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Summary: Background: Allergic sensitization is associated with eczema, asthma, and rhinitis. However, it is unknown whether and how allergic sensitization is associated over time with acquisition, remission, and persistence of these diseases and their comorbidity. Objective: To gain a better understanding of factors including allergic sensitization transitions that influence the temporal pattern of asthma, eczema, and rhinitis and their comorbidity during childhood. Methods: In the Isle of Wight birth cohort, information on allergic sensitization to common allergens was collected at ages 4, 10, and 18 years along with asthma, rhinitis, and eczema status determined by clinical diagnosis. Logistic regressions were used to estimate subsequent and concurrent odds ratios of diseases transition with allergic sensitization transition status as the main independent variable. Two transition periods were considered, 4 to 10 years of age and 10 to 18 years of age. Results: The odds of new diagnosis of allergic disease (no‐yes) was increased among subjects with acquired or persistent allergic sensitization to common allergens compared to subjects with no sensitization (acquisition of sensitization odds ratio [OR]=3.22, P < .0001; persistence of sensitization, OR=6.33, P < .0001). The odds of remission of allergic diseases (yes‐no) was lower among subjects with acquired or sustained allergic sensitization (acquisition, OR=0.18, P = .0001; persistence, OR=0.085, P < .0001), compared to subjects not sensitized. Subjects with acquired or persistent allergic sensitization were also had higher odds for persistence of disease (yes‐yes) than subjects not sensitized (acquisition, OR=5.49, P = .0001; persistence, OR=11.79, P < .0001). Conclusion: Transition of allergic sensitizations to common allergens is a prognostic factor for subsequent or concurrent transition of eczema, asthma, and rhinitis. Prevention or reduction in allergic sensitization has a potential to lead to remission of these conditions. [ABSTRACT FROM AUTHOR]

Background Modes of infant feeding such as direct and indirect breastfeeding, and formula feeding, and their combinations may play a role in child health. Objective The aim was to investigate which feeding patterns in the first 6 months pose risks of eczema/skin allergy in children up to 6 years compared to direct breastfeeding for at least 3 months. Methods The Infant Feeding Practices Study II in the United States and its 6-year follow-up provided data on feeding modes in infancy and doctor's diagnosed eczema/skin allergy in the first 6 years of life (1387 infants), based on parental reports. Different feeding patterns were identified. Log-linear models were used to estimate prevalence ratios ( PRs) of feeding patterns for doctor's diagnosed eczema/skin allergy in the first 6 years of life, adjusting for confounders. Results Compared to 'direct breastfeeding for at least 3 months' ( DBF3m), the combination of 'direct feeding at the breast ( DBF), pumping and feeding breast milk ( BM), and formula ( FF) in the first months' ( DBF/ BM/ FF) showed a statistically significant higher risk of eczema/skin allergy in the first 6 years of life ( PR = 1.46), adjusting for confounders. DBF combined with BM for the first 3 months followed by mixed feeding also had an increased risk ( PR = 1.26), although not statistically significant. Formula feeding introduced since birth had no effect on eczema. Among the confounders, paternal eczema and race/ethnicity (Hispanic vs White) were associated with a higher risk of eczema/skin allergy. Conclusions & Clinical Relevance Mixed infant feeding may carry a higher risk of eczema/skin allergy compared to direct feeding at the breast. The recent epidemic of pumping and feeding in the United States and the use of mixed infant feeding modes requires additional studies to provide appropriate and renewed assessments of the risks of feeding modes for the future development of allergies. [ABSTRACT FROM AUTHOR]

Background Filaggrin gene ( FLG) expression, particularly in the skin, has been linked to the development of the skin barrier and is associated with eczema risk. However, knowledge as to whether FLG expression in umbilical cord blood ( UCB) is associated with eczema development and prediction is lacking. Objective This study sought to assess whether FLG expression in UCB associates with and predicts the development of eczema in infancy. Methods Infants enrolled in a birth cohort study (n=94) were assessed for eczema at ages 3, 6, and 12 months. Five probes measuring FLG transcripts expression in UCB were available from genomewide gene expression profiling. FLG genetic variants R501X, 2282del4, and S3247X were genotyped. Associations were assessed using Poisson regression with robust variance estimation. Area under the curve ( AUC), describing the discriminatory/predictive performance of fitted models, was estimated from logistic regression. Results Increased level of FLG expression measured by probe A_24_P51322 was associated with reduced risk of eczema during the first year of life ( RR=0.60, 95% CI: 0.38-0.95). In contrast, increased level of FLG antisense transcripts measured by probe A_21_P0014075 was associated with increased risk of eczema ( RR=2.02, 95% CI: 1.10-3.72). In prediction models including FLG expression, FLG genetic variants, and sex, discrimination between children who will and will not develop eczema at 3 months of age was high ( AUC: 0.91, 95% CI: 0.84-0.98). Conclusions and Clinical Relevance This study demonstrated, for the first time, that FLG expression in UCB is associated with eczema development in infancy. Moreover, our analysis provided prediction models that were capable of discriminating, to a great extent, between those who will and will not develop eczema in infancy. Therefore, early identification of infants at increased risk of developing eczema is possible and such high-risk newborns may benefit from early stratification and intervention. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article by Lockett et al. Which concluded that DNA methylation in adulthood is associated with season of birth on allergy.

Background Season of birth influences allergy risk; however, the biological mechanisms underlying this observation are unclear. The environment affects DNA methylation, with potentially long-lasting effects on gene expression and disease. This study examined whether DNA methylation could underlie the association between season of birth and allergy. Methods In a subset of 18-year-old participants from the Isle of Wight (IoW) birth cohort ( n = 367), the risks of birth season on allergic outcomes were estimated. Whole blood epigenome-wide DNA methylation was measured, and season-associated CpGs detected using a training-and-testing-based technique. Validation method examined the 8-year-old Prevention and Incidence of Asthma and Mite Allergy ( PIAMA) cohort. The relationships between DNA methylation, season of birth and allergy were examined. CpGs were analysed in IoW third-generation cohort newborns. Results Autumn birth increased risk of eczema, relative to spring birth. Methylation at 92 CpGs showed association with season of birth in the epigenome-wide association study. In validation, significantly more CpGs had the same directionality than expected by chance, and four were statistically significant. Season-associated methylation was enriched among networks relating to development, the cell cycle and apoptosis. Twenty CpGs were nominally associated with allergic outcomes. Two CpGs were marginally on the causal pathway to allergy. Season-associated methylation was largely absent in newborns, suggesting it arises post-natally. Conclusions This study demonstrates that DNA methylation in adulthood is associated with season of birth, supporting the hypothesis that DNA methylation could mechanistically underlie the effect of season of birth on allergy, although other mechanisms are also likely to be involved. [ABSTRACT FROM AUTHOR]

Background WHO guidelines advocate breastfeeding for 6 months, and EAACI guideline recommends exclusive breastfeeding for 4-6 months. However, evidence for breastfeeding to prevent asthma and allergic disease is conflicting. We examined whether following recommended breastfeeding guidelines alters the long-term risks of asthma, eczema, rhinitis or atopy. Methods The effect of nonexclusive (0, >0-6, >6 months) and exclusive breastfeeding (0, >0-4, >4 months) on repeated measures of asthma (10, 18 years), eczema, rhinitis, and atopy (1-or-2, 4, 10, 18 years) risks was estimated in the IoW cohort ( n = 1456) using log-linear models with generalized estimating equations. The Food Allergy and Intolerance Research ( FAIR) cohort ( n = 988), also from the IoW, was examined to replicate results. Results Breastfeeding (any or exclusive) had no effect on asthma and allergic disease in the IoW cohort. In the FAIR cohort, any breastfeeding for >0-6 months protected against asthma at 10 years ( RR = 0.50, 95% CI = 0.32-0.79, P = 0.003), but not other outcomes, whilst exclusive breastfeeding for >4 months protected against repeated rhinitis ( RR = 0.36, 95% CI = 0.18-0.71, P = 0.003). Longer breastfeeding was protective against late-onset wheeze in the IoW cohort. Conclusion The protective effects of nonexclusive and exclusive breastfeeding against long-term allergic outcomes were inconsistent between these colocated cohorts, agreeing with previous observations of heterogeneous effects. Although breastfeeding should be recommended for other health benefits, following breastfeeding guidelines did not appear to afford a consistent protection against long-term asthma, eczema, rhinitis or atopy. Further research is needed into the long-term effects of breastfeeding on allergic disease. [ABSTRACT FROM AUTHOR]

Background: The prevalence of eczema is increasing in industrialized nations. Limited evidence has shown the association of DNA methylation (DNA-M) with eczema. We explored this association at the epigenome-scale to better understand the role of DNA-M. Data from the first generation (F1) of the Isle of Wight (IoW) birth cohort participants and the second generation (F2) were examined in our study. Epigenome-scale DNA methylation of F1 at age 18 years and F2 in cord blood was measured using the Illumina Infinium HumanMethylation450 Beadchip. A total of 307,357 cytosine-phosphate-guanine sites (CpGs) in the F1 generation were screened via recursive random forest (RF) for their potential association with eczema at age 18. Functional enrichment and pathway analysis of resulting genes were carried out using DAVID gene functional classification tool. Log-linear models were performed in F1 to corroborate the identified CpGs. Findings in F1 were further replicated in F2. Results: The recursive RF yielded 140 CpGs, 88 of which showed statistically significant associations with eczema at age 18, corroborated by log-linear models after controlling for false discovery rate (FDR) of 0.05. These CpGs were enriched among many biological pathways, including pathways related to creating transcriptional variety and pathways mechanistically linked to eczema such as cadherins, cell adhesion, gap junctions, tight junctions, melanogenesis, and apoptosis. In the F2 generation, about half of the 83 CpGs identified in F1 showed the same direction of association with eczema risk as in F1, of which two CpGs were significantly associated with eczema risk, cg04850479 of the PROZ gene (risk ratio (RR) = 15.1 in F1, 95 % confidence interval (CI) 1.71, 79.5; RR = 6.82 in F2, 95 % CI 1.52, 30.62) and cg01427769 of the NEU1 gene (RR = 0.13 in F1, 95 % CI 0.03, 0.46; RR = 0.09 in F2, 95 % CI 0.03, 0.36). Conclusions: Via epigenome-scaled analyses using recursive RF followed by log-linear models, we identified 88 CpGs associated with eczema in F1, of which 41 were replicated in F2. Several identified CpGs are located within genes in biological pathways relating to skin barrier integrity, which is central to the pathogenesis of eczema. Novel genes associated with eczema risk were identified (e.g., the PROZ and NEU1 genes). [ABSTRACT FROM AUTHOR]

Reasons for performing study Particle mapping within stalls has demonstrated a relationship between particulate concentrations and visible accumulations of tracheal mucus. However, measurement of breathing zone particulate concentrations, which is the most accurate way to measure exposure, has not been performed to determine the relationship between exposures and accumulations of tracheal mucus sufficient to affect performance. Objectives To compare breathing zone particulate exposures between horses with tracheal mucus scores ( MS) previously demonstrated to affect performance ( MS≥2) and those without ( MS = 0) visible tracheal mucus. Study design Case-control study. Methods We endoscopically examined 649 Thoroughbred racehorses over 7 months and selected 113 age-matched cases and controls based on the presence ( MS≥2) or absence ( MS = 0) of tracheal mucus, respectively. Inflammatory cell numbers in tracheal lavage were also determined. Breathing zone monitors recorded particulate exposure during 3 time periods (mid-day, evening and overnight). Total recording time averaged 17.5 h/horse. Results The overall prevalence of MS≥2 in the observed stables was 23%. Breathing zone particular matter ( PM10) concentrations were very similar to previously reported ambient concentrations. During the evening and overnight, cases had significantly higher breathing zone PM10 concentrations and neutrophil counts than controls. Inflammatory cell counts were associated with average PM10 concentrations throughout the day. Conclusions Breathing zone particulate concentrations are associated with MS≥2 and inflammatory cell numbers. If breathing zone particulate exposures are predominantly influenced by ambient PM concentrations, racing stable management practices to reduce particle exposures should greatly reduce the prevalence of tracheal mucus. [ABSTRACT FROM AUTHOR]

Background Allergic sensitization and filaggrin gene ( FLG) variants are important risk factors for allergic disorders; however, knowledge on their individual and interactive effects on the coexistence of eczema, asthma, and rhinitis is lacking. Objective This study aimed at investigating the single and combined effects of allergic sensitization and FLG variants on the development of single and multiple allergic disorders. Methods The Isle of Wight birth cohort ( n = 1456) has been examined at 1, 2, 4, 10, and 18 years of age. Repeated measurements of eczema, asthma, rhinitis, and skin prick tests were available for all follow-ups. FLG variants were genotyped in 1150 participants. Associations of allergic sensitization and FLG variants with single and multiple allergic disorders were tested in log-binomial regression analysis. Results The prevalence of eczema-, asthma-, and rhinitis-only ranged from 5.6% to 8.5%, 4.9% to 10.2%, and 2.5% to 20.4%, respectively, during the first 18 years of life. The coexistence of allergic disorders is common, with approximately 2% of the population reporting the comorbidity of 'eczema, asthma, and rhinitis' during the study period. In repeated measurement analyses, allergic sensitization and FLG variants, when analysed separately, were associated with having single and multiple allergic disorders. Of particular significance, their combined effect increased the risk of 'eczema and asthma' ( RR = 13.67, 95% CI: 7.35-25.42), 'asthma and rhinitis' ( RR = 7.46, 95% CI: 5.07-10.98), and 'eczema, asthma, and rhinitis' ( RR = 23.44, 95% CI: 12.27-44.78). Conclusions and Clinical Relevance The coexistence of allergic disorders is frequent, and allergic sensitization and FLG variants jointly increased risk of allergic comorbidities, which may represent more severe and complex clinical phenotypes. The interactive effect and the elevated proportion of allergic comorbidities associated with allergic sensitization and FLG variants emphasize their joint importance in the pathogenesis of allergic disorders. [ABSTRACT FROM AUTHOR]

Background Cluster analyses have enhanced understanding of the heterogeneity of both paediatric and adult wheezing. However, while adolescence represents an important transitional phase, the nature of young adult wheeze has yet to be clearly characterised. Objectives To use cluster analysis to define, for the first time, clinically relevant young adult wheeze clusters in a longitudinal birth cohort. Methods K-means cluster analysis was undertaken among 309 currently wheezing subjects at 18 years in the Isle of Wight birth cohort ( N = 1456). Thirteen disease-characterising clustering variables at 18 years were used. Resulting clusters were then further characterised by severity indices plus potential risk factors for wheeze development throughout the 1st 18 years of life. Results Six wheeze clusters were identified. Cluster 1 (12.3%) male-early-childhood-onset-atopic-wheeze-with-normal-lung-function had male predominance, normal spirometry, low bronchodilator reversibility ( BDR), intermediate bronchial hyper-responsiveness ( BHR), high atopy prevalence and more admissions. Cluster 2 (24.2%) early-childhood-onset-wheeze-with-intermediate-lung-function had no specific sex association, intermediate spirometry, BDR, BHR, more significant BTS step therapy and admissions. Cluster 3 (9.7%) female-early-childhood-onset-atopic-wheeze-with-impaired-lung-function showed female predominance, high allergic disease comorbidity, more severe BDR and BHR, greatest airflow obstruction, high smoking prevalence, higher symptom severity and admissions. Cluster 4 (19.4%) female-undiagnosed-wheezers had adolescent-onset non-atopic wheeze, low BDR and BHR, impaired but non-obstructed spirometry, high symptom frequency and highest smoking prevalence. Cluster 5 (24.6%) female-late-childhood-onset-wheeze-with-normal-lung-function showed no specific atopy association, normal spirometry, low BDR, BHR and symptom severity. Cluster 6 (9.7%) male-late-childhood-onset-atopic-wheeze-with-impaired-lung-function had high atopy and rhinitis prevalence, increased BDR and BHR, moderately impaired spirometry, high symptom severity and higher BTS step therapy. Conclusions and Clinical Relevance Young adult wheeze is diverse and can be classified into distinct clusters. More severe clusters merit attention and are associated with childhood onset, atopy, impaired lung function and in some, smoking. Smoking-associated undiagnosed wheezers also merit recognition. Better understanding of young adult wheeze could facilitate better later adult respiratory health. [ABSTRACT FROM AUTHOR]

Background Loss-of-function variants within the filaggrin gene ( FLG) are associated with a dysfunctional skin barrier that contributes to the development of eczema. Epigenetic modifications, such as DNA methylation, are genetic regulatory mechanisms that modulate gene expression without changing the DNA sequence. Objectives To investigate whether genetic variants and adjacent differential DNA methylation within the FLG gene synergistically act on the development of eczema. Methods A subsample ( n = 245, only females aged 18 years) of the Isle of Wight birth cohort participants ( n = 1456) had available information for FLG variants R501X, 2282del4 and S3247X and DNA methylation levels for 10 CpG sites within the FLG gene. Log-binomial regression was used to estimate the risk ratios (RRs) of eczema associated with FLG variants at different methylation levels. Results The period prevalence of eczema was 15.2% at age 18 years and 9.0% of participants were carriers (heterozygous) of FLG variants. Of the 10 CpG sites spanning the genomic region of FLG, methylation levels of CpG site 'cg07548383' showed a significant interaction with FLG sequence variants on the risk for eczema. At 86% methylation level, filaggrin haploinsufficient individuals had a 5.48-fold increased risk of eczema when compared to those with wild type FLG genotype ( P-value = 0.0008). Conclusions Our novel results indicated that the association between FLG loss-of-function variants and eczema is modulated by DNA methylation. Simultaneously assessing the joint effect of genetic and epigenetic factors within the FLG gene further highlights the importance of this genomic region for eczema manifestation. [ABSTRACT FROM AUTHOR]

Reason for performing study: Accumulations of tracheal mucus assessed by endoscopic examination are associated with poor performance in racehorses. The air quality in horses' stalls may contribute to this visible tracheal mucus. Objectives: To determine whether the concentration and number of airborne particulates in stalls are associated with visible accumulations of tracheal mucus and with the number of inflammatory cells in tracheal aspirates. Methods: We studied 107 racehorses from 3 stables, in 3 different months, and measured airborne particulate matter 3 times daily in each of the stalls. On each monthly visit, horse airways were examined endoscopically and assigned a mucus score, and tracheal lavage was performed. Bivariate procedures, general estimating equations and linear mixed models were applied to estimate the association between PM and the presence of accumulations of mucus and number of inflammatory cells. Results: Stable, stall, month and PM were all significantly associated with the presence of accumulations of tracheal mucus, which had an overall prevalence of 67%. The odds of horses having visible accumulation of mucus were increased when horses occupied enclosed stables or stalls with higher particulate concentrations, and when concentrations of larger particles (≤10 µm in diameter) were elevated. Sixty-eight percent of tracheal wash samples contained more than 20% neutrophils. Increased numbers of neutrophils were associated with the concentration of smaller particles (≤2.5 µm in diameter). Potential relevance: Careful consideration of stable construction and management practices focused on maintaining the lowest possible dust concentrations throughout the day should reduce the prevalence of visible accumulations of tracheal mucus, potentially improving racing performance. [ABSTRACT FROM AUTHOR]

Background Skin prick testing ( SPT) is fundamental to the practice of clinical allergy identifying relevant allergens and predicting the clinical expression of disease. There are only limited data on the natural history of SPT results over childhood and adolescence. Objective We aimed to describe the natural history of SPT and patterns of sensitization over childhood and adolescence. Methods The 1989 Isle of Wight birth cohort (1456 participants) was followed up at 1, 2, 4, 10 and 18 years. SPT was undertaken from 4 years. Results SPT was performed on 980 (80%), 1036 (75%) and 853 (65%) of participants at 4, 10 and 18 years. The prevalence of sensitization to any allergen at these time-points was 19.7%, 26.9% and 41.3% respectively. At each time-point, boys were significantly more likely to be sensitized ( P < 0.016) and sensitization significantly increased over childhood and adolescence (average annual increase of 7%). Some children outgrew their sensitization. The rate of sensitization to most individual allergens increased over childhood and adolescence. A configural frequency analysis showed that whether an individual was sensitizated was relatively fixed over childhood and adolescence. Cluster analysis at 4 years demonstrated four major groups of individuals with similar co-sensitization to specific allergens. Children who were sensitized at age 4 years generally went onto become sensitized to additional allergens at 10 and 18 years. Conclusions and Clinical Relevance Allergic sensitization continues to increase over childhood into adolescence although the majority of children who were not sensitized at 4 years remain non-sensitized throughout childhood and adolescence. The presence of sensitization at 4 years predicted later sensitization to additional allergens. [ABSTRACT FROM AUTHOR]

Summary Reasons for performing study: Airway inflammation and mucus in the trachea are common in racehorses. Fine airborne particles can initiate and coarse particles can worsen airway inflammation in man and in animal models of airway disease. The regional and seasonal distribution of particles of different sizes has never been investigated in American racing stables. Objectives: To determine the regional and seasonal concentration and number of airborne particles of different sizes in racing stables. Methods: Direct reading instruments were used to determine the mass concentration and numbers of particles 3 times daily (early morning, midday and late afternoon) in July, September and November, in 3 different racing stables. Results: Average particle concentrations were lowest in July and highest in September and November. Early morning concentrations were significantly higher than those measured throughout the rest of the day. The completely enclosed stable with little natural ventilation, had significantly higher particulate concentrations than the open-sided stable. With regard to numbers of particles, those 2-5 µm were greatest in July and least in November; those 0.5-1.0 µm were greatest in September and least in November. Location of stall within stable also affected concentrations and numbers. Conclusions: The concentration and number of particles in sizes known to reach the lower airways varies with stable design/management, time of day, season of year and location of the stall within the stable. Potential relevance: Particle mapping is a useful tool in the identification of stables, season, and location of stalls within stables where horses may be at greater risk of exposure to offending particulates. [ABSTRACT FROM AUTHOR]

Objective: To determine whether prenatal exposure to dichlorodiphenyl ethylene (DDE) and polychlorinated biphenyls (PCBs) and concurrent exposure to DDE, PCBs and polybrominated diphenylethers (PBDEs) affect gene expression of aromatase (CYP19A1), 17-α-hydroxylase (CYP17A1), and oestrogen receptors α and β (ESR 1 and ESR2).Methods: Based on maternal PCB and DDE levels in the parent generation of the Michigan Fisheater Cohort determined between 1973 and 1991, individual prenatal exposures were estimated and have been published. In 2007, female adult offspring of this cohort were examined. Gene expression and concurrent lipid-adjusted exposures to DDE, PCBs and PBDEs were measured in blood and serum, respectively. Using mixed models and path analyses, gene-expression data were regressed on prenatal and concurrent exposures controlling for confounders.Results: 139 daughters of Michigan fisheaters (65.3%) participated in the investigation. While prenatal PCB levels were statistically significantly associated with decreased expression of the aromatase and 17-α-hydroxylase genes, prenatal DDE levels were significantly related to increased gene expression of aromatase but not of 17-α-hydroxylase. The DDE association seems to be mediated by concurrent lipid-adjusted p,p'-DDE serum levels. Prenatal and concurrent exposure of both PCBs and DDE had comparable effects. No association was found for PBDEs or for the gene expression of ESR 1 and ESR2.Conclusions: A 40-year antecedent prenatal exposure and concurrent levels of PCBs and DDE are associated with the expression of aromatase and 17-α-hydroxylase genes. Prenatal exposures to organochlorines may instigate long-term alterations of gene expression. Mechanisms of prenatal induction of persistent gene-expression alterations are speculated to be epigenetic in nature. [ABSTRACT FROM AUTHOR]

Background Longitudinal studies of the natural history of childhood and adolescent rhinitis are lacking. Objectives To investigate the natural history of rhinitis up to 18 years of age, and how that is influenced by gender and atopy. Methods The Isle of Wight birth cohort was recruited in 1989 (n = 1456). Questionnaire data on nasal symptoms (rhinitis) were collected at 1, 2, 4, 10 and 18 years of age. To define atopy, skin prick tests were conducted at 4, 10 and 18 years. The 12-month period prevalence plus positive and negative transitions (defined as change in disease status in two consecutive study assessments) were stratified by gender and atopic status. Results Overall rhinitis prevalence increased from 5.4% at 4 years to 35.8% at 18 years (Po0.001), without gender difference. Atopic rhinitis prevalence increased steadily from 3.4% at 4 years to 27.3% at 18 years (Po0.001), was commoner in boys at 18 years (P = 0.02) and associated with greater positive transition in boys from 10 to 18 years (P = 0.01). Prevalence of non-atopic rhinitis also increased from 4 to 18 years (P = 0.003) and was greater in girls at 18 years (Po0.001) reflecting higher female positive transition from 10 to 18 years (Po0.001). Non-atopic rhinitis negative transition (remission) was highest in early life and reduced in later childhood/adolescence. Conclusion Atopic rhinitis becomes increasingly common as children grow into adolescents, with stronger associations to male gender. Non-atopic rhinitis shows a female predominance at 18 years as girls 'grow into' it more during adolescence. Our findings suggest differential gender effects on the increasing prevalence of both atopic and non-atopic rhinitis in adolescence. Clinical Relevance A better understanding of how gender and atopic status influence rhinitis during adolescence emerges from this study. Application of such knowledge could help to improve clinical recognition, judge prognosis and ultimately improve management of this common condition. [ABSTRACT FROM AUTHOR]

Trends in the prevalence of eczema in the course of childhood and adolescence are not clear although often a net remission during childhood is assumed. To investigate the dynamics of change in eczema from 1 to 18 years in a prospective study and to understand the influence of gender and atopy. Detailed information regarding eczema were collected at ages 1, 2, 4, 10 and 18 years from the 1989 Isle of Wight birth cohort ( n=1456). Skin prick testing was performed at 4, 10 and 18 years of age. The 12-month period prevalence, positive and negative transitions (defined as change in disease status in two consecutive study assessments) were stratified by gender and atopic status. The period prevalence of eczema from birth to 18 years of age remained relatively constant (11.9-14.2%) with minimal remission. Up to 10 years of age, gender did not influence prevalence. From 10 to 18 years, eczema became more prevalent among girls (16.3% for girls vs. 8.3% for boys, P<0.001) as a result of a greater positive transition in girls (9.4% for girls vs. 4.3% for boys, P=0.001) and greater negative transition in boys (65.4% for boys vs. 50% for girls, P=0.04). The higher positive transition of eczema in girls was most pronounced for non-atopic eczema (5.9% for girls vs. 1.5% for boys, P=0.002). We found only a minimal reduction in the prevalence of eczema during childhood and adolescence. During adolescence, more girls develop eczema and more boys outgrow it suggesting a role for gender-specific pubertal factors. Cite this as: A. H. Ziyab, A. Raza, W. Karmaus, N. Tongue, H. Zhang, S. Matthews, S. H. Arshad and G. Roberts, Clinical & Experimental Allergy, 2010 (40) 1776-1784. [ABSTRACT FROM AUTHOR]

In 2009 the journal published in the region of 200 papers including reviews, editorials, opinion pieces and original papers that ran the full gamut of allergic disease. It is instructive to take stock of this output to determine patterns of interest and where the cutting edge lies. We have surveyed the field of allergic disease as seen through the pages of Clinical and Experimental Allergy (CEA) highlighting trends, emphasizing notable observations and placing discoveries in the context of other key papers published during the year. The review is divided into similar sections as the journal. In the field of Asthma and Rhinitis CEA has contributed significantly to the debate about asthma phenotypes and expressed opinions about the cause of intrinsic asthma. It has also added its halfpennyworth to the hunt for meaningful biomarkers. In Mechanisms the considerable interest in T cell subsets including Th17 and T regulatory cells continues apace and the discipline of Epidemiology continues to invoke a steady stream of papers on risk factors for asthma with investigators still trying to explain the post-second world war epidemic of allergic disease. Experimental Models continue to make important contributions to our understanding of pathogenesis of allergic disease and in the Clinical Allergy section various angles on immunotherapy are explored. New allergens continue to be described in the allergens section to make those allergen chips even more complicated. A rich and vibrant year helpfully summarized by some of our associate editors. Cite this as: H. W. Chu, C. M. Lloyd, W. Karmaus, P. Maestrelli, P. Mason, G. Salcedo, J. Thaikoottathil and A. J. Wardlaw, Clinical & Experimental Allergy, 2010 (40) 1611-1631. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Early weaning is beneficial to prevent atopic dermatitis occurrence in young children" by F. Turati and colleagues.

Objectives: To investigate the effect of prenatal exposure to polychlorinated biphenyls (PCBs) and dichlorodiphenyl-dichloroethylene (DDE) on weight, height and body mass index (BMI( in adult female offspring of the Michigan fisheater cohort examined between 1973 and 1991. Methods: 259 mothers from the Michigan fisheater cohort were studied. Prenatal exposure to PCBs and DDE was estimated by extrapolating maternal measurements to the time that the women gave birth. 213 daughters aged 20-50 years in 2000 were identified and 83% of them participated in at least one of two repeated investigations in 2001/02 (n = 151) and 2006/07 (n = 129). To assess the effect of prenatal PCB and DDE exposure on anthropometric measurements, generalised estimating equations nested for repeated measurements (2001/02 and 2006/07) and for sharing the same mother were used. We controlled for maternal height and BMI and for daughters age, birth weight, having been breastfed and number of pregnancies. Results: Maternal height and BMI were significant predictors of the daughters' height, weight and BMI. Low birth weight (<2500 g) was significantly associated with reduced adult offspring weight and BMI. The weight and BMI of adult offspring were statistically significantly associated with the extrapolated prenatal DDE levels of their mothers. Controlling for confounders and compared to maternal DDE levels of <1.503 μg/l, offspring BMI was increased by 1.65 when prenatal DDE levels were 1.503-2.9 μg/l and by 2.88 if levels were >2.9 μg/l. Prenatal PCB levels showed no effect. Conclusion: Prenatal exposure to the oestrogenic endocrine-disrupting chemical DDE may contribute to the obesity epidemic in women. [ABSTRACT FROM AUTHOR]

Reasons for performing study: Airway inflammation in recurrent airway obstruction (RAO) is triggered by housing affected horses in stables. It has been suggested that RAO is an allergic condition, but innate immune mechanisms are also involved. Fungal products activate innate immune mechanisms through toll-like receptor 2 (TLR2). In human airway epithelium, TLR2 activation leads to interleukin (IL)-8 production. This pathway is negatively regulated by the zinc finger protein A20. This study was performed to enhance understanding of innate immune mechanisms in RAO. Hypothesis: TLR2 and IL-8 mRNA are elevated in RAO during stabling compared with controls. A20 mRNA is negatively associated with the numbers of airway inflammatory cells. Objectives: To determine TLR 2, IL-8 and A20 mRNA expression in lungs of stabled and pastured RAO-affected and control horses. Methods: Airway obstruction and inflammatory cell counts in bronchoalveolar lavage were measured, and TLR 2, IL-8 and A20 mRNA expression quantified by qRT-PCR in 6 RAO-affected and 6 control horses, during and after exposure to hay and straw. Results: Airway obstruction and neutrophils were increased in RAO-affected horses during stabling. While stabling increased IL- 8, TLR2 and A20 mRNA were unaffected. TLR2 and A20 were significantly correlated (r = 0.83) and A20 mRNA was negatively associated with inflammatory cells. Potential relevance: Stabling does not lead to an increase in TLR2 expression. Other molecules or processes in the TLR2 cascade might be important in fungal-induced airway inflammation. Equine epithelial-derived A20 may be involved in modulation of airway inflammation. [ABSTRACT FROM AUTHOR]

Introduction: The protective effects of breastfeeding on early life respiratory infections are established, but there have been conflicting reports on protection from asthma in late childhood. The association of breastfeeding duration and lung function was assessed in 10-year-old children. Methods: In the Isle of Wight birth cohort (n = 1456), breastfeeding practices and duration were prospectively assessed at birth and at subsequent follow-up visits (1 and 2 years). Breastfeeding duration was categorised as "not breastled" (n = 196); "<2 months" (n = 243); "2 to <4 months" (n = 142) and "≥4 months" (n = 374). Lung function was measured at age 10 years (n = 1033): forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio and peak expiratory flow (PEF). Maternal history of asthma and allergy was assessed at birth. The effect of breastfeeding on lung function was analysed using general linear models, adjusting for birth weight, sex, current height and weight, family social status cluster and maternal education. Results: Compared with those who were not breastfed, FVC was increased by 54.0 (SE 21.1) ml (p = 0.001), FEV1 by 39.5 (20.1) ml(p = 0.05) and PEF by 180.8 (66.1) ml/s (p = 0.006) in children who were breastfed for at least 4 months. In models for FEV1 and PEF that adjusted for FVC, the effect of breastfeeding was retained only for PEF (p = 0.04). Conclusions: Breastfeeding for at least 4 months enhances lung volume in children. The effect on airflow appears to be mediated by lung volume changes. Future studies need to elucidate the mechanisms that drive this phenomenon. [ABSTRACT FROM AUTHOR]

Background Atopic eczema is characterized by Th2-dominant immunity with the cytokine interleukin 13 and the transcription factor GATA binding protein 3 playing a critical role. Objectives We assessed the association of polymorphisms in the IL13 and GATA3 genes with childhood eczema. Methods A birth cohort ( n = 1456) was established on the Isle of Wight in 1989 and followed at the ages of 1 ( n = 1167), 2 ( n = 1174), 4 ( n = 1218) and 10 years ( n = 1373) to determine the prevalence of allergic disease including eczema. At 4 and 10 years, skin prick testing was performed. Whole blood samples ( n = 923) were obtained at the 10-year assessment, stored frozen, and genotyped. Five polymorphisms from IL13 and seven from GATA3 were genotyped for this analysis. Repeated measurement analyses were conducted for the occurrence of eczema at ages 1, 2, 4 and 10 years. All analyses were adjusted for maternal and paternal eczema, low birth weight (< 2500 g), breastfeeding ≥ 3 months and age. Results IL13 was not associated with childhood eczema. For GATA3, the single nucleotide polymorphism (SNP) rs2275806 (promoter region) showed an increased odds ratio for atopic eczema independent of whether the comparison group had a positive skin prick test. The SNP rs444762 (intron 3 region) was associated with atopic eczema in comparison with children without eczema. The increased relative risks remained significant after adjustment for multiple testing only for rs2275806 ( P < 0·05). Conclusions A SNP in GATA3 is associated with atopic eczema. This finding highlights the importance of GATA3 as an immune-modulating gene in atopic eczema. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that a raised level of cord serum IgE (CS-IgE) is a risk factor for allergic sensitisation. However, whether CS-IgE is a risk for asthma is controversial. A study was undertaken to investigate the association between CS-IgE levels and allergic sensitisation at 4 and 10 years of age and asthma at ages 1-2, 4 and 10. Methods: CS-IgE was available for 1358 of 1456 children born between 1989 and 1990. The cohort was evaluated for allergic diseases at ages 1, 2, 4 and 10 years. Skin prick tests for six allergens were performed on 981 children at age 4 and 1036 at age 10. Asthma was defined based on a physician's diagnosis. Using logistic regression analysis, the risk of asthma and allergic sensitisation for raised levels of CS-IgE (⩾0.5 ku/l) was estimated. Results: At ages 4 and 10 years 20.2% and 27.0% of children, respectively, had allergic sensitisation. The risk of allergic sensitisation was significantly associated with raised CS-IgE levels at ages 4 (OR 2.29) and 10 years (OR 1.73). The prevalence of asthma was 10.3% at age 1-2, 15.2% at age 4, and 12.8% at age 10. CS-IgE was not associated with asthma at age 1-2 and 4 but showed an increased relative risk at age 10 (OR 1.66, 95% Cl 1.05 to 2.62). The association was stronger in children who did not develop allergic sensitisation at age 4 or 10 (OR 3.35, 95% CI 1.41 to 7.93). Conclusions: Raised cord serum IgE is a risk factor for allergic sensitisation at ages 4 and 10 years. This is the second study suggesting that CS-IgE is also a risk factor for asthma at age 10, probably related to the late onset of asthma. This association is not necessarily mediated by allergic sensitisation. [ABSTRACT FROM AUTHOR]

Aims: To investigate whether twinning occurs more frequently in residents in the vicinity of a toxic waste incinerator (TWI).Methods: Within a longitudinal environmental study that addressed child health second grade school children and their parents were recruited. The proportion of twinning in the TWI region was compared with two comparison areas. In a second confirmatory investigation, birth records for the years 1994-97 from the Hessian Perinatal Survey (HEPS) were accessed to determine whether the incidence of twinning was higher in regions around the TWI compared to adjacent reference areas.Results: In the environmental study, 61.5% of the children and 95% of their mothers participated. In mothers, twinning was 5.3% in the TWI region compared to 1.6% and 2.3% in the comparison regions. The proportion of mothers with fertility assessment/treatment was 5.7%, 8.3%, and 0% respectively. The prevalence of twinning was not significantly higher (4.5%) in mothers with treatment compared to mothers without (3.7%). From the HEPS, data of 20 603 births was analysed. The incidence of twins was significantly higher in areas which surround the TWI and other industries (1.4-1.6 per 100 births) compared to births in reference areas (0.8 per 100).Conclusions: Twinning rates may be associated with exposure to industrial pollution. Future environmental health studies that consider multiple births as an outcome are warranted. These should also investigate whether the incidence of monozygotic or dizygotic twinning may be associated with industrial pollution. [ABSTRACT FROM AUTHOR]

Identifying the protective effect of a higher number of siblings is a significant finding in understanding the actiology of allergic sensitization, asthma, eczema, and hayfever. We tested the hypothesis that rising order of live offspring increases maternal immune tolerance (immune non-reactivity) against allergens. To this end, we investigated whether maternal IgE levels are associated with the number of live offspring. In a cohort of 1456 newborns recruited between January 1989 and February 1990 on the Isle of Wight. UK, we determined maternal and cord serum IgE, and the order of live offspring. The data were analyzed by means of linear and path analysis. Maternal and cord serum IgE were available in 820 mother-infant pairs with birth order information. We found that the number of live offspring significantly reduces maternal IgE. The decline was more prominent in mothers with atopy (n=268). The geometric means of IgE after the first, second, and third or higher delivery were 74.4. 66.6, and 43.0 kU L. respectively. Findings of path analysis suggest a significant direct effect of birth order on maternal IgE, but no direct effect of birth order on cord serum IgE. The findings support that maternal immune tolerance against allergens may increase with increasing order of live offspring and thus pass on a lower risk of developing atopy in children of higher birth order. [ABSTRACT FROM AUTHOR]

Unlabelled: The aim of this study was to collect representative data on the incidence and clinical characteristics of community-acquired acute gastroenteritis (AGE) due to rotavirus (RV) in German children up to 4 y of age. In 20 paediatric practices in 5 German regions every child aged 0-4 y presenting with symptoms of AGE from May 1997 to April 1998 was eligible for inclusion into the study. Stool samples were tested for RV antigen by enzyme-linked immunosorbent assay and polymerase chain reaction was performed for serotyping. The course of the disease, additional diagnoses and treatment regimen were recorded. Incidences adjusted for month and region of observation were calculated by Poisson regression. Of 15,451 children under observation 3980 (26%) presented with AGE. Of 3156 stool samples available 748 (24%) proved RV positive. The incidence of AGE and RV-positive AGE was 25.2 and 4.0 per 100 children per year, respectively, with a maximum in February/March 1998. RV-positive cases were more severe than RV-negative cases (28% vs 12% severe cases, hospitalization rate 6.2% vs 2.0%, p < 0.001). The predominant genotype of RV isolated was G1/P[8] (77%), followed by G4/P[8] (17%).Conclusion: Rotavirus accounts for a substantial part of severe cases of AGE in children up to 4 y of age. Efficient prevention, including immunization against the circulating serotypes, could save at least 122,000 children in Germany from falling ill with RV-AGE each year. [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Study objective: To review the 'protective' effects of having a higher number of siblings for the risk of atopic eczema, asthma wheezing, hay fever, and allergic sensitisation.Method: Review of the literature (Medline since 1965 and references).Main results: 53 different studies were identified. For eczema, 9 of 11 studies reported an inverse relation with number of siblings; for asthma and wheezing, 21 of 31 reported the inverse association; for hay fever, all 17 studies showed the effect; for allergic sensitisation or immunoglobulin E reactivity 14 of 16 studies supported the 'protective' effect of a higher number of siblings. The studies emphasise a 'theory' that is based exclusively on epidemiological associations.Conclusions: Research has not yet answered the question of which causal factors explain the sibling effect. Causal factors must meet two criteria; they must vary with sibship size and they must protect against atopic manifestations. The prevailing 'hygiene hypothesis' failed to explain the findings adequately. Alternative explanations include in utero programming or endocrine explanatory models. The epidemiology research into siblings and atopic disorders has entered an intellectually challenging phase. Possessing sufficient knowledge about the causal factors might prevent at least 30% of all cases of asthma, eczema, and hay fever. [ABSTRACT FROM AUTHOR]

Aims--To examine the disease burden and epidemiology of community acquired rotavirus gastroenteritis in Austrian children treated in a paediatric practice. Methods--A prospective, population based, multicentre study in four paediatric practices and two children's hospitals (Innsbruck and Leoben). Children &les; 48 months of age presenting with gastroenteritis during a six month period of rotavirus peak between December 1997 and May 1998 were included. Prospective testing of stool samples for rotavirus was performed using ELISA. Results--A total of 6969 children were enrolled; 171 (2.4%) had community acquired gastroenteritis. Of 144 children who could be included in further analysis, 49 (34%; median age 16.7 months) were rotavirus positive, and 95 (66%; median age 17.0 months) were rotavirus negative. Three of the rotavirus positive children (median age 14.6 months) were hospitalised. The severity of rotavirus positive gastroenteritis was significantly higher than that of rotavirus negative gastroenteritis. The incidence of community acquired gastroenteritis was 4.67 per 100 children per year, and of rotavirus positive gastroenteritis 1.33 per 100 children per year. Conclusion--Rotavirus is a relevant cause of community acquired gastroenteritis in children aged 4 years and younger treated by a paediatrician. The data can be used as a basis for developing strategies to pre- vent infection. [ABSTRACT FROM AUTHOR]

A review of the literature was conducted to investigate the importance to offspring of in utero and breast milk polychlorinated biphenyl (PCB) exposure. All reports that we could identify (n = 25) were included, representing 16 study populations. Tissue-specific PCB concentrations in human placenta, breast milk, maternal blood and cord blood were compared to determine accumulation ratios between tissue compartments. On a lipid basis, the highest concentration of PCB in placenta (5027 ng/g fat) was 2.8 times higher than the highest concentration of PCB in breast milk (1770 ng/g fat). While there are limitations with regard to quantitation methods and statistical methods utilized by the reviewed studies, our results suggest that PCBs may be capable of crossing the placenta to a greater extent than previously believed. Future studies of PCB body burden in the perinatal period should include placenta, breast milk, maternal and cord blood specimens. In order to compare PCB concentrations in various tissues and with other studies, concentrations should be determined on a lipid basis. [ABSTRACT FROM AUTHOR]

Objectives: To identify work related risk factors of future low back pain (LBP) in a cohort of construction workers free of LBP at the start of follow up.Methods: The Hamburg construction worker study comprises 571 male construction workers who have undergone two comprehensive interview and physical examination surveys. A cohort of 285 subjects without LBP at baseline was identified. After a follow up of 3 years, the 1 year prevalence of self reported LBP was determined in the 230 men followed up (80.7%). Prevalence ratios (PRs) with 95% confidence intervals (95% CIs) of LBP at follow up according to self reported work tasks of construction workers measured at baseline were estimated from Cox's regression models which were adjusted for age, and anthropometric measures.Results: At follow up 71 out of 230 workers (30.9%) reported LBP during the preceding 12 months. Four work tasks (scaffolding, erecting roof structures, sawing wood, laying large sandstones) with an increased risk of 1 year prevalence of LBP at follow up were further evaluated. After further adjustment for occupation the relative risk was increased for workers who had reported > or = 2 hour/shifts laying large sandstones (PR = 2.6; 95% CI 1.1 to 6.5). Work load of bricklayers was additionally estimated by an index on stone load (high exposure: PR = 4.0; 95% CI 0.8 to 19.8), and an index for laying huge bricks/blocks (yes/no: PR = 1.7; 95% CI 0.5 to 5.7).Conclusions: The results suggest that self reported differences in brick characteristics (size and type of stone) and temporal aspects of the work of bricklayers (average hours per shift laying specified stones) can predict the future prevalence of LBP. The data have to be interpreted with caution because multiple risk factors were tested. [ABSTRACT FROM AUTHOR]

Editorial. Focuses on the use of antibiotics in the first year of life and development of asthma. Environmental factors that increase the risk of developing asthma and atopy in early life; Biological mechanisms of the association between antibiotics and development of asthma; Dose-dependent association between the courses of antibiotics prescribed in the first year of life and asthma in later life.

Objective: To examine the possible influence of exposure to toluene on human fertility.Methods: In a cross sectional study, a sample of 150 male and 90 female printing industry workers were interviewed retrospectively on reproductive experience with a modified version of the European study of infertility and subfecundity questionnaire. Exposure categories comprised job descriptions and information on exposure measurements obtained by industrial hygienists. The fecundability ratio (FR) was estimated on the basis of time to pregnancy (TTP) or periods of unprotected intercourse not leading to pregnancy (PUNP) by means of survival analysis with proportional hazard models. Confounders such as age, ethnicity, smoking, parity, pelvic inflammatory diseases, and frequency of sexual intercourse were controlled for in the analyses.Results: 256 Periods of TTP or PUNP were reported by men and 174 by women. After exclusion of induced abortions, birth control failures, and periods without employment for female workers we were able to analyse 169 periods in men and 100 periods in women. Male workers who had been exposed to different concentrations of toluene and their partners did not show a reduction in fecundity. In women (39 periods occurred during exposure) fecundity was reduced (FR 0.47, 95% confidence interval (95% CI) 0.29 to 0.77). Neither, restriction to only the first period nor exclusion of PUNPs changed the results (FR 0.48, 95% CI 0.24 to 0.97).Conclusion: After considering possible biases, low daily exposure to toluene in women seems to be associated with reduced fecundity. This result is in accordance with other findings for organic solvents and supports both the hypotheses that (a) organic solvents could affect hormonal regulation, and that (b) organic solvents increase early fetal losses which in turn contributes to longer times of unprotected intercourse. [ABSTRACT FROM AUTHOR]

The objective of this study was examine geographical variation in couple fecundity in Europe. The study was based upon all recently pregnant (or still pregnant) women within well-defined geographical areas in Europe (Denmark, Germany, Italy, Sweden and France) at a given time period in 1992. Altogether, 4035 women responded to a highly structured questionnaire. Highest fecundity was found in Southern Italy and Northern Sweden; lowest fecundity was seen in data from the East German centre. Approximately 16% of the study population had a waiting time of more than 12 months to become pregnant. Most of the pregnancies were planned (64%) and approximately 14% were the result of contraceptive failures. The study shows that smoking, body mass index, age and parity did not explain the differences in fecundity found between the centres. Regional differences in fecundity exist and the causes may be genetic or due to variations in behavioural and environmental exposures. [ABSTRACT FROM AUTHOR]

The objective of this study was examine geographical variation in couple fecundity in Europe. The study was based upon all recently pregnant (or still pregnant) women within well-defined geographical areas in Europe (Denmark, Germany, Italy, Sweden and France) at a given time period in 1992. Altogether, 4035 women responded to a highly structured questionnaire. Highest fecundity was found in Southern Italy and Northern Sweden; lowest fecundity was seen in data from the East German centre. Approximately 16% of the study population had a waiting time of more than 12 months to become pregnant. Most of the pregnancies were planned (64%) and approximately 14% were the result of contraceptive failures. The study shows that smoking, body mass index, age and parity did not explain the differences in fecundity found between the centres. Regional differences in fecundity exist and the causes may be genetic or due to variations in behavioural and environmental exposures. [ABSTRACT FROM PUBLISHER]

Eosinophil inflammation is a common feature of allergic disorders and particularly in allergic asthma interest has been paid to related markers. In a community-based survey of 10-year-old children, the association of eosinophil count (EC) and serum eosinophil cationic protein (ECP) with allergic sensitization, clinical history and exposure to mite allergen was studied. Relying on the results of skin prick tests, the children were divided to three groups: (1) children showing no sensitization to one of the seven inhalant allergens (n = 16); (2) children with sensitization to at least one of five non-mite allergens (n = 16); and (3) children with sensitization to mite allergens (n = 75). Clinical history of asthma and hay fever was ascertained using standardized questionnaires. EC in peripheral blood and serum ECP were measured on one single occasion. Prior to blood sampling, mite allergen exposure at home had been assessed by taking dust samples and measuring the mite antigen concentration by means of an enzyme immunoassay. Compared to group 1, higher ECs were obvious in group 2 (P = 0.037) and in group 3 (P = 0.0013). Regarding serum ECP, higher levels occurred in group 2 (P = 0.0033) as well as in group 3 (P = 0.0001) when comparing them to the reference group. Sensitized children with neither asthma, nor asthma-like symptoms, nor hay fever (n = 28) did not have significantly lower ECs and serum ECP levels than those with hay fever (n = 15; P = 0.09, P = 0.17) and those with asthma (n = 22; P = 0.69, P = 0.64).(ABSTRACT TRUNCATED AT 250 WORDS) [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To investigate the year-to-year variation of mite antigen density (Der p I, Der f I) in dust from mattresses and the relevance of residential factors for antigen load, information derived from an epidemiologic study including two surveys carried out in the households of a cohort of elementary school children (n = 1291) was analysed. When considering residences with measurements taken in both years in question (n = 1050), rank-correlation indicated a predominance of stability for both antigens (Der p I: rs = 0 82, P = 0 0001; Der f I: rs = 0 72, P = 0 0001). Using multiple regression analyses, significant associations between antigen concentrations and a variety of residential factors were found. Use of a blanket of animal hair, use of a cover or underblanket, wet spots in the bedroom, higher relative humidity and a low storey level were significantly associated with increased concentrations of Der p I, whereas inverse relationships between this antigen and room temperature, number of persons per m2 as well as use of underfloor heating were seen. Regarding Der f I, older mattresses, use of a cover or underblanket, higher weight of sampled dust, high educational level and higher ratio of inhabitants per m' were significantly associated with increased concentrations of the antigen. On the other hand, lower Der f I concentrations were found when interior sprung mattresses were used and when the mattress was ‘treated regularly’. In conclusion, two measurements, 1 year apart from each other, show that stability of mite antigen concentrations predominated. Our data suggest that allergic patients should be advised against living in lower storeys and damp homes and to use a newer or encased mattress and to give preference to a residence with underfloor heating. [ABSTRACT FROM AUTHOR]

The coincidence of allergic sensitization was investigated in 302 school-aged children and their parents. Specific sensitization to four common inhalant allergens (grass and birch pollens, cat dander, Dermatophagoides pteronyssinus) was ascertained by means of skin-prick tests (SPT) carried out on the complete family unit at the beginning of a 22- month follow-up period. The same test procedure was then repeated on the children twice at 11-month intervals to provide cumulative prevalences of sensitization. A clinical history of atopy in the children (hay fever or asthma; n = 47), which was derived from an interview, is associated with sensitization (positive SPT in 89%). For three allergens (grass and birch pollens, cat dander) sensitization occurs significantly more frequently in the children of mothers who are sensitized to the same allergen (odds-ratios (ORs), 2.5- 4.1). Additionally, in three of the four explanatory models related to a single antigen, maternal sensitization to one of the complementary allergens is of importance (ORs, 2.7-3.7). In contrast to this finding, none of the paternal sensitizations has statistical significance. Based on a reaction to at least one of the four allergens, the child's relative risk to be sensitized is increased in case of maternal (OR, 2.88; P=0.001) but not of paternal (OR, 1.06; P=0.83) sensitization. In conclusion, our data indicate that the maternal status is more predictive than that of the father with regard to the child's risk of sensitization. [ABSTRACT FROM AUTHOR]

The skin prick test (SPT) is a commonly used procedure for assessing a specific sensitization. The longitudinal variability of test results is of interest for clinical as well as epidemiological investigations. The sensitization to four common aeroallergens (grass pollen, birch pollen, Dermatophagoides pteronyssinus., cat dander) is investigated within the framework of three consecutive SPTs at 11 -month intervals for a population of 587 school children. The prevalence of sensitization based on a weal diameter of at least 2 mm was between 12.9% (cat dander) and 23.9% (grass pollen) in the initial testing. The positive predictive values of the initial SPT were between 75.3% (birch pollen) and 88.2% (cat dander) for the two subsequent SPTs. In the case of initially negative tests with positive second and third SPTs the incidence ranged between 3.2% (cat dander) and 4.3% (birch pollen) per year. A clear increase in the intensity of reaction in subsequent tests was observed in a number of probands testing positively in the initial SPT. In conclusion, our data indicate a high long-term stability of a specific sensitization to aeroallergens in SPT. [ABSTRACT FROM AUTHOR]

Background: Variability in peak expiratory flow (PEF) has been proposed as a simple method of screening for asthma in epidemiological studies. This study was designed to assess whether the bronchial response to exercise and the diurnal variation in PEF identified the same subjects.Methods: Bronchial response to a free running exercise test was assessed in a cohort of 918 seven year old children and was compared with variability of PEF as assessed by twice daily recordings for a one week period. Mini Wright peak flow meters were used throughout the study.Results: Baseline PEFs of both tests were highly correlated but there was no significant correlation between a response to exercise and variability of PEF. Of 33 children with a physician's diagnosis of asthma, 18 had at least one abnormal test, but only five children were abnormal in both tests, showing that the tests did not identify the same subjects.Conclusion: Increased variability of PEF, as well as a response to exercise, was associated with respiratory symptoms, but only a response to exercise was closely associated with atopy (defined as a positive skin test to any of seven aero-allergens). [ABSTRACT FROM AUTHOR]