Comparison of Der p1-specific antibody levels in children with allergic airway disease and healthy controls

Although children, with allergic airway disease, who are sensitized to house-dust mite (HDM) are known to have increased levels of allergen-specific IgE and IgG, the association between the quantity of those immunoglobulins and the clinical features of disease is not yet well established. The purpose of this study was (i) to evaluate Der p1-specific IgA, IgG1, IgG4, and IgE levels of children with HDM-allergic asthma and allergic rhinitis and to compare it with that of healthy controls (ii) to assess the association with disease duration. A total of 73 patients were included. Of those, 58 had asthma (M/F: 27/31, mean age 7.9 +/- 2.7 yr) and 15 were diagnosed as allergic rhinitis (M/F: 8/7, mean age 10.1 +/- 4.0 yr) without asthma. Twenty-five (M/F: 13/12, mean age 9.5 +/- 4.2 yr) non-allergic children were included as healthy controls. Data on age at onset and duration of disease were recorded. Then, Der p1-specific IgA, IgG1, IgG4, IgE levels were measured in all of the 98 subjects by ELISA. Comparison of Der p1-specific antibody levels of patients and controls revealed that Der p1-specific IgG1, IgG4 and IgE levels of patients with asthma (p = 0.012, p = 0.021, p = 0.004, respectively) were significantly higher than healthy controls. Also, the ratio of Der p1-specific IgA/IgE was significantly lower in asthmatic children when compared with children with allergic rhinitis and controls (p = 0.029, p < 0.001, respectively). Der p1-specific IgG1, IgG4, IgE and IgA levels of asthmatic children with duration of disease of >or=4 yr were significantly higher than those with disease duration of <4 yr. IgA/IgE ratio was not significantly different in those two groups of asthmatics. We concluded that although all of the specific antibody levels increased with longer duration of asthma, IgA/IgE ratio remains to be low in asthmatic children allergic to HDM.     

Long-lasting sensitization to food during the first two years precedes allergic airway disease

The purpose of the study was to investigate whether the duration of sensitization to food allergens during early childhood is related to later development of IgE mediated hypersensitivity to inhalant allergens and of allergic rhinitis and asthma in 5-year-old children and whether long-lasting food-sensitization may be used to predict subsequent allergic airway diseases. Five hundred and eight children of a prospective birth cohort study with available serum samples at one and two years of age were included and followed up until five years of age. Specific sensitization to food and inhalant allergens and the occurrence of subsequent allergic airway diseases were determined. Children with a long-lasting sensitization to food allergens (persistently sensitized for more than one year) produced significantly higher total IgE and specific IgE levels than children who were only transiently food-sensitized by two years of age. Children persistently sensitized to food had a 3.4 fold higher risk of developing allergic rhinitis and a 5.5 fold higher risk of developing asthma than infants who were only transiently food sensitized. Persistent food sensitization in combination with a positive atopic family history was a strong predictor for the development of allergic rhinitis and asthma at five years of age. The risks for these children are up to 50%, and 67% respectively. Persistently detectable sensitization to food over more than one year in early childhood is a strong prognostic factor for subsequent allergic airway disease. Persistently food-sensitized children especially in atopic families have to be regarded as a high-risk group and should be considered for preventive measures against respiratory atopy.     

Natural History of Allergic Diseases in Children

Abstract. Questionnaire data from 1335 14-year-old children with a history of past or present asthma, allergic rhinitis or eczema were analysed regarding age at onset and cessation of symptoms. Incidence of asthma and eczema was highest during the first years of life. Early incidence of asthma was higher in boys than in girls but the sex ratio equalized gradually during childhood. Early incidence of eczema was equal between the sexes but the proportion of girls increased gradually with later age at onset. In 24 % of the children more than one symptom was found. Cessation of symptoms was common in asthma (55 %), in particular in those with early onset (74 %), but less common in eczema (34 %). Cessation of symptoms was less common in both diseases when associated with other allergic symptoms. Incidence of allergic rhinitis was fairly constant during childhood and cessation of symptoms was uncommon. A high risk of allergic airways disease was found after early eczema.     

Natural history of allergic diseases in children

Questionnaire data from 1335 14-year-old children with a history of past or present asthma, allergic rhinitis or eczema were analysed regarding age at onset and cessation of symptoms. Incidence of asthma and eczema was highest during the first years of life. Early incidence of asthma was higher in boys than in girls but the sex ratio equalized gradually during childhood. Early incidence of eczema was equal between the sexes but the proportion of girls increased gradually with later age at onset. In 24% of the children more than one symptom was found. Cessation of symptoms was common in asthma (55%), in particular in those with early onset (74%), but less common in eczema (34%). Cessation of symptoms was less common in both diseases when associated with other allergic symptoms. Incidence of allergic rhinitis was fairly constant during childhood and cessation of symptoms was uncommon. A high risk of allergic airways disease was found after early eczema.     

Increased rate and greater severity of allergic reactions to insect sting among schoolchildren with atopic diseases

The question of whether atopic diseases are a risk factor for allergic reactions to insect sting is still unresolved. The aim of this study was to evaluate the association between atopic diseases (asthma, allergic rhinitis, atopic eczema) and allergic reactions to insect stings among schoolchildren in Israel. A self‐report questionnaire of the International Study of Asthma and Allergies in Childhood was administered to a national sample of 13–14‐yr‐old schoolchildren. Questions regarding reactions to insect stings were added. A total of 10,021 questionnaires were available for analysis. Among the children who reported insect stings (56.3%), the prevalence of current asthma was 6.0%, of allergic rhinitis, 10.5%, and of atopic eczema, 8.7%, with no significant differences from the whole study population. Among children with any of the atopic diseases, 36.9% reported an allergic reaction to insect sting compared to 24.8% of the non‐atopic children (p < 0.0001). On multivariate analysis, asthma, allergic rhinitis, and atopic eczema were found to be significant risk factors for allergic reactions of any severity. Children in the atopic group had a significantly higher rate of severe allergic reactions than the non‐atopic children, and relatively higher rates of milder ones (p < 0.0001). Asthmatic patients with severe allergic reactions had more parameters of severe asthma than asthmatic patients with mild or no reactions. In conclusions, allergic diseases are associated with a higher rate and greater severity of allergic reactions to insect sting in children. The severity of the allergic reaction is related to the severity of the asthma symptoms.     

Atopy patch testing in children with asthma and rhinitis symptoms allergic to house dust mite

The atopy patch test (APT) is generally used to assess immunoglobulin E (IgE) mediated sensitization to allergens in patients with atopic dermatitis, but its diagnostic role in children with respiratory allergy is still controversial. The aim of the study was to evaluate APT with house dust mite (HDM) in children with asthma and rhinitis symptoms allergic to HDM and its relevance to skin prick test (SPT) diameters and specific IgE levels. The study population consisted of 33 children, aged 8-16 yr (median: 12 yr) with asthma and 30 children with allergic rhinitis in the same age range (median: 11 yr). All patients had positive SPT results and high serum specific IgE levels for Dermatophagoides pteronyssinus APT was performed on back skin of all patients with 200 index of reactivity (IR)/ml of D. pteronyssinus allergen extracts in petrolatum (Stallerpatch) and evaluated at 72 h. Of 63 patients, 16 (25%) showed a positive patch test result. APT with HDM showed 30% (10/33) positivity among the patients with asthma and 20% (6/30) positivity among the patients with allergic rhinitis. APT presented no significant correlation with age, SPT diameter, serum total and specific IgE levels for D. pteronyssinus, nasal provocation test or pulmonary function test results. Patch testing with HDM may partly identify mite sensitive children with respiratory allergy. Positive APT results may imply that delayed hypersensitivity reactions play a role in children with asthma and rhinitis allergic to HDM.     

Allergic conjunctivitis in children with asthma, rhinitis and eczema in a secondary outpatient clinic

Little evidence is available on the prevalence of allergic conjunctivitis in pediatric populations. The objective of this study was to assess the cumulative prevalence of allergic conjunctivitis in children with rhinitis, asthma and eczema in a secondary pediatric outpatient clinic. Children aged 5-15 yr referred during the period of 2002-2004 in whom allergic conjunctivitis, asthma, allergic rhinitis or eczema was diagnosed were included in a retrospective survey. At referral patient characteristics, history, symptoms, signs and results of type 1 allergy tests were entered into an electronic form. Four hundred and fifty-eight children with a mean age of 9.4 yr were studied. Of 316, 324 and 149 children with rhinitis, asthma or eczema, respectively, 133 (42%), 78 (24%) and 45 (30%) had concomitant allergic conjunctivitis. One hundred and thirty-seven (30%) had allergic conjunctivitis, of whom 133 (97%) also had allergic rhinitis, 77 (56%) asthma and 45 (33%) eczema. One hundred and twenty-five (91%) of the children with allergic conjunctivitis had positive allergy tests to one or more allergens, sensitization to house dust mites being more frequent in chronic allergic conjunctivitis than in acute allergic conjunctivitis (95% vs. 53%; p < 0.01). Sensitization to grass was more frequent in children with acute allergic conjunctivitis (78% vs. 57%; p = 0.03). In a secondary pediatric outpatient clinic allergic conjunctivitis is a frequent co-morbidity to allergic rhinitis and to asthma and eczema. Allergic conjunctivitis need to be included as an important co-morbidity in future guidelines on asthma, rhinitis and eczema management.     

Exhaled nitric oxide, total serum IgE and allergic sensitization in childhood asthma and allergic rhinitis

Exhaled nitric oxide (eNO) levels are correlated with several markers of atopy and inflammatory activity in the airways, but the relationship between eNO and total serum IgE has not been fully elucidated in the context of allergic sensitization. The aim of this study was to investigate the relationship between eNO, total serum IgE and allergic sensitization in childhood asthma and allergic rhinitis. eNO levels, lung function, skin prick tests and total serum IgE were determined in 109 children (mean age, 10.4 yr) with mild intermittent asthma and in 41 children (mean age, 10.1 yr) with allergic rhinitis; 25 healthy non-atopic children were recruited as controls. eNO levels (median) were significantly higher in patients with asthma (22.7 p.p.b.) and in those with allergic rhinitis (15.3 p.p.b.) than in healthy controls (5.9 p.p.b.). Children with allergic asthma had higher eNO levels than children with allergic rhinitis. A significant positive correlation was found between eNO and total serum IgE (asthma, r = 0.42, p < 0.0001; allergic rhinitis, r = 0.31, p < 0.01), and between eNO and the number of positive skin prick tests (asthma, r = 0.31, p < 0.0001; allergic rhinitis, r = 0.39, p < 0.01). eNO levels were better correlated with total IgE than with the number of positive skin prick tests. This correlation was independent of allergic sensitization. High total serum IgE represents a specific and predictive marker of eNO increase in children with asthma or allergic rhinitis. This finding adds further support to the hypothesis that increased serum IgE could be a marker itself of airway inflammation in patients with allergic disease.     

Does airway allergic inflammation pre‐exist before late onset wheeze in children?

Thavagnanam S, Williamson G, Ennis M, Heaney LG, Shields MD. Does airway allergic inflammation pre‐exist before late onset wheeze in children?
Pediatr Allergy Immunol 2010: 21: 1002–1007.
© 2010 John Wiley & Sons A/S Epidemiological studies show that some children develop wheezing after 3 yr of age which tends to persist. It is unknown how this starts or whether there is a period of asymptomatic inflammation. The aim of this study is to determine whether lower airway allergic inflammation pre‐exists in late onset childhood wheeze (LOCW). Follow‐up study of children below 5 yr who had a non‐bronchoscopic bronchoalveolar lavage (BAL) performed during elective surgery. The children had acted as normal controls. A modified ISAAC questionnaire was sent out at least 7 yr following the initial BAL, and this was used to ascertain whether any children had subsequently developed wheezing or other atopic disease (eczema, allergic rhinitis). Cellular and cytokine data from the original BAL were compared between those who never wheezed (NW) and those who had developed LOCW. Eighty‐one normal non‐asthmatic children were recruited with a median age of 3.2 . Of the 65 children contactable, 9 (16.7%) had developed wheeze, 11 (18.5%) developed eczema and 14 (22.2%) developed hay fever. In five patients, wheeze symptoms developed mean 3.3‐ yr (range: 2–5 yr) post‐BAL. Serum IgE and blood eosinophils were not different in the LOCW and NW, although the blood white cell count was lower in the LOCW group. The median BAL eosinophil % was significantly increased in the patients with LOCW (1.55%, IQR: 0.33 to 3.92) compared to the children who never wheezed, NW (0.1, IQR: 0.0 to 0.3, p = 0.01). No differences were detected for other cell types. There were no significant differences in BAL cytokine concentrations between children with LOCW and NW children. Before late onset childhood wheezing developed, we found evidence of elevated eosinophils in the airways. These data suggest pre‐existent airways inflammation in childhood asthma some years before clinical presentation.     

Prevalence and risk factors of asthma and allergic diseases among schoolchildren in Bolu, Turkey

AIM: In this study we aimed to detect the prevalence and risk factors of asthma and allergic diseases in children aged between 7 and 14 years old at rural and urban areas of Bolu, Turkey. METHODS: Questionnaire of International Study of Asthma and Allergies in Childhood (ISAAC) phase one and questionnaire including questions about family, demographic, socio-economic characteristics of children were applied to 931 schoolchildren who were selected by randomized sampling. RESULTS: In children, the prevalence of diseases and symptoms were as follows: wheeze ever: 15.5%, asthma: 5.6%, nasal symptoms ever: 41.4%, allergic rhinitis: 23.2%, itchy rash ever: 5.9% and eczema: 5.0%. In multivariate regression analysis, presence of allergic disease in the family was risk factor for wheezing (OR=1.74, 95% CI=1.19-2.76), asthma (OR=2.19, CI=1.06-4.52), allergic rhinitis (OR=2.68, CI=1.80-3.98) and eczema (OR=2.33, CI=1.17-4.65); living in shanties was risk factor for allergic rhinitis (OR=5.26, CI=2.1-13.16); a monthly income below $300 was risk factor for asthma (OR=2.54, CI=1.06-6.08). CONCLUSION: It was detected that the prevalence of allergic rhinitis and its symptoms was more common in schoolchildren living in Bolu. Presence of allergic disease in fathers or mothers and low socio-economic level increase the risk of asthma and other allergic diseases in children.     

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目的比较3~14岁哮喘和变应性鼻炎患儿吸入性致敏原分布特征的异同。方法2004-10—2005-10,北京儿童医院对527例哮喘和620例变应性鼻炎患儿进行吸入性致敏原皮肤点刺试验(skin prick test,SPT),分析比较检出阳性的致敏原在两组病例中的分布特征。结果哮喘和变应性鼻炎患儿SPT阳性检出率分别为77·8%和78·9%(χ2=0·823,P>0·05)。户尘螨、粉尘螨、交链孢霉、猫上皮、艾蒿是两种疾病主要致敏原。哮喘患儿户尘螨、粉尘螨、混合霉菌的阳性率分别为64·6%、59·8%、8·8%,均高于变应性鼻炎患儿(49·5%、47·9%、3·9%,均P<0·05)。变应性鼻炎患儿杂草花粉和艾蒿的阳性率分别为25·6%、26·0%,均高于哮喘患儿(19·3%、19·3%,均P<0·05)。40·2%的哮喘和46·2%的变应性鼻炎为单致敏原阳性。尘螨霉菌混合致敏及尘螨宠物混合致敏在哮喘和变应性鼻炎中最为常见。结论尘螨、霉菌、夏秋季花粉和宠物是3~14岁哮喘和变应性鼻炎患儿主要吸入性致敏原,两病具有相似的致敏原分布特征,但尘螨及霉菌过敏多见于哮喘,夏秋季花粉过敏多见于变应性鼻炎。     

Abnormal spirometry in children with persistent allergic rhinitis due to mite sensitization: the benefit of nasal corticosteroids.

Inflammatory processes affecting nasal and bronchial mucosa are similar in nature. The purpose of this study was to examine whether children with perennial allergic rhinitis, without underlying asthma, have impaired pulmonary function. We also investigated whether nasal corticosteroids and loratidine would improve the pulmonary function tests of those children with impaired lung function. Fifty subjects with moderate/severe persistent allergic rhinitis due to exclusively dust mite sensitization and no past medical history suggestive of asthma were assessed. The control group consisted of 26 matched healthy subjects. Subjects with airway obstruction, as detected by forced expiratory volume/1 s (FEV1) or forced expiratory flow from 25/% to 75% (FEF(25-75)) values <80% of those predicted, were treated with loratidine, once a day for 10 days, and daily nasal budesonide for 3 months. We found that 11 of 50 patients (22%) with perennial allergic rhinitis had impaired pulmonary function (FEF(25-75) values <80%), compared to 1/26 (3.8%) of the control group (p < or = 0.05). Reversibility was observed in 9/11 (81.8%), mean 24.7% +/- 10.3%. Within 3 months of treatment, 7/10 had FEF(25-75) > 80% of their predicted values as well as significant improvements in their FEV1 (p = 0.04), and FEV1/FVC (p = 0.04). We conclude that a substantial proportion of children with perennial allergic rhinitis have diminished FEF (25-75) values and reversible airway obstruction. Nasal corticosteroids improve the pulmonary function tests of these children with impaired lung function.     

吸入变应原sIgE在不同气道过敏性疾病儿童中的分布特征

目的了解不同气道过敏性疾病患儿吸入变应原血清特异性Ig E(slg E)的分布特征。方法应用Uni CAP250变应原定量Ig E检测系统的荧光酶联免疫法,对256例3~14岁气道过敏疾病患儿测定9种常见吸入变应原的血清slg E。256例患儿按临床诊断分为:变应性鼻炎组(简称"鼻炎组",37例)、支气管哮喘组(简称"哮喘组",82例)和变应性鼻炎合并支气管哮喘组(简称"鼻炎并哮喘组",137例)。比较3组患儿9种吸入变应原阳性检出率的分布差异,并比较3组患儿变应原致敏级别和致敏种类数的差异。结果哮喘组、鼻炎组和鼻炎并哮喘组患儿吸入变应原血清s Ig E的阳性检出率分别为57.3%(47/82)、86.5%(32/37)、82.5%(113/137),3组间比较差异有统计学意义(P0.05)。哮喘组、鼻炎组、鼻炎并哮喘组患儿常见变应原均依次为霉菌类(32.9%、54.1%、48.9%)、尘螨类(30.5%、45.9%、46.0%)、花粉类(26.8%、35.1%、32.8%)、宠物类(12.2%、27.0%、18.2%)、蟑螂(9.8%、5.4%、5.8%)。鼻炎组和鼻炎并哮喘组患儿霉菌混合的阳性检出率均高于哮喘组,差异有统计学意义(均P0.0166)。3组患儿9种变应原的致敏级别和致敏种类数比较差异无统计学意义。结论支气管哮喘、变应性鼻炎或二者合并患儿前3位吸入变应原均依次是霉菌类、尘螨类、花粉类;与支气管哮喘相比,霉菌致敏可能与变应性鼻炎关系更密切;这3种常见气道过敏性疾病吸入变应原的致敏分布具有相似性。     

吸入激素联合奥马珠单抗治疗中重度儿童过敏性哮喘合并过敏性鼻炎自身前后对照试验

背景 国外研究显示奥马珠单抗对≥6岁儿童中重度过敏性哮喘疗效肯定,目前缺乏中国哮喘儿童临床数据.目的 评价奥马珠单抗治疗过敏性哮喘合并过敏性鼻炎儿童的有效性和安全性.设计自身前后对照试验.方法 纳入符合中重度过敏性哮喘合并过敏性鼻炎诊断、年龄6～18岁、能够承受16周疗程费用、使用奥马珠单抗前血清IgE 75～1500...     

The changing prevalence of asthma, allergic rhinitis and atopic eczema in African adolescents from 1995 to 2002

The prevalence of asthma and allergic disease in children has been increasing in developed countries, but there is little information on these trends in Africa. The aim of this study was to assess time trends in the symptoms of asthma, allergic rhinitis, and atopic eczema among South African adolescents. The study was carried out by comparing cross-sectional data from two International Study of Asthma and Allergies in Childhood (ISAAC phase I and phase III) questionnaire based surveys conducted 7 yr apart of self-reported symptoms in 13- to 14-yr-old adolescents. In both surveys, schools in the same geographical area in Cape Town, South Africa, were randomly selected. A school-based sample of 5178 (in 1995) and 5037 (in 2002) pupils participated. The 12-month prevalence of wheezing (16% vs. 20.3%), exercise-induced wheeze (21.5% vs. 32.5%), nocturnal cough (23.6% vs. 36.6%), sleep disturbance due to wheeze (9.6% vs. 16%), or severe wheeze (5.1% vs. 7.8%) increased significantly, as measured by the written questionnaire. A rise in asthma symptoms was confirmed by the video questionnaire responses, in which the 12-month prevalence of wheezing (6.5% vs.11.2%), exercise-induced wheeze (11.5% vs. 13.9%), nocturnal wheeze (3.9% vs. 5.3%), nocturnal cough (11.6% vs. 19.2%), or severe wheeze (5% vs. 7%) also increased significantly. There was a small increase in the percentage of children diagnosed with asthma from 1995 to 2002 (13.1% vs. 14.4%), this was not significant. The 12-month prevalence of symptoms of allergic rhinitis (30.4% vs. 38.5%), rhinoconjunctivitis (17.6% vs. 24.3%) and eczema (11.8% vs. 19.4%) also increased significantly. An increase in the prevalence of allergic symptoms occurred in girls and boys. Limitation of daily activity from nasal symptoms (22.3% vs. 37.8%) and sleep disturbance because of eczema (8.4% vs. 15.7%) increasingly affected quality of life on the quality of life. Symptoms of asthma, allergic rhinitis and atopic eczema in adolescents have increased over the past 7 yr in this geographical area. Allergic diseases are common in this group of adolescents and increasingly impair their quality of life.     

Paracetamol in early infancy: the risk of childhood allergy and asthma

Aim: We investigated whether paracetamol exposure in pregnancy and until 6 months of age was associated with allergic disease in school children. Methods: In a prospective birth cohort study in Oslo, 1016 children included at birth were re‐investigated at 10 years. Paracetamol exposure in pregnancy and until 6 months of age was registered. Outcomes at 10 years included current asthma, a history of asthma, allergic sensitization and allergic rhinitis. Results: Maternal paracetamol use in the first trimester increased the risk for allergic rhinitis at 10 years OR (odds ratio) (95%CI) 2.30 (1.06, 4.97) in boys and girls. Paracetamol use until 6 months in girls increased the risk for allergic sensitization OR 2.20 (1.15, 4.22) and a history of asthma OR 2.20 (1.13, 4.30). The ORs for allergic sensitization and history of asthma in girls remained unchanged adjusting for upper or lower airway infections during the first 6 months of life. Conclusion: Paracetamol exposure in pregnancy was associated with allergic rhinitis, but not with asthma or allergic sensitization at 10 years of age. Paracetamol used until 6 months of age was associated with allergic sensitization and having a history of asthma in girls at 10 years of age, even considering concomitant airway infections.     

A randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containing Lactobacillus casei in pre-school children with allergic asthma and/or rhinitis

To examine whether long-term consumption of fermented milk containing a specific Lactobacillus casei may improve the health status of preschool children suffering from allergic asthma and/or rhinitis a randomized, prospective, double blind, controlled trial was conducted in 187 children 2-5 y of age. The children received for 12 mo either fermented milk (100 mL) containing Lactobacillus casei (10(8) cfu/mL) or placebo. The time free from and the number of episodes of asthma/rhinitis after starting intervention were the outcome measures. The number of fever or diarrhea episodes and the change in serum immunoglobulin were further assessed. No statistical difference between intervention and control group occurred in asthmatic children. In children with rhinitis, the annual number of rhinitis episodes was lower in the intervention group, mean difference (95% CI), -1.6 (-3.15 to -0.05); the mean duration of an episode of diarrhea was lower in the intervention group, mean difference -0.81 (-1.52 to -0.10) days. While long-term consumption of fermented milk containing Lactobacillus casei may improve the health status of children with allergic rhinitis no effect was found in asthmatic children.     

Left-handedness in asthmatic children

Left-handedness has been associated with asthma and allergic disorders. The Geschwind–Behan–Galaburda (GBG) hypothesis could explain this association. In view of previous findings, we investigated the distribution of laterality scores among asthmatic children and controls aged 4–8 years old. Seventy families with asthmatic children were administered the International Study of Asthma and Allergy in Childhood (ISAAC) questionnaire and the Edinburgh Left-handedness Inventory. A sample of 70 families with non-asthmatic, healthy children was used as controls. The majority of children had mild asthma. Ambidexterity was the main feature in the asthmatic children. A statistically significant difference in the laterality quotient (LQ) distribution was found in the group of asthmatic children with allergic rhinitis (LQ mean value in the asthmatic children with allergic rhinitis: 42.85 vs. 79.50 in the rest of the asthmatic children). These results suggest that there is a tendency towards left-handedness in asthmatic children and lend support to the GBG hypothesis.     

Parental smoking, nasal resistance and rhinitis in children

Aim: To determine whether parent‐reported perennial rhinitis or objectively measured nasal resistance is more common in children from smoking families. To assess tonsillar size, nasopharyngeal airway and upper airway surgery frequency in children with smoking and non‐smoking parents. Methods: Ninety‐five children (age 3–6 years, median 68 months) participated in this prospective cross‐sectional clinical study. History of nasal symptoms was obtained, and all underwent an ear–nose–throat examination, anterior rhinomanometry and a lateral cephalogram. Regular smoking by either parent and their child’s snoring was inquired about with a parental questionnaire. We compared children with a parental smoker and children without a parental smoker in the family. Results: Smoking in the family led to increased risk for perennial rhinitis in the children up to 2.76‐fold (aOR, 95%CI 1.00–7.67), but with no difference in nasal resistance between children from smoking and non‐smoking households. Neither tonsillar size, nasopharyngeal airway nor upper airway surgery was associated with parental smoking. Conclusions: Parental smoking is associated with symptoms of perennial rhinitis in children. The possible role of environmental tobacco smoke should be taken into account in parent counselling and in evaluation of children being treated for symptoms of rhinitis and nasal obstruction.     

口鼻呼出气一氧化氮检测在儿童支气管哮喘控制评估及过敏性鼻炎诊断中的应用

目的 探讨口呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)与鼻呼出气一氧化氮(nasal nitric oxide,nNO)检测值和儿童支气管哮喘(简称哮喘)控制水平的关系,以及对过敏性鼻炎的诊断价值.方法 以上海市儿童医院呼吸科门诊就诊的5～12岁哮喘和/或过敏性鼻炎患儿,...