Paediatric Allergic Asthma: Risk Factors, Diagnosis, Control and Treatment

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Allergy and Immunology".

Deadline for manuscript submissions: 25 January 2025 | Viewed by 8989

Special Issue Editors


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Guest Editor
Allergy Center, Department of Pediatrics, Istituto Giannina Gaslini, Genoa, Italy
Interests: pediatrics; allergy; asthma; immunology; infections
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Interests: pediatrics; allergy; asthma; immunology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Asthma is the most common chronic disease in childhood and adolescence; its prevalence is steadily increasing, affecting approximately 12% of children and 14% of adolescents. It is well established that asthma involves chronic airway inflammation and bronchial hyperresponsiveness to various stimuli. Despite the wide dissemination of guidelines on the subject, asthma is not controlled in 50% of cases, as documented by some recent studies conducted worldwide. The priority objectives of healthcare should be early diagnoses and the maintenance of control, aiming to prevent flare-ups, sometimes serious and potentially fatal, especially in adolescents. Uncontrolled asthma, the main risk factor for severe asthma, leads to frequent recourse to hospital care and significant deteriorations in patients’ quality of life. Among children, the most common asthma phenotype is allergic asthma. Despite considerable progress in understanding the underlying pathogenetic mechanisms, several aspects concerning environmental and genetic risk factors, diagnosis, phenotype and endotype identification, and personalized drug treatments based on novel molecular therapeutic targets are yet to be fully elucidated. Therefore, we welcome a collection of original and/or review articles focusing on paediatric allergic asthma, natural history, comorbidities, diagnosis, possible early interventions, prevention, environmental impact, lifestyle, precision medicine, new therapeutic strategies, and innovative approaches in asthma control and management. 

Dr. Maria Angela Tosca
Dr. Cristiana Indolfi
Guest Editors

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Keywords

  • paediatric asthma
  • childhood asthma
  • allergic diseases in paediatrics
  • comorbidities
  • risk factors
  • environmental measures
  • asthma prevention
  • asthma control and treatment

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Published Papers (5 papers)

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Research

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10 pages, 240 KiB  
Article
Respiratory Status in Children and Exposure to Animal Allergens—The Problem of Reverse Causality in Cross-Sectional Studies
by Agata Wypych-Ślusarska, Karolina Krupa-Kotara, Klaudia Oleksiuk, Joanna Głogowska-Ligus and Jerzy Słowiński
Children 2024, 11(8), 941; https://doi.org/10.3390/children11080941 - 5 Aug 2024
Viewed by 741
Abstract
Background: Some epidemiological studies suggest that early exposure to animal allergens during infancy reduces the risk of bronchial asthma in school-age children. However, the observed associations in some cases may be an effect of the study used (epidemiological observational studies, especially a cross-sectional [...] Read more.
Background: Some epidemiological studies suggest that early exposure to animal allergens during infancy reduces the risk of bronchial asthma in school-age children. However, the observed associations in some cases may be an effect of the study used (epidemiological observational studies, especially a cross-sectional study) and indicate reverse causality. Aim: This study aimed to determine the association between exposure to animal allergens and the prevalence of respiratory diseases, including bronchial asthma, considering the potential impact of reverse causality on the observed relationships. Material and methods: An analysis of data from a cross-sectional epidemiological study conducted in 2020 involving 3237 primary school students aged 7–15 years in the Silesian Province (Southern Poland) was carried out. The parents of students completed a questionnaire based on The International Study on Asthma and Allergies in Childhood (ISAAC). The relationship between the occurrence of chronic cough, wheezing, and dyspnea in the last 12 months, night waking due to dyspnea, and asthma in the presence of pets was assessed. Exposure to animal allergens was determined by answering the question, “Are there any furry or feathered animals in the home?” with three response options: “yes; they have been in the past; no” (Scenario 1). For the analyses and to reveal a potential reverse causality effect, the last two response categories regarding pet ownership were combined to form a “no” category in Scenario 2, and the first two answers were combined into a “yes” category in Scenario 3. A chi-square test was used to assess the relationship between variables, and a statistical significance level of p < 0.05 was adopted. Results: Chronic cough affected 9.5% of children, wheezing in the last 12 months—9.2%, night waking due to dyspnea—5.8%, dyspnea in the last 12 months—4.8%, bronchial asthma—9.2%. Analysis considering the category of having or not having pets (yes vs. no) showed that bronchial asthma was statistically significantly more common in children who did not have pets at home (10.9% vs. 7.9%, p = 0.002). A similar situation was observed for wheezing in the past 12 months (10.7% vs. 8.1%; p = 0.01) and nocturnal awakening due to dyspnea (6.8% vs. 5.1%, p = 0.03). No statistically significant differences were observed for the other symptoms. Analysis by time of pet ownership (a. present; b. present but in the past; c. not present) highlighted similar relationships. Asthma (a. 7.7% vs. b. 13.4% vs. c. 7.7%; p = 0.004), wheezing in the past 12 months (a. 8.1% vs. b. 8.9% vs. c. 10.9%, p = 0.03) and night waking (a. 5.0% vs. b. 4.5% vs. c. 7.1%; p = 0.04) were more common in children without pets and those who had owned pets in the past. The highest proportion of children with asthma was in homes where pets were present in the past. Conclusions: Analyses indicating a relationship between a higher prevalence of asthma and some respiratory symptoms, and the absence of pets cannot be considered as a casual association. The analysis conducted did not reveal a reverse causality effect. The results of observational epidemiological studies, especially a cross-sectional study, should always be interpreted with caution, considering possible distortions and conclusions drawn. Full article
15 pages, 1880 KiB  
Article
Exploring the Relationship between Wind Patterns and Hospital Admissions Due to Respiratory Symptoms in Children
by Despoina Boura, Marios Spanakis, George Markakis, George Notas, Christos Lionis, Nikolaos Tzanakis and Emmanouil Paraskakis
Children 2024, 11(6), 717; https://doi.org/10.3390/children11060717 - 12 Jun 2024
Viewed by 1297
Abstract
Respiratory disorders significantly impact adolescents’ health, often resulting in hospital admissions. Meteorological elements such as wind patterns have emerged as potential contributors to respiratory symptoms. However, it remains uncertain whether fluctuations in wind characteristics over extended periods have a tangible impact on respiratory [...] Read more.
Respiratory disorders significantly impact adolescents’ health, often resulting in hospital admissions. Meteorological elements such as wind patterns have emerged as potential contributors to respiratory symptoms. However, it remains uncertain whether fluctuations in wind characteristics over extended periods have a tangible impact on respiratory health, particularly in regions characterized by distinct annual wind patterns. Crete is situated in the central-eastern Mediterranean Sea and frequently faces southerly winds carrying Sahara Desert sand from Africa and northerly winds from the Aegean Sea. This retrospective study analyzes long-term wind direction data and their relationship to respiratory symptoms observed in children up to 14 years old admitted at the University Hospital of Heraklion between 2002 and 2010. Symptoms such as headache, dyspnea, dry cough, dizziness, tachypnea, throat ache, and earache were predominantly reported during the presence of southern winds. Fever, productive cough, and chest pain were more frequently reported during northern winds. Cough was the most common symptom regardless of the wind pattern. Southern winds were significantly associated with higher probabilities of productive or non-productive cough, headache, dyspnea, tachypnea, dizziness, earache, and throat ache. Northern winds were related to a higher incidence of productive cough. Rhinitis, asthma, allergies, pharyngitis, and sinusitis were related to southern winds, while bronchiolitis and pneumonia were associated with northern winds. These findings underscore the critical role of local climatic factors, emphasizing their potential impact on exacerbating respiratory conditions in children. Moreover, they point out the need for further research to elucidate the underlying mechanisms and develop targeted interventions for at-risk populations. Full article
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11 pages, 807 KiB  
Article
A Closer Look at Parental Anxiety in Asthma Outpacing Children’s Concerns: Fear of Physical Activity over the Fear of Drug Side Effects
by Marijana Rogulj, Katarina Vukojević and Linda Lušić Kalcina
Children 2024, 11(3), 289; https://doi.org/10.3390/children11030289 - 29 Feb 2024
Cited by 2 | Viewed by 1631
Abstract
Background: The recognition of comorbidities is relevant for asthma management, especially if these conditions/diseases are treatable traits such as anxiety. This study aimed to explore the associations between asthma severity and child and parent asthma-related anxiety and to recognize the most common specific [...] Read more.
Background: The recognition of comorbidities is relevant for asthma management, especially if these conditions/diseases are treatable traits such as anxiety. This study aimed to explore the associations between asthma severity and child and parent asthma-related anxiety and to recognize the most common specific fears. Methods: This cross-sectional study consisted of 150 parents and their children diagnosed with asthma, and was conducted at the Pediatric Clinic of the University Hospital Center Split in Croatia. All children, from ages 3 to 17 years, underwent a thorough clinical examination. A total of 150 parents and 108 children filled out an asthma-related anxiety questionnaire in paper form. Results: Parents of children with moderate and severe asthma had higher asthma-related anxiety due to restrictions related to asthma symptoms (p = 0.032), and children diagnosed with moderate and severe asthma had greater anxiety due to restrictions related to asthma symptoms than children diagnosed with mild asthma (p = 0.004). Children’s anxiety was the highest when they experienced an asthmatic attack during physical activity (PA), and they fear that they will not be successful in sports or dancing due to asthma. Parents commonly reported the fear of an asthma attack without warning signs (p < 0.001), fear of drug side effects (p < 0.001), fear of absence from school (p = 0.006), and fear of an asthma attack during PA (p < 0.001). Conclusions: The current study reports findings of increased parental levels of anxiety when compared to their children, related to fear of an asthma attack occurring without warning signs, fear of side effects and fear of absence from school, as well as the fear of an asthma attack occurring during sports activities. When assessing individual items on anxiety associated with asthma, children most commonly reported concern related to physical activity. Full article
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Review

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13 pages, 583 KiB  
Review
Current Challenges in Pediatric Asthma
by Andrija Miculinić, Iva Mrkić Kobal, Tin Kušan, Mirjana Turkalj and Davor Plavec
Children 2024, 11(6), 632; https://doi.org/10.3390/children11060632 - 24 May 2024
Viewed by 1707
Abstract
Asthma is a chronic lung disease characterized by reversible bronchoconstriction and inflammation of the bronchi. Its increasing prevalence in childhood as well as different triggers make asthma a challenging disease in several ways: defining its phenotype/endotype, the diagnostic approach (especially in younger children), [...] Read more.
Asthma is a chronic lung disease characterized by reversible bronchoconstriction and inflammation of the bronchi. Its increasing prevalence in childhood as well as different triggers make asthma a challenging disease in several ways: defining its phenotype/endotype, the diagnostic approach (especially in younger children), therapeutic options, and systematic follow-up. Considering these problems, this review approaches the current status and limitations of guidelines used for asthma management in children. It also emphasizes the key points which could lead to a better understanding and the direction to take in future studies. Full article
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15 pages, 605 KiB  
Review
The Prevention of House Dust Mite Allergies in Pediatric Asthma
by Angela Klain, Antonio Andrea Senatore, Amelia Licari, Francesca Galletta, Irene Bettini, Leonardo Tomei, Sara Manti, Francesca Mori, Michele Miraglia del Giudice and Cristiana Indolfi
Children 2024, 11(4), 469; https://doi.org/10.3390/children11040469 - 15 Apr 2024
Cited by 2 | Viewed by 3026 | Correction
Abstract
This review provides a concise overview of preventive measures against dust mite allergies in pediatric populations, emphasizing the need for a comprehensive and evolving approach. Dust mites, ubiquitous microscopic arachnids, pose a significant threat to children’s health, triggering allergies and asthma. Traditional preventive [...] Read more.
This review provides a concise overview of preventive measures against dust mite allergies in pediatric populations, emphasizing the need for a comprehensive and evolving approach. Dust mites, ubiquitous microscopic arachnids, pose a significant threat to children’s health, triggering allergies and asthma. Traditional preventive strategies such as regular cleaning, mattress covers, and humidity control are essential but warrant refinement. Empowering children through personalized hygiene education and exploring innovative bedding solutions showcase a forward-thinking paradigm. Collaboration with healthcare professionals and embracing technology-driven solutions ensures a holistic and adaptable approach to safeguarding pediatric health against dust mite-related ailments. This abstract underscores the importance of continually reassessing and innovating preventive measures to create resilient and health-conscious living environments for children. Full article
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