Background
Allergen immunotherapy (AIT) is a disease‐modifying treatment for IgE‐mediated diseases. Randomized controlled trials (RCTs) support AIT's potential role in asthma prevention but evidence ...from non‐randomized studies of interventions (NRSI) and longitudinal observational studies has been poorly addressed. Therefore, we aimed to conduct a systematic review and meta‐analysis to assess clinical data from all study types to evaluate quantitatively the preventive role of AIT in asthma onset.
Methods
We search three databases. Studies were screened, selected and evaluated for quality using risk‐of‐bias (ROB) tools. Data were descriptively summarized and meta‐analysed using random effects. We performed a sensitivity, influence and subgroup analyses. Publication bias and heterogeneity were assessed.
Results
From the 4549 identified studies, 24 (12 RCTs and 12 NRSI) were included in the qualitative synthesis and 18 underwent meta‐analysis. One study was at low ROB, seven had moderate ROB, and 15 were proven of high ROB. Random‐effects analysis showed a significant decrease in the risk of developing asthma following AIT by 25% (RR, 95% CI: 0.75, 0.64–0.88). This effect was not significant in the sensitivity analysis. Publication bias raised concerns, together with the moderate heterogeneity between studies (I2 = 58%). Subgroup analysis showed a remarkable preventive effect of AIT in children (RR, 95% CI: 0.71, 0.53–0.96), when completing 3 years of therapy (RR, 95% CI: 0.64, 0.47–0.88), and in mono‐sensitized patients (RR, 95% CI: 0.49, 0.39–0.61).
Conclusions
Our findings support a possible preventive effect of AIT in asthma onset and suggest an enhanced effect when administered in children, mono‐sensitized, and for at least 3 years, independently of allergen type.
The number of microbiome-related studies has notably increased the availability of data on human microbiome composition and function. These studies provide the essential material to deeply explore ...host-microbiome associations and their relation to the development and progression of various complex diseases. Improved data-analytical tools are needed to exploit all information from these biological datasets, taking into account the peculiarities of microbiome data, i.e., compositional, heterogeneous and sparse nature of these datasets. The possibility of predicting host-phenotypes based on taxonomy-informed feature selection to establish an association between microbiome and predict disease states is beneficial for personalized medicine. In this regard, machine learning (ML) provides new insights into the development of models that can be used to predict outputs, such as classification and prediction in microbiology, infer host phenotypes to predict diseases and use microbial communities to stratify patients by their characterization of state-specific microbial signatures. Here we review the state-of-the-art ML methods and respective software applied in human microbiome studies, performed as part of the COST Action ML4Microbiome activities. This scoping review focuses on the application of ML in microbiome studies related to association and clinical use for diagnostics, prognostics, and therapeutics. Although the data presented here is more related to the bacterial community, many algorithms could be applied in general, regardless of the feature type. This literature and software review covering this broad topic is aligned with the scoping review methodology. The manual identification of data sources has been complemented with: (1) automated publication search through digital libraries of the three major publishers using natural language processing (NLP) Toolkit, and (2) an automated identification of relevant software repositories on GitHub and ranking of the related research papers relying on learning to rank approach.
Children are by far more susceptible to the negative effects of air pollutants than adults. Building-level characteristics are structural factors largely beyond the control of those who live in them. ...Yet, there are gaps in understanding of the relationship of school building characteristics and/or occupant behaviour and indoor air parameters with implications for health and well-being.
The aims of the study were to investigate the potential sources of CO2, PM10 and volatile organic compound (VOCs) in naturally ventilated primary schools and to assess the potential health hazards of PM10 on schoolchildren.
CO2 and PM10 levels were determined in seventy three classrooms located in Porto city over a period of 8 h using low-drift NDIR sensors and light-scattering laser photometers, respectively. The VOCs samples were collected over 5-days in Tenax TA tubes and then analysed by gas chromatography coupled mass spectrometry.
Principal component analysis revealed the influence of activities or building features as major sources of indoor CO2, PM10 and VOCs associated to the reduced airing of the classrooms which underlines the influence of indoor sources, occupant behaviour and maintenance/cleaning activities in schools and the high density of occupants.
The hazard quotient calculated based on the formula suggested by the United States Environmental Protection Agency is higher than the acceptable level of 1; being for children almost twelve times higher than the safe level. This indicates that the inhalation exposure to PM10 by children and adults occupying the school environment is not negligible.
•Potential sources of CO2, PM10 and VOCs was determined.•PCA revealed the influence of activities or building features as major sources of indoor pollution.•Children exhibited dose rates twice higher than adults.•The PM10 hazard quotient is higher than the acceptable level of 1.•Inhalation exposure to PM10 by children and adults is not negligible.
A cross-sectional survey was conducted to characterize the indoor air quality (IAQ) in schools and its relationship with children's respiratory symptoms. Concentrations of volatile organic compounds ...(VOC), aldehydes, PM2.5, PM10, carbon dioxide, bacteria and fungi were assessed in 73 classrooms from 20 public primary schools located in Porto, Portugal. Children who attended the selected classrooms (n = 1134) were evaluated by a standardised health questionnaire completed by the legal guardians; spirometry and exhaled nitric oxide tests.
The results indicated that no classrooms presented individual VOC pollutant concentrations higher than the WHO IAQ guidelines or by INDEX recommendations; while PM2.5, PM10 and bacteria levels exceeded the WHO air quality guidelines or national limit values. High levels of total VOC, acetaldehyde, PM2.5 and PM10 were associated with higher odds of wheezing in children. Thus, indoor air pollutants, some even at low exposure levels, were related with the development of respiratory symptoms. The results pointed out that it is crucial to take into account the unique characteristics of the public primary schools, to develop appropriate control strategies in order to reduce the exposure to indoor air pollutants and, therefore, to minimize the adverse health effects.
•Indoor air measurement campaigns in 73 classrooms from 20 public primary schools.•Children health information obtained using a questionnaire and clinical tests.•Relationships between IAQ and children's respiratory symptoms.•Even at low levels indoor air pollutants were related with the respiratory symptoms.
Background
A lower exposure to the natural environment has been hypothesized to adversely affect the human microbiome and its immunomodulatory capacity. However, the underlying effects of this ...hypothesis are still not understood. We aimed to evaluate the effect of early‐life exposure to greenness and species richness on the development of allergic diseases and asthma in children.
Methods
A longitudinal study was conducted comprising 1050 children from a population‐based birth cohort recruited in Portugal. Residential normalized difference vegetation index (NDVI) and species richness index (SRI) were assessed at baseline to estimate their association with allergic diseases and asthma at the ages of 4 and 7.
Results
Significant predisposing associations were observed between the exposure to species richness at baseline and the onset of asthma and wheezing at the age of 7. Children living in neighbourhoods surrounded by high levels of SRI were at a significantly higher risk developing allergic sensitization(OR 95% CI = 2.00 1.04:3.86 at age 4; 2.35 1.20:4.63 at age 7). Living surrounded by greener environments was significantly associated with a lower prevalence of asthma and rhinitis at the age of 7(0.41 0.18:0.97 and 0.37 0.15:0.93, respectively).
Conclusions
Living in close proximity to a greener environment at birth has a protective effect on the development of allergic diseases and asthma at the age of 7. Conversely, living in neighbourhoods with a high number of fauna species appears to be associated with a higher risk for allergy, asthma and wheezing.
Living in a greener neighbourhood at birth is associated with a lower prevalence of asthma and rhinitis at the age of seven. Living in a neighbourhood with high numbers of fauna species is associated with an increased risk for allergic diseases and asthma in children. The associations between the contact with nature and the development of asthma are stronger among children with a later onset of disease. Abbreviations: CI, confidence intervals; OR, odds ratio; NDVI, normalized difference vegetation index; SRI, species richness index.
Introduction
Whether you benefit from high‐quality urban environments, such as those rich in green and blue spaces, that may offer benefits to allergic and respiratory health depends on where you ...live and work. Environmental inequality, therefore, results from the unequal distribution of the risks and benefits that stem from interactions with our environment.
Methods
Within this perspective, this article reviews the evidence for an association between air pollution caused by industrial activities, traffic, disinfection‐by‐products, and tobacco/e‐cigarettes, and asthma in children. We also discuss the proposed mechanisms by which air pollution increases asthma risk, including environmental epigenetic regulations, oxidative stress, and damage, disrupted barrier integrity, inflammatory pathways, and enhancement of respiratory sensitization to aeroallergens.
Results and conclusions
Environmental air pollution is a major determinant of childhood asthma, but the magnitude of effect is not shared equally across the population, regions, and settings where people live, work, and spend their time. Improvement of the exposure assessment, a better understanding of critical exposure time windows, underlying mechanisms, and drivers of heterogeneity may improve the risk estimates. Urban conditions and air quality are not only important features for national and local authorities to shape healthy cities and protect their citizens from environmental and health risks, but they also provide opportunities to mitigate inequalities in the most deprived areas where the environmental burden is highest. Actions to avoid exposure to indoor and outdoor air pollutants should be complementary at different levels—individual, local, and national levels—to take effective measures to protect children who have little or no control over the air they breathe.
Detection and quantification of microRNAs (miRNAs) in exhaled breath condensate (EBC) has been poorly explored. Therefore we aimed to assess miRNAs in EBC as potential biomarkers to diagnose and ...endotype asthma in school aged children. In a cross sectional, nested case control study, all the asthmatic children (n = 71) and a random sample of controls (n = 115), aged 7 to 12 years, attending 71 classrooms from 20 local schools were selected and arbitrarily allocated to the development or validation set. Participants underwent skin-prick testing, spirometry with bronchodilation, had exhaled level of nitric oxide determined and EBC collected. Based on previous studies eleven miRNAs were chosen and analyzed in EBC by reverse transcription-quantitative real-time PCR. Principal component analysis was applied to identify miRNAs profiles and associations were estimated using regression models. In the development set (n = 89) two clusters of miRNAs were identified. After adjustments, cluster 1 and three of its clustered miRNAs, miR-126-3p, miR-133a-3p and miR-145-5p were positively associated with asthma. Moreover miR-21-5p was negatively associated with symptomatic asthma and positively associated with positive bronchodilation without symptoms. An association was also found between miR-126-3p, cluster 2 and one of its clustered miRNA, miR-146-5p, with higher FEF25-75 reversibility. These findings were confirmed in the validation set (n = 97) where two identical clusters of miRNAs were identified. Additional significant associations were observed between miR-155-5p with symptomatic asthma, negative bronchodilation with symptoms and positive bronchodilation without symptoms. We showed that microRNAs can be measured in EBC of children and may be used as potential biomarkers of asthma, assisting asthma endotype establishment.
Land use mix (LUM) in the neighbourhoods has been associated with healthier lifestyles. However, less is known about the association between LUM and health outcomes, namely during childhood. The ...objective of this study was to evaluate the association between different LUM indexes for Porto Metropolitan Area and asthma and respiratory symptoms in children. A cross-sectional analysis was performed involving 6260 children enrolled in Generation XXI. Land use around the child’s residence was assessed with the Portuguese official map of land cover using a GIS. Generalized linear mixed-effects models were fitted to estimate the association between LUM and respiratory symptoms and asthma at 7 years of age. Adjusted associations were quantified using odds ratio (OR) and 95% confidence interval (95% CI). After adjustment, LUM was associated with a lower odds of wheezing in the last 12 months OR (95% CI) = 0.37 (0.15; 0.93) using Shannon’s Evenness Index within 500 m; and OR = 0.93 (0.89; 0.98) using the number of different land use types within 250 m. Living in neighbourhoods with high LUM has a protective effect on current wheezing symptoms. Our results highlight the association between LUM and respiratory symptoms among children, suggesting that public health considerations should be incorporated in land use decision-making.
Elderly citizens are concentrated in urban areas and are particularly affected by the immediate residential environment. Cities are unequal and segregated places, where there is an intensification of ...urban change processes such as gentrification and displacement. We aimed to understand how neighbourhood socioeconomic processes and dynamics influence older people's health. Three bibliographic databases-PubMed, Web of Science, and Scopus-were used to identify evidence of the influence of neighbourhood socioeconomic deprivation, socio-spatial segregation, urban renewal, and gentrification on healthy ageing. We followed the method of Arksey and O'Malley, Levac and colleagues, the Joanna Briggs Institute, and the PRISMA-ScR. The included studies (
= 122) were published between 2001 and 2021. Most evaluated neighbourhood deprivation (
= 114), followed by gentrification (
= 5), segregation (
= 2), and urban renewal (
= 1). Overall, older people living in deprived neighbourhoods had worse healthy ageing outcomes than their counterparts living in more advantaged neighbourhoods. Older adults pointed out more negative comments than positive ones for gentrification and urban renewal. As to segregation, the direction of the association was not entirely clear. In conclusion, the literature has not extensively analysed the effects of segregation, gentrification, and urban renewal on healthy ageing, and more quantitative and longitudinal studies should be conducted to draw better inferences.
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