Asthma cases attributable to atopy: Results from the Third National Health and Nutrition Examination Survey

Arbes, Samuel J.; Gergen, Peter J.; Vaughn, Ben; Zeldin, Darryl C.

doi:10.1016/j.jaci.2007.07.056

Cited by 199 publications

(165 citation statements)

References 19 publications

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“…It has been estimated that more than half of asthma cases in the USA can be attributed to allergic sensitisation [36]. Numerous studies have found associations between exposure to indoor allergens and respiratory health, especially in the case of HDM [37,38].…”

Section: Biological Pollutantsmentioning

confidence: 99%

Respiratory health and indoor air pollutants based on quantitative exposure assessments

et al. 2012

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We reviewed the main epidemiological studies that evaluate the respiratory effects of indoor air pollutants quantitatively in industrialised countries. Consistent results support short-term (aggravation) and, although more rarely, long-term (prevalence augmentation) effects on asthma, chronic bronchitis and chronic obstructive pulmonary disease (COPD) in indoor settings with poor air quality. Environmental tobacco smoke is one of the most important risks for respiratory symptoms and diseases worldwide. The evidence is also reliable for indoor nitrogen dioxide and particulate matter, which have been associated with asthma, bronchitis and COPD. Whereas formaldehyde and volatile organic compounds seem to be the main pollutants in indoor settings, relevant papers on their respiratory effects are still scarce, and limited to asthma and bronchitis. Moulds have been associated with an increased risk of asthma and COPD. Contradictory results have been found between endotoxins and asthma. The role of phthalates, persistent organic pollutants and flame retardants in respiratory diseases remains to be established. Results from rural areas of industrialised countries indicate that exposure to some indoor bio-contaminants might be protective in early life, while it is associated with adverse respiratory adverse effects in adulthood. Studies focusing on indoor air pollutants should be developed to better understand their involvement in the inception and aggravation of respiratory diseases.

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Section: Biological Pollutantsmentioning

confidence: 99%

Respiratory health and indoor air pollutants based on quantitative exposure assessments

et al. 2012

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“…Risk factors in relationship to asthma have been evaluated in the context of disease inception [e.g., viral infections(1,2,39); environmental exposures (e.g., aeroallergens (40), pollution (41)(42)(43), tobacco smoke (44)(45)(46)(47)) and lifestyle (e.g., living on a farm (48), diet (49), antibiotic use(50)); comorbid conditions (e.g., atopic dermatitis(51), obesity(52)); occupational exposures(3); among others], as well as disease severity (as defined by the risk domaindiscussed subsequently) [hospitalizations (53,54); frequency and severity of exacerbations (55); and loss of lung function (8,56)]. Genetic factors also contribute significantly to disease expression and severity.…”

Section: Risk Factorsmentioning

confidence: 99%

“…Chronic low-level exposure to indoor allergens, and dust mite and cockroach, in particular, may play a major role in both asthma inception and subsequent provocation of symptoms. (61) Although a wide variety of inhaled allergens can provoke asthma symptoms, sensitization to house dust mite(62), cockroach (63), Alternaria (64) and, possibly, cat (40) are important in the pathogenesis of asthma. Dog, but not cat, ownership during infancy has been shown to reduce the subsequent development of allergic sensitization and atopic dermatitis(65); numbers of pets, not the type of furred pet, may also reduce future risk.…”

Section: Exacerbating Factorsmentioning

confidence: 99%

Asthma: Clinical expression and molecular mechanisms

2010

Journal of Allergy and Clinical Immunology

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Asthma is a heterogenous disorder that is characterized by variable airflow obstruction, airway inflammation and hyperresponsiveness, and reversibility either spontaneously or as a result of treatment. Multiple etiologies no doubt exist for both its inception and symptom exacerbation once the disease is established. Factors underlying inception can range from viral respiratory tract infections in infancy(1,2) to occupational exposures in adults.(3) Factors underlying asthma exacerbations include allergen exposure in sensitized individuals, viral infections, exercise, irritants, ingestion of nonsteroidal anti-inflammatory agents, among others. Exacerbating factors may include one or all of these exposures, and vary both among and within patients. Asthma treatment is determined to a large extent following an initial assessment of severity and subsequent establishment of control, both of which can be variable over time and assessed in two domains: impairment (current) and risk (long term consequences).(4) Unfortunately, despite the availability of effective therapies, suboptimal asthma control exists in many patients on a world-wide basis.(5) The future development of novel therapies and treatment paradigms should address these disparities.

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“…The majority of schoolchildren with asthma are allergic to airborne allergens and allergy is a common trigger of asthma symptoms [Arbes et al 2007;Covar et al 2010]. Nevertheless, subcutaneous immunotherapy (SCIT) is still questioned as a safe and efficacious way of treating allergic asthma in children.…”

Section: Introductionmentioning

confidence: 99%

The role of immunotherapy in the management of childhood asthma

Hedlin

Hage

2012

Ther Adv Respir Dis

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Subcutaneous immunotherapy (SCIT) is still questioned as a safe and efficacious way of treating allergic asthma in children. In a Cochrane review published in 2010 it was, however, concluded that SCIT has significant and beneficial effects on symptoms and medication use in both children and adults with mostly mild asthma. Only a few studies have been performed to specifically study if SCIT in children with moderate asthma reduces the need for inhaled corticosteroids. There are conflicting results that illustrate the problem of the heterogeneity of the asthma disease and the fact that allergies may play different roles on the severity and symptoms of the disease. Furthermore, children with severe allergic asthma are often sensitized to multiple allergens, which makes SCIT both complicated and less safe to administer. On the other hand, if the child suffers from asthmatic symptoms despite adherence to pharmacotherapy, omalizumab or a combination of omalizumab and allergen immunotherapy might be useful. There is a need for more studies on this combination before it can be considered as an additional therapy in children with asthma and severe allergies. Sublingual immunotherapy (SLIT) has also been shown to improve asthma symptoms and medication use. SLIT is safe although its efficacy compared with SCIT has been studied very little. Another approach is to try to prevent asthma by treating children with SCIT for allergic rhinoconjunctivitis before asthma has developed. The most attractive prospect, however, is to find ways of preventing asthma by vaccination against the most common viruses, particularly rhinovirus. There is evidence that there are children at high risk of developing asthma in whom a viral infection can also enhance the risk of allergen sensitization. So far this vaccination has not been achievable although research is in progress.

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Asthma cases attributable to atopy: Results from the Third National Health and Nutrition Examination Survey

Abstract: Background-The percentage of asthma cases attributable to atopy is the subject of debate.

Cited by 199 publications

References 19 publications

Respiratory health and indoor air pollutants based on quantitative exposure assessments

Respiratory health and indoor air pollutants based on quantitative exposure assessments

Asthma: Clinical expression and molecular mechanisms

The role of immunotherapy in the management of childhood asthma

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