Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology最新文献

{"title":"Trajectories of allergic diseases in children: Destination unknown?","authors":"Birgit Kalb, Ekaterina Khaleva, Mattia Giovannini, Karine Adel-Patient, Flore Amat, Stefania Arasi, Susanne Lau, Antonio Nieto, Bianca Schaub, Marie Standl, Jonathan O'B Hourihane, Philippe Eigenmann, Antoine Deschildre","doi":"10.1111/pai.70131","DOIUrl":"10.1111/pai.70131","url":null,"abstract":"<p><p>The trajectories of allergic diseases represent one of the most currently debated topics both when referred to childhood and likewise adulthood. Data from cohorts show their heterogeneity as well as the key role of genetic and environmental factors. More insight has been recently provided in the pathophysiological mechanisms underlying the development and amplification of T2 (hyper)inflammation. Recent data support the hypothesis of associated allergic diseases (multimorbidity) reflecting, at a given time and in given organ(s)/tissue(s), the expression of the same favorable predisposition. In particular, the impairment of the epithelial barrier, especially in subjects genetically predisposed, and the dysregulation of the host's microbiome promote the onset of allergic diseases and multimorbidity, their persistence and/or severity. These findings challenge the classical theory of the atopic march with a temporal sequence characterized by the transition from one disease (eczema) to another (food allergy, airway allergic diseases). A better understanding of the diversity of disease trajectories and the underpinning mechanisms is crucial for prevention and identification of children at risk of a \"unfavorable trajectory\" (early intervention, i.e., early primary or secondary prevention), for a personalized therapeutic approach based on identification of specific endotypes, and, therefore, addressing specific pathophysiological pathways (treat to target strategies). In the perspective of the so-called \"remission\" and \"treatment-induced-remission\", the whole spectrum of the long-term consequences of the disease(s) including their treatment has to be considered. The concept of disease modifying treatment able to interfere with their trajectories and overall long-term induced morbidity is emerging.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70131"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse alveolar hemorrhage syndrome in children: Primary immunodeficiency diseases and implications for clinical management.","authors":"Xiaoyan Zhang, Hui Liu, Xiaolei Tang, Hui Xu, Yuelin Shen, Haiming Yang, Jinrong Liu, Huimin Li, Chunju Zhou, Shunying Zhao","doi":"10.1111/pai.70138","DOIUrl":"https://doi.org/10.1111/pai.70138","url":null,"abstract":"<p><strong>Background: </strong>With the advances in genetic diagnosis in the past decade, primary immunodeficiency diseases (PIDs) have been increasingly identified as emerging causes of (DAH) among children treated in our department. The literature regarding PID-associated DAH are limited. Thus, we aim to enhance the awareness that PIDs can be underlying causes of pediatric DAH and evaluate the implications of genetic diagnosis for treatment.</p><p><strong>Methods: </strong>This analysis included 68 children with DAH who had undergone genetic tests in the pediatric respiratory ward during the preceding 10 years. Their clinical findings, genetic results, and treatment were retrospectively examined.</p><p><strong>Results: </strong>In total, 16 children were diagnosed with PIDs. Genetic diagnoses of PIDs yielded in 14 patients revealed involvement of 10 immunity-defective genes (TNFRSF13B, TCF3, NFKB2, PIK3CD, COPA, ADA2, PLCG2, RAG1, BCL11B, and STAT3). The remaining two children had diagnoses of CVID without associated variants. The overall prevalence of PID-associated DAH in our cohort was 23.5% (16/68). The median age at DAH symptom onset was 3.5 (interquartile range: 2.1-9.3) years. In all children, DAH is the primary or even initial clinical manifestation of the PIDs. Of the children, 37.5% (6/16) developed additional autoimmune or inflammatory complications. 50% (8/16) of patients adjusted their therapeutic management according to the genetic diagnosis. 87.5% (14/16) of patients achieved remission.</p><p><strong>Conclusion: </strong>This study suggests that PID is one of the most important causes of DAH in children. The identification of the PIDs and the causal variants enables genotype-specific treatment, which may offer critical guidance for clinical management.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70138"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between corticosteroid use and fracture risk in children with asthma: A nationwide cohort study.","authors":"Hyunmin Ji, Hye-Ji Han, In-Young Choi, Eun Lee, Hwan Soo Kim, Hyeon-Jong Yang, Gahgene Gweon, Kyunghoon Kim","doi":"10.1111/pai.70143","DOIUrl":"https://doi.org/10.1111/pai.70143","url":null,"abstract":"<p><strong>Background: </strong>Pediatric asthma, as a chronic inflammatory condition, has been associated with increased fracture risk due to persistent inflammation and corticosteroid treatment. This study investigates the association between pediatric asthma and fracture risk using data from the National Health Insurance Service database of South Korea.</p><p><strong>Methods: </strong>Children born from 2002 to 2004 were selected for the analysis, utilizing information from the Korean National Health Insurance Service National Sample Cohort up to 2019. Exclusion criteria included asthma diagnosis before age 6, history of prior fractures, and the presence of severe comorbidities. Asthma cases were identified by the Korean Standard Classification of Diseases, 8th Revision (KCD-8) codes J45 and J46, and fractures were determined using all relevant KCD-8 codes. Propensity score matching was used to balance demographic and clinical characteristics between the asthma and non-asthma groups. Fracture risk was analyzed using logistic regression models adjusted for covariates. Within the asthma cohort, the analysis investigated corticosteroid exposure, focusing on both recent and cumulative exposure to inhaled corticosteroids (ICS) and systemic corticosteroids within 1 year before the occurrence of fractures.</p><p><strong>Results: </strong>From an initial cohort of 30,409 children, 13,275 were included in the final analysis, comprising 2325 asthma patients and 10,950 non-asthma controls. Asthma was associated with a higher risk of fractures (Odds Ratio [OR]: 1.22, 95% CI: 1.12-1.34, p < .001). Among asthma patients, recent ICS use within 90 days before a fracture was linked to the highest risk (Adjusted Odds Ratio [Adjusted OR]: 2.98, 95% CI: 2.95-3.05, p < .001). Systemic corticosteroid use showed a dose-dependent relationship with increased fracture risk.</p><p><strong>Conclusion: </strong>Pediatric asthma and corticosteroid treatment are both significantly associated with elevated fracture risk. These results emphasize the necessity for comprehensive asthma management strategies that prioritize bone health.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70143"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighborhood sociome factors and pediatric asthma exacerbations: Protective role of tree crown density and importance of pharmacy access in Chicago's south side.","authors":"Sandra Tilmon, Shashi Bellam, Kathy Bobay, Ellen Cohen, Emily Dillon, Brian Furner, Sarah E Gray, Julie Johnson, David Meltzer, Doriane Miller, Sharmilee Nyenhuis, Jonathan Ozik, Carlos Santos, Anthony Solomonides, Julian Solway, Elizabeth Zampino, Sanjaya Krishnan, Samuel L Volchenboum","doi":"10.1111/pai.70127","DOIUrl":"10.1111/pai.70127","url":null,"abstract":"<p><strong>Background: </strong>Pediatric asthma exacerbations remain a critical public health concern, particularly in historically underserved urban settings.</p><p><strong>Objective: </strong>This study investigates sociome factors-the social context of disease-associated with asthma exacerbations among children living in Chicago's South Side, leveraging clinical and publicly available generalizable census tract-level datasets from agencies including ChiVes, the City of Chicago Data Portal, EPA, Census Bureau, HUD, NOAA, and more. The aim is to uncover novel hypotheses for potential new interventions.</p><p><strong>Methods: </strong>A generalized linear model assessed associations with the outcome of asthma exacerbations while accounting for clustering at the patient level. Predictors included all variables from the Sociome Data Commons, including social, environmental, behavioral, economic, housing, and school variables.</p><p><strong>Results: </strong>Predictors of decreased risk included patient age (+4.8 years, -22%), tree crown density (+6% coverage, -17%), parks per acre (+0.41, -8%), and labor market engagement (+0.8 points, -9%). Conversely, predictors of increased risk included increased distance to the nearest pharmacy (+0.28 miles, +12%), limited English skills (+2.3%, +10%), higher inequality (+0.08 points, +8%), and visits in the Spring (+11%) and Fall (+20%).</p><p><strong>Conclusion: </strong>The results suggest that tree crown density, a novel finding in the context of asthma exacerbations, may play a protective role. Limited access to health care facilities such as pharmacies continues to complicate care.</p><p><strong>Clinical implications: </strong>These findings provide hypotheses for future interventions for long-standing asthma disparities.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70127"},"PeriodicalIF":4.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atopic dermatitis in children: Untargeted proteomics highlights the interaction between barrier dysfunction and immune dysregulation as key pathways.","authors":"Sean Wee, Anna de Beer, Hiromi Wl Koh, Jocelyn Ong, Jing Hui Low, Yan Ting Lim, Shi Mei Wang, Radoslaw M Sobota, Elena Goleva, Donald Y M Leung, Wen Chin Chiang, Mei Chien Chua, Anand Kumar Andiappan","doi":"10.1111/pai.70142","DOIUrl":"https://doi.org/10.1111/pai.70142","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70142"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Yiwen Chen et al.","authors":"Regina Nakiranda, Linda Malan, Hannah Ricci, Arista Nienaber, Cecile Cooke, Cristian Ricci, Mieke Faber, Cornelius M Smuts","doi":"10.1111/pai.70140","DOIUrl":"https://doi.org/10.1111/pai.70140","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 7","pages":"e70140"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental factors shaping atopic dermatitis: Lessons from longitudinal cohort studies.","authors":"Eun Lee, Song-I Yang, Dong In Suh, Hyo-Bin Kim, So-Yeon Lee, Sung Ok Kwon, Soo-Jong Hong","doi":"10.1111/pai.70130","DOIUrl":"https://doi.org/10.1111/pai.70130","url":null,"abstract":"<p><p>Atopic dermatitis (AD) is a prevalent chronic inflammatory skin disease arising from a multifaceted interplay between genetic susceptibility and environmental exposures. Longitudinal cohort studies have been instrumental in elucidating the contribution of environmental factors to both the onset and persistence of AD. This review synthesizes evidence from such studies to delineate key environmental determinants across various domains. Early-life exposures, including delivery mode and antibiotic exposure, modulate microbial composition and function, thereby influencing immune development and predisposing individuals to AD. Both outdoor and indoor air pollutants, such as particulate matter and volatile organic compounds, have been shown to impair skin barrier integrity and dysregulate immune responses, facilitating the initiation and progression of AD. Nutritional factors, encompassing maternal and infant dietary patterns, shape gut microbiota and metabolite profiles and systemic immune activity, further modulating AD risk. Moreover, psychological stress during the prenatal and postnatal periods has been associated with alterations in immune function and epigenetic programming, which may heighten susceptibility to AD. Environmental influences also appear to vary by AD phenotype and trajectory, underscoring the need for individualized prevention strategies. Advances in exposome research, encompassing both external and internal environmental components, have enhanced mechanistic understanding and facilitated the identification of candidate biomarkers. Collectively, current evidence supports the notion that early-life environmental exposures act not as isolated determinants but in concert with genetic, microbial, and immunologic factors to shape AD pathogenesis. A comprehensive framework integrating exposomics and multiomics may ultimately inform the development of targeted preventive and therapeutic strategies for children with AD.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 6","pages":"e70130"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Wei Zou, et al.","authors":"Siyi Huang, Ye Xu, Fangfang Tao","doi":"10.1111/pai.70124","DOIUrl":"https://doi.org/10.1111/pai.70124","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 6","pages":"e70124"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial comment on \"food allergy-related bullying: Risk factors and psychosocial functioning\".","authors":"Laura Polloni, Ömer Kalayci, Philippe Eigenmann","doi":"10.1111/pai.70125","DOIUrl":"https://doi.org/10.1111/pai.70125","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 6","pages":"e70125"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal BCG vaccination to prevent asthma: Results from the MIS BAIR randomized controlled trial.","authors":"Laure F Pittet, Emily K Forbes, Susan Donath, Kate L Francis, Kaya Gardiner, Katie L Flanagan, Anne-Louise Ponsonby, Roy Robins-Browne, Frank Shann, Mike South, Peter Vuillermin, Dan Casalaz, Nigel Curtis, Nicole L Messina","doi":"10.1111/pai.70110","DOIUrl":"10.1111/pai.70110","url":null,"abstract":"<p><strong>Background: </strong>Asthma has a significant impact worldwide, but prevention strategies remain limited. We aimed to evaluate the efficacy of neonatal BCG vaccination in preventing asthma by modulating early-life immunity.</p><p><strong>Methods: </strong>The Melbourne Infant Study: BCG for Allergy and Infection Reduction (MIS BAIR) was a phase 3 multicentre randomized controlled trial in Victoria, Australia. Infants were randomly assigned to receive the BCG-Denmark vaccine or no intervention within 10 days of birth. The incidence of asthma at 5 years of age was estimated using the International Study of Asthma and Allergies in Childhood questions.</p><p><strong>Clinicaltrial: </strong>gov (NCT01906853).</p><p><strong>Results: </strong>A total of 1272 infants were randomized. The adjusted incidence of asthma was 14.4% in the BCG group compared to 16.0% in the control group (adjusted risk difference [aRD] -1.7 percentage points; 95%CI -7.4, 3.9). Secondary outcomes, including severe asthma and use of preventer medication, showed similar trends, with an aRD of -3.9 (95%CI -7.7, 0.0), and -5.6 (95%CI -10.9, -0.4), respectively, favoring the BCG group. Among participants with one or both parents asthmatic, the rate of asthma was also lower in the BCG group (17.6%) compared with the control group (24.7%; aRD -7.2; 95%CI -15.9, 1.5), although a test for interaction was not significant (p = .07).</p><p><strong>Conclusions: </strong>While the point estimates suggested BCG vaccination might protect against asthma, the wide uncertainty around the estimates means further studies with larger sample sizes are needed to evaluate the long-term benefits of BCG vaccination beyond its primary indication.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 6","pages":"e70110"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}