Characteristic Hospital-based study Population-based study Case Control Number 1239 447 3361 Responders to questionnaire, n (%) NA NA 3299 (98.2) Age (y) 5.18 ± 3.86 9.32 ± 2.47 8.75 ± 2.90 Sex (M/F) ...717/522 231/216 1719/1588 BMIlow * NA NA 17.89 ± 3.17 Lifetime AD symptoms NA NA 709 of 2349 (23.2%) Parental history of allergic diseases NA NA 1068 of 3056 (34.9%) Parental history of asthma NA NA 117 of 2911 (4.0%) Parental history of AR NA NA 953 of 3033 (31.4%) Parental history of AD NA NA 237 of 2933 (8.1%) Environmental tobacco smoking NA NA 1342 of 3095 (43.4%) Educational level of mother <=High school graduate NA NA 1242 of 3039 (40.9%) >=University graduate NA NA 1797 of 3039 (59.1%) Economic state (monthly income) Low (<3 million won) NA NA 1282 of 2977 (43.1%) Middle (3-5 million won) NA NA 1280 of 2977 (43.0%) High (>=5 million won) NA NA 415 of 2977 (13.9%) Mold exposure (visible mold) During infancy NA NA 564 of 2932 (19.2%) During the previous year NA NA 635 of 2930 (21.7%) Biomarker Total IgE (IU/mL) 512.62 ± 1095.99 57.70 ± 124.34 204.08 ± 394.16 Claudin-1 Frequency of rs9290929 A 0.933 0.953 0.946 G 0.067 0.047 0.054 Table E1 Subject characteristics Values are mean ± SD or proportion.AR, Allergic rhinitis; F, female; M, male; NA, not available. Risk factors AD Sx everlow * aOR (95% CI)dagger P value Demographic factors Sex: male 1.11 (0.91-1.34) .299 BMI 1.03 (0.99-1.06) .142 Age 0.92 (0.89-0.96) <.001 Higher economic state (monthly income >=5 million won) 1.05 (0.78-1.41) .747 Maternal education (<university graduate) 0.90 (0.73-1.12) .338 Genetic factors Parental history of allergic disease 1.70 (1.41-2.06)double dagger <.001 Parental history of AD 2.82 (2.09-3.79)double dagger <.001 Parental history of AR 1.31 (1.06-1.61) .013 Parental history of asthma 1.36 (0.87-2.13) .171 Environmental factors Environmental tobacco smoking 1.06 (0.87-1.28) .570 Pet ownership in the past 12 mo 0.89 (0.63-1.25) .490 Pet ownership during infancy 1.42 (0.94-2.14) .098 Mold exposure during infancy (visible mold) 1.60 (1.26-2.03) <.001 Biomarkers Total IgE (>200.0 IU/mL) 1.20 (0.94-1.53) .138 Table E2 Risk factors for AD in the population-based study Data were calculated by logistic regression multivariate analysis.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Although previous studies have investigated the association between atopy phenotypes and allergic diseases, atopy characterizations in association with the development of allergic diseases remain ...poorly understood.
To identify atopy phenotypes in school-age children and to evaluate the association between atopy phenotypes and allergic diseases.
We enrolled 616 children with atopy defined as 1 or more positive allergen responses on skin prick tests and 665 children without atopy from the Children's Health and Environmental Research (CHEER) study. All children were followed up for 4 years at 2-year intervals. Atopy phenotypes were classified using latent class analysis.
Four atopy phenotypes were characterized: later sensitization to indoor allergens (cluster 1); multiple early sensitization (cluster 2); early sensitization to outdoor allergens, especially Alternaria, and later sensitization to indoor allergens, including Aspergillus (cluster 3); and early sensitization to indoor allergens and later sensitization to outdoor allergens (cluster 4). New cases of asthma during follow-up were increased in clusters 2 and 3 (adjusted odds ratio aOR, 2.76 and 4.25, respectively). The risk of new-onset bronchial hyperresponsiveness was highest in cluster 3 (aOR, 5.03). Clusters 2 and 4 had an increased risk of allergic rhinitis (aOR, 7.21 and 2.37, respectively).
Identification of atopy phenotypes facilitates prediction of the development of asthma and bronchial hyperresponsiveness in school-age children. Our study suggests prevention of additional sensitization is required to modify the progression of allergic diseases.
Allergic rhinitis (AR) has a wide range of clinical features and may be accompanied by comorbid allergic diseases.
To identify rhinitis phenotypes in school aged children and to predict the prognosis ...for developing bronchial hyperresponsiveness (BHR) and asthma.
This prospective follow-up study involved schoolchildren from the Children's Health and Environment Research cohort with current rhinitis, which was defined based on parental-reported, physician-diagnosed rhinitis and symptoms of rhinitis in the previous 12 months. All participants were followed up at 2 and 4 years later. Rhinitis clusters were identified by latent class analysis that used demographic, clinical, and environmental variables.
In 512 eligible children (age range, 6-8 years), 4 rhinitis phenotypes were identified: cluster 1 (25% of children) was associated with nonatopy and a low socioeconomic status; cluster 2 (36%) was associated with a high-atopic burden but normal lung function; cluster 3 (22%) was associated with a high-atopic burden and impaired lung function; and cluster 4 (17%) was associated with low atopy and a high socioeconomic status. Cluster 3 was associated with the highest total serum IgE levels and blood eosinophil percentages at enrollment and the highest incidence of new cases of BHR (P = .04) and asthma symptoms (P = .005) during follow-up.
The rhinitis cluster of schoolchildren with atopy and impaired lung function is associated with allergic march. This identification of distinct rhinitis phenotypes in affected children may help to prevent allergic march in children with rhinitis.
...we examined the effects of air pollution on AHR in a nationwide prospective epidemiologic study.4,7 The study population was derived from a prospective 2-year follow-up survey consisting of ...parental responses to the International Studies of Asthma Allergic diseases in Childhood (ISAAC) questionnaire and allergic evaluation, including methacholine challenge test, skin prick test, and pulmonary function test. ...their study population was a cohort of adults aged 18 to 70 years, and only cross-sectional association was analyzed. ...it may be postulated that there is a critical period of development during which a person is vulnerable to air pollution.
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Antibiotic use in infancy induces alteration in intestinal microbiota and is associated with the development of allergic diseases. Mold exposure is also associated with allergic diseases. Genetic ...susceptibility may interact with specific environmental factors in allergic disease development.
To investigate independent and combined effects of antibiotic use and mold exposure in infancy on the risk of allergic rhinitis (AR) in adolescents.
Data on AR and environmental factors were collected using the International Study of Asthma and Allergies in Childhood questionnaire from 7,389 adolescents from Seoul, Korea. TaqMan genotyping was performed for interleukin 13 (IL-13) (rs20541) and Toll-like receptor 4 (rs1927911) polymorphisms in 1,395 adolescents.
Age, parental history of AR, antibiotic use in infancy, and pet ownership during pregnancy or infancy were associated with an increased risk of current AR (diagnosis of AR and symptoms of AR within the preceding 12 months). Having older siblings was a protective effect. The adjusted odds ratio (aOR) for current AR for combined antibiotic use and mold exposure in infancy was 1.45 (95% confidence interval CI, 1.01-2.09). For each factor separately, aORs were 1.25 (95% CI, 1.04-1.50) and 0.99 (95% CI, 0.75-1.31), respectively. Antibiotic and mold exposure in infancy, GA or AA genotypes of IL-13 (rs20541) (aOR 4.53; 95% CI, 1.66-12.38; P for interaction = .05), and CT+TT genotype of Toll-like receptor 4 (rs1927911) (aOR, 3.20; 95% CI, 1.24-8.26; P for interaction = .18) increased the risk of current AR.
Antibiotic use and mold exposure in infancy have additive effects on the risk of current AR in genetically susceptible adolescents. Gene-environment interactions between IL-13 (rs20541) and antibiotics or mold may play a role in AR.
Background Reconstruction of the aortic arch in patients with complex aortic coarctation or interruption continues to be a challenge because of early left main bronchial compression or recoarctation ...and late Gothic arch formation. We propose a modified arch reconstruction technique augmenting the lesser curvature with an autologous vascular patch, which can relieve tension on the anastomosis without a prosthetic material. Methods We retrospectively reviewed 33 patients with coarctation and arch hypoplasia (n = 31) or arch interruption (n = 2) who underwent arch reconstruction with an autologous vascular patch from 2007 to 2012. Median age at the operation was 17 days (range, 5 to 200 days). Median body weight was 3.7 kg (range, 2.3 to 7.0 kg). Cardiopulmonary bypass was used for all operations. Median antegrade selective cerebral perfusion time was 35 minutes (range, 23 to 59 minutes). Combined intracardiac anomalies in 29 patients (88%) were corrected simultaneously. The reconstructed arch was supplemented in the lesser curvature with an autologous vascular patch that was harvested from aortic isthmus (n = 25), pulmonary artery (n = 4), left subclavian artery (n = 2), aberrant right subclavian artery (n = 1), or distal arch (n = 1). Results One patient (3%) died of acute respiratory distress syndrome. All survivors were discharged at 15 days (range, 7 to 58 days) postoperatively without neurologic complications or bronchial obstructions. Median follow-up was 24.8 months (range, 0.2 to 48.5 months). No recoarctation was observed during follow-up, and no patient needed reoperation. Conclusions Augmenting the lesser curvature with an autologous vascular patch during arch reconstruction resulted in excellent midterm outcomes. Not only can a more natural shape of arch and less tension on the anastomosis be obtained, but complications, such as left main bronchial obstruction or recoarctation, can also be minimized. Long-term follow-up is needed to evaluate late development of recoarctation, hypertension, or aneurysm formation.
The group 2 included 280 subjects with a history of recent wheeze, physician diagnosed asthma, or recent asthma treatment by a Korean version of ISAAC questionnaire from population-based researches.
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