• Allergic diseases
• Chronic respiratory diseases
• Epidemiology
• GARD
• Household air pollution
• Italy

• Humans
• Air Pollution, Indoor/adverse effects
• Italy/epidemiology
• Respiratory Tract Diseases/epidemiology
• Respiratory Tract Diseases/etiology
• Allergens/adverse effects
• Tobacco Smoke Pollution/adverse effects
• Tobacco Smoke Pollution/statistics & numerical data
• Cooking/methods

• Biomarker
• Dupilumab
• Italy
• Type 2 asthma

• Rabigh
• Saudi Arabia
• air quality
• asthma
• children and adolescents
• prevalence
• risk factors

• asthma
• children
• prenatal education
• rhinitis
• structural equation modelling

• Child
• Adolescent
• Male
• Female
• Pregnancy
• Humans
• Rhinitis/epidemiology
• Rhinitis/etiology
• Cross-Sectional Studies
• Asthma/chemically induced
• Tobacco Smoke Pollution/adverse effects
• Rhinitis, Allergic/chemically induced
• Fathers
• Risk Factors

Available guidelines for asthma management represent an important and suitable tool to make the entire medical process evidence-based, effective, and safe for patients. Their purpose is to help doctors and patients formulate the best decisions in regard to asthma management by choosing the most appropriate strategies in each specific clinical situation.

The Global Initiative for Asthma (GINA) document, together with other national and international recommendations, is one of the main documents used for asthma prevention and management in Italy, but several studies reported that these recommendations are often not applied in real-life clinical practice, which consequently results in inadequate asthma control.

In this context, a substantial simplification of the GINA document and asthma guidelines may represent a feasible strategy to be pursued to ameliorate the knowledge among GPs, primary care pediatricians, and specialists taking care of children and adults with asthma.

On the other hand, another critical factor that may explain unsatisfactory control of asthma is the limited importance that all recommendations place on asthma heterogeneity. In the era of personalized medicine and target therapies, phenotype-driven asthma management may become a desirable approach for optimizing the management of asthmatic patients. In addition, digital health strategies have been investigated in the literature to improve asthma monitoring and may represent a promising tool in the future from this point of view.

Relevant stakeholders should continue to investigate how to optimize real-life asthma control to propose novel solutions to translate into clinical practice.

• Asthma
• Global Initiative for Asthma
• Improvement
• Pediatrics
• Real-life

Moderate‐to‐severe atopic dermatitis (AD) in the adolescence is a high burden disease, and its treatment can be very challenging due to paucity of approved systemic drugs for this age and their side‐effects. Dupilumab was recently approved for treatment of adolescent AD.

A multicentre, prospective, real‐world study on the effectiveness and safety of dupilumab in adolescents (aged from ≥12 to <18 years) with moderate‐to‐severe AD was conducted. The main AD clinical phenotypes were also examined.

Data of adolescents with moderate‐to‐severe AD treated with dupilumab at label dosage for 16 weeks were collected. Treatment outcome was assessed by EASI, NRS itch, NRS sleep loss and CDLQI scores at baseline and after 16 weeks of treatment. The clinical scores were also evaluated according to clinical phenotypes.

One hundred and thirty‐nine adolescents were enrolled in the study. Flexural eczema and head and neck eczema were the most frequent clinical phenotypes, followed by hand eczema and portrait‐like dermatitis. Coexistence of more than 1 phenotype was documented in 126/139 (88.5%) adolescents. Three patients (2.1%) contracted asymptomatic SARS‐CoV‐2 infection and 1 of the discontinued dupilumab treatment before the target treatment period. A significant improvement in EASI, NRS itch, NRS sleep loss and CDLQI was observed after 16 weeks of treatment with dupilumab. This outcome was better than that observed in clinical trials. Dupilumab resulted effective in all AD phenotypes, especially in diffuse eczema. Twenty‐eight (20.1%) patients reported adverse events, conjunctivitis and flushing being the most frequent. None of patients discontinued dupilumab due to adverse event.

Dupilumab in adolescent AD showed excellent effectiveness at week 16 with consistent improvement of all clinical scores. Moreover, dupilumab showed a good safety profile also in this COVID‐19 pandemic era.

• Atopic dermatitis
• adolescents
• dupilumab
• effectiveness
• real-world experience
• safety

• asthma
• burden
• children
• dietary inflammatory index
• indoor exposures
• latent class analysis
• lung function

Researchers use different definitions to identify children with asthma in epidemiological surveys. We conducted a systematic review to describe the definitions used in epidemiologic studies for wheeze and asthma in the paediatric population, aimed to inform the development of a uniform definition of paediatric asthma for future epidemiological research.

We systematically searched terms to identify asthma and/or wheeze among children aged <13 years and published between 1995-2020 across seven databases (MEDLINE, EMBASE, PsycINFO, Global Health, AMED, LILACS and CINAHL). PRISMA guidelines were followed for this review.

We extracted a total of 11 886 records, where 190 met our eligibility criteria and included in the analysis. Among the included studies, 62.1% (n = 118/190) used the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires, predominantly in developing countries (80%, n = 64/80). ‘Wheeze’ was reported in five categories, subdivided by 14 different definitions. “Current wheeze”, defined as caregivers report of wheezing sounds from the chest of the child in the past 12 months and “Wheeze ever”, defined as caregivers’ report of wheezing or whistling in the chest of the child at any previous time, were the most common wheeze category reported in 129 and 95 studies, respectively. Asthma was reported in nine categories using 53 definitions. The most common asthma category was “Asthma ever”, which was reported in 89 studies, based on caregiver statement that the child had asthma in the past.

Definitions of wheeze and asthma for children used in surveys are primarily based on parent-reported clinical features. Studies from developing countries more frequently used the ISAAC definitions to report childhood asthma and wheeze compared to the studies from developed counties. The use of a uniform asthma definition will aid the interpretation of research findings globally.

• COVID-19
• adolescents
• atopic dermatitis
• dupilumab
• real-world

Prenatal smoking exposure and early-life respiratory infections are major determinants of asthma during childhood. We investigate the factors influencing allergic sensitization (AS), asthma, and lung function in children and the balance between individual and environmental characteristics at different life stages. 1714 children aged 7–16 years and living in southern Italy were investigated using a parental questionnaire, skin prick tests, and spirometry. We found 41.0% AS prevalence: among children without parental history of asthma, male sex, maternal smoking during pregnancy (MatSmoke), and acute respiratory diseases in the first two years of life (ARD2Y) were significant risk factors for AS. MatSmoke was associated (OR = 1.79) with ARD2Y, and this association was influenced by sex. ARD2Y was, in turn, a significant risk factor (OR = 8.53) for childhood current asthma, along with AS (OR up to 3.03) and rhinoconjuctivitis (OR = 3.59). Forced mid-expiratory flow (FEF_25–75%) was negatively affected by ARD2Y, with a sex-related effect. Thus, males exposed to MatSmoke had significantly lower FEF_25–75% than unexposed males. Despite the difficulty of discriminating among the complex interactions underlying the development of allergic respiratory diseases, ARD2Y appears to strongly influence both asthma and lung function during childhood. In turn, ARD2Y is influenced by prenatal exposure to tobacco smoke with a sex-dependent effect.

• acute respiratory infections
• allergic sensitization
• asthma
• child health
• cigarette smoking

• Adolescent
• Asthma/epidemiology
• Asthma/etiology
• Child
• Cross-Sectional Studies
• Female
• Forced Expiratory Volume
• Humans
• Italy/epidemiology
• Lung/physiopathology
• Male
• Pregnancy
• Risk Factors
• Spirometry
• Tobacco Smoke Pollution/adverse effects

• Acetaminophen
• Allergic rhinitis
• Meta-analysis
• Risk factors

• intensive care
• neonatology
• pharmacology

• allergic rhinitis
• allergic sensitisation
• prevalence
• specific IgE
• time trends

Paediatric Asthma contributes in paediatric global burden of diseases, as the most common chronic disease in children. Children are exposed to many environmental risk-factors, able to determine or worsen respiratory diseases, and contributing to asthma and asthma-like symptoms increases, especially in metropolitan areas. In urban settings, surrounding vegetation (greenness) may provide important benefits to health, including the promotion of physical activity and the mitigation of air and noise pollution. The aim of this study was to investigate the association between greenness and respiratory health. A total of 187 children (10–13 yrs old) were recruited in Turin, the north-western part of Italy. The prevalence of asthma and asthma-like symptoms was calculated from self-reported data collected by SIDRIA questionnaire. Spirometry test was performed to obtain respiratory flow measurements. Greenness was measured at individual level through the Normalised Difference Vegetation Index (NDVI) estimations from remote-sensing images. Higher exposure (3rd tertile vs. 1st tertile) to NDVI was associated to significantly lower ORs for asthma [0.13 CI 95% 0.02–0.7, p = 0.019], bronchitis [0.14 CI 95% 0.05–0.45, p = 0.001], and current wheezing [0.25 CI 95% 0.09–0.70, p = 0.008]. A significative positive association was found between greenness and FEF_25–75, since children exposed to the 2nd tertile of NDVI reported a significantly decreased FEF_25–75 compared to those in the 3rd tertile [B: −2.40; C.I.95%: −0.48–0.01; p = 0.049]. This cross-sectional study provided additional data on still inconsistent literature referring to respiratory health in children and green spaces, attesting a positive effect of greenness in a specific area of Italy. Further research is still needed.

• asthma
• children health
• environmental primary prevention
• greenness
• respiratory function

• Birth weight
• allergic asthma
• allergic rhinitis
• eczema
• food allergy
• systematic review

• blood pressure
• extremely preterm infant
• randomised trial

The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and undertreatment persist. There are substantial global variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.

Asthma and rhino-conjunctivitis are common chronic diseases in childhood. In this cross-sectional study, we performed a gene association analysis with current asthma and rhino-conjunctivitis in a cohort of Sicilian children aged 10–15 years. Overall, our findings reveal the importance of different genetic variants at 4p14, 16p12.1, 17q12, 6p12.2 and 17q21.1, identifying possible candidate genes responsible for susceptibility to asthma and rhino-conjunctivitis.

• Asthma
• Genetics
• Rhino-conjunctivitis
• SNPs
• Sicilian children

• Adherence
• Allergic rhinitis
• Asthma
• Control
• Cross sectional study
• Drug prescriptions
• GINA guidelines

• Allergic rhinitis
• China
• diagnosis
• treatment

• National Key R & D Program of China
• National Natural Science Foundation of China
• program for Changjiang scholars and innovative research team
• Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support
• Beijing health bureau program for high level talents
• Beijing Municipal Administration of Hospitals

• Asthma algorithm
• asthma diagnosis
• pulmonary function
• schoolchildren
• urban-rural gradient

• IgE
• allergen extract
• allergen immunotherapy
• allergic rhinitis
• allergy
• antihistamine
• asthma
• atopic dermatitis
• avoidance
• biologic
• cockroach
• conjunctivitis
• consensus
• corticosteroid
• cough
• cromolyn
• decongestant
• environment
• eosinophilic esophagitis
• epicutaneous immunotherapy
• epidemiology
• evidence-based medicine
• food allergy
• genetics
• house dust mite
• immunoglobulin E
• immunotherapy
• inhalant allergy
• leukotriene
• microbiome
• occupational rhinitis
• omalizumab
• pathophysiology
• perennial
• pet dander
• pollen
• probiotic
• quality of life
• rhinitis
• rhinosinusitis
• risk factor
• saline
• seasonal
• sensitization
• sinusitis
• sleep
• socioeconomic
• specific IgE
• subcutaneous immunotherapy
• sublingual immunotherapy
• systematic review
• total IgE
• transcutaneous immunotherapy
• validated survey

• Adrenal Cortex Hormones/therapeutic use
• Allergens/analysis
• Biological Products/therapeutic use
• Complementary Therapies/methods
• Cytokines/physiology
• Diagnosis, Differential
• Drug Therapy, Combination
• Endoscopy/methods
• Environmental Exposure/adverse effects
• Epidemiologic Methods
• Histamine Antagonists/therapeutic use
• Humans
• Immunoglobulin E/physiology
• Microbiota
• Nasal Decongestants/therapeutic use
• Occupational Diseases/diagnosis
• Physical Examination/methods
• Probiotics/therapeutic use
• Quality of Life
• Respiratory Mucosa/physiology
• Rhinitis, Allergic/diagnosis
• Rhinitis, Allergic/etiology
• Rhinitis, Allergic/therapy
• Risk Factors
• Saline Solution/therapeutic use
• Skin Tests/methods
• Socioeconomic Factors

• KL2 TR001065 NCATS NIH HHS
• KL2 TR002381 NCATS NIH HHS
• UL1 TR002378 NCATS NIH HHS

• asthma
• child
• drug therapy
• epidemiology
• spirometry

• asthma
• burden
• children
• cost
• epidemiology
• morbidity
• mortality
• prevalence

• Buffered hypertonic solution
• Children
• Nasal cytology
• Nasal symptoms
• Quality of life
• Seasonal allergic rhinitis

Asthma exacerbations are a common reason for Emergency Department (ED) visits in children.

To analyze differences among age groups in terms of triggering factors and seasonality and to identify those with higher risk of severe exacerbations.

We retrospectively revised the files of children admitted for acute asthma in 2016 in our Pediatric ED.

Visits for acute asthma were 603/23197 (2.6%). 76% of the patients were <6 years old and 24% ≥6. Infections were the main trigger of exacerbations in both groups; 33% of the school-aged children had a triggering allergic condition (versus 3% in <6 years; p < .01). 191 patients had a previous history of asthma; among them, 95 were ≥6 years, 67% of whom were not using any controller medication, showing a higher risk of a moderate-to-severe exacerbation than those under long-term therapy (p < .01). Exacerbations peaked in autumn and winter in preschoolers and in spring and early autumn in the school-aged children.

Infections are the main trigger of acute asthma in children of any age, followed by allergy in the school-aged children. Efforts for an improved management of patients affected by chronic asthma might go through individualized action plans and possibly vaccinations and allergen-avoidance measures.

Allergic diseases represent a frequent and increasing condition affecting children. A screening questionnaire allowing an easy identification of children with symptoms of allergic diseases may improve management and clinical outcome. The aim of this study was to develop and validate an easy-to-use screening questionnaire to detect children requiring further allergological evaluations.

A 10-item questionnaire, evaluating the presence and the history of the most frequent allergic conditions affecting children, including allergic asthma, allergic rhinitis and conjunctivitis, food allergy, and atopic dermatitis, was developed and administered to 214 parents of children from 5 to 10 years of age (163 with allergic disease and 51 healthy, nonallergic children). Validation was performed by Pearson’s correlation between the clinical diagnosis and the responses to the questionnaire. Internal consistency was computed by Cronbach’s alpha correlation coefficient. Sensitivity and specificity of the novel questionnaire were assessed by the receiver operating characteristic (ROC) curve.

Validation analysis of the new children atopy (ChAt) questionnaire showed good internal consistency with a Cronbach’s alpha of 0.757. Responses to the items evaluating the presence of individual allergic conditions significantly correlated with the clinical diagnosis (p<0.001). The ROC curve showed an area of 0.956 and identified a cutoff value >2 of the ChAt questionnaire total score for detection of allergy (sensitivity =0.92 and specificity =0.902).

The novel ChAt questionnaire represents a simple tool able to detect the presence of all major allergic diseases in a pediatric population allowing an early identification of allergic multimorbidity and potentially facilitating clinical management.

• allergy
• children
• questionnaire
• screening
• validation

• Paediatrics
• Pulmonary function
• Reference equation
• Z-score

• Allergic sensitization
• Incidence
• Longitudinal study
• Prevalence
• Risk factors
• Schoolchildren

In industrialized countries atopic diseases have been reported to be less likely in children and adolescents with a migrant background compared to non-migrants. This paper aimed at both examining and comparing prevalence of asthma, allergic rhinoconjunctivitis and atopic dermatitis and allergic sensitization to specific IgE antibodies in children and adolescents with and without a migrant background. Using data of the population-based German Health Interview and Examination Survey for children and adolescents (KiGGS; n = 17,450; 0–17 years), lifetime and 12-month prevalence of atopic diseases and point prevalence of 20 common allergic sensitizations were investigated among migrants compared to non-migrants. Multiple regression models were used to estimate the association of atopic disease and allergic sensitization with migrant background. In multivariate analyses with substantial adjustment we found atopic dermatitis about one-third less often (OR 0.73, 0.57–0.93) in participants with a two-sided migrant background. Statistically significant associations between allergic sensitizations and a two-sided migrant background remained for birch (OR 0.73, 0.58–0.90), soybean (OR 0.72, 0.54–0.96), peanut (OR 0.69, 0.53–0.90), rice (OR 0.64, 0.48–0.87), potato (OR 0.64, 0.48–0.85), and horse dander (OR 0.58, 0.40–0.85). Environmental factors and living conditions might be responsible for the observed differences.

• adolescents
• allergies
• atopic hypersensitivity
• children
• prevalence
• transients and migrants

• allergic rhinitis
• rhinoconjunctivitis
• hayfever
• traffic
• air pollution
• south africa

• Adolescent
• Air Pollutants/toxicity
• Conjunctivitis/chemically induced
• Conjunctivitis/epidemiology
• Cross-Sectional Studies
• Female
• Housing
• Humans
• Male
• Motor Vehicles
• Prevalence
• Rhinitis/chemically induced
• Rhinitis/epidemiology
• Rhinitis, Allergic/chemically induced
• Rhinitis, Allergic/epidemiology
• Rhinitis, Allergic, Seasonal/chemically induced
• Rhinitis, Allergic, Seasonal/epidemiology
• Self Report
• South Africa/epidemiology
• Students
• Vehicle Emissions/toxicity

• Air pollution
• Asthma
• Traffic-related
• Urban land-use

• Adult
• Aged
• Air Pollutants/analysis
• Asthma/diagnosis
• Asthma/epidemiology
• Cities/epidemiology
• Female
• Humans
• Male
• Middle Aged
• Nitrogen Dioxide/analysis
• Odds Ratio
• Particulate Matter/analysis
• Republic of Korea/epidemiology
• Risk
• Urbanization
• Young Adult

• Arterial hypotension
• cerebral autoregulation
• cerebral regional tissue oxygenation
• near-infrared spectroscopy
• peterm infants