scala, Michael J. Boffa, Lea Schmidt, Mariusz Sikora, Tiago Torres, Pavel V. Chernyshov, Alexander Zink
<p>Atopic dermatitis (AD) or atopic eczema (AE) is a complex chronic inflammatory skin disease with a high prevalence and disease burden.<span><sup>1</sup></span> The nomenclature for this condition has long been the subject of controversial debate within the medical community and even among global experts.<span><sup>2, 3</sup></span> However, the terminology used not only affects experts, daily clinical practice, and research but especially patients and the general public in terms of their understanding and access to disease-related information.<span><sup>2-5</sup></span> Given the potential of crowdsourced internet data,<span><sup>6</sup></span> this study aimed to investigate the use of ‘atopic dermatitis’, ‘atopic eczema’, and their lay terms in internet searches and the content of these searches across 21 European countries in their respective main language.</p><p>A total of 71,620,240 AD-related searches, 33,913,480 AE-related searches, and 136,405,350 searches to the respective lay terms were identified across European countries between 02/2019 and 01/2023 using Google Ads Keyword Planner. The top 20 keywords for each country and search term were translated into English and inductively classified into 9 categories: <i>age group</i>, <i>causes</i>, <i>comorbidities</i>, <i>general</i> information, <i>localisation</i>, <i>other disease</i>, <i>others</i>, <i>symptoms</i>, and <i>treatment</i>. Subcategories were formed for recurring keywords, for example, different body localisations. For cross-country comparison, the monthly number of web searches per 100,000 inhabitants was calculated. For detailed methodology, see the Appendix.</p><p>Most European countries (<i>n</i> = 11) had the highest median number of web searches per 100,000 inhabitants for AD-related lay terms, followed by AD (<i>n</i> = 8) and AE (<i>n</i> = 2, Figure 1). Analysis revealed common search themes across European countries, including <i>general</i> disease information, <i>age groups</i>, <i>localisations</i>, and <i>treatment</i>, with slight variations between countries (Figure 2A). The lay term's keywords were often about other diseases. Depending on the search terms, internet queries in some categories focused on different subcategories (Figure 2B). For example, when using the lay term, more countries searched for <i>(natural) remedies</i> and anogenital localisations, and only AD-related searches included searches for <i>animals</i>. However, there were also similarities between the search terms, with <i>face</i>, <i>hands</i>, and <i>scalp</i> being the most frequently searched localisations. <i>Age-</i>related internet searches concerned primarily babies and children, whereas in Austria and Germany, adults were the only search subjects. Search content for lay terms appeared less differentiated than for the other search terms.</p><p>Consistent with previous research, both a review study and a global crowdsourced approach found that the term AD was used more freque
特应性皮炎（AD）或特应性湿疹（AE）是一种复杂的慢性炎症性皮肤病，发病率和疾病负担都很高。1 长期以来，医学界甚至全球专家对这种疾病的术语一直存在争议。鉴于众包互联网数据6 的潜力，本研究旨在调查 "特应性皮炎"、"特应性湿疹 "及其非专业术语在互联网搜索中的使用情况，以及这些搜索在 21 个欧洲国家各自主要语言中的内容。每个国家和搜索词的前 20 个关键词被翻译成英文，并归纳为 9 个类别：年龄组、病因、合并症、一般信息、定位、其他疾病、其他、症状和治疗。对于重复出现的关键词，例如不同的身体定位，则会形成子类别。为了进行跨国比较，我们计算了每 10 万居民每月的网络搜索次数。大多数欧洲国家（n = 11）每 100,000 名居民中与 AD 相关的非专业词汇的网络搜索中位数最高，其次是 AD（n = 8）和 AE（n = 2，图 1）。分析表明，欧洲各国的共同搜索主题包括一般疾病信息、年龄组、本地化和治疗，各国之间略有不同（图 2A）。非专业术语的关键词通常与其他疾病有关。根据搜索词的不同，某些类别的网络查询侧重于不同的子类别（图 2B）。例如，在使用非专业用语时，更多的国家搜索（自然）疗法和肛门定位，只有与注意力缺失症有关的搜索包括对动物的搜索。不过，搜索词之间也有相似之处，脸部、手部和头皮是最常被搜索的局部。与年龄相关的网络搜索主要涉及婴儿和儿童，而在奥地利和德国，成年人是唯一的搜索对象。与之前的研究一致，一项综述研究和一项全球众包方法都发现，AD 一词的使用频率高于 AE。3, 4 然而，特定国家的非专业用语的网络搜索次数几乎是 AE 的两倍，并且在大多数国家都受到青睐，这表明普通人群可能对有关 AD 或 AE 的学术争论并不感兴趣，而是在寻求与疾病相关的一般信息，因为诊断结果可能尚未可知。例如，常用的非专业用语 "湿疹 "缺乏准确性，可能包括其他皮肤病，如脂溢性湿疹或麻疹湿疹，这些疾病都会出现湿疹性皮损。2, 3 此外，欧洲不同国家的搜索主题和数量各不相同，这可能反映了各国人口对 AD 的特定需求，在传播可靠准确的在线健康信息时应加以考虑。此外，AD、AE 及其非专业用语之间在内容上的差异可能表明人们对不同疾病的混淆和认知，这一点应在患者交流中加以解决。3 该研究强调了欧洲人在网上搜索疾病相关信息时对 AD 和 AE 非专业用语的偏好。这些发现提倡在健康信息和患者交流中使用标准化的术语和语言，并根据各国的具体需求对信息进行调整。汉娜-韦克进行了统计分析。Sebastian Sitaru、Emma K. Johansson、Jesper Elberling、Anaïs Doll、Electra Nicolaidou、Emanuele Scala、Michael J. Boffa、Lea Schmidt、Mariusz Sikora、Tiago Torres 和 Pavel V. Chernyshov 提供了数据，并对结果讨论和最终手稿的起草做出了积极贡献。Hannah Wecker、Stefanie Ziehfreund、Sebastian Sitaru、Anaïs Doll、Electra Nicolaidou、Emanuele Scala、Michael J. Boffa、Lea Schmidt、Mariusz Sikora 和 Pavel V. Chernyshov 没有需要声明的利益冲突。Emma K. Johansson 曾接受过 AbbVie、ACO、Almirall、LEO Pharma、Novartis、Pfizer、Sanofi-Genzyme 以及瑞典哮喘和过敏协会的演讲酬金和/或担任其顾问。Jesper Elberling 曾担任以下公司的顾问委员会成员，并/或从这些公司获得演讲酬金和/或会议和差旅费资助：辉瑞（Pfizer）、赛诺菲（Sanofi）、利奥制药（Leo Pharma）、诺华（Novartis）、阿斯利康（AstraZeneca）、Almirall、艾伯维（AbbVie）、礼来（Eli Lilly）、Galderma、武田（Takeda）、CSL Vifor。Tiago Torres 曾因在艾伯维、Almirall、安进、Arena Pharmaceuticals、Biocad、勃林格殷格翰、百时美施贵宝、Celgene、礼来、杨森、利奥制药、MSD、诺华、辉瑞、三星生物、山德士和赛诺菲赞助的活动中担任顾问和/或演讲人而获得酬金。亚历山大-辛克曾担任以下公司的顾问和/或领取演讲酬金和/或接受以下公司的资助和/或参与以下公司的临床试验：AbbVie, ALK Abello, Almirall, Amgen, Beiersdorf Dermo Medical, Bencard Allergie, BMS, Celgene, Eli Lilly, GSK, Incyte, Janssen Cilag, Leo Pharma, Miltenyi Biotec, MSD, Novartis, Pfizer, Sanofi-Aventis, Takeda Pharma, Thermo Fisher Scientific Phadia, UCB.慕尼黑工业大学
{"title":"Dilemmas of nomenclature: Web search analysis reveals European preferences in atopic skin diseases","authors":"Hannah Wecker, Stefanie Ziehfreund, Sebastian Sitaru, Emma K. Johansson, Jesper Elberling, Anaïs Doll, Electra Nicolaidou, Emanuele Scala, Michael J. Boffa, Lea Schmidt, Mariusz Sikora, Tiago Torres, Pavel V. Chernyshov, Alexander Zink","doi":"10.1002/clt2.12355","DOIUrl":"https://doi.org/10.1002/clt2.12355","url":null,"abstract":"<p>Atopic dermatitis (AD) or atopic eczema (AE) is a complex chronic inflammatory skin disease with a high prevalence and disease burden.<span><sup>1</sup></span> The nomenclature for this condition has long been the subject of controversial debate within the medical community and even among global experts.<span><sup>2, 3</sup></span> However, the terminology used not only affects experts, daily clinical practice, and research but especially patients and the general public in terms of their understanding and access to disease-related information.<span><sup>2-5</sup></span> Given the potential of crowdsourced internet data,<span><sup>6</sup></span> this study aimed to investigate the use of ‘atopic dermatitis’, ‘atopic eczema’, and their lay terms in internet searches and the content of these searches across 21 European countries in their respective main language.</p><p>A total of 71,620,240 AD-related searches, 33,913,480 AE-related searches, and 136,405,350 searches to the respective lay terms were identified across European countries between 02/2019 and 01/2023 using Google Ads Keyword Planner. The top 20 keywords for each country and search term were translated into English and inductively classified into 9 categories: <i>age group</i>, <i>causes</i>, <i>comorbidities</i>, <i>general</i> information, <i>localisation</i>, <i>other disease</i>, <i>others</i>, <i>symptoms</i>, and <i>treatment</i>. Subcategories were formed for recurring keywords, for example, different body localisations. For cross-country comparison, the monthly number of web searches per 100,000 inhabitants was calculated. For detailed methodology, see the Appendix.</p><p>Most European countries (<i>n</i> = 11) had the highest median number of web searches per 100,000 inhabitants for AD-related lay terms, followed by AD (<i>n</i> = 8) and AE (<i>n</i> = 2, Figure 1). Analysis revealed common search themes across European countries, including <i>general</i> disease information, <i>age groups</i>, <i>localisations</i>, and <i>treatment</i>, with slight variations between countries (Figure 2A). The lay term's keywords were often about other diseases. Depending on the search terms, internet queries in some categories focused on different subcategories (Figure 2B). For example, when using the lay term, more countries searched for <i>(natural) remedies</i> and anogenital localisations, and only AD-related searches included searches for <i>animals</i>. However, there were also similarities between the search terms, with <i>face</i>, <i>hands</i>, and <i>scalp</i> being the most frequently searched localisations. <i>Age-</i>related internet searches concerned primarily babies and children, whereas in Austria and Germany, adults were the only search subjects. Search content for lay terms appeared less differentiated than for the other search terms.</p><p>Consistent with previous research, both a review study and a global crowdsourced approach found that the term AD was used more freque","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140550044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Y. Kim, J. Yun, D. Y. Kang, T. H. Kim, M. K. Oh, S. Lee, et al. HLA-A* 24: 02 increase the risk of allopurinol-induced drug reaction with eosinophilia and systemic symptoms in HLA-B* 58: 01 carriers in a Korean population; a multicenter cross-sectional case-control study. Clin Transl Allergy. 2022 Sep 15;12(9):e12193.
This article [1] was published with a technical error in Figure 2, a size of bars in the allopurinol-tolerant controls. The authors have re-examined the data and confirmed that this correction would not have resulted in any alteration to the results or conclusion of the paper. The figure 2 should be shown as below.
M.M. Y. Kim、J. Yun、D. Y. Kang、T. H. Kim、M. K. Oh、S. Lee, et al. HLA-A* 24: 02 会增加韩国人群中 HLA-B* 58: 01 携带者发生别嘌醇诱导的伴有嗜酸性粒细胞增多和全身症状的药物反应的风险；一项多中心横断面病例对照研究。Clin Transl Allergy.2022 Sep 15;12(9):e12193.This article [1] was published with a technical error in Figure 2, a size of bars in the allopurinol-tolerant controls.作者重新检查了数据，确认这一改正不会对论文的结果或结论造成任何改变。图 2 应如下所示。
{"title":"Correction to HLA-A*24:02 increase the risk of allopurinol-induced drug reaction with eosinophilia and systemic symptoms (DRESS) in HLA-B*58:01 carriers in Korean population; A multicenter cross-sectional case-control study","authors":"","doi":"10.1002/clt2.12351","DOIUrl":"https://doi.org/10.1002/clt2.12351","url":null,"abstract":"<p>M. Y. Kim, J. Yun, D. Y. Kang, T. H. Kim, M. K. Oh, S. Lee, et al. HLA-A* 24: 02 increase the risk of allopurinol-induced drug reaction with eosinophilia and systemic symptoms in HLA-B* 58: 01 carriers in a Korean population; a multicenter cross-sectional case-control study. Clin Transl Allergy. 2022 Sep 15;12(9):e12193.</p><p>This article [1] was published with a technical error in Figure 2, a size of bars in the allopurinol-tolerant controls. The authors have re-examined the data and confirmed that this correction would not have resulted in any alteration to the results or conclusion of the paper. The figure 2 should be shown as below.</p><p></p>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140351695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Allergic diseases typically refer to a heterogeneous group of conditions primarily caused by the activation of mast cells or eosinophils, including atopic dermatitis (AD), allergic rhinitis (AR), and asthma. Asthma, AR, and AD collectively affect approximately one-fifth of the global population, imposing a significant economic burden on society. Despite the availability of drugs to treat allergic diseases, they have been shown to be insufficient in controlling relapses and halting disease progression. Therefore, new drug targets are needed to prevent the onset of allergic diseases.</p> </section> <section> <h3> Method</h3> <p>We employed a Mendelian randomization approach to identify potential drug targets for the treatment of allergic diseases. Leveraging 1798 genetic instruments for 1537 plasma proteins from the latest reported Genome-Wide Association Studies (GWAS), we analyzed the GWAS summary statistics of Ferreira MA et al. (nCase = 180,129, nControl = 180,709) using the Mendelian randomization method. Furthermore, we validated our findings in the GWAS data from the FinnGen and UK Biobank cohorts. Subsequently, we conducted sensitivity tests through reverse causal analysis, Bayesian colocalization analysis, and phenotype scanning. Additionally, we performed protein-protein interaction analysis to determine the interaction between causal proteins. Finally, based on the potential protein targets, we conducted molecular docking to identify potential drugs for the treatment of allergic diseases.</p> </section> <section> <h3> Results</h3> <p>At Bonferroni significance (<i>p</i> < 3.25 × 10<sup>−5</sup>), the Mendelian randomization analysis revealed 11 significantly associated protein-allergic disease pairs. Among these, the increased levels of TNFAIP3, ERBB3, TLR1, and IL1RL2 proteins were associated with a reduced risk of allergic diseases, with corresponding odds ratios of 0.82 (0.76–0.88), 0.74 (0.66–0.82), 0.49 (0.45–0.55), and 0.81 (0.75–0.87), respectively. Conversely, increased levels of IL6R, IL1R1, ITPKA, IL1RL1, KYNU, LAYN, and LRP11 proteins were linked to an elevated risk of allergic diseases, with corresponding odds ratios of 1.04 (1.03–1.05), 1.25 (1.18–1.34), 1.48 (1.25–1.75), 1.14 (1.11–1.18), 1.09 (1.05–1.12), 1.96 (1.56–2.47), and 1.05 (1.03–1.07), respectively. Bayesian colocalization analysis suggested that LAYN (coloc.abf-PPH4 = 0.819) and TNFAIP3 (coloc.abf-PPH4 = 0.930) share the same variant associated with allergic diseases.</p> </section> <section> <h3> Conclusions</h3> <p>Our s
{"title":"Identification of potential drug targets for allergic diseases from a genetic perspective: A mendelian randomization study","authors":"Hui Wang, Jianyu Pang, Yuguan Zhou, Qi Qi, Yuheng Tang, Samina Gul, Miaomiao Sheng, Juhua Dan, Wenru Tang","doi":"10.1002/clt2.12350","DOIUrl":"https://doi.org/10.1002/clt2.12350","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Allergic diseases typically refer to a heterogeneous group of conditions primarily caused by the activation of mast cells or eosinophils, including atopic dermatitis (AD), allergic rhinitis (AR), and asthma. Asthma, AR, and AD collectively affect approximately one-fifth of the global population, imposing a significant economic burden on society. Despite the availability of drugs to treat allergic diseases, they have been shown to be insufficient in controlling relapses and halting disease progression. Therefore, new drug targets are needed to prevent the onset of allergic diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We employed a Mendelian randomization approach to identify potential drug targets for the treatment of allergic diseases. Leveraging 1798 genetic instruments for 1537 plasma proteins from the latest reported Genome-Wide Association Studies (GWAS), we analyzed the GWAS summary statistics of Ferreira MA et al. (nCase = 180,129, nControl = 180,709) using the Mendelian randomization method. Furthermore, we validated our findings in the GWAS data from the FinnGen and UK Biobank cohorts. Subsequently, we conducted sensitivity tests through reverse causal analysis, Bayesian colocalization analysis, and phenotype scanning. Additionally, we performed protein-protein interaction analysis to determine the interaction between causal proteins. Finally, based on the potential protein targets, we conducted molecular docking to identify potential drugs for the treatment of allergic diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At Bonferroni significance (<i>p</i> < 3.25 × 10<sup>−5</sup>), the Mendelian randomization analysis revealed 11 significantly associated protein-allergic disease pairs. Among these, the increased levels of TNFAIP3, ERBB3, TLR1, and IL1RL2 proteins were associated with a reduced risk of allergic diseases, with corresponding odds ratios of 0.82 (0.76–0.88), 0.74 (0.66–0.82), 0.49 (0.45–0.55), and 0.81 (0.75–0.87), respectively. Conversely, increased levels of IL6R, IL1R1, ITPKA, IL1RL1, KYNU, LAYN, and LRP11 proteins were linked to an elevated risk of allergic diseases, with corresponding odds ratios of 1.04 (1.03–1.05), 1.25 (1.18–1.34), 1.48 (1.25–1.75), 1.14 (1.11–1.18), 1.09 (1.05–1.12), 1.96 (1.56–2.47), and 1.05 (1.03–1.07), respectively. Bayesian colocalization analysis suggested that LAYN (coloc.abf-PPH4 = 0.819) and TNFAIP3 (coloc.abf-PPH4 = 0.930) share the same variant associated with allergic diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our s","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140348563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tiina Mattila, Vesa Jormanainen, Marina Erhola, Tuula Vasankari, Sanna Toppila-Salmi, Fredrik Herse, Riikka-Leena Leskelä, Tari Haahtela
<p>Asthma, chronic obstructive pulmonary disease (COPD), and allergic rhinitis are major long-term airway diseases.<span><sup>1-5</sup></span> Asthma appears in all age groups and COPD causes major morbidity and mortality particularly in smokers.<span><sup>1, 2, 5</sup></span> Allergic rhinitis and other allergic conditions are often associated with asthma.<span><sup>3, 4, 6</sup></span></p><p>In Finland, three nationwide respiratory programmes have been implemented since 1994: the Asthma Programme (1994–2004), the COPD Programme (1998–2007), and the Allergy Programme (2008–2018).<span><sup>4, 6</sup></span> After the 1990s, the burden of asthma, COPD, and allergic conditions has decreased and the prevalence has stabilised.<span><sup>4, 6</sup></span> Smoking has also decreased.<span><sup>7</sup></span></p><p>International guidelines are available for asthma (since 1995), COPD (since 1997), and chronic rhinitis (since 2005).<span><sup>1-3</sup></span></p><p>Inhaled short- and long-acting β2 adrenoceptor agonists (LABA), muscarinic receptor antagonists (LAMA), and corticosteroids (ICS) have been used for first-line treatment in asthma and COPD since the 1990s.<span><sup>1, 2, 4, 8</sup></span> Intranasal corticosteroids have been used in rhinitis for decades.<span><sup>3</sup></span></p><p>In the present study, we present consumption (sales) data of medication for asthma, COPD, rhinitis, cough, and cold from 1990 to 2021, and analyse the overall costs of asthma and severe COPD from 1996 to 2018.</p><p>Since 1988, the <i>Social Insurance Institution of Finland</i> (SII) and the <i>Finnish Medicines Agency</i> (Fimea) have jointly published the <i>Finnish Statistics on Medicine</i> (FSM), which includes all medications purchased in Finland.<span><sup>8</sup></span></p><p>For sales statistics, medications are listed according to the <i>Anatomical Therapeutic Chemical</i> groups (R, Respiratory system).<span><sup>9</sup></span> We report medication consumption for asthma and COPD (R03; inhaled (R03A-B), systemic (R03DC), and molecular targeted medications (R03DX05, R03DX08–10)), nasal preparations (R01), systemic antihistamines (R06), and medications for cough and cold (R05; such as expectorants (R05C) and cough suppressants (R05D)).<span><sup>9</sup></span></p><p>Medication consumption was followed using the unit <i>Defined Daily Doses</i> (DDD/1000 population/day) in the Finnish nationwide registries (FSM, SII). The results are presented as annual time series.</p><p>Cost analysis was made for asthma and severe COPD comparably to our previous work (data 1996–2018).<span><sup>4</sup></span> This included only those individuals entitled to special reimbursed medication (same criterions 1996–2018).<span><sup>4</sup></span></p><p>The population of Finland was accessed from <i>Statistics Finland,</i> and it increased from 5.0 million in 1990 to 5.5 million in 2021 (+10%).</p><p>Respiratory medications consumption increased from 98 in 1996 to 200 DDD/1000/
{"title":"Real-world drug use in asthma, chronic obstructive pulmonary disease, rhinitis, cough, and cold in Finland from 1990 to 2021: Association with reduced disease burden","authors":"Tiina Mattila, Vesa Jormanainen, Marina Erhola, Tuula Vasankari, Sanna Toppila-Salmi, Fredrik Herse, Riikka-Leena Leskelä, Tari Haahtela","doi":"10.1002/clt2.12340","DOIUrl":"10.1002/clt2.12340","url":null,"abstract":"<p>Asthma, chronic obstructive pulmonary disease (COPD), and allergic rhinitis are major long-term airway diseases.<span><sup>1-5</sup></span> Asthma appears in all age groups and COPD causes major morbidity and mortality particularly in smokers.<span><sup>1, 2, 5</sup></span> Allergic rhinitis and other allergic conditions are often associated with asthma.<span><sup>3, 4, 6</sup></span></p><p>In Finland, three nationwide respiratory programmes have been implemented since 1994: the Asthma Programme (1994–2004), the COPD Programme (1998–2007), and the Allergy Programme (2008–2018).<span><sup>4, 6</sup></span> After the 1990s, the burden of asthma, COPD, and allergic conditions has decreased and the prevalence has stabilised.<span><sup>4, 6</sup></span> Smoking has also decreased.<span><sup>7</sup></span></p><p>International guidelines are available for asthma (since 1995), COPD (since 1997), and chronic rhinitis (since 2005).<span><sup>1-3</sup></span></p><p>Inhaled short- and long-acting β2 adrenoceptor agonists (LABA), muscarinic receptor antagonists (LAMA), and corticosteroids (ICS) have been used for first-line treatment in asthma and COPD since the 1990s.<span><sup>1, 2, 4, 8</sup></span> Intranasal corticosteroids have been used in rhinitis for decades.<span><sup>3</sup></span></p><p>In the present study, we present consumption (sales) data of medication for asthma, COPD, rhinitis, cough, and cold from 1990 to 2021, and analyse the overall costs of asthma and severe COPD from 1996 to 2018.</p><p>Since 1988, the <i>Social Insurance Institution of Finland</i> (SII) and the <i>Finnish Medicines Agency</i> (Fimea) have jointly published the <i>Finnish Statistics on Medicine</i> (FSM), which includes all medications purchased in Finland.<span><sup>8</sup></span></p><p>For sales statistics, medications are listed according to the <i>Anatomical Therapeutic Chemical</i> groups (R, Respiratory system).<span><sup>9</sup></span> We report medication consumption for asthma and COPD (R03; inhaled (R03A-B), systemic (R03DC), and molecular targeted medications (R03DX05, R03DX08–10)), nasal preparations (R01), systemic antihistamines (R06), and medications for cough and cold (R05; such as expectorants (R05C) and cough suppressants (R05D)).<span><sup>9</sup></span></p><p>Medication consumption was followed using the unit <i>Defined Daily Doses</i> (DDD/1000 population/day) in the Finnish nationwide registries (FSM, SII). The results are presented as annual time series.</p><p>Cost analysis was made for asthma and severe COPD comparably to our previous work (data 1996–2018).<span><sup>4</sup></span> This included only those individuals entitled to special reimbursed medication (same criterions 1996–2018).<span><sup>4</sup></span></p><p>The population of Finland was accessed from <i>Statistics Finland,</i> and it increased from 5.0 million in 1990 to 5.5 million in 2021 (+10%).</p><p>Respiratory medications consumption increased from 98 in 1996 to 200 DDD/1000/","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12340","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rafael José Vieira, Ana Margarida Pereira, Luís Taborda-Barata, Frederico S. Regateiro, Manuel Marques-Cruz, Carlos Robalo Cordeiro, Cláudia Chaves Loureiro, Ignacio J. Dávila, Jean Bousquet, João A. Fonseca, Bernardo Sousa-Pinto
Background
Asthma presents a significant health challenge, imposing a considerable burden on healthcare services. Discrepancies in asthma-related hospitalisations may reflect underlying health disparities. We aimed to analyse inequities in asthma hospital admissions in mainland Portugal and Spain, from a regional perspective and considering sex and age.
Methods
We conducted a retrospective study using data from the Spanish and Portuguese national hospitalisations databases. We calculated crude national and regional yearly hospitalisation rates according per Nomenclature of Territorial Units for Statistics region. Additionally, we calculated hospitalisation rates adjusted for asthma prevalence and the female-to-male ratio in asthma hospital admissions per age group, considering the female-to-male ratio in the overall population.
Results
Between 2012 and 2016, there were 92,084 asthma hospital admissions in mainland Spain and 7717 in mainland Portugal. There was a trend for a higher-than-average rate of asthma-related hospitalisations in the Northern regions of both countries. Women had a hospitalisation rate that was 3.2 times higher than men. Age was associated with higher risk for asthma hospitalisation, with individuals aged 65 and older displaying a hospitalisation rate 4.5 times higher than those under 65. Additionally, while hospitalisations in women aged <65 years were 2.3 times more likely than in men of the same age, hospitalisations in women aged ≥65 years were 3.5 times higher than in men aged ≥65 years.
Conclusion
This study suggests that marked regional inequities in asthma hospital admissions exist in Spain and Portugal. Additionally, women are particularly at risk of hospitalisation due to asthma, and such risk increases with age.
{"title":"Regional, sex, and age inequities in asthma hospital admissions in Spain and Portugal","authors":"Rafael José Vieira, Ana Margarida Pereira, Luís Taborda-Barata, Frederico S. Regateiro, Manuel Marques-Cruz, Carlos Robalo Cordeiro, Cláudia Chaves Loureiro, Ignacio J. Dávila, Jean Bousquet, João A. Fonseca, Bernardo Sousa-Pinto","doi":"10.1002/clt2.12349","DOIUrl":"10.1002/clt2.12349","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Asthma presents a significant health challenge, imposing a considerable burden on healthcare services. Discrepancies in asthma-related hospitalisations may reflect underlying health disparities. We aimed to analyse inequities in asthma hospital admissions in mainland Portugal and Spain, from a regional perspective and considering sex and age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective study using data from the Spanish and Portuguese national hospitalisations databases. We calculated crude national and regional yearly hospitalisation rates according per Nomenclature of Territorial Units for Statistics region. Additionally, we calculated hospitalisation rates adjusted for asthma prevalence and the female-to-male ratio in asthma hospital admissions per age group, considering the female-to-male ratio in the overall population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 2012 and 2016, there were 92,084 asthma hospital admissions in mainland Spain and 7717 in mainland Portugal. There was a trend for a higher-than-average rate of asthma-related hospitalisations in the Northern regions of both countries. Women had a hospitalisation rate that was 3.2 times higher than men. Age was associated with higher risk for asthma hospitalisation, with individuals aged 65 and older displaying a hospitalisation rate 4.5 times higher than those under 65. Additionally, while hospitalisations in women aged <65 years were 2.3 times more likely than in men of the same age, hospitalisations in women aged ≥65 years were 3.5 times higher than in men aged ≥65 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggests that marked regional inequities in asthma hospital admissions exist in Spain and Portugal. Additionally, women are particularly at risk of hospitalisation due to asthma, and such risk increases with age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140329726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth I. Adesanya, Alasdair Henderson, Joseph F. Hayes, Alexandra Lewin, Rohini Mathur, Amy Mulick, Caroline Morton, Catherine Smith, Sinéad M. Langan, Kathryn E. Mansfield
Background
Evidence demonstrates that individuals with atopic eczema (eczema) have increased depression and anxiety; however, the role of ethnicity in these associations is poorly understood. We aimed to investigate whether associations between eczema and depression or anxiety differed between adults from white and minority ethnic groups in the UK.
Methods
We used UK Clinical Practice Research Datalink GOLD to conduct matched cohort studies of adults (≥18 years) with ethnicity recorded in primary care electronic health records (April 2006-January 2020). We matched (age, sex, practice) adults with eczema to up to five adults without. We used stratified Cox regression with an interaction between eczema and ethnicity, to estimate hazard ratios (HRs) for associations between eczema and incident depression and anxiety in individuals from white ethnic groups and a pooled minority ethnic group (adults from Black, South Asian, Mixed and Other groups).
Results
We identified separate cohorts for depression (215,073 with eczema matched to 646,539 without) and anxiety (242,598 with eczema matched to 774,113 without). After adjusting for matching variables and potential confounders (age, sex, practice, deprivation, calendar period), we found strong evidence (p < 0.01) of ethnic differences in associations between eczema and depression (minority ethnic groups: HR = 1.33, 95% CI = 1.22,1.45; white ethnic groups: HR = 1.15, 95% CI = 1.12,1.17) and anxiety (minority ethnic groups: HR = 1.41, 95% CI = 1.28,1.55; white ethnic groups: HR = 1.17, 95% CI = 1.14,1.19).
Conclusions
Adults with eczema from minority ethnic groups appear to be at increased depression and anxiety risk compared with their white counterparts. Culturally adapted mental health promotion and prevention strategies should be considered in individuals with eczema from minority ethnic groups.
{"title":"Ethnic differences in depression and anxiety among adults with atopic eczema: Population-based matched cohort studies within UK primary care","authors":"Elizabeth I. Adesanya, Alasdair Henderson, Joseph F. Hayes, Alexandra Lewin, Rohini Mathur, Amy Mulick, Caroline Morton, Catherine Smith, Sinéad M. Langan, Kathryn E. Mansfield","doi":"10.1002/clt2.12348","DOIUrl":"10.1002/clt2.12348","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Evidence demonstrates that individuals with atopic eczema (eczema) have increased depression and anxiety; however, the role of ethnicity in these associations is poorly understood. We aimed to investigate whether associations between eczema and depression or anxiety differed between adults from white and minority ethnic groups in the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used UK Clinical Practice Research Datalink GOLD to conduct matched cohort studies of adults (≥18 years) with ethnicity recorded in primary care electronic health records (April 2006-January 2020). We matched (age, sex, practice) adults with eczema to up to five adults without. We used stratified Cox regression with an interaction between eczema and ethnicity, to estimate hazard ratios (HRs) for associations between eczema and incident depression and anxiety in individuals from white ethnic groups and a pooled minority ethnic group (adults from Black, South Asian, Mixed and Other groups).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified separate cohorts for depression (215,073 with eczema matched to 646,539 without) and anxiety (242,598 with eczema matched to 774,113 without). After adjusting for matching variables and potential confounders (age, sex, practice, deprivation, calendar period), we found strong evidence (<i>p</i> < 0.01) of ethnic differences in associations between eczema and depression (minority ethnic groups: HR = 1.33, 95% CI = 1.22,1.45; white ethnic groups: HR = 1.15, 95% CI = 1.12,1.17) and anxiety (minority ethnic groups: HR = 1.41, 95% CI = 1.28,1.55; white ethnic groups: HR = 1.17, 95% CI = 1.14,1.19).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adults with eczema from minority ethnic groups appear to be at increased depression and anxiety risk compared with their white counterparts. Culturally adapted mental health promotion and prevention strategies should be considered in individuals with eczema from minority ethnic groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anne-Lotte Redel, Wojciech Feleszko, Alessandra Arcolaci, Francesca Cefaloni, Marina Atanaskovic-Markovic, Gert-Jan Braunstahl, Cristina Boccabella, Matteo Bonini, Aspasia Karavelia, Eefje Louwers, Norbert Mülleneisen, Liam O'Mahony, Laura Pini, Anna Rapiejko, Esmeralda Shehu, Milena Sokolowska, Eva Untersmayr, Gerdien Tramper-Stranders, EAACI Task Force on Conscious and Rational use of Antibiotics in Allergic Diseases
Introduction
Guidelines recommend treating asthma exacerbations (AAEs) with bronchodilators combined with inhaled and/or systemic corticosteroids. Indications for antibiotic prescriptions for AAEs are usually not incorporated although the literature shows antibiotics are frequently prescribed.
Aim
To investigate the antibiotic prescription rates in AAEs and explore the possible determining factors of those practices.
Methods
A digital survey was created to determine the antibiotic prescription rates in AAEs and the influencing factors for the prescription practices. The survey was distributed among European academy of allergy and clinical immunology (EAACI) members by mass emailing and through regional/national societies in the Netherlands, Italy, Greece, and Poland. Furthermore, we retrieved local antibiotic prescription rates.
Results
In total, 252 participants completed the survey. Respondents stated that there is a lack of guidelines to prescribe antibiotics in AAEs. The median antibiotic prescription rate in this study was 19% [IQR: 0%–40%] and was significantly different between 4 professions: paediatrics 0% [IQR: 0%–37%], pulmonologists 25% [IQR: 10%–50%], general practitioners 25% [IQR: 0%–50%], and allergologists 17% [IQR: 0%–33%]) (p = 0.046). Additional diagnostic tests were performed in 71.4% of patients before prescription and the most common antibiotic classes prescribed were macrolides (46.0%) and penicillin (42.9%). Important clinical factors for health care providers to prescribe antibiotics were colorised/purulent sputum, abnormal lung sounds during auscultation, fever, and presence of comorbidities.
Conclusion
In 19% of patients with AAEs, antibiotics were prescribed in various classes with a broad range among different subspecialities. This study stresses the urgency to compose evidence-based guidelines to aim for more rational antibiotic prescriptions for AAE.
{"title":"A survey study on antibiotic prescription practices for acute asthma exacerbations: An European academy of allergy and clinical immunology task force report","authors":"Anne-Lotte Redel, Wojciech Feleszko, Alessandra Arcolaci, Francesca Cefaloni, Marina Atanaskovic-Markovic, Gert-Jan Braunstahl, Cristina Boccabella, Matteo Bonini, Aspasia Karavelia, Eefje Louwers, Norbert Mülleneisen, Liam O'Mahony, Laura Pini, Anna Rapiejko, Esmeralda Shehu, Milena Sokolowska, Eva Untersmayr, Gerdien Tramper-Stranders, EAACI Task Force on Conscious and Rational use of Antibiotics in Allergic Diseases","doi":"10.1002/clt2.12345","DOIUrl":"10.1002/clt2.12345","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Guidelines recommend treating asthma exacerbations (AAEs) with bronchodilators combined with inhaled and/or systemic corticosteroids. Indications for antibiotic prescriptions for AAEs are usually not incorporated although the literature shows antibiotics are frequently prescribed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate the antibiotic prescription rates in AAEs and explore the possible determining factors of those practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A digital survey was created to determine the antibiotic prescription rates in AAEs and the influencing factors for the prescription practices. The survey was distributed among European academy of allergy and clinical immunology (EAACI) members by mass emailing and through regional/national societies in the Netherlands, Italy, Greece, and Poland. Furthermore, we retrieved local antibiotic prescription rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 252 participants completed the survey. Respondents stated that there is a lack of guidelines to prescribe antibiotics in AAEs. The median antibiotic prescription rate in this study was 19% [IQR: 0%–40%] and was significantly different between 4 professions: paediatrics 0% [IQR: 0%–37%], pulmonologists 25% [IQR: 10%–50%], general practitioners 25% [IQR: 0%–50%], and allergologists 17% [IQR: 0%–33%]) (<i>p</i> = 0.046). Additional diagnostic tests were performed in 71.4% of patients before prescription and the most common antibiotic classes prescribed were macrolides (46.0%) and penicillin (42.9%). Important clinical factors for health care providers to prescribe antibiotics were colorised/purulent sputum, abnormal lung sounds during auscultation, fever, and presence of comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In 19% of patients with AAEs, antibiotics were prescribed in various classes with a broad range among different subspecialities. This study stresses the urgency to compose evidence-based guidelines to aim for more rational antibiotic prescriptions for AAE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12345","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The incidence of atopic dermatitis (AD) in children is increasing. Early exposure to stress factors may be associated with the AD development. This study aimed to summarize studies that reported an association between stress exposure and AD development in later life.
Methods and findings
A comprehensive literature search was performed using online databases (PubMed, EMBASE, PsycINFO, and Web of Science) for articles published up to May 1, 2023. Eligible studies were screened and selected based on the inclusion criteria. We incorporated cohort or case-control studies published in English which explored the relationship between stress experienced by parents or children and AD. The pooled odds ratio (OR) was calculated according to the type of stress using a random-effects model. Twenty-two studies were included. AD was related to maternal distress (OR 1.29, 95% Confidence Interval [CI]: 1.13–1.47), maternal anxiety (OR 1.31, 95% CI: 1.18–1.46), and negative life events (OR 2.00, 95% CI: 1.46–2.76). Maternal depression during pregnancy was associated with AD (OR 1.21, 95% CI: 1.09–1.33), whereas no significant association was found for postpartum depression. Research on stress experienced by paternal or children is scare.
Conclusions
Early maternal stress may potentially elevate the risk of AD in their offspring. Importantly, rigorously designed studies are required to corroborate the link between maternal stress and AD in children. These studies should aim to gather insights about the impact of stress during specific trimesters of pregnancy, postnatal stress, and paternal stress, and to identify potential prevention strategies.
{"title":"Early exposure to maternal stress and risk for atopic dermatitis in children: A systematic review and meta-analysis","authors":"Yuan Ai, Jichong Huang, Ting Ting Zhu","doi":"10.1002/clt2.12346","DOIUrl":"10.1002/clt2.12346","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The incidence of atopic dermatitis (AD) in children is increasing. Early exposure to stress factors may be associated with the AD development. This study aimed to summarize studies that reported an association between stress exposure and AD development in later life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and findings</h3>\u0000 \u0000 <p>A comprehensive literature search was performed using online databases (PubMed, EMBASE, PsycINFO, and Web of Science) for articles published up to May 1, 2023. Eligible studies were screened and selected based on the inclusion criteria. We incorporated cohort or case-control studies published in English which explored the relationship between stress experienced by parents or children and AD. The pooled odds ratio (OR) was calculated according to the type of stress using a random-effects model. Twenty-two studies were included. AD was related to maternal distress (OR 1.29, 95% Confidence Interval [CI]: 1.13–1.47), maternal anxiety (OR 1.31, 95% CI: 1.18–1.46), and negative life events (OR 2.00, 95% CI: 1.46–2.76). Maternal depression during pregnancy was associated with AD (OR 1.21, 95% CI: 1.09–1.33), whereas no significant association was found for postpartum depression. Research on stress experienced by paternal or children is scare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early maternal stress may potentially elevate the risk of AD in their offspring. Importantly, rigorously designed studies are required to corroborate the link between maternal stress and AD in children. These studies should aim to gather insights about the impact of stress during specific trimesters of pregnancy, postnatal stress, and paternal stress, and to identify potential prevention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12346","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140130923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maryam Jafari, Eduardo I. Cardenas, Sandra Ekstedt, Julia Arebro, Marianne Petro, Agnetha Karlsson, Eric Hjalmarsson, Daniel Arnarson, Monika Ezerskyte, Susanna Kumlien Georén, Lars Olaf Cardell
<p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory disease of the sinonasal mucosa that is often accompanied by local <i>Staphylococcus aureus</i> colonization,<span><sup>1</sup></span> as well as comorbid asthma.<span><sup>2</sup></span> Although both CRSwNP and asthma are associated with a type 2 inflammatory profile, a growing body of literature indicates that neutrophils can also contribute to the pathophysiology of these diseases. For instance, shedding of CD62L (L-selectin) is commonly used as a marker of neutrophil activation,<span><sup>3</sup></span> and we have previously shown that neutrophils isolated from nasal polyps of patients with CRSwNP are characterized by low CD62L and high CD16 (FcγRIII) surface expression.<span><sup>4</sup></span> Moreover, we have also shown that inhaled allergen provocation results in CD62L shedding in circulating neutrophils from patients with allergic asthma.<span><sup>5</sup></span> However, the response of circulating neutrophils to bacterial stimuli has not been characterized in patients with both CRSwNP and asthma in comparison with healthy controls.</p><p>In this study, we isolated blood neutrophils from 19 patients with CRSwNP and comorbid asthma, as well as 20 healthy controls, and assessed their phenotype at baseline and in response to <i>S. aureus</i> enterotoxin A (SEA). A detailed description of the methods used can be found in Supporting Information S1, and the main characteristics of all study participants are summarized in Table 1. Freshly isolated blood neutrophils from healthy controls and patients with CRSwNP and comorbid asthma had a similar baseline surface expression of CD62L and CD16 (Figure S1), which confirms our previous findings in other cohorts of patients with CRSwNP or asthma.<span><sup>4, 5</sup></span> Notably, most patients included in our study received inhaled corticosteroids (ICS) (Table S1), and a previous study suggests that ICS can impact the baseline surface expression of CD62L in unstimulated neutrophils.<span><sup>6</sup></span> Nevertheless, the study by Pasternak et al. also determined that ICS have no impact on CD62L expression when administered via active inhaler, and our patients received ICS exclusively via active inhaler.</p><p>Interestingly, in vitro stimulation with SEA for 2 h resulted in a marked decrease in CD62L surface expression in neutrophils from healthy controls, but not in neutrophils from patients with CRSwNP and asthma (Figure 1A,B). No significant changes in the neutrophil activation markers CD11b, CD66b or IL-1β were detected in either study group at this timepoint (Figure S2). Nevertheless, neutrophils from both study groups had a similar decrease in CD62L surface expression 4 h post-stimulation (Figure 1C,D), as well as a similar increase in CD66b surface expression at this timepoint (Figure S3A–C). In addition, neutrophils from healthy controls had an increase in CD11b and IL-1β expression 4 h post-stimulation, while ne
Maryam Jafari、Sandra Ekstedt、Eric Hjalmarsson、Monika Ezerskyte、Susanna Kumlien Georén和Lars Olaf Cardell设计了研究大纲。Maryam Jafari、Julia Arebro、Marianne Petro、Agnetha Karlsson 和 Daniel Arnarson 收集了患者材料。Maryam Jafari、Sandra Ekstedt 和 Marianne Petro 进行了中性粒细胞刺激和流式细胞仪评估。玛丽亚姆-贾法里和爱德华多-卡德纳斯（Eduardo I. Cardenas）对收集到的数据进行了分析和汇编，并进行了所有统计分析。Maryam Jafari、Eduardo I. Cardenas、Eric Hjalmarsson 和 Lars Olaf Cardell 起草了原稿，所有作者都阅读并审阅了原稿。所有作者都对文章做出了贡献，并批准了提交的版本。作者声明没有利益冲突。
{"title":"Delayed neutrophil shedding of CD62L in patients with chronic rhinosinusitis with nasal polyps and asthma: Implications for Staphylococcus aureus colonization and corticosteroid treatment","authors":"Maryam Jafari, Eduardo I. Cardenas, Sandra Ekstedt, Julia Arebro, Marianne Petro, Agnetha Karlsson, Eric Hjalmarsson, Daniel Arnarson, Monika Ezerskyte, Susanna Kumlien Georén, Lars Olaf Cardell","doi":"10.1002/clt2.12347","DOIUrl":"10.1002/clt2.12347","url":null,"abstract":"<p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory disease of the sinonasal mucosa that is often accompanied by local <i>Staphylococcus aureus</i> colonization,<span><sup>1</sup></span> as well as comorbid asthma.<span><sup>2</sup></span> Although both CRSwNP and asthma are associated with a type 2 inflammatory profile, a growing body of literature indicates that neutrophils can also contribute to the pathophysiology of these diseases. For instance, shedding of CD62L (L-selectin) is commonly used as a marker of neutrophil activation,<span><sup>3</sup></span> and we have previously shown that neutrophils isolated from nasal polyps of patients with CRSwNP are characterized by low CD62L and high CD16 (FcγRIII) surface expression.<span><sup>4</sup></span> Moreover, we have also shown that inhaled allergen provocation results in CD62L shedding in circulating neutrophils from patients with allergic asthma.<span><sup>5</sup></span> However, the response of circulating neutrophils to bacterial stimuli has not been characterized in patients with both CRSwNP and asthma in comparison with healthy controls.</p><p>In this study, we isolated blood neutrophils from 19 patients with CRSwNP and comorbid asthma, as well as 20 healthy controls, and assessed their phenotype at baseline and in response to <i>S. aureus</i> enterotoxin A (SEA). A detailed description of the methods used can be found in Supporting Information S1, and the main characteristics of all study participants are summarized in Table 1. Freshly isolated blood neutrophils from healthy controls and patients with CRSwNP and comorbid asthma had a similar baseline surface expression of CD62L and CD16 (Figure S1), which confirms our previous findings in other cohorts of patients with CRSwNP or asthma.<span><sup>4, 5</sup></span> Notably, most patients included in our study received inhaled corticosteroids (ICS) (Table S1), and a previous study suggests that ICS can impact the baseline surface expression of CD62L in unstimulated neutrophils.<span><sup>6</sup></span> Nevertheless, the study by Pasternak et al. also determined that ICS have no impact on CD62L expression when administered via active inhaler, and our patients received ICS exclusively via active inhaler.</p><p>Interestingly, in vitro stimulation with SEA for 2 h resulted in a marked decrease in CD62L surface expression in neutrophils from healthy controls, but not in neutrophils from patients with CRSwNP and asthma (Figure 1A,B). No significant changes in the neutrophil activation markers CD11b, CD66b or IL-1β were detected in either study group at this timepoint (Figure S2). Nevertheless, neutrophils from both study groups had a similar decrease in CD62L surface expression 4 h post-stimulation (Figure 1C,D), as well as a similar increase in CD66b surface expression at this timepoint (Figure S3A–C). In addition, neutrophils from healthy controls had an increase in CD11b and IL-1β expression 4 h post-stimulation, while ne","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12347","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140093518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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