Prevalence of atopy, asthma and COPD in an urban and a rural area of an African country

The objectives of this study were to determine the prevalence of asthma, atopy and COPD in Rwanda and to identify risk factors. The survey was conducted in Kigali, the Capital of Rwanda, and in Huye District, a rural area located in southern Rwanda.

Methods

A total of 2138 subjects were invited to participate in the study.1920 individuals (90%) answered to questionnaires on respiratory symptoms and performed spirometry, 1824 had acceptable spirograms and performed skin-prick test. In case of airflow obstruction (defined as pre-bronchodilator ratio FEV₁/FVC < LLN) a post bronchodilator spirometry was performed. Reversibility was defined as an increase in FEV₁ of 200 ml and 12% above baseline FEV₁ after inhalation of 400 mcg of salbutamol.

Results

The mean age was 38.3 years; 48.1% of participants were males and 51.9% females. Airflow obstruction was found in 256 participants (14%); 163(8.9%) subjects were asthmatics and 82 (4.5%) had COPD. COPD was found in 9.6% of participants aged 45 years and above. 484 subjects had positive skin-prick tests (26.5%); house dust mite and grass pollen mix were the main allergens. Risk factors for asthma were allergy, female gender and living in Kigali. COPD was associated with cigarette smoking, age and male sex.

Conclusion

this is the first study which shows the prevalence of atopy, asthma and COPD in Rwanda. Asthma and COPD were respectively diagnosed in 8.9% and 4.5% of participants. COPD was diagnosed in 9.6% of subjects aged ≥45 years.The prevalence of asthma was higher in urban compared to rural area.     

Uncertain areas in the diagnosis of allergic bronchopulmonary aspergillosis in patients with asthma

Background and objectiveThe prevalence of allergic bronchopulmonary aspergillosis (ABPA) in patients with bronchial asthma remains unknown. We evaluated the roles of various laboratory tests in the diagnosis of ABPA, including, skin prick test (SPT) for Aspergillus fumigatus (Af), and serum Af specific IgE and IgG antibody measurement.MethodsA total of 50 asthma patients with more than 1000 cell/μL of peripheral blood eosinophils were prospectively collected between January 2007 and September 2011. Evaluations using SPT for Af, serum total IgE and specific IgE antibody to Af by CAP system, IgG antibody to Af by enzyme immunoassay (EIA) or CAP system were performed according to the essential minimal criteria for the diagnosis of ABPA – asthma, immediate cutaneous reactivity to Af, elevated total IgE, and raised Af specific IgE and IgG.ResultsAmong 50 patients, three patients (6.0%) were diagnosed as ABPA, of whom each confirmed five items of the essential minimal diagnostic criteria for the diagnosis of ABPA. Six patients (12.0%) showed negative responses to Af in SPT, but positive responses in specific IgE by CAP system. Eight patients (16.0%) showed negative responses to IgG to Af by CAP system, but positive responses by enzyme immunoassay (EIA).ConclusionsSPT and serum IgE to Af measurement by CAP system should be performed simultaneously. It is reasonable to set up cut-off values in Af specific IgE/IgG by CAP system for the differentiation of ABPA from Af sensitised asthma patients.     

全国多中心支气管哮喘与过敏性鼻炎门诊患者对蟑螂变应原皮肤反应性的调查

目的 探讨支气管哮喘(简称哮喘)和过敏性鼻炎患者对常见蟑螂(美洲大蠊和德国小蠊)的过敏水平及一些流行病学的特点,同时比较对不同品种蟑螂间的研究,为深入研究昆虫过敏症奠定基础.方法 在全国范围内挑选了25家主要从事变应性疾病防治研究的三级甲等医院,对就诊于呼吸科、儿科或变态反应科门诊的哮喘和(或)过敏性鼻炎患者6081例,采用统一的调查问卷和蟑螂抗原皮肤点刺试验.结果 哮喘和过敏性鼻炎患者对两种蟑螂抗原的反应性是显著相关的,其阳性程度也显著相关(P<0.001);对美洲大蠊抗原的阳性率26.34%高于德国小蠊19.37%,南方地区阳性率高于北方与东部地区,对蜂螂过敏的患者大多在2级水平,强阳性患者极少;男性患者对美洲大蠊和德国小蠊的阳性率分别是28%与19%,均高于女性的25%与15%;成人对美洲大蠊和德国小蠊的阳性率30%与24%也显著高于儿童的23%与14%,对于蜂螂过敏的患者,约有90%同时对屋尘螨抗原阳性.结论 蟑螂是哮喘和过敏性鼻炎患者的主要变应原之一、对美洲大蠊的阳性率高于德国小蠊,成人的阳性率高于儿童,男性高于女性,蟑螂和屋尘螨之间可能存在着抗原交叉的现象.     

全国多中心支气管哮喘与过敏性鼻炎门诊患者对蟑螂变应原皮肤反应性的调查

目的探讨支气管哮喘（简称哮喘）和过敏性鼻炎患者对常见蟑螂（美洲大蠊和德国小蠊）的过敏水平及一些流行病学的特点,同时比较对不同品种蟑螂间的研究,为深入研究昆虫过敏症奠定基础。方法在全国范围内挑选了25家主要从事变应性疾病防治研究的三级甲等医院,对就诊于呼吸科、儿科或变态反应科门诊的哮喘和（或）过敏性鼻炎患者6081例,采用统一的调查问卷和蟑螂抗原皮肤点刺试验。结果哮喘和过敏性鼻炎患者对两种蟑螂抗原的反应性是显著相关的,其阳性程度也显著相关（P〈0．001）;对美洲大蠊抗原的阳性率26．34％高于德国小蠊19．37％,南方地区阳性率高于北方与东部地区,对蟑螂过敏的患者大多在2级水平,强阳性患者极少;男性患者对美洲大蠊和德国小蠊的阳性率分别是28％与19％,均高于女性的25％与15％;成人对美洲大蠊和德国小蠊的阳性率30％与24％也显著高于儿童的23％与14％,对于蟑螂过敏的患者,约有90％同时对屋尘螨抗原阳性。结论蟑螂是哮喘和过敏性鼻炎患者的主要变应原之一、对美洲大蠊的阳性率高于德国小蠊,成人的阳性率高于儿童,男性高于女性,蟑螂和屋尘螨之间可能存在着抗原交叉的现象。     

A rural environment does not protect against asthma or other allergic diseases amongst Mexican children

Introduction

The commonly held notion that a rural environment decreases the frequency of allergic diseases has proven to be inconsistent amongst children.

Ciclesonide in wheezy preschool children with a positive asthma predictive index or atopy

Background

Few large-scale studies have examined inhaled corticosteroid treatment in preschool children with recurrent wheeze. We assessed the effects of ciclesonide in preschool children with recurrent wheeze.

Methods

We included children 2–6 yrs with recurrent wheeze and a positive asthma predictive index or aeroallergen sensitization to, excluding patients with episodic viral wheezing. After a 2–4-week baseline period, patients with ongoing symptoms or rescue medication use were randomised to once-daily ciclesonide 40, 80, 160 μg or placebo for 24 weeks.

Results

The number of wheeze exacerbations requiring systemic corticosteroids was unexpectedly low in all groups: 25 (10.2%) in placebo group, as compared to 11 (4.4%), 18 (7.3%), and 17 (6.7%) in ciclesonide 40, 80, and 160 μg, respectively. The difference in time to first exacerbation was not significantly different between groups (p = 0.786), but the difference in exacerbation rates between placebo and the pooled ciclesonide groups was (p = 0.03). Large and significant (p < 0.0001) improvements in symptom scores and rescue medication use occurred in all groups, including placebo. Improvements in FEV₁ and FEF_25–75 (measured in 284 4–6 yr olds) were larger in the ciclesonide than in the placebo group. No differences in safety parameters (adverse events, height growth, serum and urinary cortisol levels) between ciclesonide and placebo were observed.

Conclusions

In preschool children with recurrent wheeze and a positive asthma predictive index, ciclesonide modestly reduces wheeze exacerbation rates and improves lung function. A large placebo response and unexpected selection of patients with mild disease may have affected outcomes, highlighting the heterogeneity of preschool wheezing disorders.     

广州地区儿童呼吸道变态反应性疾病常见变应原的流行病学分析

目的 了解广州地区呼吸道变态反应性疾病儿童常见变应原,为预防和治疗儿童变应性疾病提供科学依据.方法 选择2006年2月至2007年3月在广州医学院第一附属医院儿科门诊符合支气管哮喘(简称哮喘)和(或)变应性鼻炎(简称鼻炎)的广州地区5岁以上患儿183例,其中男132例,年龄(8.2-4-0.2)岁;女51例,年龄(7.8士0.4)岁;哮喘并鼻炎者105例,哮喘患儿58例,仅鼻炎患儿20例.所有对象均进行皮肤变应原点刺试验(SPT)及血清总IgE、特异性IgE和嗜酸粒细胞计数.结果 在人选的183例患儿中,SPT阳性(≥1个变应原阳性)157例(85.8%),各变应原阳性率为5.5%～75.4%,变应原中以屋尘螨致敏的阳性率最高,达79.8%,其次为粉尘螨与热带螨,分别为72.7%与65.0%,其余变应原阳性率依次为:狗毛48.6%,美洲大蠊47.0%,猫毛34.4%,德国小蠊29.5%,霉菌类19.7%,花粉类15.9%,艾蒿7.7%,豚草5.5%.螨过敏阳性患儿有146例,常合并其他一种或多种变应原阳性(115例,78.8%),而螨过敏阴性患儿(37例,20.2%)中仅有11例(29.7%)合并其他一种或多种变应原阳性(x2=33.099,P<0.001),差异有统计学意义.各年龄组发病率特点:高龄组(>7岁)SPT阳性率为82.3%,高于低龄组(≤7岁)(79.3%),两组间SPT阳性率的差异有统计学意义(P<0.05).在吸入变应原种类的比较中,高龄组在螨类过敏阳性率、猫毛与狗毛阳性率、蟑螂阳性率均高于低龄组,差异有统计学意义(P<0.05);两组在霉菌类及花草类阳性率的差异无统计学意义.哮喘并鼻炎、哮喘、鼻炎3组患儿均以螨类过敏最为常见,3组间除蟑螂SPT阳性率差异有统计学意义外(P<0.05),螨类、动物皮毛类、霉菌及花草类的变应原阳性率差异均无统计学意义.结论 过敏性因素是儿童呼吸系统变态反应性疾病发病的重要诱发因素,在广州地区哮喘和(或)鼻炎儿童可以通过SPT检查明确过敏原,最常见的变应原是屋尘螨、粉尘螨及热带螨.随着年龄增长,呼吸道变态反应性疾病患儿对吸入性变应原更为敏感.鼻炎、哮喘、哮喘并鼻炎患儿有共同的变应原.研究不同年龄段变态反应性疾病患者的变应原特征,有助于对疾病的早期诊断和早期干预.     

广州地区儿童呼吸道变态反应性疾病常见变应原的流行病学分析

目的了解广州地区呼吸道变态反应性疾病儿童常见变应原,为预防和治疗儿童变应性疾病提供科学依据。方法选择2006年2月至2007年3月在广州医学院第一附属医院儿科门诊符合支气管哮喘（简称哮喘）和（或）变应性鼻炎（简称鼻炎）的广州地区5岁以上患儿183例,其中男132例,年龄（8．2±0．2）岁;女51例,年龄（7．8±0．4）岁;哮喘并鼻炎者105例,哮喘患儿58例,仅鼻炎患儿20例。所有对象均进行皮肤变应原点刺试验（SPT）及血清总IgE、特异性IgE和嗜酸粒细胞计数。结果在入选的183例患儿中．SPT阳性（≥1个变应原阳性）157例（85．8％）,各变应原阳性率为5．5％～75．4％,变应原中以屋尘螨致敏的阳性率最高,达79．8％,其次为粉尘螨与热带螨,分别为72．7％与65．0％,其余变应原阳性率依次为：狗毛48．6％,美洲大蠊47．0％,猫毛34．4％．德国小蠊29．5％,霉菌类19．7％,花粉类15．9％,艾蒿7．7％,豚草5．5％。螨过敏阳性患儿有146例,常合并其他一种或多种变应原阳性（115例,78．8％）,而螨过敏阴性患儿（37例,20．2％）中仅有11例（29．7％）合并其他一种或多种变应原阳性（X2=33．099,P〈0．001）,差异有统计学意义。各年龄组发病率特点：高龄组（〉7岁）SPT阳性率为82．3％,高于低龄组（≤7岁）（79．3％）,两组间SPT阳性率的差异有统计学意义（P〈O．05）。在吸入变应原种类的比较中,高龄组在螨类过敏阳性率、猫毛与狗毛阳性率、蟑螂阳性率均高于低龄组,差异有统计学意义（P〈0．05）;两组在霉菌类及花草类阳性率的差异无统计学意义。哮喘并鼻炎、哮喘、鼻炎3组患儿均以螨类过敏最为常见,3组间除蟑螂SPT阳性率差异有统计学意义外（P〈0．05）,螨类、动物皮毛类、霉菌及花草类的变应原阳性率差异均无?     

Relationship between skin prick and atopic patch test reactivity to aeroallergens and disease severity in children with atopic dermatitis

BackgroundThe immunological mechanism in aetiology of atopic dermatitis (AD) shows significant differences from other allergic diseases. Allergen inhalation exacerbates AD lesions and AD patients’ complaints decrease in house dust mite (HDM) low level environments, which reveals the importance of inhalant allergens.ObjectiveWe evaluated the skin prick test (SPT) and atopy patch test (APT) positivity rates with aeroallergens and studied the effect of test results, and aimed to determine the value of allergic test reactivity on the clinical characteristics of children with AD.MethodsForty-five children aged 2–15 years with AD were included to study between May 2006 and May 2007 in GATA Haydarpasa Teaching Hospital, Allergy Department. The reactivity to inhalant allergens using SPT and APT was evaluated. The severity of AD, which was assessed with SCORAD, was compared with aeroallergen hypersensitivity.ResultsThe highest positivity of APT was seen against HDM (48.9%). HDM SPT positivity and subjective symptoms score were statistically correlated (P < 0.05). Patients with strong SPT positivity to HDM had a higher total SCORAD score (P < 0.05). Although there was no statistical correlation between HDM APT and SCORAD parameters, APT positive patients had generally higher SCORAD parameters. The statistical significance was only shown between the extent of the disease and strong APT positive reactions to Dermatophagoides pteronyssinus.ConclusionHDM allergens play an important role in determining the clinical severity of AD and strong APT positivity could be more meaningful clinically.     

广州地区儿童呼吸道变态反应性疾病螨性变应原相关危险因素分析

目的 了解广州地区呼吸道变态反应性疾病患儿常见变应原种类特点及螨性变应原相关危险因素,为预防和治疗患儿变应性疾病提供科学依据.方法 选择2006年2月至2007年3月在广州医学院第一附属医院儿科门诊符合哮喘和(或)鼻炎的广州地区5岁以上患儿183例,其中男132例,平均年龄(8.2±0.21)岁;女51例,平均年龄(7.8±0.44)岁;哮喘并鼻炎者105例,哮喘患儿58例,仅鼻炎患儿20例.所有对象均由家长及其监护人回答统一标准的问卷调查,并进行皮肤变应原点刺试验(SPT)及血清总IgE、特异性IgE和嗜酸粒细胞计数.结果 在入选的183例患儿中,SPT阳性(≥1个变应原阳性)157例,占85.8%,各变应原阳性率为5.5%～75.4%,变应原中以屋尘螨致敏的阳性率最高,达79.8%(146/183),其次为粉尘螨与热带螨,分别为72.7%(133/183)～65.0%(119/183),其余过敏原阳性率依次为:狗毛48.6%(89/183),美洲大蠊47.0%(86/183),猫毛34.4%(63/183),德国小蠊29.5%(54/183),霉菌类19.7%(36/183),花粉类15.9%(29/183),艾蒿7.7%(14/183),豚草5.5%(10/183).螨过敏阳性患儿有146例,常合并其他一种或多种变应原阳性(115例,78.8%),而螨过敏阴性患儿(37例,20.2%)中仅有11例(29.7%)合并其他一种或多种变应原阳性(x2=33.099,P<0.001),差异有统计学意义,提示螨类过敏是呼吸道变态反应性疾病的重要致敏原,而螨性已致敏的患者会增加对其他过敏原的风险.以一种或多种螨过敏SPT结果++及以上作为阳性,其余为阴性,经多因素Logistic回归分析:年龄每增加1岁、反复鼻炎、眼部及呼吸道症状是螨过敏呼吸道变态反应性疾病患儿的危险因素,而家族过敏史、居住环境及饮食习惯等因素与螨过敏所致的哮喘和(或过敏性鼻炎)差异无统计学意义.结论 过敏性因素是患儿呼吸系统变态反应性疾病发病的重要环境相关危险因素,广州地区哮喘和(或)鼻炎患儿最常见的变应原是屋尘螨、粉尘螨及热带螨,可以通过SPT检查明确过敏原.年龄增加、反复鼻炎、眼部、哮喘症状控制不良是螨类致敏呼吸道变态反应性疾病发病的危险因素.变态反应性疾病应以早期防治为医疗工作的重要方针,研究本地区变态反应性疾病患者的变应原种类特点及危险因素,有助于疾病的早期诊断和早期防治,并可针对变应原采取特异性免疫治疗,可望使螨性哮喘和鼻炎患儿达到并维持稳定.     

Uncontrolled asthma and its risk factors in Chinese children: A cross-sectional observational study

Objective: Asthma afflicts many children in China but information about asthma management among Chinese pediatric asthma patients is limited. This study aims to evaluate asthma control among Chinese pediatric patients and identify risk factors associated with uncontrolled asthma. Methods: A total of 4223 patients with persistent asthma aged 2–16 years from 42 tertiary hospitals across all regions of mainland China except Tibet were surveyed. Asthma Control Test (ACT), Childhood Asthma Control Test (C-ACT) and Global Initiative for Asthma (GINA) criteria were used to assess asthma control for children aged 12–16 years, 4–11 years and 2–3 years, respectively. Uncontrolled asthma was defined as ACT or C-ACT score ≤19 or GINA-defined uncontrolled asthma. Risk factors associated with uncontrolled asthma were identified using multivariate logistic regression models. Results: Asthma was uncontrolled in 19.9% of the subjects. High rates of uncontrolled asthma were found in subjects with treatment non-adherence (44.1%), concomitant allergic rhinitis (AR) (23.3%), disease duration ≥ 1.5 years (22.8%), and first-degree relatives with AR (21.5%). The risk of uncontrolled asthma was much higher in the treatment non-adherence group compared to the complete adherence group (OR = 5.79, p < 0.001). Concomitant AR, disease duration ≥ 1.5 years, and first-degree relatives with AR were also confirmed as risk factors associated with uncontrolled asthma. Conclusions: About 20% of Chinese pediatric asthma patients had uncontrolled asthma. Treatment adherence and AR were the most significant risk factors. Tailored measures aimed at improving treatment adherence and diagnosis and treatment of AR should be adopted to improve the level of asthma control in Chinese children.     

Cardiovascular disease in asthma and COPD: a population-based retrospective cross-sectional study

We conducted a large population-based retrospective cross-sectional study for determining the extent of clinically recognized chronic obstructive pulmonary disease (COPD) and asthma, and the prevalence of associated cardiovascular diseases (CVDs), using information obtained from the Health Search Database (HSD) owned by the Italian College of General Practitioners (SIMG). Our study provides further evidence that patients with the diagnosis of COPD are at increased association with the diagnosis of most CVDs. It also documents that age clusters between 35 and 54 years are those at highest association of simultaneous presence of the diagnosis of CVD and that of COPD, with a progressive significant reduction in older age clusters. Moreover, it shows that the diagnosis of asthma is modestly associated with the diagnosis of different CV morbidities.     

Prevalence of allergic bronchopulmonary aspergillosis in asthmatic patients: A prospective institutional study

Background

Allergic bronchopulmonary aspergillosis (ABPA) is characterized by an allergic inflammatory response to colonization by Aspergillus species, most commonly Aspergillus fumigatus.

Phadiatop,Phadiatop Infant and total IgE evaluated in allergic Brazilian children and adolescents

The clinical history is of importance in the investigation of allergic diseases but does have limitations. Many allergic conditions will be over-diagnosed if anamnesis alone is used for diagnostic criteria. Serum total immunoglobulin E (TIgE) quantification, as well as panels containing allergens prevalent in the studied population, may serve as screening tests and facilitate the diagnosis of allergic disease or its exclusion. We assessed the positivity of two versions of these tests, Phadiatop Europe® (PhEU) and Phadiatop Infant® (PhInf), as well as total IgE (TigE) values in patients with a medical diagnosis of allergic disease and non-allergic individuals.MethodsA cross-sectional study performed in eleven Brazilian pediatric allergy centers with patients divided into groups according to the primary condition and a group of assessed control subjects. They were submitted to TIgE measurement and screening tests (PhEu and PhInf).ResultsTIgE mean serum levels were significantly higher among allergic patients, especially those with asthma/rhinitis or atopic dermatitis. The positivity of the screening tests, considering the total population, was 63.8% for PhEU and 72.6% for PhInf. These increased when we evaluated only the allergic subjects. The concordance index of the two tests was Kappa = 0.7 and higher among those of greater age.ConclusionsIn the assessed population, there were significantly higher levels among those with positive screening tests and PhInf showed better performance in the identification of sensitized individuals, regardless of age. This is the first study to evaluate Phadiatop and Phadiatop Infant in the same population.     

Prevalence of asthma and other allergic diseases in children born after in vitro fertilisation

BackgroundChildren born after in vitro fertilisation (IVF) are under greater risk of development of some health problems than those children born after spontaneous conception. Yet it is not exactly known what the prevalence of asthma and other allergic diseases among these children is.Aims of the studyTo investigate the prevalence of asthma, allergic rhinitis and atopic dermatitis in children born after IVF, and controls born after spontaneous pregnancy using questionnaires of International Study of Asthma and Allergies in Children (ISAAC).MethodsWe recruited 158 children (mean age: 4.60 ± 2.14 years) born after IVF pregnancies and 102 children (mean age: 5.27 ± 2.8 years) as control group to investigate the prevalences of asthma, atopic dermatitis and allergic rhinitis. The questions in the questionnaire were asked to the parents by telephone or face to face.ResultsWheezing ever has been reported in 19 % of the children born after IVF and in 17.6 % of the control group (p > 0.05). No significant differences were found between groups, in terms of use of any anti-asthma drugs, physician diagnosed asthma and admission to emergency room with wheezing (p > 0.05). In addition, prevalence of allergic rhinitis and atopic dermatitis were also comparable between two groups (p > 0.05).ConclusionsPrevalences of asthma, allergic rhinitis and atopic dermatitis are similar in children born after IVF and children born after spontaneous conception.     

Drug allergy in tertiary care in Turkey: Results of a national survey. The ADAPT study: Adult drug allergy perception in Turkey

BackgroundNo data are available on the incidence of drug hypersensitivity (DH) reactions in outpatient settings of tertiary allergy/immunology clinics. Our aims were to document the frequency of outpatient hospital admissions due to DH reactions to allergy/immunology clinics in adults and the management of these reactions in real life. We also investigated whether drug allergy affected social and medical behaviours of the patients.MethodsThis multi-centre study was performed for one year with the participation of 11 out of 16 tertiary allergy/clinical immunology clinics in Turkey. The study group consisted of the patients with DH reactions. Results of a questionnaire including drug reactions and management were recorded.ResultsAmong 54,863 patients, 1000 patients with DH were enrolled with a median of 2.1% of all admissions. In real life conditions, the majority of approaches were performed for finding safe alternatives (65.5%; 1102 out of 1683) with 11.7% positivity. Diagnostic procedures were positive in 27% (154/581) of the patients. The majority of the patients had higher VAS scores for anxiety. A total of 250 subjects (25%) reported that they delayed some medical procedures because of DH.ConclusionOur results documented the frequency of admissions due to DH reactions to allergy/clinical immunology clinics for the first time. Although physicians mostly preferred to perform drug tests in order to find safe alternatives, considering the fact that DH was confirmed in 27% of the patients, use of diagnostic tests should be encouraged, if no contraindication exists in order to avoid mislabelling patients as DH.     

Adolescent flourishing in relation to having asthma: Results from a population-based cross-sectional study

Objective: This study investigated parent report of adolescent behaviors and flourishing of adolescents with asthma from a nationwide sample. Methods: A secondary analysis of the 2011–2012 National Survey of Children's Health was conducted. There were 2,880 youth with asthma in our sample and 25,841 without asthma between 13 and 17 years of age. Analyses examined flourishing among adolescents with and without asthma and the impact of adolescent arguing, bullying, and mood difficulties on adolescent flourishing for adolescents with asthma, while controlling for sex, age, and race. Results: Findings indicated lower flourishing for youth with asthma compared to youth without asthma. Moreover, adolescents with asthma who experienced negative behaviors, such as arguing and bullying, and adolescents who were experiencing sad feelings had lower flourishing. Conclusions: The results were consistent with literature, indicating that relatively poorer behavioral and emotional functioning is related to lower flourishing in adolescents with asthma. The results highlight the importance of screening for emotional functioning in adolescents and the need for further research to understand characteristics of adolescents related to their positive functioning.     

Microbiome in the primary prevention of allergic diseases and bronchial asthma

Tremendous progress in the ability to identify and test the function of microorganisms in recent years has led to a much better understanding of the role of environmental and host microbiome in the development of immune function, allergic sensitization and asthma. In this review, the most recent findings on the relationships between environmental microbiota, respiratory, intestinal microbiome, the consequences of early-life microbial exposure type and gut–lung microbial axis and the development of asthma and atopy are summarized. The current perspective on gut and airway microbiome manipulation for the primary prevention of allergic diseases and asthma is also discussed.