Allergy and sports in children

Physical activity is beneficial for children with positive outcomes for mental and physical well-being. Allergic conditions unique to the sporting arena may serve as an impediment to participation in physical activity for allergic children. A common example is exercise-induced asthma; less common activity-related allergic conditions include food-dependent exercise-induced anaphylaxis, exercise-induced anaphylaxis, and exercise-induced urticaria. Allergic children may also be at risk of allergic reactions when exposed to allergens that are more commonly found in the sports environment, e.g., latex, sports drinks, and medications such as NSAIDs. Recent advances in our understanding of the patho-physiological and immunologic mechanisms that may account for these conditions have facilitated more effective and safer management strategies. There are also important immunologic lessons to be learnt with respect to specific physical factors that may result in diminished allergen tolerance; indeed, these lessons may facilitate safer allergen desensitisation regimens. The role of the immune system in exercise-induced immunoallergic syndromes, clinical aspects, and diagnostic and therapeutic approaches are discussed in this review.     

No evidence that early use of inhaled corticosteroids reduces current asthma at 10 years of age

BACKGROUND: It is debated whether early treatment with inhaled corticosteroids (ICS) can change the natural course of childhood asthma. AIM: To assess if ICS treatment before 2 years of age in children with obstructive airways disease reduces current asthma at 10 years of age. METHODS: Children with (n=233) and without (n=219) recurrent (r) bronchial obstruction (BO) attending clinical examination at 2 years of age in the birth cohort Environment and Childhood Asthma study in Oslo, were reinvestigated at 10 years of age. Current asthma (CA) at 10 years was defined as asthma with either symptoms and/or asthma treatment during the last year, and/or 10% fall in forced expired volume in 1s after standardized treadmill run. The risk of CA was assessed by logistic regression and propensity modelling (including gender, parental atopy and severity score at 2 years) in children with rBO who received ICS or not by 2 years. RESULTS: CA was found in 97 children, more often among rBO children with (56.9%) and without ICS treatment (30.8%) compared to no-BO children (5.5%) (p<0.001). In rBO children logistic regression analyses (adjusted odds ratio aOR (95% confidence interval)) identified male gender (aOR 1.82 (1.01-3.27), p=0.046) and severity score at 2 years 1.14 (1.03-1.28), (p=0.01), as significant and ICS treatment as non-significant 2.00 (0.98-4.12) risk factors for CA. With propensity modelling adjusting for disease severity, ICS treatment by 2 years caused a non-significant increased risk aOR of CA of 1.84 (0.89-3.82). CONCLUSION: No evidence was found that early use of ICS before age two in children with rBO reduces current asthma 8 years later.     

A nested case–control study: personal,social and environmental correlates of vigorous physical activity in adolescents with asthma

Objective: Physical activity (PA) is associated with health benefits. Children and adolescents with asthma may be limited in their PA, particularly at vigorous intensity due to asthma symptoms or poor psychological adjustment to asthma. We aimed to investigate if self-perceived competence, enjoyment, support from others and social-physical environment were associated with vigorous physical activity (VPA) and secondarily to assess if such associations were modified by asthma and asthma severity. Methods: Data from a nested case–control study at 13 years of age within the birth-cohort Environment and Childhood Asthma Study were compiled from 95 participants with and 79 without asthma. The participants completed a questionnaire designed to capture self-perceived competence, enjoyment, support from others and social-physical environment. VPA, defined as ≥?6 Metabolic Equivalents, was recorded objectively by SenseWear? Pro₂ Armband. Asthma severity was assessed pragmatically by lung function and use of inhaled glucocorticosteroids and β_2-agonists and incidence of exacerbations in the last 14 days. Data were analysed using linear regression analysis. Results: No significant differences between adolescents with and without asthma were identified in terms of VPA, competence-enjoyment, support from others and social-physical environment. Peer support (b?=?0.29 (0.05–0.52)) and competence-enjoyment (b?=?0.23 (0.01–0.44)) were significantly and positively associated with VPA, and teacher support (b?=?–0.26 (?0.50 to ?0.02)) were inversely associated. The model explained 25% of the variance in VPA. Conclusions: Peer support and competence-enjoyment were positively associated with increased VPN in adolescents irrespectively of asthma and asthma severity.     

Interleukin 18 receptor 1 gene polymorphisms are associated with asthma

The interleukin 18 receptor (IL18R1) gene is a strong candidate gene for asthma. It has been implicated in the pathophysiology of asthma and maps to an asthma susceptibility locus on chromosome 2q12. The possibility of association between polymorphisms in IL18R1 and asthma was examined by genotyping seven SNPs in 294, 342 and 100 families from Denmark, United Kingdom and Norway and conducting family-based association analyses for asthma, atopic asthma and bronchial hyper-reactivity (BHR) phenotypes. Three SNPs in IL18R1 were associated with asthma (0.01131相似文献   

Pharmaceutical treatment strategies for childhood asthma

PURPOSE OF REVIEW: Although great improvement has been obtained in quality of life and mastering of illness by asthmatic children over recent decades, controversies still exist related to asthma treatment. The objective of the present article is to discuss such controversies. RECENT FINDINGS: Results from recent publications related to childhood asthma treatment question existing dogmas. Important for prescribing correct treatment to children is correct diagnosis. Phenotypes of childhood asthma related to treatment decisions are discussed. Early use of inhaled steroids in young children is still debated as well as the preference of inhaled long-acting beta2-agonists versus leukotriene receptor antagonists as add on to inhaled steroids. When present, both allergic rhinitis and asthma should be treated to obtain improved control. Also as regards the treatment of exercise-induced asthma in children, new results concerning use of leukotriene receptor antagonists is discussed as well as the acute treatment in infants with bronchial obstruction. SUMMARY: There are still several controversies regarding treatment of the asthmatic child. New studies designed specifically for children are needed to solve these questions. One cannot rely on studies performed in adults for treatment in children. New studies designed for childhood asthma are needed to solve these controversies.     

FeSiCr Alloy Powder to Carbonyl Iron Powder Mixing Ratio Effects on the Magnetic Properties of the Iron-Based Alloy Powder Cores Prepared Using Screen Printing

A screen printing process was used to substitute dry molding to solve the uneven compaction problem in the coil center column during molding in this study. FeSiCr alloy powders (FSC) with a large particle size were mixed with fine spherical carbonyl iron powder to increase the compaction density. FSC to carbonyl iron powder (CIP) mixing ratio effects on magnetic paste rheological behaviors and magnetic properties of the molding coil prepared using screen printing were investigated. A magnetic paste with the lowest viscosity can be obtained using 3C7F (30% CIP + 70% FSC) due to the small-sized CIP adsorbed onto the FSC surface. This process reduces the interlocked network formation resulting from the CIP. The toroidal core with 3C7F exhibited the highest relative density and highest inductance. The coils with pure CIP and higher CIP content exhibited the better DC superposition characteristic. The toroidal core loss increased rapidly as the FSC content was increased. A proper trade-off between the inductance, DC-bias superposition characteristic, and magnetic core loss can be reached by choosing a suitable powder mixing ratio.     

Understanding the complexity of IgE-related phenotypes from childhood to young adulthood: a Mechanisms of the Development of Allergy (MeDALL) seminar

Mechanisms of the Development of Allergy (MeDALL), a Seventh Framework Program European Union project, aims to generate novel knowledge on the mechanisms of initiation of allergy. Precise phenotypes of IgE-mediated allergic diseases will be defined in MeDALL. As part of MeDALL, a scientific seminar was held on January 24, 2011, to review current knowledge on the IgE-related phenotypes and to explore how a multidisciplinary effort could result in a new integrative translational approach. This article provides a summary of the meeting. It develops challenges in IgE-related phenotypes and new clinical and epidemiologic approaches to the investigation of allergic phenotypes, including cluster analysis, scale-free models, candidate biomarkers, and IgE microarrays; the particular case of severe asthma was reviewed. Then novel approaches to the IgE-associated phenotypes are reviewed from the individual mechanisms to the systems, including epigenetics, human in?vitro immunology, systems biology, and animal models. The last chapter deals with the understanding of the population-based IgE-associated phenotypes in children and adolescents, including age effect in terms of maturation, observed effects of early-life exposures and shift of focus from early life to pregnancy, gene-environment interactions, cohort effects, and time trends in patients with allergic diseases. This review helps to define phenotypes of allergic diseases in MeDALL.     

Effects of posture on lung function in obese children

Forced expiratory manoeuvres are recommended performed in sitting posture; however, standing posture has been reported to be usually more advantageous since any diaphragmatic restriction associated with obesity is reduced. Information on the effect of posture on forced expiratory manoeuvres in obese children is lacking. Aim: To determine whether lung function measured in standing compared with sitting posture is increased in overweight and obese children. Methods: One hundred fifteen overweight (n = 23) and obese (n = 92) children (7–17 years old) performed forced expiratory flow‐volume manoeuvres in sitting and standing posture in random order. Results: Forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC) and forced expiratory flow after 50% of FVC (FEF₅₀) was significantly higher in sitting compared with standing posture [0.8, 1.1 and 2.2 percentage change in absolute values (all with P < 0.05)]. FEV₁/FVC and peak expiratory flow were not significantly different measured in sitting and standing posture; 95%–99% of the variance were explained by differences among individuals (all with P < 0.0001). Conclusions: In conclusion, FEV₁, FVC and FEF₅₀ were all significantly higher when measured in sitting compared with standing posture; however, the improvements were of little clinical significance. These findings confirm that sitting posture is appropriate in obese children when performing forced expiratory flow‐volume manoeuvres. Please cite this paper as: Berntsen B, Edvardsen E, Carlsen K‐H, Kolsgaard MLP and Carlsen KCL. Effects of posture on lung function in obese children. Clin Respir J 2011; 5: 252–257.     

Parental Smoking and Childhood Asthma

Environmental tobacco smoke and constituents are global risks for human health. Considerable evidence shows that environmental tobacco smoke exposure contributes to, and exacerbates, respiratory disorders. This review assesses the causal role of environmental tobacco smoke exposure for childhood respiratory disorders, and in particular asthma. Tobacco smoke and environmental tobacco smoke exposure during pregnancy have an effect upon lung function in newborn infants; exposure after birth also has an effect upon lung function. An effect upon bronchial responsiveness has been suggested but the evidence is not as strong as for lung function. From 1997 to 1999 a comprehensive set of systematic reviews concerning the relationship between exposure to environmental tobacco smoke and respiratory health in children summarized the results from hundreds of published papers. The evidence for a causal relationship between environmental tobacco smoke exposure and asthmatic symptoms on the one hand, and between environmental tobacco smoke exposure and reduction in lung function on the other hand, was quite strong, whereas the evidence between environmental tobacco smoke exposure and development of allergy was much weaker. Here we present an overview of the effects of environmental tobacco smoke exposure on lung health in children. A hypothesis has been put forward regarding upregulation of pulmonary neuroendocrine cells in relationship to mechanisms of tobacco smoke products (TSP)-induced pulmonary disease. It has also been reported that genetic variation makes part of the population especially vulnerable to environmental tobacco smoke exposure during pregnancy. Furthermore, there is a need for intervention to reduce environmental tobacco smoke exposure in young children, by educating parents and adolescents about the health effects of environmental tobacco smoke exposure. Studies are needed to identify possible critical periods when environmental tobacco smoke exposure is more likely to induce harmful effects on lung health in young children in order to implement effective preventive strategies.