Atopic Sensitization and the International Variation of Asthma Symptom Prevalence in Children

Weinmayr, Gudrun; Weiland, Stephan K.; Björkstén, Bengt; Brunekreef, Bert; Büchele, Gisela; Cookson, William; García‐Marcos, Luis; Gotua, Maia; Gratziou, C.; Hage, Marianne van; Mutius, Erika von; Riikjärv, Mall-Anne; Rzehak, Peter; Stein, Renato T.; Strachan, David P.; Tsanakas, John; Wickens, Kristin; Wong, Gary

doi:10.1164/rccm.200607-994oc

Cited by 285 publications

(266 citation statements)

References 43 publications

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“…Asthma is the leading chronic disease among children in most industrialized countries 1 . Approximately 72 80% of children with asthma develop symptoms prior to the fifth birthday 2 .…”

Section: Abbreviations Usedmentioning

confidence: 99%

Reduced breath condensate pH in asymptomatic children with prior wheezing as a risk factor for asthma

Jagwitz

Peßler

Akmatov

et al. 2011

Journal of Allergy and Clinical Immunology

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“…Asthma is the leading chronic disease among children in most industrialized countries 1 . Approximately 72 80% of children with asthma develop symptoms prior to the fifth birthday 2 .…”

Section: Abbreviations Usedmentioning

confidence: 99%

Reduced breath condensate pH in asymptomatic children with prior wheezing as a risk factor for asthma

Jagwitz

Peßler

Akmatov

et al. 2011

Journal of Allergy and Clinical Immunology

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“…La amplia variabilidad de la prevalencia de sensibilización a alérgenos en niños, tanto en poblaciones seleccionadas como a nivel general 11,12 , indica que el ambiente es crucial para determinar la prevalencia y el perfil de sensibilización alérgica en poblaciones humanas. Eso ha sido demostrado por Ronchetti et al 25 , quienes encontraron una alta correlación entre la atopia en niños asmáticos y no asmáticos lo cual sugiere fuertemente que la prevalencia de atopia en el asma depende de factores ambientales que inducen simultáneamente atopia en pacientes asmáticos y en los sujetos no asmáticos.…”

Section: Discussionunclassified

“…El más grande de los estudios internacionales de asma y alergias en la niñez (ISAAC), en su segunda fase, estudió las relaciones entre atopia y síntomas actuales de asma (30 centros en 22 países, TC en 31.759 escolares de 8-12 años), y no encontró correlación entre sensibilización alérgica y síntomas de asma 12 . La fracción de sibilancias en los últimos 12 meses atribuible a sensibilización atópica varió desde 0% en Ankara (Turquía) a 93,8% en Guangzhou (China); también se encontró que en los países desarrollados 41% de los síntomas actuales de asma son atribuibles a la atopia.…”

Section: Discussionunclassified

“…Aunque en la edad pediátrica el asma se asocia con frecuencia a atopia, algunos autores han reportado que su rol en el asma estaría sobreestimado 11 , habiéndose demostrado que la sensibilización a alérgenos comunes no se relaciona con la presencia de síntomas actuales de asma y que la fracción de asma atribuible a atopia varía enormemente entre distintas localidades 12 . Además, varios estudios diseñados para medir asma y atopia en la misma población en diferentes momentos, no han encontrado correlación entre los cambios de prevalencia de asma y atopia, de tal forma que aumentos significativos en el asma no se asociaron con aumentos en la prevalencia de atopia 13,14 y viceversa 15 .…”

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Prevalencia y perfil de sensibilización a aeroalérgenos en 1.199 niños asmáticos: serie consecutiva de casos

et al. 2014

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“…However, sensitization is neither necessary nor sufficient for disease expression 3. Among other contributing mechanisms, the expression of asthma may be in part determined by the T‐cell immunity to inhalant allergens 4.…”

Section: Introductionmentioning

confidence: 99%

Relationship between cytokine expression patterns and clinical outcomes: two population‐based birth cohorts

Prosperi

Simpson

et al. 2015

Clin Experimental Allergy

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SummaryBackgroundModels that incorporate patterns of multiple cytokine responses to allergens, rather than individual cytokine production, may better predict sensitization and asthma.ObjectiveTo characterize the patterns of peripheral blood mononuclear cells’ (PBMCs) cytokine responses to house dust mite (HDM) allergens among children from two population‐based birth cohorts using machine learning techniques.Methods PBMCs collected at 8 years of age from the UK Manchester Asthma and Allergy Study (n = 268) and at 14 years of age from the Australian Raine Study (n = 1374) were cultured with HDM extract (10 μg/ml). Cytokine expression (IL‐13, IL‐5, IFN‐γ, and IL10) was measured in the supernatant. Cytokine patterns were identified using a Gaussian mixture model clustering, and classification stability was assessed by bootstrapping.ResultsA six‐class model indicated complex latent structure of cytokine expression. Based on the characteristics of each class, we designated them as follows: ‘Nonresponders’ (n = 905, 55%); ‘IL‐10 responders’ (n = 49, 3%); ‘IFN‐γ and IL‐13 medium responders’ (n = 56, 3.4%); ‘IL‐13 medium responders’ (n = 351, 21.4%); ‘IL‐5 and IL‐13 medium responders’ (n = 77, 4.7%); and ‘IL‐13 and IL‐5 high responders’ (n = 204, 12.4%). ‘IL‐13 and IL‐5 high responders’ were at much higher risk of HDM sensitization and asthma compared to all other classes, with 88% of children assigned to this class being sensitized and 28.5% having asthma.ConclusionUsing model‐based clustering, we identified several distinct patterns of cytokine response to HDM and observed interplay between cytokine expression level, cytokine patterns (especially IL‐13 and IL‐5), and clinical outcomes. ‘IL‐13 and IL‐5 high responders’ class was strongly associated with HDM sensitization. However, among HDM‐sensitized children, one‐third showed no PBMC response to HDM, and the majority of HDM‐sensitized children did not have asthma or wheeze. Our findings suggest that positive HDM ‘allergy tests’ and asthma are associated with a broad range of immunophenotypes, which may have important implications for the use of cytokine‐targeted treatment approaches.

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Atopic Sensitization and the International Variation of Asthma Symptom Prevalence in Children

Abstract: The link between atopic sensitization and asthma symptoms in children differs strongly between populations and increases with economic development.

Cited by 285 publications

References 43 publications

Reduced breath condensate pH in asymptomatic children with prior wheezing as a risk factor for asthma

Reduced breath condensate pH in asymptomatic children with prior wheezing as a risk factor for asthma

Prevalencia y perfil de sensibilización a aeroalérgenos en 1.199 niños asmáticos: serie consecutiva de casos

Relationship between cytokine expression patterns and clinical outcomes: two population‐based birth cohorts

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