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This article explores the relationship between skin barrier integrity and type 2 inflammatory diseases. The study found that individuals with allergic rhinitis, food allergy, and eczema had higher levels of transepidermal water loss (TEWL), indicating compromised skin barrier integrity. The study also identified factors such as gender, testicular volume, armpit hair growth, and medical diagnoses that influenced skin barrier function. However, the model only captured a small percentage of the variation in TEWL. The study suggests an association between T2 inflammatory diseases and epithelial barrier disruption, but further research is needed to determine the diagnostic and predictive utility of TEWL in allergic diseases. [Extracted from the article]

Poor dietary choices have been rising concurrently with an increase in asthma prevalence, especially in children. Dietary indexes that simultaneously measure the healthiness and sustainability of dietary patterns have emerged to address the dual concerns of human and planetary health. Accordingly, we aimed to evaluate adherence to a sustainable dietary pattern and its impact on airway inflammation and asthma. In this study, 660 school-aged children (49.1% females, 7–12 years) were considered. A cross-sectional analysis was performed to assess the association between diet and asthma and airway inflammation according to overweight/obesity. Diet was evaluated through the Planetary Health Diet Index (PHDI). Higher scores represent a healthier and more sustainable diet. Three definitions of asthma were considered based on a self-reported medical diagnosis, symptoms, asthma medication, measured lung function, and airway reversibility. Airway inflammation was assessed by exhaled fractional nitric oxide (eNO). We considered two categories of body mass index: non-overweight/non-obese and overweight/obese. The associations between diet with asthma and airway inflammation were estimated using adjusted binary logistic regressions. The odds of having airway inflammation decreased with the increase in PHDI score. Moreover, children in the non-overweight/non-obesity group in the fourth quartile of the PHDI had lower odds of having airway inflammation compared to children in the first quartile. Our study indicates that a healthier and sustainable diet is associated with lower levels of eNO, but only among children without overweight/obesity. [ABSTRACT FROM AUTHOR]

ABSTRACT Recognition of obesity as a treatable trait of asthma, impacting its development, clinical presentation and management, is gaining widespread acceptance. Obesity is a significant risk factor and disease modifier for asthma, complicating treatment. Epidemiological evidence highlights that obese asthma correlates with poorer disease control, increased severity and persistence, compromised lung function and reduced quality of life. Various mechanisms contribute to the physiological and clinical complexities observed in individuals with obesity and asthma. These encompass different immune responses, including Type IVb, where T helper 2 cells are pivotal and driven by cytokines like interleukins 4, 5, 9 and 13, and Type IVc, characterised by T helper 17 cells and Type 3 innate lymphoid cells producing interleukin 17, which recruits neutrophils. Additionally, Type V involves immune response dysregulation with significant activation of T helper 1, 2 and 17 responses. Finally, Type VI is recognised as metabolic‐induced immune dysregulation associated with obesity. Body mass index (BMI) stands out as a biomarker of a treatable trait in asthma, readily identifiable and targetable, with significant implications for disease management. There exists a notable gap in treatment options for individuals with obese asthma, where asthma management guidelines lack specificity. For example, there is currently no evidence supporting the use of incretin mimetics to improve asthma outcomes in asthmatic individuals without Type 2 diabetes mellitus (T2DM). In this review, we advocate for integrating BMI into asthma care models by establishing clear target BMI goals, promoting sustainable weight loss via healthy dietary choices and physical activity and implementing regular reassessment and referral as necessary. [ABSTRACT FROM AUTHOR]

Introduction: Component‐resolved diagnosis (CRD) has been decisive in exploring the mechanisms of IgE sensitization, but the predictive ability to detect asthma has not been addressed. We aim to develop and evaluate the performance of a personalized predictive algorithm for asthma that integrates information on allergic sensitization using CRD. Methods: One thousand one hundred one twenty‐five children from the Generation XXI birth cohort were randomly selected to perform a screening test for allergic sensitization and a subsample was characterized using CRD against 112 allergen components. Allergen components were analyzed using volcano plots and partial least squares (PLS) analysis. Logistic regression was performed to assess the associations between the obtained latent components (LC) and allergic outcomes (asthma, rhinitis, eczema) including other potential predictors used in previous asthma risk scores. The accuracy of the model in predicting asthma was assessed using Receiver Operating Characteristic (ROC) curve statistics. Results: In the PLS, the first LC was positively associated with asthma, rhinitis, and eczema. This LC was mainly driven by positive weights for Der p 1/2/23, Der f 1/2, and Fel d 1. The main components in the second LC were pollen and food allergens. History of early wheezing and parental allergy were included in the predictive model and the area under the curve improved to 0.82. Conclusions: This is the first approach to improve the clinical applicability of CRD by combining CRD and clinical data to predict asthma at 13 years. Sensitization to distinct allergen molecules seems relevant to improve the accuracy of asthma prediction models. [ABSTRACT FROM AUTHOR]

An adequate sodium intake is related to various health benefits. Parallelly, the Mediterranean diet (MD) is a dietary pattern known for its many positive impacts on health. Nonetheless, the association between adherence to the MD and sodium urinary excretion is scarce, even more in children. This study aimed to assess the association between MD adherence and the excretion of sodium, as a proxy of intake. This cross-sectional analysis comprised 295 children (46.8% females, aged 7–11 years, mean age: 8.53 ± 0.73 years) from 20 schools within Porto, Portugal. MD adherence was evaluated utilizing the alternate Mediterranean score (aMED). Higher scores denote a healthier dietary pattern (0–8). Sodium excretion was estimated by 24-h urine collection. The association between adherence to MD and Na excretion was estimated by logistic regression, adjusting for confounders. Children in the higher sodium excretion group had a higher intake of legumes, a higher body mass index and parents with lower education levels compared to children in the lower sodium excretion group. In logistic regression analysis, sodium urinary excretion was not associated with higher MD adherence, even after adjustment for confounders. High MD adherence could not be associated with lower sodium excretion in children. [ABSTRACT FROM AUTHOR]

There seems to exist an intricate relationship between airway inflammation, body mass index (BMI), and diet. The intake of specific foods or food groups has been suggested to suppress the oxidative stress and inflammatory processes that characterize airway inflammation, but little is known about dietary patterns and their complex interplay with BMI and airway inflammation. Therefore, this cross-sectional study aimed to explore the association between adherence to the Mediterranean diet (MD), a characteristic European diet, and levels of airway inflammation in school-aged children, taking into account their BMI. This cross-sectional analysis comprised 660 children: 49.1% females, 7–12 years old. Adherence to the MD was assessed through the alternate Mediterranean score (aMED). Higher scores represent a healthier diet (0–8). Airway inflammation was assessed measuring exhaled fractional nitric oxide (eNO). Two categories of BMI were considered: non-overweight/non-obese (p < 85th) and overweight/obese (p ≥ 85th). The associations between diet and airway inflammation were estimated using logistic regression models. Higher scores of the aMED were associated with decreased odds of having eNO ≥ 35 ppb, but only in non-overweight/non-obese children (OR = 0.77; 95% CI, 0.61–0.97). For overweight/obese children, the previous association was not significant (OR = 1.57, 95% CI, 0.88–2.79). Our findings suggest that adherence to the MD is associated with lower levels of airway inflammation among non-overweight/non-obese children. [ABSTRACT FROM AUTHOR]

Background: The characteristics of allergic sensitization profiles can differ between populations and geographic regions, contributing differently to the association with allergic diseases. Consequently, the sensitization trajectories found in previous studies conducted in Northern Europe may not apply in Southern European countries. Objective: To identify trajectories of allergic sensitization profiles during childhood and evaluate the association with allergic outcomes, using data from a Portuguese birth cohort. Methods: A random sample from Generation XXI was screened for allergic sensitization at 10 years of age. Among 452 allergic sensitized children, 186 were tested with ImmunoCAP™ ISAC multiplex array that detects 112 molecular components, at three follow‐ups (4, 7, and 10 years old). Information on allergic outcomes (asthma, rhinitis, atopic dermatitis) was obtained at the 13‐year‐old follow‐up. Latent class analysis (LCA) was used to identify clusters of participants with similar sensitization profiles. Then, sensitization trajectories were defined based on the most prevalent transitions between clusters over time. Logistic regression was applied to estimate the association between sensitization trajectories and allergic diseases. Results: Five trajectories were proposed: "no/few sensitizations," "early persistent house dust mites (HDM)," "early HDM and persistent/late grass pollen," "late grass pollen," and "late HDM." The "early HDM and persistent/late grass pollen" trajectory was associated with rhinitis and "early persistent HDM" with asthma and rhinitis. Conclusion: Distinct sensitization trajectories pose different risks in the development of allergic diseases. These trajectories present some differences from those in Northern European countries and are important for planning adequate prevention health plans. [ABSTRACT FROM AUTHOR]

Asthma is a chronic respiratory disease that impacts millions of people worldwide. Recent studies suggest that diet may play a role in asthma pathophysiology. Several dietary factors have been recognized as potential contributors to the development and severity of asthma for its inflammatory and oxidative effects. Some food groups such as fruits and vegetables, whole grains, and healthy fats appear to exert positive effects on asthma disease. On the other hand, a high consumption of dietary salt, saturated fats, and trans-fat seems to have the opposite effect. Nonetheless, as foods are not consumed separately, more research is warranted on the topic of dietary patterns. The mechanisms underlying these associations are not yet fully understood, but it is thought that diet can modulate both the immune system and inflammation, two key factors in asthma development and exacerbation. The purpose of this review is to examine how common food groups and dietary patterns are associated with asthma. In general, this research demonstrated that fruits and vegetables, fiber, healthy fats, and dietary patterns considered of high quality appear to be beneficial to asthma disease. Nonetheless, additional research is needed to better understand the interrelation between diet and asthma, and to determine the most effective dietary interventions for asthma prevention and management. Currently, there is no established dietary pattern for asthma management and prevention, and the nuances of certain food groups in relation to this disease require further investigation. [ABSTRACT FROM AUTHOR]

Exhaled breath condensate (EBC) analysis is a recently developed, non-invasive method used to identify and quantify biomarkers, mainly those coming from the lower respiratory tract. It seems that diet can influence the airway's inflammation and change the exhaled breath composition. This study aimed to assess the association between diet quality intake and markers in EBC among school-aged children. A cross-sectional analysis included 150 children (48.3% females, aged 7–12 years, mean age: 8.7 ± 0.8 years) from 20 schools across Porto, Portugal. We assessed diet quality through the Healthy Eating Index (HEI)-2015, which was estimated based on a single 24 h food recall questionnaire. EBC samples were collected, and we assessed their ionic content (Na+, K+) and conductivity. The association between diet quality and Na+, K+, Na+/K+ ratio and conductivity was estimated using logistic regression models adjusted for potential confounders. After adjustment, a higher quality diet score increases the odds of higher conductivity values of the EBC (aOR = 1.04, 95%CI 1.00; 1.08). Our findings suggest that a higher diet quality in school-aged children is associated with higher conductivity levels of the EBC. [ABSTRACT FROM AUTHOR]

The goal of this work was to examine whether elevated iodine intake was associated with adverse effects on IQ among school-age children in Portugal. In a representative sample of children from the north of the country, IQ percentiles by age (assessed with Raven's Colored Progressive Matrices) were dichotomized to <50 ("below-average" IQs) and ≥50. Morning urine iodine concentrations, corrected for creatinine, were dichotomized to <250 µg/g and ≥250 µg/g, according to the European Commission/Scientific Committee on Food's tolerable upper level of daily iodine intake for young children. Data were examined with Chi-square tests, logistic regression, and GLM univariate analysis. The sample (N = 1965) was classified as generally iodine-adequate (median urinary iodine concentration = 129 µg/L; median iodine-to-creatinine ratio = 126 µg/g) according to the WHO's criteria. A greater proportion of children in the ≥250 µg/g group had below-average IQs, compared to children with less than 250 µg/g (p = 0.037), despite a sizable (though non-significant) proportion of children in the less-than-250 µg/g group also presenting below-average IQs, at the bottom of the iodine distribution (<50 µg/g). The proportion of below-average IQs increased with increasingly elevated iodine concentrations (p = 0.047). The association remained significant after the adjustment for confounders, with the elevated iodine group showing increased odds of having below-average IQs when compared with the non-elevated iodine group (OR 1.55; 95% CI 1.11–2.17; p = 0.011). Consistently, the former group presented a lower mean IQ than the latter (p = 0.006). High iodine intake was associated with lower IQs even in a population classified as iodine-adequate. These results bear on child cognition and on initiatives involving iodine supplementation. [ABSTRACT FROM AUTHOR]

Background: Cost‐effectiveness studies evaluating allergen immunotherapy (AIT) in children are limited but needed to drive clinical and policy‐making decisions such as reimbursement of new interventions. In this study, we compared the cost effectiveness of subcutaneous (SCIT) and sublingual immunotherapy (SLIT) tablets to the standard of care (SOC) treatment in children with house dust mite‐driven (HDM) allergic asthma. Methods: We developed a hypothetical Markov model based on the Global Initiative for Asthma (GINA) severity steps to compare the three strategies over a 10‐year horizon divided by cycles of 6 months. SOC was used as a reference to calculate the incremental cost‐effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses were used to assess models' uncertainty. Other scenarios were evaluated to strengthen the presentation of results. Results: The ICER for SCIT and SLIT tablets was 1281€ and 7717€, respectively. The cost‐effectiveness threshold for Portugal was 18,482.80€; both treatment approaches were below this limit. The major contributors to these results were the AIT effects on reducing moderate and severe exacerbations and asthma controller medication. In the sensitivity analysis, SCIT revealed a higher probability of cost‐effectiveness than SLIT. When including allergic rhinitis as comorbidity, ICER values reduced markedly, especially for SCIT intervention. Conclusions: AIT was cost effective in children with HDM‐driven allergic asthma, especially when given by the subcutaneous route. The high probability of cost effectiveness, especially for SCIT, may drive future policy decisions and AIT‐prescribing habits. AIT adherence greatly influenced the results highlighting the value of implementing strategies to promote adherence rates. [ABSTRACT FROM AUTHOR]

Background: Allergen immunotherapy (AIT) is a disease‐modifying treatment for IgE‐mediated diseases. Randomized controlled trials (RCTs) support AIT's potential role in asthma prevention but evidence from non‐randomized studies of interventions (NRSI) and longitudinal observational studies has been poorly addressed. Therefore, we aimed to conduct a systematic review and meta‐analysis to assess clinical data from all study types to evaluate quantitatively the preventive role of AIT in asthma onset. Methods: We search three databases. Studies were screened, selected and evaluated for quality using risk‐of‐bias (ROB) tools. Data were descriptively summarized and meta‐analysed using random effects. We performed a sensitivity, influence and subgroup analyses. Publication bias and heterogeneity were assessed. Results: From the 4549 identified studies, 24 (12 RCTs and 12 NRSI) were included in the qualitative synthesis and 18 underwent meta‐analysis. One study was at low ROB, seven had moderate ROB, and 15 were proven of high ROB. Random‐effects analysis showed a significant decrease in the risk of developing asthma following AIT by 25% (RR, 95% CI: 0.75, 0.64–0.88). This effect was not significant in the sensitivity analysis. Publication bias raised concerns, together with the moderate heterogeneity between studies (I2 = 58%). Subgroup analysis showed a remarkable preventive effect of AIT in children (RR, 95% CI: 0.71, 0.53–0.96), when completing 3 years of therapy (RR, 95% CI: 0.64, 0.47–0.88), and in mono‐sensitized patients (RR, 95% CI: 0.49, 0.39–0.61). Conclusions: Our findings support a possible preventive effect of AIT in asthma onset and suggest an enhanced effect when administered in children, mono‐sensitized, and for at least 3 years, independently of allergen type. [ABSTRACT FROM AUTHOR]

Individual nutrients and bioactive compounds have been implicated in the expression of microRNAs (miRNAs), which are related to inflammation and asthma. However, evidence about the impact of diet is scarce. Therefore, we aimed to assess the association between dietary acid load and asthma-related miRNA in the exhaled breath condensate (EBC) of school-aged children. This cross-sectional analysis included 150 participants aged 7 to 12 years (52% girls) from a nested case–control study, which randomly selected 186 children attending 71 classrooms from 20 public schools located in city of Porto, Portugal. Dietary data were collected by one 24 h-recall questionnaire. Dietary acid load was assessed using the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. Based on previous studies, eleven asthma-related miRNAs were chosen and analyzed in EBC by reverse transcription-quantitative real-time PCR. PRAL, NEAP and miRNAs were categorized as high or low according to the median. Logistic regression models were performed to assess the association between dietary acid load scores and miRNAs. Children in high dietary acid load groups (PRAL ≥ 14.43 and NEAP ≥ 55.79 mEq/day) have significantly increased odds of having high miR-133a-3p levels. In conclusion, higher dietary acid loads possibly modulate asthma-related miRNAs of school-aged children. [ABSTRACT FROM AUTHOR]

Background: A diet rich in fruits and vegetables has been suggested to counteract the oxidative stress and inflammation that characterize asthma. We aimed to assess the association between vegetable and fruit diversity consumption and asthma and its related outcomes in school‐aged children. Methods: Participants included 647 children (49% females, aged 7‐12 years) recruited from 20 public schools across the city of Porto, in Portugal. Vegetable intake and fruit intake were ascertained using a single self‐reported 24‐hour recall questionnaire. A diversity score was built taking into account the different number of individual vegetables and fruits consumed and categorized into two groups based on the total reported median consumption, which was rounded to the nearest whole number (≤3 and >3, for vegetables; and ≤1 and >1, for fruits). A questionnaire was used to enquire about self‐reported medical diagnosis of asthma and respiratory symptoms. Airway inflammation was assessed measuring exhaled fractional nitric oxide concentration (eNO) and was categorized into two groups (<35 and ≥35 ppb). The association between fruit and vegetable diversity and respiratory outcomes was examined using logistic regression models, adjusting for confounders. Results: A higher vegetable diversity consumption per day was negatively associated with having self‐reported asthma (OR = 0.67; 95% CI 0.47, 0.95), while having a vegetable diversity consumption superior to 3 items per day was negatively associated with levels of eNO ≥ 35 ppb (OR = 0.38; 95% CI 0.16, 0.88) and breathing difficulties (OR = 0.39; 95% CI 0.16, 0.97). Conclusion: Eating a greater variety of vegetables was associated with a lower chance of airway inflammation and prevalence of self‐reported asthma in school children. [ABSTRACT FROM AUTHOR]

Background: Analyses of exhaled volatile organic compounds (VOCs) have shown promising results when distinguishing individuals with asthma. Currently, there are no biomarkers for uncontrolled asthma. Therefore, we aimed to assess, in a real‐life clinical setting, the ability of the exhaled VOC analysis, using an electronic nose (eNose), to identify individuals with uncontrolled asthma. Methods: A cross‐sectional study was conducted, and breath samples from 199 participants (130 females, aged 6‐78, 66% with asthma) were analysed using an eNose. A multivariate unsupervised cluster analysis, using the resistance data from 32 sensors, could distinguish three clusters of VOC patterns in the training and testing groups. Comparisons between the clusters were performed using the one‐way ANOVA, Kruskal‐Wallis and chi‐squared tests. Results: In the training set (n = 121), three different clusters covering asthma, lung function, symptoms in the previous 4 weeks and age were identified. The pairwise comparisons showed significant differences with respect to chest tightness during exercise, dyspnoea and gender. These findings were confirmed in the testing set (n = 78) where the training model identified three clusters. The participants who reported fewer respiratory symptoms (dyspnoea and night‐time awakenings) were grouped into one cluster, while the others comprised participants who showed similar poor control over symptoms with the distribution of the individuals with asthma being significantly different between them. Conclusions: In a clinical setting, the analysis of the exhaled VOC profiles using an eNose could be used as a fast and noninvasive complementary assessment tool for the detection of uncontrolled asthma symptoms. [ABSTRACT FROM AUTHOR]

Background: Inhalation of fine particulate matter (PM) can cause systematic inflammation and oxidative stress, which may further aggravate the development and progression of asthma. Although nutritional intake of fatty acids and antioxidants may attenuate some effects of fine PM, the role of the inflammatory potential of diet has not been addressed. Therefore, we aimed to investigate possible modulatory effects of dietary inflammatory potential on the association between indoor air pollution and childhood asthma–related outcomes. Methods: In a sample of 501 children (48.1% females, aged 7‐12 years) from 20 public schools located in Porto, Portugal, we evaluated airway reversibility, exhaled nitric oxide levels, atopy, and current respiratory symptoms. Dietary inflammatory index was calculated based on information collected through a reported 24‐hour recall questionnaire, and participants were categorized as having an anti‐inflammatory or pro‐inflammatory diet. Concentrations of indoor PM2.5 and PM10 were measured to assess indoor air quality. Generalized linear mixed models were used to investigate the proportion of effects explained by the exposure to PM2.5 and PM10. Results: After adjustment, the exposure effect of PM2.5 and PM10 levels on children with asthma was higher for those having a pro‐inflammatory diet (OR = 1.44, 95% CI: 1.01‐2.21; and OR = 1.29, 95% CI: 1.03‐1.68, respectively) compared to those having an anti‐inflammatory diet. Conclusion: These findings suggest that the quality of diet might affect the association between indoor pollution and asthma in children, highlighting the relevance of children's diet as a potential protective factor to pollutant exposure in childhood asthma. [ABSTRACT FROM AUTHOR]

Detection and quantification of microRNAs (miRNAs) in exhaled breath condensate (EBC) has been poorly explored. Therefore we aimed to assess miRNAs in EBC as potential biomarkers to diagnose and endotype asthma in school aged children. In a cross sectional, nested case control study, all the asthmatic children (n = 71) and a random sample of controls (n = 115), aged 7 to 12 years, attending 71 classrooms from 20 local schools were selected and arbitrarily allocated to the development or validation set. Participants underwent skin-prick testing, spirometry with bronchodilation, had exhaled level of nitric oxide determined and EBC collected. Based on previous studies eleven miRNAs were chosen and analyzed in EBC by reverse transcription-quantitative real-time PCR. Principal component analysis was applied to identify miRNAs profiles and associations were estimated using regression models. In the development set (n = 89) two clusters of miRNAs were identified. After adjustments, cluster 1 and three of its clustered miRNAs, miR-126-3p, miR-133a-3p and miR-145-5p were positively associated with asthma. Moreover miR-21-5p was negatively associated with symptomatic asthma and positively associated with positive bronchodilation without symptoms. An association was also found between miR-126-3p, cluster 2 and one of its clustered miRNA, miR-146-5p, with higher FEF25-75 reversibility. These findings were confirmed in the validation set (n = 97) where two identical clusters of miRNAs were identified. Additional significant associations were observed between miR-155-5p with symptomatic asthma, negative bronchodilation with symptoms and positive bronchodilation without symptoms. We showed that microRNAs can be measured in EBC of children and may be used as potential biomarkers of asthma, assisting asthma endotype establishment. [ABSTRACT FROM AUTHOR]

Background: Indoor air contaminants may act as endocrine‐disrupting chemicals (EDCs). However, to what extent these contaminants affect health is poorly known. We aimed to assess the association between EDCs exposure and asthma, respiratory symptoms and obesity in schoolchildren. Methods: Data from a cross‐sectional analysis of 815 participants from 20 schools in Porto, Portugal, were analysed. Symptoms were assessed, asthma was defined on lung function, and airway reversibility and body mass index (BMI) were calculated. The concentrations of 13 volatile organic compounds and 2 aldehydes identified as EDCs were measured in 71 classrooms throughout 1 week. Principal component analysis (PCA) was used to assess the effect of co‐exposure. Associations were estimated by regression coefficients using linear and logistic regression models. Results: Increased individual and combined EDCs levels were found in classrooms having more children with asthma and obesity. Higher levels of hexane, styrene, cyclohexanone, butylated hydroxytoluene and 2‐butoxyethanol were associated with obesity, and higher levels of cyclohexanone were associated with increased child BMI. Toluene, o‐xylene, m/p‐xylene and ethylbenzene were significantly associated with nasal obstruction. A positive association was found between PC1 and the risk of obese asthma (OR = 1.43, 95% CI 1.01, 1.98) and between PC2 and overweight (OR = 1.51, 95% CI 1.28, 1.79). PC1 and PC2 were also associated with nasal obstruction, and PC2 was associated with breathing difficulties and lean body mass, although EDCs concentrations were low. Conclusions: Our findings further support the role of EDCs in asthma and obesity development. Moreover, even low levels of indoor exposure may influence the risk of asthma, respiratory symptoms and obesity. [ABSTRACT FROM AUTHOR]

Background: The diagnosis and phenotyping of paediatric asthma are particularly complex due to the lack of currently available sensitive diagnostic tools. This often results in uncertainties associated with inhaled steroid therapy prescription. Therefore, this study aimed to investigate whether volatile organic compounds measured in exhaled breath condensate can be used as biomarkers for asthma diagnosis in the paediatric population. Methods: A total of 64 participants, aged 6‐18 years, were recruited on a random basis during visits to an outpatient allergy clinic and to a juvenile football team training session. Lung function, airway reversibility and skin prick tests were performed. Exhaled breath condensate samples were collected, and breathprints were assessed using an electronic nose. Information on medical diagnosis of asthma, rhinitis and atopic dermatitis was retrieved for each participant. A hierarchical cluster model based on the volatilome profiles was then created. Results: A two‐cluster exhaled volatile organic compound‐based hierarchical model was able to significantly discriminate individuals with asthma from those without the disease (AUC = 0.81 [0.69‐0.93], P < 0.001). Individuals who had persistent asthma and were prescribed corticosteroid therapy by the physician were also significantly distinguished in the model (AUC = 0.81 [0.70‐0.92], P < 0.001). Despite being less specific, the method showed higher overall accuracy, sensitivity and AUC values when compared to spirometry with bronchodilation. Conclusions: Analysis of the exhaled breath condensate volatilome allowed the distinction of paediatric individuals with a medical diagnosis of asthma, identifying those in need of corticosteroid therapy. The developed breathomics model was able to identify individuals with asthma and with persistent asthma with improved performance over spirometry with bronchodilation. The study shows that a breathomics model was able to identify individuals with a medical diagnosis of asthma with high accuracy. Individuals with asthma in need of inhaled corticosteroid therapy were significantly clustered in the model. Breathomics has the potential to assist the physician in the diagnosis of asthma and/or administration of corticosteroid therapy for paediatric patients with asthma. [ABSTRACT FROM AUTHOR]

Keywords: asthma; bronchodilator response; diagnosis; pediatrics; responsiveness cutoffs EN asthma bronchodilator response diagnosis pediatrics responsiveness cutoffs 371 373 3 02/02/21 20210201 NES 210201 To the editor, The term asthma refers to a heterogeneous group of diseases characterized by variable and reversible airflow limitation. Diagnosis of asthma was based on parent-reported prior medical diagnosis, previously demonstrated by our group to be the most accurate measure to predict questionnaire-driven symptom patterns, for this sample.5 We assessed the normal range for BDR of each measure in healthy children, that is, with no previous parent-reported medical diagnosis of asthma. In children, while over-diagnosis is an issue to be tackled, under-diagnosis is still a problem.8 As such, increasing the cutoff to 16% may cause damage to a countless number of children with asthma and the authors do not recommend its use. [Extracted from the article]

Objective: To evaluate the antidiabetic effect of galactomannans extracted from Adenanthera pavonina's L. seeds (GAP) in streptozotocin (STZ) induced diabetic mice. Methods: The preliminary galactomannan yield from Adenanthera pavonina L. plant and extraction products composition were evaluated. Various chemical characterization methods like thin layer chromatography, Fourier transform infrared spectroscopy, ¹H and 13C nuclear magnetic resonance, and molecular weight by gel permeation chromatography have been employed to characterize the extracted galactomannan. The mice were divided in four groups: Normal control, diabetic control, GAP (1% and 2%) treated and standard drug treated groups. Diabetic mice received treatment daily for 30 d. Diabetes was induced by STZ at a single dose of 120 mg/kg. Body weight, water and food intake, fasting blood glucose, total cholesterol and triglycerides were measured. Histopathological analysis of pancreas and liver were performed to evaluate STZ-induced tissue injuries. Results: The isolated and extracted galactomannan from Adenanthera pavonina was confirmed by various chemical characterization methods. GAP exhibited a 1.46:1 mannose: galactose ratio, and high molar weight. Both GAP enriched food decreased glycaemia, total cholesterol and triacylglycerol. GAP didn't interfere on food intakes or body weight, although it increased water intake. Furthermore, the relative liver weight indicated toxic galactomannan effects on the histopathological changes of the pancreas in STZ induced diabetes. Conclusions: It is concluded that GAP is a natural product that contains potent galactomannan and is useful in preventing and treating diabetes. [ABSTRACT FROM AUTHOR]

The present objective of the investigation is to evaluate the antihypercholesterolemic activity of the aqueous fruit pulp extract (APE) of Copernicia prunifera (Miller) H. E. Moore (Arecaceae family). Various chemical characterization methods like thin layer chromatography, Fourier transform infrared spectroscopy, 1H and 13C NMR, and molecular weight by gel permeation chromatography have been employed to characterize the extracted pectin. The present study demonstrated that hypercholesterolemic diet (HD) created hypercholesterolemia, caused significant increases in body weight, total cholesterol, and low-density lipoprotein, and caused decreases in high-density lipoprotein in serum compared with SD group. Two doses (APE 150 and 300 mg/Kg b.w./day) were administered to hyperlipidemic mice for 90 days. APE reversed body weight changes, changed serum lipids to normal values, and significantly inhibited the changes of lipid peroxidation and inflammation in the liver tissues. The renal parameters analyzed (urea and creatinine) altered by diet were reverted to normal values. Our results revealed that aqueous fruit pulp extracts of carnauba reduced hypercholesterolemia showing a potential preventive effect against cardiovascular diseases without side effects cause. [ABSTRACT FROM AUTHOR]

The World Health Organization promotes salt iodisation to control iodine deficiency. In Portugal, the use of iodised salt in school canteens has been mandatory since 2013. The present study aimed to evaluate iodine status in school-aged children (6-12 years) and to monitor the use of iodised salt in school canteens. A total of 2018 participants were randomly selected to participate in a cross-sectional survey in northern Portugal. Children's urine and salt samples from households and school canteens were collected. A lifestyle questionnaire was completed by parents to assess children's eating frequency of iodine food sources. Urinary iodine concentration (UIC) was measured by inductively coupled plasma-mass spectrometry. The median UIC was 129 Mg/L which indicates the adequacy of iodine status and 32% of the children had UIC < 100 µg/L. No school canteen implemented the iodised salt policy and only 2% of the households were using iodised salt. Lower consumption of milk, but not fish, was associated with a higher risk of iodine deficiency. Estimation of sodium intake from spot urine samples could be an opportunity for adequate monitoring of population means. Implementation of iodine deficiency control policies should include a monitoring program aligned with the commitment of reducing the population salt intake. [ABSTRACT FROM AUTHOR]

The caatinga, an exclusively Brazilian biome, is one of the most endangered vegetation systems in the planet. To be exploited rationally, its potential needs to be scientifically demonstrated. Among these is the faveleira, used in northeastern Brazil. It stands out for its extraordinary drought resistance and medicinal properties. The objective of this study was to assess the therapeutic potential of compounds extracted from Cnidoscolus quercifolius Pohl in preventing disease and its rational use as a herbal therapeutic tool. The methodology began with the collection and herborization of the plant material, to obtain the chemical compounds, preliminary phytochemical analysis, and extraction of the constituents of the active extracts. To determine the biological activities the authors conducted investigation of antioxidant and antimicrobial activities, inhibition capacity of the acetylcholinesterase enzyme, and initial assessment of toxicity of the extracts. The results demonstrated great potential as an antimicrobial agent, an important antioxidant capacity, and acetylcholinesterase inhibition response with no significant difference compared with the reference drug. The authors expect to develop a new herbal product, resulting in lower production costs and that, consequently, could be commercialized in more accessible form to the population, highlighting the risk reduction of contraindication of this category of medications. [ABSTRACT FROM AUTHOR]

This study aimed to determine the content of quercetin, rutin and isoquercitrin in by-products of certain fruits and vegetables sold in northeastern Brazil and propose their use as functional ingredients in food production. Skins from avocado (Persea americana Mill.), acerola (Malpighia emarginata DC.), beet (Beta vulgaris L.), cajarana (Spondias dulcis Parkinson), yellow and red onion (Allium cepa L.), guava (Psidium guajava L.), kiwi (Actinidia deliciosa (A. Chev.) E. F. Liang and A. R. Ferguson), seriguela (Spondias purpurea L.) and umbu (Spondias tuberosa Arr. Cam.) were freeze-dried and subjected to extraction with organic solvents. The extracts obtained were analysed for selected flavonoids using high-performance liquid chromatography. The highest levels of quercetin were found in red onion (19 836.11 mg·kg-1), yellow onion (4 917.11 mg·kg-1), acerola (60.28 mg·kg-1) and umbu (55.98 mg·kg-1). Rutin had high contents in cajarana (4 198.46 mg·kg-1), umbu (3 265.37 mg·kg-1), acerola (1 538.29 mg·kg-1) and yellow onion (1 362.91 mg·kg-1). Isoquercitrin was found only in red onion (1 475.76 mg·kg-1), acerola (388.46 mg·kg-1), guava (295.37 mg·kg-1) and umbu (288.91 mg·kg-1). The levels of flavonoids found may be sufficient to use them as functional ingredients and fortify certain foods with health-promoting compounds, thereby adding value to food processing waste materials. [ABSTRACT FROM AUTHOR]

Surfaces with antimicrobial properties are gaining notoriety as an efficient method to avoid surface contamination. Self-disinfecting paints are a promising strategy towards cleaner indoor environments by preventing the colonization of walls with microorganisms. However, its widespread use needs an appropriate toxicological safety evaluation due to the potential for biological disturbance associated to its biocidal activity. In this work, the cyto- and genotoxic assessment of two self-disinfecting paints containing the antimicrobial substances triclosan (TCS) and isoborneol (ISB) is performed. HaCaT and A549 cell lines models were selected for the in vitro assessment. To evaluate the cytotoxicity, tests by direct contact and on extracts obtained from leaching were performed following ISO 10993, whereas the genotoxicity was assessed by comet assay and cytokinesis-block micronucleus (CBMN) assay. The results showed low levels of cyto- and genotoxicity under the models and conditions tested, indicating that these substances have commercial potential. [ABSTRACT FROM AUTHOR]

Wound care has been clinically demanding due to inefficacious treatment that represents an economic burden for healthcare systems. In Europe, approximately 7 million people are diagnosed with untreated wounds, leading to a cost between 6.000€ and 10.000€ per patient/year. In the United States of America, 1.5 million people over 65 years old suffer from chronic wounds. A promising therapeutic strategy is the use of exogenous growth factors because they are decreased at the wound site, limiting the recovery of the skin. Insulin is one of the cheapest growth factors in the market able to accelerate the re-epithelialization and stimulate angiogenesis and cell migration. However, the effectiveness of topical insulin in wound healing is hampered by the proteases in the wound bed. The encapsulation into nanoparticles improves its stability in the wound, providing adhesion to the mucosal surface and allowing its sustained release. The aim of this review is to perform a standing point about a promising strategy to treat different types of wounds by the topical delivery of insulin-loaded nanocarriers. [ABSTRACT FROM AUTHOR]