Pub Date : 2024-10-01Epub Date: 2024-06-18DOI: 10.1111/all.16193
Ru-Xin Foong, George Du Toit, Ronald van Ree, Henry T Bahnson, Suzana Radulovic, Jo Craven, Matthew Kwok, Zainab Jama, Serge A Versteeg, Helen A Brough, Kirsty Logan, Michael R Perkin, Carsten Flohr, Gideon Lack, Alexandra F Santos
Background: Various biomarkers are used to define peanut allergy (PA). We aimed to observe changes in PA resolution and persistence over time comparing biomarkers in PA and peanut sensitised but tolerant (PS) children in a population-based cohort.
Methods: Participants were recruited from the EAT and EAT-On studies, conducted across England and Wales, and were exclusively breastfeed babies recruited at 3 months old and followed up until 7-12 years old. Clinical characteristics, skin prick test (SPT), sIgE to peanut and peanut components and mast cell activation tests (MAT) were assessed at 12 months, 36 months and 7-12 years. PA status was determined at the 7-12 year time point.
Results: The prevalence of PA was 2.1% at 7-12 years. Between 3 and 7-12 year, two children developed PA and one outgrew PA. PA children had larger SPT, higher peanut-sIgE, Ara h 2-sIgE and MAT (all p < .001) compared to PS children from 12 months onwards. SPT, peanut-sIgE, Ara h 2-sIgE and MAT between children with persistent PA, new PA, outgrown PA and PS were statistically significant from 12 months onwards (p < .001). Those with persistent PA had SPT, peanut-sIgE and Ara h 2-sIgE that increased over time and MAT which was highest at 36 months. New PA children had increased SPT and peanut-sIgE from 36 months to 7-12 years, but MAT remained low. PS children had low biomarkers across time.
Conclusions: In this cohort, few children outgrow or develop new PA between 36 months and 7-12 years. Children with persistent PA have raised SPT, peanut-sIgE, Ara h 2-sIgE and MAT evident from infancy that consistently increase over time.
背景:各种生物标志物被用于确定花生过敏(PA)。我们的目的是通过比较花生过敏儿童和对花生过敏但有耐受性的儿童(PS)的生物标志物,观察随着时间的推移,PA 的分辨率和持续性的变化:研究对象来自英格兰和威尔士的 EAT 和 EAT-On 研究,均为 3 个月大的纯母乳喂养婴儿,随访至 7-12 岁。分别在婴儿12个月、36个月和7-12岁时对其临床特征、皮肤点刺试验(SPT)、花生和花生成分sIgE以及肥大细胞活化试验(MAT)进行评估。PA 状态在 7-12 岁时进行测定:结果:7-12 岁时 PA 患病率为 2.1%。在 3 岁至 7-12 岁期间,两名儿童出现 PA,一名儿童不再出现 PA。PA 儿童的 SPT 值更高,花生-SIgE、Ara h 2-sIgE 和 MAT 值也更高(均为 p 结论:PA 儿童的 SPT 值更高,花生-SIgE、Ara h 2-sIgE 和 MAT 值也更高):在该队列中,很少有儿童在 36 个月至 7-12 岁期间长出或发展出新的 PA。持续 PA 儿童的 SPT、花生-SIgE、Ara h 2-sIgE 和 MAT 从婴儿期开始就明显升高,并且随着时间的推移持续升高。
{"title":"Biomarkers of peanut allergy in children over time.","authors":"Ru-Xin Foong, George Du Toit, Ronald van Ree, Henry T Bahnson, Suzana Radulovic, Jo Craven, Matthew Kwok, Zainab Jama, Serge A Versteeg, Helen A Brough, Kirsty Logan, Michael R Perkin, Carsten Flohr, Gideon Lack, Alexandra F Santos","doi":"10.1111/all.16193","DOIUrl":"10.1111/all.16193","url":null,"abstract":"<p><strong>Background: </strong>Various biomarkers are used to define peanut allergy (PA). We aimed to observe changes in PA resolution and persistence over time comparing biomarkers in PA and peanut sensitised but tolerant (PS) children in a population-based cohort.</p><p><strong>Methods: </strong>Participants were recruited from the EAT and EAT-On studies, conducted across England and Wales, and were exclusively breastfeed babies recruited at 3 months old and followed up until 7-12 years old. Clinical characteristics, skin prick test (SPT), sIgE to peanut and peanut components and mast cell activation tests (MAT) were assessed at 12 months, 36 months and 7-12 years. PA status was determined at the 7-12 year time point.</p><p><strong>Results: </strong>The prevalence of PA was 2.1% at 7-12 years. Between 3 and 7-12 year, two children developed PA and one outgrew PA. PA children had larger SPT, higher peanut-sIgE, Ara h 2-sIgE and MAT (all p < .001) compared to PS children from 12 months onwards. SPT, peanut-sIgE, Ara h 2-sIgE and MAT between children with persistent PA, new PA, outgrown PA and PS were statistically significant from 12 months onwards (p < .001). Those with persistent PA had SPT, peanut-sIgE and Ara h 2-sIgE that increased over time and MAT which was highest at 36 months. New PA children had increased SPT and peanut-sIgE from 36 months to 7-12 years, but MAT remained low. PS children had low biomarkers across time.</p><p><strong>Conclusions: </strong>In this cohort, few children outgrow or develop new PA between 36 months and 7-12 years. Children with persistent PA have raised SPT, peanut-sIgE, Ara h 2-sIgE and MAT evident from infancy that consistently increase over time.</p>","PeriodicalId":122,"journal":{"name":"Allergy","volume":null,"pages":null},"PeriodicalIF":12.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141416867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-07-12DOI: 10.1111/all.16208
Girish Hiremath, Yash Choksi, Hernan Correa, Justin Jacobse, Suman R Das, Siyuan Ma, Jeremy A Goettel, Seesandra V Rajagopala
Background: A combination of proton-pump inhibitors (PPI) and topical steroids (TS) is used to treat children with eosinophilic esophagitis (EoE). However, a subset of children do not respond to this combination therapy. We aimed to identify the esophageal transcriptional, cell composition, and microbial differences between the non-responders (EoE-PPI-TSnr; n = 7) and responders (EoE-PPI-TSr; n = 7) to the combination therapy for EoE and controls (n = 9) using metatranscriptomics.
Methods: Differential gene expression analysis was used to identify transcriptional differences, validated using the EoE diagnostic panel (EDP). Deconvolution analysis was performed to identify differences in their cell type composition. Microbiome analysis was conducted from esophageal biopsies RNAseq data, and microbial abundance was correlated with esophageal gene expression.
Results: In all, 3164 upregulated and 3154 downregulated genes distinguished EoE-PPI-TSnr from EoE-PPI-TSr. Eosinophilic inflammatory response, cytokine signaling, and collagen formation pathways were significantly upregulated in EoE-PPI-TSnr. There was a 56% overlap in dysregulated genes between EoE-PPI-TSnr and EDP, with a perfect agreement in the directionality of modulation. Eosinophils, dendritic cells (DCs), immature DCs, megakaryocytic-erythroid progenitors, and T helper type 1 cells were significantly higher in EoE-PPI-TSnr. There was no significant difference in microbiome diversity. The relative abundance of Fusobacterium sp. and Acinetobacter sp. notably differed in EoE-PPI-TSnr and correlated with the key pathways.
Conclusion: Our results provide critical insights into the molecular, cellular, and microbial factors associated with the lack of response to PPI and TS combination therapy in children with EoE. This study advances our understanding of the pathobiology of EoE while guiding personalized treatment strategies.
{"title":"Children with eosinophilic esophagitis non-responsive to combination therapy have distinct esophageal transcriptomic and microbiome profile.","authors":"Girish Hiremath, Yash Choksi, Hernan Correa, Justin Jacobse, Suman R Das, Siyuan Ma, Jeremy A Goettel, Seesandra V Rajagopala","doi":"10.1111/all.16208","DOIUrl":"10.1111/all.16208","url":null,"abstract":"<p><strong>Background: </strong>A combination of proton-pump inhibitors (PPI) and topical steroids (TS) is used to treat children with eosinophilic esophagitis (EoE). However, a subset of children do not respond to this combination therapy. We aimed to identify the esophageal transcriptional, cell composition, and microbial differences between the non-responders (EoE-PPI-TSnr; n = 7) and responders (EoE-PPI-TSr; n = 7) to the combination therapy for EoE and controls (n = 9) using metatranscriptomics.</p><p><strong>Methods: </strong>Differential gene expression analysis was used to identify transcriptional differences, validated using the EoE diagnostic panel (EDP). Deconvolution analysis was performed to identify differences in their cell type composition. Microbiome analysis was conducted from esophageal biopsies RNAseq data, and microbial abundance was correlated with esophageal gene expression.</p><p><strong>Results: </strong>In all, 3164 upregulated and 3154 downregulated genes distinguished EoE-PPI-TSnr from EoE-PPI-TSr. Eosinophilic inflammatory response, cytokine signaling, and collagen formation pathways were significantly upregulated in EoE-PPI-TSnr. There was a 56% overlap in dysregulated genes between EoE-PPI-TSnr and EDP, with a perfect agreement in the directionality of modulation. Eosinophils, dendritic cells (DCs), immature DCs, megakaryocytic-erythroid progenitors, and T helper type 1 cells were significantly higher in EoE-PPI-TSnr. There was no significant difference in microbiome diversity. The relative abundance of Fusobacterium sp. and Acinetobacter sp. notably differed in EoE-PPI-TSnr and correlated with the key pathways.</p><p><strong>Conclusion: </strong>Our results provide critical insights into the molecular, cellular, and microbial factors associated with the lack of response to PPI and TS combination therapy in children with EoE. This study advances our understanding of the pathobiology of EoE while guiding personalized treatment strategies.</p>","PeriodicalId":122,"journal":{"name":"Allergy","volume":null,"pages":null},"PeriodicalIF":12.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Importance of SREBP signaling in controlling lipid metabolism and homeostasis in B cells for future vaccine design.","authors":"Zsófia Unger, Alina Kuklinski, Cristina Gomez-Casado","doi":"10.1111/all.16134","DOIUrl":"10.1111/all.16134","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":null,"pages":null},"PeriodicalIF":12.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-06-08DOI: 10.1111/all.16189
Claus Bachert, Philippe Gevaert, Brian Lipworth, Syed Shahzad Mustafa, Andrew P Lane, Joaquim Mullol, Paul Rowe, Yamo Deniz, Siddhesh Kamat, Asif H Khan, Juby Jacob-Nara, Shahid Siddiqui, Marcella Ruddy, Elizabeth Laws, Jérôme Msihid, Sivan Harel, Alexandre Jagerschmidt, Nikhil Amin, Leda Mannent, Raj Rout
{"title":"Dupilumab efficacy across serum IgE and blood eosinophil levels in chronic rhinosinusitis with nasal polyposis.","authors":"Claus Bachert, Philippe Gevaert, Brian Lipworth, Syed Shahzad Mustafa, Andrew P Lane, Joaquim Mullol, Paul Rowe, Yamo Deniz, Siddhesh Kamat, Asif H Khan, Juby Jacob-Nara, Shahid Siddiqui, Marcella Ruddy, Elizabeth Laws, Jérôme Msihid, Sivan Harel, Alexandre Jagerschmidt, Nikhil Amin, Leda Mannent, Raj Rout","doi":"10.1111/all.16189","DOIUrl":"10.1111/all.16189","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":null,"pages":null},"PeriodicalIF":12.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141292852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-08-04DOI: 10.1111/all.16262
Paxton Loke, Xiaofang Wang, Melanie Lloyd, Sarah E Ashley, Adriana C Lozinsky, Michael Gold, Michael D O'Sullivan, Patrick Quinn, Marnie Robinson, Audrey Dunn Galvin, Francesca Orsini, Mimi L K Tang
Background: Few studies have examined long-term outcomes following oral immunotherapy (OIT); none have examined long-term risks and benefits associated with distinct clinical outcomes (desensitization, remission).
Methods: Participants completing the probiotic and peanut oral immunotherapy (PPOIT) -003 randomized trial were enrolled in a follow-on study, PPOIT-003LT. Peanut ingestion, reactions, and health-related quality of life (HRQOL) were monitored prospectively. Outcomes at 1-year and 2-years post-treatment were examined by treatment group and by post-OIT clinical outcome (remission, desensitization without remission [DWR], allergic).
Results: 86% (151/176) of eligible children enrolled. Post-treatment peanut ingestion at 2-years post-treatment were similar for PPOIT (86.7%) and OIT (78.7%) groups, both higher than placebo (10.3%). Reactions reduced over time for all treatment and clinical outcome groups (PPOIT 31.7% to 23.3%, OIT 37.7% to 19.7%, placebo 13.8% to 6.9%; remission 27.5% to 15.9%; DWR 57.9% to 36.8%; allergic 11.6% to 7%). At 2-years post-treatment, similar proportions of remission and allergic participants reported reactions (RD 0.09 (95%CI -0.03, 0.20), p = .127), whereas more DWR participants reported reactions than remission (remission vs DWR: RD -0.21 (95%CI -0.39; -0.03), p = .02) and allergic (DWR vs allergic: RD 0.30 (95%CI 0.13, 0.47), p = .001) participants. At 2-years post-treatment, 0% remission versus 5.3% DWR versus 2.3% allergic participants reported adrenaline injector usage. Remission participants had significantly greater HRQOL improvement (adjusted for baseline) compared with both DWR (MD -0.54 (95%CI -0.99, -0.10), p = .017) and allergic (MD -0.82 (95%CI -1.25, -0.38), p < .001).
Conclusion: By 2-years post-treatment, remission participants reported fewer reactions, less severe reactions and greater HRQOL improvement compared with DWR and allergic participants, indicating that remission is the patient-preferred treatment outcome over desensitization or remaining allergic.
{"title":"Two-year post-treatment outcomes following peanut oral immunotherapy in the Probiotic and Peanut Oral Immunotherapy-003 Long-Term (PPOIT-003LT) study.","authors":"Paxton Loke, Xiaofang Wang, Melanie Lloyd, Sarah E Ashley, Adriana C Lozinsky, Michael Gold, Michael D O'Sullivan, Patrick Quinn, Marnie Robinson, Audrey Dunn Galvin, Francesca Orsini, Mimi L K Tang","doi":"10.1111/all.16262","DOIUrl":"10.1111/all.16262","url":null,"abstract":"<p><strong>Background: </strong>Few studies have examined long-term outcomes following oral immunotherapy (OIT); none have examined long-term risks and benefits associated with distinct clinical outcomes (desensitization, remission).</p><p><strong>Methods: </strong>Participants completing the probiotic and peanut oral immunotherapy (PPOIT) -003 randomized trial were enrolled in a follow-on study, PPOIT-003LT. Peanut ingestion, reactions, and health-related quality of life (HRQOL) were monitored prospectively. Outcomes at 1-year and 2-years post-treatment were examined by treatment group and by post-OIT clinical outcome (remission, desensitization without remission [DWR], allergic).</p><p><strong>Results: </strong>86% (151/176) of eligible children enrolled. Post-treatment peanut ingestion at 2-years post-treatment were similar for PPOIT (86.7%) and OIT (78.7%) groups, both higher than placebo (10.3%). Reactions reduced over time for all treatment and clinical outcome groups (PPOIT 31.7% to 23.3%, OIT 37.7% to 19.7%, placebo 13.8% to 6.9%; remission 27.5% to 15.9%; DWR 57.9% to 36.8%; allergic 11.6% to 7%). At 2-years post-treatment, similar proportions of remission and allergic participants reported reactions (RD 0.09 (95%CI -0.03, 0.20), p = .127), whereas more DWR participants reported reactions than remission (remission vs DWR: RD -0.21 (95%CI -0.39; -0.03), p = .02) and allergic (DWR vs allergic: RD 0.30 (95%CI 0.13, 0.47), p = .001) participants. At 2-years post-treatment, 0% remission versus 5.3% DWR versus 2.3% allergic participants reported adrenaline injector usage. Remission participants had significantly greater HRQOL improvement (adjusted for baseline) compared with both DWR (MD -0.54 (95%CI -0.99, -0.10), p = .017) and allergic (MD -0.82 (95%CI -1.25, -0.38), p < .001).</p><p><strong>Conclusion: </strong>By 2-years post-treatment, remission participants reported fewer reactions, less severe reactions and greater HRQOL improvement compared with DWR and allergic participants, indicating that remission is the patient-preferred treatment outcome over desensitization or remaining allergic.</p>","PeriodicalId":122,"journal":{"name":"Allergy","volume":null,"pages":null},"PeriodicalIF":12.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141887617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-09-03DOI: 10.1111/all.16312
Peter Bager, Jan Wohlfahrt, Mads Melbye
{"title":"Reply to correspondence: \"The effectiveness of pollen allergen immunotherapy on allergic rhinitis over 18 years: A national cohort study in Denmark\".","authors":"Peter Bager, Jan Wohlfahrt, Mads Melbye","doi":"10.1111/all.16312","DOIUrl":"10.1111/all.16312","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":null,"pages":null},"PeriodicalIF":12.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-05-07DOI: 10.1111/all.16147
D Stölzl, N Sander, D Siegels, I Harder, B Kind, M Fonfara, L Heinrich, Hagen Ott, S Abraham, I Neustädter, A Kleinheinz, S Gerdes, A Wollenberg, S Lau, K Nemat, A Heratizadeh, I Gellhaus, T Werfel, J Schmitt, S Weidinger
{"title":"Clinical and molecular response to dupilumab treatment in pediatric atopic dermatitis: Results of the German TREATkids registry.","authors":"D Stölzl, N Sander, D Siegels, I Harder, B Kind, M Fonfara, L Heinrich, Hagen Ott, S Abraham, I Neustädter, A Kleinheinz, S Gerdes, A Wollenberg, S Lau, K Nemat, A Heratizadeh, I Gellhaus, T Werfel, J Schmitt, S Weidinger","doi":"10.1111/all.16147","DOIUrl":"10.1111/all.16147","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":null,"pages":null},"PeriodicalIF":12.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-07-07DOI: 10.1111/all.16224
Orianne Dumas, Nicole Le Moual
{"title":"Correspondence: \"The impact of indoor pollution on asthma-related outcomes: A systematic review for the EAACI guidelines on environmental science for allergic diseases and asthma\".","authors":"Orianne Dumas, Nicole Le Moual","doi":"10.1111/all.16224","DOIUrl":"10.1111/all.16224","url":null,"abstract":"","PeriodicalId":122,"journal":{"name":"Allergy","volume":null,"pages":null},"PeriodicalIF":12.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-07-10DOI: 10.1111/all.16184
Jennifer L Perret, N Sabrina Idrose, E Haydn Walters, Dinh S Bui, Adrian J Lowe, Caroline J Lodge, Anne R Fernandez, Vivian Yao, Iain Feather, Xiao-Wen Zeng, Bruce R Thompson, Bircan Erbas, Michael J Abramson, Shyamali C Dharmage
Introduction: Evidence on the early life risk factors of adult CRS, and the history of asthma and allergies across the life course, is limited.
Aim: To investigate relationships between respiratory infective/allergic conditions in childhood, and asthma and allergies across the life course and CRS in middle age.
Methods: Data were from the population-based Tasmanian Longitudinal Health Study (TAHS) cohort, first studied in 1968 when aged 6-7 years (n = 8583) and serially followed into middle age (n = 3609). Using a well-accepted epidemiological definition, participants were assigned a CRS-severity subtype at age 53: no sinusitis/CRS (reference); past doctor diagnosis only; current symptoms without doctor diagnosis; and doctor-diagnosed CRS with current symptoms. Relationships with infective/allergic respiratory illnesses at age 7, and previously published asthma-allergy trajectories from 7 to 53 years, were examined using multinominal regression.
Results: In middle age, 5.8% reported current CRS symptoms with 2.5% doctor-diagnosed. Childhood conditions associated with symptomatic doctor-diagnosed CRS included frequent head colds (multinomial odds ratio [mOR] = 2.04 (95% confidence interval [95% CI]: 1.24, 3.37)), frequent tonsillitis (mOR = 1.61 [95% CI: 1.00, 2.59]) and current childhood asthma (mOR = 2.23 [95% CI: 1.25, 3.98]). Life course trajectories that featured late-onset or persistent asthma and allergies were associated with all CRS subtypes in middle age; early-onset persistent asthma and allergies (mOR = 6.74, 95% CI: 2.76, 16.4); late-onset asthma allergies (mOR = 15.9, 95% CI: 8.06, 31.4), and late-onset hayfever (mOR = 3.02, 95% CI: 1.51, 6.06) were associated with symptomatic doctor-diagnosed CRS.
Conclusion: Current asthma, frequent head colds and tonsillitis at age 7 could signal a susceptible child who is at higher risk for CRS in mid-adult life and who might benefit from closer monitoring and/or proactive management. Concurrent asthma and allergies were strongly associated and are potential treatable traits of adult CRS.
{"title":"Childhood infections, asthma and allergy trajectories, and chronic rhinosinusitis in middle age: A prospective cohort study across six decades.","authors":"Jennifer L Perret, N Sabrina Idrose, E Haydn Walters, Dinh S Bui, Adrian J Lowe, Caroline J Lodge, Anne R Fernandez, Vivian Yao, Iain Feather, Xiao-Wen Zeng, Bruce R Thompson, Bircan Erbas, Michael J Abramson, Shyamali C Dharmage","doi":"10.1111/all.16184","DOIUrl":"10.1111/all.16184","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence on the early life risk factors of adult CRS, and the history of asthma and allergies across the life course, is limited.</p><p><strong>Aim: </strong>To investigate relationships between respiratory infective/allergic conditions in childhood, and asthma and allergies across the life course and CRS in middle age.</p><p><strong>Methods: </strong>Data were from the population-based Tasmanian Longitudinal Health Study (TAHS) cohort, first studied in 1968 when aged 6-7 years (n = 8583) and serially followed into middle age (n = 3609). Using a well-accepted epidemiological definition, participants were assigned a CRS-severity subtype at age 53: no sinusitis/CRS (reference); past doctor diagnosis only; current symptoms without doctor diagnosis; and doctor-diagnosed CRS with current symptoms. Relationships with infective/allergic respiratory illnesses at age 7, and previously published asthma-allergy trajectories from 7 to 53 years, were examined using multinominal regression.</p><p><strong>Results: </strong>In middle age, 5.8% reported current CRS symptoms with 2.5% doctor-diagnosed. Childhood conditions associated with symptomatic doctor-diagnosed CRS included frequent head colds (multinomial odds ratio [mOR] = 2.04 (95% confidence interval [95% CI]: 1.24, 3.37)), frequent tonsillitis (mOR = 1.61 [95% CI: 1.00, 2.59]) and current childhood asthma (mOR = 2.23 [95% CI: 1.25, 3.98]). Life course trajectories that featured late-onset or persistent asthma and allergies were associated with all CRS subtypes in middle age; early-onset persistent asthma and allergies (mOR = 6.74, 95% CI: 2.76, 16.4); late-onset asthma allergies (mOR = 15.9, 95% CI: 8.06, 31.4), and late-onset hayfever (mOR = 3.02, 95% CI: 1.51, 6.06) were associated with symptomatic doctor-diagnosed CRS.</p><p><strong>Conclusion: </strong>Current asthma, frequent head colds and tonsillitis at age 7 could signal a susceptible child who is at higher risk for CRS in mid-adult life and who might benefit from closer monitoring and/or proactive management. Concurrent asthma and allergies were strongly associated and are potential treatable traits of adult CRS.</p>","PeriodicalId":122,"journal":{"name":"Allergy","volume":null,"pages":null},"PeriodicalIF":12.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-08-04DOI: 10.1111/all.16247
Claudia Traidl-Hoffmann, Jamie Afghani, Cezmi A Akdis, Mübecel Akdis, Handan Aydin, Katja Bärenfaller, Heidrun Behrendt, Thomas Bieber, Paul Bigliardi, Mei Bigliardi-Qi, Charlotte Menné Bonefeld, Stefanie Bösch, Marie Charlotte Brüggen, Sebastian Diemert, Hans-Werner Duchna, Martina Fähndrich, Danielle Fehr, Marc Fellmann, Remo Frei, Lena H Garvey, Raschid Gharbo, Mehmet Gökkaya, Karin Grando, Carole Guillet, Erman Guler, Jan Gutermuth, Nadine Herrmann, Dirk Jan Hijnen, Claudia Hülpüsch, Alan D Irvine, Erika Jensen-Jarolim, Heidi H Kong, Hillel Koren, Claudia C V Lang, Roger Lauener, Laura Maintz, Pierre-Yves Mantel, Emanuel Maverakis, Matthias Möhrenschlager, Svenja Müller, Kari Nadeau, Avidan U Neumann, Liam O'Mahony, Fahafahantsoa Rapelanoro Rabenja, Harald Renz, Claudio Rhyner, Ernst Rietschel, Johannes Ring, Caroline Roduit, Mari Sasaki, Mirjam Schenk, Jens Schröder, Dagmar Simon, Hans-Uwe Simon, Milena Sokolowska, Sonja Ständer, Martin Steinhoff, Doris Straub Piccirillo, Alain Taïeb, Roberto Takaoka, Martin Tapparo, Henrique Teixeira, Jacob Pontoppidan Thyssen, Stephan Traidl, Miriam Uhlmann, Willem van de Veen, Marianne van Hage, Christian Virchow, Andreas Wollenberg, Mitamura Yasutaka, Alexander Zink, Peter Schmid-Grendelmeier
The 4th Davos Declaration was developed during the Global Allergy Forum in Davos which aimed to elevate the care of patients with atopic dermatitis (AD) by uniting experts and stakeholders. The forum addressed the high prevalence of AD, with a strategic focus on advancing research, treatment, and management to meet the evolving challenges in the field. This multidisciplinary forum brought together top leaders from research, clinical practice, policy, and patient advocacy to discuss the critical aspects of AD, including neuroimmunology, environmental factors, comorbidities, and breakthroughs in prevention, diagnosis, and treatment. The discussions were geared towards fostering a collaborative approach to integrate these advancements into practical, patient-centric care. The forum underlined the mounting burden of AD, attributing it to significant environmental and lifestyle changes. It acknowledged the progress in understanding AD and in developing targeted therapies but recognized a gap in translating these innovations into clinical practice. Emphasis was placed on the need for enhanced awareness, education, and stakeholder engagement to address this gap effectively and to consider environmental and lifestyle factors in a comprehensive disease management strategy. The 4th Davos Declaration marks a significant milestone in the journey to improve care for people with AD. By promoting a holistic approach that combines research, education, and clinical application, the Forum sets a roadmap for stakeholders to collaborate to improve patient outcomes in AD, reflecting a commitment to adapt and respond to the dynamic challenges of AD in a changing world.
第四届达沃斯宣言是在达沃斯全球过敏论坛期间制定的,该论坛旨在通过联合专家和利益相关方,提升特应性皮炎(AD)患者的护理水平。论坛探讨了特应性皮炎的高发病率问题,其战略重点是推进研究、治疗和管理,以应对该领域不断变化的挑战。这次多学科论坛汇聚了来自研究、临床实践、政策和患者权益倡导等领域的顶级领导者,共同探讨了 AD 的关键问题,包括神经免疫学、环境因素、合并症以及预防、诊断和治疗方面的突破。讨论的目的是促进合作,将这些进展融入以患者为中心的实用护理中。论坛强调了注意力缺失症带来的日益沉重的负担,并将其归因于环境和生活方式的重大改变。论坛承认在了解注意力缺失症和开发针对性疗法方面取得了进展,但也认识到在将这些创新成果转化为临床实践方面还存在差距。宣言强调需要加强认识、教育和利益相关者的参与,以有效弥补这一差距,并在全面的疾病管理战略中考虑环境和生活方式因素。第四届达沃斯宣言是改善对注意力缺失症患者护理的一个重要里程碑。通过推广一种将研究、教育和临床应用相结合的整体方法,论坛为利益相关者制定了合作改善注意力缺失症患者治疗效果的路线图,体现了在不断变化的世界中适应和应对注意力缺失症动态挑战的承诺。
{"title":"Navigating the evolving landscape of atopic dermatitis: Challenges and future opportunities: The 4th Davos declaration.","authors":"Claudia Traidl-Hoffmann, Jamie Afghani, Cezmi A Akdis, Mübecel Akdis, Handan Aydin, Katja Bärenfaller, Heidrun Behrendt, Thomas Bieber, Paul Bigliardi, Mei Bigliardi-Qi, Charlotte Menné Bonefeld, Stefanie Bösch, Marie Charlotte Brüggen, Sebastian Diemert, Hans-Werner Duchna, Martina Fähndrich, Danielle Fehr, Marc Fellmann, Remo Frei, Lena H Garvey, Raschid Gharbo, Mehmet Gökkaya, Karin Grando, Carole Guillet, Erman Guler, Jan Gutermuth, Nadine Herrmann, Dirk Jan Hijnen, Claudia Hülpüsch, Alan D Irvine, Erika Jensen-Jarolim, Heidi H Kong, Hillel Koren, Claudia C V Lang, Roger Lauener, Laura Maintz, Pierre-Yves Mantel, Emanuel Maverakis, Matthias Möhrenschlager, Svenja Müller, Kari Nadeau, Avidan U Neumann, Liam O'Mahony, Fahafahantsoa Rapelanoro Rabenja, Harald Renz, Claudio Rhyner, Ernst Rietschel, Johannes Ring, Caroline Roduit, Mari Sasaki, Mirjam Schenk, Jens Schröder, Dagmar Simon, Hans-Uwe Simon, Milena Sokolowska, Sonja Ständer, Martin Steinhoff, Doris Straub Piccirillo, Alain Taïeb, Roberto Takaoka, Martin Tapparo, Henrique Teixeira, Jacob Pontoppidan Thyssen, Stephan Traidl, Miriam Uhlmann, Willem van de Veen, Marianne van Hage, Christian Virchow, Andreas Wollenberg, Mitamura Yasutaka, Alexander Zink, Peter Schmid-Grendelmeier","doi":"10.1111/all.16247","DOIUrl":"10.1111/all.16247","url":null,"abstract":"<p><p>The 4th Davos Declaration was developed during the Global Allergy Forum in Davos which aimed to elevate the care of patients with atopic dermatitis (AD) by uniting experts and stakeholders. The forum addressed the high prevalence of AD, with a strategic focus on advancing research, treatment, and management to meet the evolving challenges in the field. This multidisciplinary forum brought together top leaders from research, clinical practice, policy, and patient advocacy to discuss the critical aspects of AD, including neuroimmunology, environmental factors, comorbidities, and breakthroughs in prevention, diagnosis, and treatment. The discussions were geared towards fostering a collaborative approach to integrate these advancements into practical, patient-centric care. The forum underlined the mounting burden of AD, attributing it to significant environmental and lifestyle changes. It acknowledged the progress in understanding AD and in developing targeted therapies but recognized a gap in translating these innovations into clinical practice. Emphasis was placed on the need for enhanced awareness, education, and stakeholder engagement to address this gap effectively and to consider environmental and lifestyle factors in a comprehensive disease management strategy. The 4th Davos Declaration marks a significant milestone in the journey to improve care for people with AD. By promoting a holistic approach that combines research, education, and clinical application, the Forum sets a roadmap for stakeholders to collaborate to improve patient outcomes in AD, reflecting a commitment to adapt and respond to the dynamic challenges of AD in a changing world.</p>","PeriodicalId":122,"journal":{"name":"Allergy","volume":null,"pages":null},"PeriodicalIF":12.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141887616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}