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Journal of the American Academy of... Jul 2017It is unclear whether patients with atopic dermatitis (AD) have an altered prevalence or risk for contact sensitization. Increased exposure to chemicals in topical... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It is unclear whether patients with atopic dermatitis (AD) have an altered prevalence or risk for contact sensitization. Increased exposure to chemicals in topical products together with impaired skin barrier function suggest a higher risk, whereas the immune profile suggests a lower risk.
OBJECTIVE
To perform a systematic review and meta-analysis of the association between AD and contact sensitization.
METHODS
The PubMed/Medline, Embase, and Cochrane databases were searched for articles that reported on contact sensitization in individuals with and without AD.
RESULTS
The literature search yielded 10,083 citations; 417 were selected based on title and abstract screening and 74 met inclusion criteria. In a pooled analysis, no significant difference in contact sensitization between AD and controls was evident (random effects model odds ratio [OR] = 0.891; 95% confidence interval [CI] = 0.771-1.03). There was a positive correlation in studies that compared AD patients with individuals from the general population (OR 1.50, 95% CI 1.23-1.93) but an inverse association when comparing with referred populations (OR 0.753, 95% CI 0.63-0.90).
LIMITATIONS
Included studies used different tools to diagnose AD and did not always provide information on current or past disease. Patch test allergens varied between studies.
CONCLUSION
No overall relationship between AD and contact sensitization was found. We recommend that clinicians consider patch testing AD patients when allergic contact dermatitis is suspected.
Topics: Dermatitis, Atopic; Dermatitis, Contact; Humans
PubMed: 28392290
DOI: 10.1016/j.jaad.2017.02.001 -
Pediatric Dermatology 2009Atopic diseases are common and becoming more prevalent. Efforts have focused on primary disease prevention by identifying high-risk children and applying preventative... (Review)
Review
Atopic diseases are common and becoming more prevalent. Efforts have focused on primary disease prevention by identifying high-risk children and applying preventative strategies. Our aim was to evaluate methods used to identify high-risk children in atopy prevention studies. A literature search for relevant articles published between 1986 and 2006 was conducted, and all abstracts were reviewed. The search yielded 1,535 publications, 133 were reviewed in detail, and 57 met inclusion criteria. High risk was defined by 30 different methods. First-degree relatives with an atopic disorder were included in all methods, but only three publications used referenced questionnaires to determine this. Less frequently included were cord blood immunoglobulin E measurements and skin prick or radioallergosorbent testing, and 16 methods relied on history alone. Family history was the most common method used to predict high risk of atopic disease in a child, but a minority of studies used a tested questionnaire to determine the presence of atopy in family members. The methods used to identify high-risk children are variable, and the development and widespread use of a validated, practical screening tool is needed.
Topics: Child; Humans; Hypersensitivity, Immediate; Immunoglobulin E; Primary Prevention; Risk Factors; Skin Tests
PubMed: 19706083
DOI: 10.1111/j.1525-1470.2008.00807.x -
The Journal of Dermatological Treatment Jun 2022Accumulated evidences support the fetus's intestinal flora unbalance is associated with the development of allergic diseases. Probiotic supplements in pregnancy and... (Meta-Analysis)
Meta-Analysis Review
Accumulated evidences support the fetus's intestinal flora unbalance is associated with the development of allergic diseases. Probiotic supplements in pregnancy and childhood might prevent atopic diseases. The aim of this systematic review and meta-analysis was to evaluate the effect of probiotic supplementation during pregnancy and early infancy in preventing eczema, atopic eczema, and other allergic diseases. We also explored whether different probiotic strains or intervention objects affected the antiallergic effect of probiotics and the prevention atopy effect of the long-term period. Fixed-effect models were used, and random-effects models where significant heterogeneity was present. Results were expressed as odds ratios (ORs) with a 95% confidence interval (CI). Twenty-one studies were included in the meta-analysis. The probiotics group had a significantly lower risk of eczema and atopic eczema compared to controls, especially those treated with probiotic combinations. Mothers' probiotics intake significantly contributed to reducing the risk of eczema as well as atopic eczema. What's more, probiotics seemed effective on eczema prevention ≤2 years of age, but against atopic eczema after 1 of age year. No significant difference in terms of prevention of asthma, rhinitis, wheeze, allergic diseases and sensation. In brief, a probiotic supplement is expected to become a novel potential strategy for infant eczema and atopic eczema.
Topics: Asthma; Child; Dermatitis, Atopic; Dietary Supplements; Eczema; Female; Humans; Infant; Pregnancy; Probiotics
PubMed: 34006167
DOI: 10.1080/09546634.2021.1925077 -
The Journal of Allergy and Clinical... Mar 2011Epidemiologic studies suggest that deficiencies of the nutrients selenium; zinc; vitamins A, C, D, and E; and low fruit and vegetable intake may be associated with the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Epidemiologic studies suggest that deficiencies of the nutrients selenium; zinc; vitamins A, C, D, and E; and low fruit and vegetable intake may be associated with the development of asthma and allergic disorders.
OBJECTIVES
To investigate the evidence that nutrient and food intake modifies the risk of children developing allergy.
METHODS
We systematically searched 11 databases. Studies were critically appraised, and meta-analyses were undertaken.
RESULTS
We identified 62 eligible reports. There were no randomized controlled trials. Studies used cohort (n = 21), case-control (n = 15), or cross-sectional (n = 26) designs. All studies were judged to be at moderate to substantial risk of bias. Meta-analysis revealed that serum vitamin A was lower in children with asthma compared with controls (odds ratio [OR], 0.25; 95% CI, 0.10-0.40). Meta-analyses also showed that high maternal dietary vitamin D and E intakes during pregnancy were protective for the development of wheezing outcomes (OR, 0.56, 95% CI, 0.42-0.73; and OR, 0.68, 95% CI, 0.52-0.88, respectively). Adherence to a Mediterranean diet was protective for persistent wheeze (OR, 0.22; 95% CI, 0.08-0.58) and atopy (OR, 0.55; 95% CI, 0.31-0.97). Seventeen of 22 fruit and vegetable studies reported beneficial associations with asthma and allergic outcomes. Results were not supportive for other allergic outcomes for these vitamins or nutrients, or for any outcomes in relation to vitamin C and selenium.
CONCLUSION
The available epidemiologic evidence is weak but nonetheless supportive with respect to vitamins A, D, and E; zinc; fruits and vegetables; and a Mediterranean diet for the prevention of asthma. Experimental studies of these exposures are now warranted.
Topics: Asthma; Avitaminosis; Child; Diet; Female; Fruit; Humans; Nutritional Physiological Phenomena; Pregnancy; Vegetables; Vitamin A; Vitamin D
PubMed: 21185068
DOI: 10.1016/j.jaci.2010.11.001 -
Neuroscience and Biobehavioral Reviews Mar 2017Over the last decades, the hypothesis has been raised that an atopic response could lead to the development of attention-deficit/hyperactivity disorder (ADHD). This... (Meta-Analysis)
Meta-Analysis Review
Over the last decades, the hypothesis has been raised that an atopic response could lead to the development of attention-deficit/hyperactivity disorder (ADHD). This study systematically reviews the observational cross-sectional and longitudinal studies that assessed the association between atopic disorders including asthma, atopic eczema, allergic rhinitis, and ADHD in children and adolescents. For longitudinal studies, a weighted Mantel-Haenszel odds ratio of these associations was estimated. The majority of cross-sectional and longitudinal studies reported a statistically significant positive association. The meta-analysis of longitudinal studies revealed an overall weighted odds ratio for asthma of 1.34 (95% confidence interval [CI] 1.24-1.44), 1.32 (95% CI 1.20-1.45) for atopic eczema, and 1.52 (95% CI 1.43-1.63) for allergic rhinitis. Heterogeneity of study data was low (I: 0%, p=0.46 and p=0.64, respectively) for both studies examining asthma and eczema but substantial for rhinitis studies (I: 82%, p=0.004). This current systematic review provides strong evidence that ADHD is associated with atopic diseases and that individuals have a 30% to 50% greater chance of developing ADHD compared to controls.
Topics: Attention; Attention Deficit Disorder with Hyperactivity; Cross-Sectional Studies; Dermatitis, Atopic; Humans; Hypersensitivity, Immediate; Risk Factors
PubMed: 28111269
DOI: 10.1016/j.neubiorev.2017.01.011 -
Pediatric Allergy and Immunology :... May 2018Chronic spontaneous urticaria (CSU) is not frequent in children. Management guidelines have been developed for adults and randomized controlled trials (RCTs) included... (Review)
Review
BACKGROUND
Chronic spontaneous urticaria (CSU) is not frequent in children. Management guidelines have been developed for adults and randomized controlled trials (RCTs) included teenagers aged 12-18, but data for children under age 12 are limited. We performed a systematic review to assess comorbidities in children <12 years old with CSU and the efficacy and safety of treatments.
METHODS
We searched for original articles of epidemiologic and treatment data in children <12 years old with CSU that were published from 2005 to July 2016 in MEDLINE, EMBASE, CENTRAL, and LILACS. Article selection and data extraction were performed in duplicate.
RESULTS
Our systematic review included 9 reports on epidemiologic data (633 children). Five comorbidities and laboratory anomalies associated with CSU found were atopy (28.1%), positive autologous serum skin test (36.8%), thyroid biologic anomalies (6.4%) and detectable antinuclear antigen (10.4%), seroprevalence for Helicobacter pylori (21.1%), low vitamin D level (69.1%), and psychiatric disorders (70.4%). Only one study allowed for comparison with a control group. Our review included 10 studies (322 children), describing 5 different drug families, mostly H1-antihistamines (n = 297). One randomized controlled study compared single-dose rupatadine with single-dose desloratadine and placebo. Cyclosporine was effective and had no adverse effects in 18 children. Omalizumab, montelukast, and cefuroxime were reported in very small series (5, 1, and 1 patients).
CONCLUSIONS
H1-antihistamines are effective for CSU in children <12 years old, with reassuring safety data at licensed doses. Cyclosporine seems effective, but the level of evidence is low.
Topics: Child; Child, Preschool; Chronic Disease; Comorbidity; Histamine Antagonists; Humans; Immunosuppressive Agents; Prevalence; Urticaria
PubMed: 29392757
DOI: 10.1111/pai.12870 -
International Journal of Environmental... Nov 2018In the last decade, studies investigating greenspace have highlighted several benefits to human health. However, the effect of greenspace on allergies and atopic...
In the last decade, studies investigating greenspace have highlighted several benefits to human health. However, the effect of greenspace on allergies and atopic sensitization in children was not clear. While several studies have investigated this link, the evidence has not been systematically synthesized. We conducted a systematic search of eight databases. Study characteristics and findings were extracted from five articles covering 11 cohorts published between 2012 and 2016, and study quality assessments were performed. Due to significant heterogeneity, meta-analysis was not conducted. Findings were not consistent, possibly due to variations in exposure measurements, study populations and location, the specific allergens tested, and inclusion of confounders. Protective effects from greenspace were reported in four cohorts, while two cohorts showed an increase in sensitization related to greenspace. The other five cohorts found no significant effect of greenspace on atopic sensitization. There is limited understanding of the contributions of greenspace to specific allergens. Future research should consider amount and type of greenspace, as well as the specific allergens tested.
Topics: Adolescent; Allergens; Child; Gardens; Humans; Hypersensitivity; Hypersensitivity, Immediate; Immunoglobulin E; Parks, Recreational
PubMed: 30428525
DOI: 10.3390/ijerph15112539 -
Homeopathy : the Journal of the Faculty... Jul 2005The 'hygiene hypothesis' has been used to justify a belief common among homeopaths, that the suppression of childhood infections and immunisation may lead to the... (Review)
Review
BACKGROUND
The 'hygiene hypothesis' has been used to justify a belief common among homeopaths, that the suppression of childhood infections and immunisation may lead to the development of chronic atopic diseases.
OBJECTIVES
To analyse the influence of childhood infections and immunisation on the development of atopy.
METHODS
Qualitative systematic review of direct epidemiological evidence (Medline 1993-2004) concerning the influence of childhood infections and immunisation on the development of atopy and discussion based on homeopathy.
CONCLUSIONS
(1) Childhood infections do not protect against atopy; on the contrary, they increase the risk of allergic diseases, in agreement to Hahnemann's observations, which included epidemic diseases among the factors capable of stimulating the development of chronic diseases. (2) Vaccination is not a risk factor for atopy, notwithstanding the allergenic effect of some vaccines.
Topics: Child; Dermatitis, Atopic; Evidence-Based Medicine; Humans; Hygiene; Hypersensitivity; Immunity, Innate; Infections; Risk Factors; Time Factors; Vaccines
PubMed: 16060204
DOI: 10.1016/j.homp.2005.03.003 -
Clinical and Experimental Allergy :... Apr 2011There is evidence to suggest that the risk of asthma might be increased with exposure to paracetamol in the intrauterine environment, infancy, later childhood and adult... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There is evidence to suggest that the risk of asthma might be increased with exposure to paracetamol in the intrauterine environment, infancy, later childhood and adult life.
OBJECTIVE
To review the evidence from studies investigating the association between paracetamol use in pregnancy and childhood asthma.
METHODS
A systematic review and meta-analysis was undertaken of studies reporting the association between paracetamol use in pregnancy and subsequent asthma in childhood. The primary outcome variable was wheeze in the last 12 months. For tabulated raw data, not adjusted for confounders, random effects odds ratios (OR) were pooled by the inverse variance weighted method.
RESULTS
There were six studies identified that were included in the meta-analysis. The age of children studied ranged from 30 to 84 months. The pooled random effects OR for the risk of current wheeze in the children of women who were exposed to any paracetamol during any stage of pregnancy was 1.21 (95% confidence interval 1.02-1.44). Features of the studies variably included an association with paracetamol use during all trimesters of pregnancy and an association with persistent asthma, severe asthma, and with atopy.
CONCLUSION AND CLINICAL RELEVANCE
The use of paracetamol during pregnancy is associated with an increased risk of childhood asthma. More research is urgently required to determine the impact of paracetamol during pregnancy on the risk of wheezing in offspring so that appropriate public health recommendations can be made.
Topics: Acetaminophen; Analgesics, Non-Narcotic; Asthma; Child; Female; Humans; Pregnancy; Prenatal Exposure Delayed Effects; Respiratory Sounds; Risk Factors
PubMed: 21338428
DOI: 10.1111/j.1365-2222.2010.03691.x -
The Journal of Allergy and Clinical... Sep 2020The interaction between early life viral respiratory illness and atopy in the genesis of asthma has been widely discussed in the literature as the "two-hit hypothesis." (Meta-Analysis)
Meta-Analysis
BACKGROUND
The interaction between early life viral respiratory illness and atopy in the genesis of asthma has been widely discussed in the literature as the "two-hit hypothesis."
OBJECTIVE
To synthesize evidence regarding the association of childhood viral respiratory illness and atopy in the development of persistent wheezing and asthma.
METHODS
A systematic review was performed, according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Human studies investigating early life associations between atopy and viral respiratory illness with outcomes of asthma and wheezing were included. Meta-analysis was performed to investigate the association of viral illness across atopic and nonatopic groups. Subgroup analysis was undertaken to investigate potential effect modification of age at outcome.
RESULTS
Nine cohort studies were included, with data available for meta-analysis in 4 birth cohort studies. There was a stronger association of viral respiratory illness with persistent asthma/wheeze in atopic (odds ratio [OR], 4.02; 95% CI, 1.46-11.06) compared with nonatopic (OR, 2.32; 95% CI, 1.22-4.40) individuals; however, the evidence for this was limited. In 3 studies amenable to subanalysis based on outcome age, a stronger effect was observed up to 7 years for those with atopy (OR, 7.27; 95% CI 4.65-11.36) compared with those without atopy (OR, 3.19; 95% CI, 2.09-4.87).
CONCLUSIONS
There was a stronger association between viral respiratory illness and asthma/wheeze outcomes in individuals with atopy as compared with those without atopy. When outcomes were considered at younger ages, a greater differential effect was observed. Within the limitations of the few available studies however, definite conclusions cannot be made. There was also insufficient evidence for differential effects of early versus late atopy. Further research, in particular regarding virus type, timing of atopy, and atopic phenotype, would contribute to untangling this complex association.
Topics: Asthma; Child; Humans; Hypersensitivity, Immediate; Respiratory Sounds; Respiratory Tract Infections; Risk Factors; Virus Diseases
PubMed: 32298852
DOI: 10.1016/j.jaip.2020.03.032