Astma Kinderen Wetenschap

Small intestinal bacterial overgrowth: could it be associated with chronic abdominal pain in children with allergic diseases?
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Small intestinal bacterial overgrowth: could it be associated with chronic abdominal pain in children with allergic diseases?

Rev Esp Enferm Dig. 2019 Oct 16;111:

Authors: Peña-Vélez R, Toro-Monjaraz E, Avelar-Rodríguez D, Ignorosa-Arellano K, Zárate-Mondragón F, Cervantes-Bustamante R, Montijo-Barrios E, Cadena-León J, Ramírez-Mayans J

Abstract
BACKGROUND AND AIMS: small intestinal bacterial overgrowth (SIBO) is a well-known cause of chronic abdominal pain (CAP) during the pediatric age. On the other hand, children with a history of some allergic disorder present CAP more frequently. The aim of this study was to determine the association between the presence of allergic diseases and SIBO in patients diagnosed with CAP.
MATERIALS AND METHODS: this was an observational, analytical, retrospective study. Children with CAP who had undergone a lactulose hydrogen breath test to determine the presence of SIBO were included in the study. All patients underwent an evaluation for allergies by means of a skin prick test or the determination of specific IgE, according to clinical diagnosis. The study groups were established according to the presence of SIBO and the results of the allergic evaluation were statistically compared between the groups.
RESULTS: seventy patients were included (41 females and 29 males) and SIBO was diagnosed in 35 patients. In addition, 71.4% of children with SIBO were found to have an allergic disease, in contrast with 28.6% of children without SIBO (p = 0.001). The odds ratio for having any type of allergy in patients with SIBO was 5.45 (95% CI, 1.96-15.17; p = 0.001).
CONCLUSIONS: we found an association between SIBO and allergic disease, especially allergic rhinitis, cow's milk protein allergy and asthma. Thus, SIBO should be ruled out in pediatric patients with CAP and allergic disease.

PMID: 31617366 [PubMed - as supplied by publisher]



Exploratory Study of Signals for Asthma Drugs in Children, Using the EudraVigilance Database of Spontaneous Reports.
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Exploratory Study of Signals for Asthma Drugs in Children, Using the EudraVigilance Database of Spontaneous Reports.

Drug Saf. 2019 Oct 15;:

Authors: Baan EJ, de Smet VA, Hoeve CE, Pacurariu AC, Sturkenboom MCJM, de Jongste JC, Janssens HM, Verhamme KMC

Abstract
INTRODUCTION: As asthma medications are frequently prescribed for children, knowledge of the safety of these drugs in the paediatric population is important. Although spontaneous reports cannot be used to prove causality of adverse events, they are important in the detection of safety signals.
OBJECTIVE: Our objective was to provide an overview of adverse drug events associated with asthma medications in children from a spontaneous reports database and to identify new signals.
METHODS: Spontaneous reports concerning asthma drugs were obtained from EudraVigilance, the European Medicine Agency's database for suspected adverse drug reactions. For each drug-event combination, we calculated the proportional reporting ratio (PRR) in the study period 2011-2017. Signals in children (aged 0-17 years) were compared with signals in the whole population. Analyses were repeated for different age categories, by sex and by therapeutic area.
RESULTS: In total, 372,345 reports in children resulted in 385 different signals concerning asthma therapy. The largest group consisted of psychiatric events (65 signals). Only 30 signals were new, with seven, including herpes viral infections, associated with omalizumab. Stratification by age, sex and therapeutic area provided additional new signals, such as hypertrichoses with budesonide and encephalopathies with theophylline. Of all signals in children, 60 (16%) did not appear in the whole population.
CONCLUSIONS: The majority of signals regarding asthma therapy in children were already known, but we also identified new signals. We showed that signals can be masked if age stratification is not conducted. Further exploration is needed to investigate the risk and causality of the newly found signals.

PMID: 31617080 [PubMed - as supplied by publisher]



Association between soft drinks consumption and asthma: a systematic review and meta-analysis.
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Association between soft drinks consumption and asthma: a systematic review and meta-analysis.

BMJ Open. 2019 Oct 14;9(10):e029046

Authors: Al-Zalabani AH, Noor Elahi I, Katib A, Alamri AG, Halawani A, Alsindi NM, Almatrafi M, Wesselius A, Stewart KFJ

Abstract
OBJECTIVES: To carry out meta-analysis and systematic review on the association between soft drinks consumption and asthma prevalence among adults and children.
DESIGN: Systematic review and meta-analysis of observational research.
DATA SOURCES: Medline, Scopus, ISI Web of Science and the Cochrane Library were searched up to December 2018.
ELIGIBILITY CRITERIA: We included observational studies investigating the association between soft drinks consumption (including maternal consumption during pregnancy) and asthma or wheeze.
DATA EXTRACTION AND SYNTHESIS: Data were extracted by one author and reviewed independently by two other authors. The most adjusted estimate from each original study was used in the meta-analysis. Meta-analysis was conducted using random-effects model. The quality of studies was assessed using the Newcastle-Ottawa scale and heterogeneity was evaluated using I2 statistic.
RESULTS: Of 725 publications originally identified, 19 were included in this systematic review, including 3 cohort studies and 16 cross-sectional studies. Ten articles reported on children up to 18 years, 5 articles on adults (>18 years) and 2 articles on prenatal exposure. In total, 468 836 participants were included, with more than 50 000 asthma cases. Soft drinks consumption was associated with significantly increased odds of asthma in both adults (OR=1.37; 95% CI, 1.23 to 1.52) and children (OR=1.14; 95% CI, 1.06 to 1.21). Prenatal exposure had marginally statistically significant association (OR=1.11; 95% CI, 1.00 to 1.23) with asthma in children. In subgroup analysis for childhood exposure, the association persists for sugar-sweetened soft drinks but not for carbonated drinks.
CONCLUSION: Our findings show a positive association between soft drinks consumption and asthma prevalence, mostly from cross-sectional studies. Therefore, more longitudinal research is required to establish causality.

PMID: 31615794 [PubMed - in process]



Relationship between birth weight or fetal growth rate and postnatal allergy: A systematic review.
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Relationship between birth weight or fetal growth rate and postnatal allergy: A systematic review.

J Allergy Clin Immunol. 2019 Oct 09;:

Authors: Wooldridge AL, McMillan M, Kaur M, Giles LC, Marshall HS, Gatford KL

Abstract
BACKGROUND: Individual susceptibility to allergic diseases is developmentally programmed by early-life exposures. Evidence from preclinical studies suggests that intrauterine growth restriction is protective against later inflammatory responses to allergens.
OBJECTIVE: We sought to evaluate whether prenatal growth affects susceptibility to allergy in human subjects.
METHODS: We systematically searched for relevant studies in 11 databases, including Web of Science, ProQuest, EMBASE, and PubMed. We included only studies that corrected for gestational age or were restricted to full-term infants to separate effects of fetal growth from those of prematurity.
RESULTS: The 42 eligible studies included prospective and retrospective cohort, cross-sectional, and case-control studies. Only 2 studies reported allergic asthma. A birth weight increase of 1 kg was associated with a 44% greater risk of food allergy in children (odds ratio [OR], 1.44; 95% CI, 1.04-1.99; P = .001), a 17% greater risk of ever allergic dermatitis in children (OR, 1.17; 95% CI, 1.04-1.32; P = .008), and a 34% greater risk of ever or current allergic dermatitis in infants up to 2 years of age (OR, 1.34; 95% CI, 1.08-1.68; P = .009). Risks of allergic rhinitis were not associated with birth weight.
CONCLUSIONS: The results of these meta-analyses suggest that intrauterine growth restriction protects against allergic diseases in human subjects consistent with preclinical evidence but that effects might differ between allergic diseases. The strongest evidence is available for infancy and early childhood, and additional studies in older children and adults are needed to determine whether the effects of prenatal growth on each allergic disease persist or differ between those with severe and mild phenotypes.

PMID: 31615640 [PubMed - as supplied by publisher]



Diet and Food Allergy as Risk Factors for Asthma in the Arabian Gulf Region: Current Evidence and Future Research Needs.
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Diet and Food Allergy as Risk Factors for Asthma in the Arabian Gulf Region: Current Evidence and Future Research Needs.

Int J Environ Res Public Health. 2019 Oct 12;16(20):

Authors: Alsharairi NA

Abstract
Asthma is a chronic respiratory disease which is associated with higher levels of systemic inflammation. The causes of asthma remain poorly understood. Unhealthy diet and food allergy are potential risk factors for developing asthma. The prevalence of asthma in the Arabian Gulf region (AGR), and Kuwait, Saudi Arabia and Qatar in particular, is higher than in other Eastern Mediterranean countries. In the AGR, diets tend to be of low nutritional value due to high levels of total energy, cholesterol, sodium, added sugars and saturated fat, and low levels of fiber, fruit and vegetables. A few studies that include children and adults in the AGR have suggested a potential link between unhealthy diets/specific food allergens and increased risk of asthma, however, the association of food allergy with asthma is still a controversial issue. The aim of this commentary is to consider the evidence from the AGR regarding the effects of diet/food allergy on asthma risk that may be used to make recommendations for future research.

PMID: 31614710 [PubMed - in process]



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