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(Suppl 1):A1Background Asthma is the most common chronic respiratory disease in childhood. However, it is quite difficult to make a prompt diagnosis of asthma in a child 5 years and younger, partly due to a lack of objective diagnostic means. Our previous studies on susceptibility gene of asthma showed that a gene-gene interaction among 4 single nucleotide polymorphisms including IL13 rs20541 and IL4 rs2243250, ADRB2 rs1042713 and FcER1B rs569108 had a predictable role for asthma in wheezing children. Objective The study was aimed to further investigate the predictive effects of the four-loci interaction model in Chinese preschool children with asthma. Methods A total of 212 wheezing children aged 6 months to 5 years were enrolled and followed up for at least one year at Shanghai Xinhua Hospital between Dec 2014 and Mar 2016. Clinical data and lab findings of atopy were collected. All the children were divided into the high-risk group and the low-risk group according to genotypes of the four-loci interaction model. The differences of clinical features were compared between the two groups. The predictive effects for asthma were analyzed among asthma predictive index (API), 2015 Canadian Diagnostic Criteria for Asthma in Preschoolers and our four-loci interaction model. Results Of all the enrolled 212 children, 117 (55.2%) were assigned into the high-risk group and 95 (44.8%) were the low-risk group. Compared with the low-risk group, the high-risk group had more yearly episodes of wheeze and a higher level of blood eosinophilia. More children in the high-risk group presented with afebrile wheeze, eczema and positive food or aero allergens and had a history of tobacco exposure. If the asthma-predictive effect of positive API was considered as 1, the four-loci interaction model had a sensitivity of 77.2%, a specificity of 80.0% and an AUC area of 0.786 with a modest consistency (P=0.22, Kappa=0.49), while the Canadian criteria had a sensitivity of 97.8%, a specificity of 53.3% and an AUC area of 0.539 with a low consistency (P<0.01, Kappa=0.265). ConclusionsThe four-loci interaction model is associated with the phenotypes of wheezing in Chinese preschoolers. It has a consistent predictive effect with API for asthma and is more specific than the Canadian criteria in the diagnosis of asthma, which indicates that the four-loci interaction model may be developed as a new objective predictive tool for asthma in Chinese children 5 years and younger. A2Loss of esophageal epithelial SPINK7 unleashes uncontrolled proteolytic activity, impaired epithelial barrier, defective differentiation and pro-inflammatory cytokine production Background Epithelial barrier impairment has been implicated in the development of allergic disease. However, the molecular mechanisms by which impaired epithelial barrier function induces Th2-type immune responses remain largely unknown. In this study, we examined the role of the serine peptidase inhibitor kazal type (SPINK)7 on epithelial barrier function and mucosal Th2-associated immune responses...

IntroductionAmong children, the main postnatal HIV category of exposure is breastfeeding. When acute maternal infection occurs during lactation, the high maternal viral rate results in a higher risk of infant infection. There are few researches showing the impact of HIV infection on children of previously seronegative mothers, who acquire the HIV virus during breastfeeding. To elucidate the importance of this category of exposure, this study aims to evaluate HIV infection in infants assisted by a Paediatric Infectology Service in Brazil, emphasising the cases where vertical transmission occurred lately through breastfeeding.MethodsTransversal, analytical and descriptive study, with quantitative and qualitative approach analysing HIV infected patients from 0 to 16 years old. Data was collected during 2016, from charts of children assisted between 2010 and 2015. After previous selection, breastfed children of mothers who had negative HIV testing during pregnancy and/or at birth, had charts analysed in detail. ResultsFrom a total of 122 cases, 95% were mother-to-child-transmissions. Between these cases, 11 were considered possible/confirmed late postnatal transmission through breastfeeding. This group characterisation showed that at diagnosis, 72,7% presented significant and/or recurrent symptoms of HIV infection. In 45,4%, mother and children were diagnosed at the same time and 72,7% of mothers were sexually infected.ConclusionThere was a significant prevalence of late postnatal transmission through breastfeeding in our sample. Differently from resource limited settings, most countries avoid breastfeeding by HIV infected mothers. Considering cases where women were infected only during lactation, our study highlights a gap in prevention of vertical transmission of HIV. The severity of infant symptoms, the moment of diagnosis and mother’s category of exposure confirm the importance of preventive measures and scientific improvement to reduce postnatal HIV transmission.