Pediatric Allergy and Respiratory Diseases

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Pediatrics".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 25857

Special Issue Editors


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Guest Editor
Department of Medical and Surgical Sciences, Alma Mater Studiorum Università di Bologna, Bologna, Italy
Interests: atopic dermatitis; food allergy; allergic asthma; respiratory obstructive sleep disorders; anaphylaxis
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
Interests: asthma; atopic dermatitis; rhinitis; food allergy; anaphylaxis; immunodeficiencies; vaccine; allergy prevention; drug
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The constant developments in the knowledge of allergic and immunological diseases, both from a pathogenetic and therapeutic point of view, require constant updating, especially for the introduction of new therapies with biological drugs. The purpose of this Special Issue is to facilitate young researchers to share their research and formulate synthetic reviews on innovations that have emerged in recent years. We invite authors to submit original articles, review articles, and case reports dealing with, but not limited to, the following cutting-edge research: biologic treatments, epigenetic studies, and exposome and environmental influences on allergic diseases.

Prof. Dr. Giampaolo Ricci
Prof. Dr. Carlo Caffarelli
Guest Editors

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Keywords

  • allergy
  • asthma
  • atopic dermatitis rhinitis
  • food allergy
  • immunology

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Published Papers (6 papers)

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Research

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15 pages, 999 KiB  
Article
Factors Influencing the Concentration of Exhaled Nitric Oxide (FeNO) in School Children Aged 8–9-Years-Old in Krakow, with High FeNO Values ≥ 20 ppb
by Marta Czubaj-Kowal, Grzegorz Józef Nowicki, Ryszard Kurzawa, Maciej Polak and Barbara Ślusarska
Medicina 2022, 58(2), 146; https://doi.org/10.3390/medicina58020146 - 18 Jan 2022
Cited by 12 | Viewed by 3772
Abstract
Background and Objectives: Measurement of fractional exhaled nitric oxide (FeNO) concentration is currently used as a non-invasive biomarker to assess airway inflammation. Many factors can influence the FeNO level. However, there have been no reports concerning factors attributed to FeNO levels in [...] Read more.
Background and Objectives: Measurement of fractional exhaled nitric oxide (FeNO) concentration is currently used as a non-invasive biomarker to assess airway inflammation. Many factors can influence the FeNO level. However, there have been no reports concerning factors attributed to FeNO levels in different age groups of children, especially those with high FeNO values. Therefore, this study aimed to assess the influence of selected factors on nitric oxide concentration in exhaled air in children aged 8–9 attending class 3 of public primary schools in Krakow with high FeNO values ≥ 20 ppb. Materials and Methods: The population-based study covered all third-grade pupils attending primary schools in the city of Krakow. Five thousand, four hundred and sixty children participated in the first screening stage, conducted from October 2017 to January 2018. Then, 792 participants with an FeNO level ≥ 20 ppb were selected. Finally, those selected pupils were invited to participate in the second stage, diagnostic, in April 2018. Four hundred and fifty-four children completed the diagnostic stage of the study, and their data was included in the presented analysis. Results and Conclusions: Significantly higher FeNO levels were observed in children diagnosed with the following diseases: asthma, allergic rhinitis, atopic dermatitis, and allergy (p < 0.05). In addition, it was observed that a higher FeNO concentration characterised children taking antihistamines compared to children not taking those medications (p = 0.008). In multivariate models, we observed that regardless of sex, age, BMI value, home smoking, and whether they were taking medications, children who had allergic rhinitis, or atopic dermatitis, or allergies had significantly higher FeNO levels. The strongest relationship was noted with allergic diseases. The results of our study may be of importance to clinicians when interpreting FeNO results, for example, when making a therapeutic decision. Full article
(This article belongs to the Special Issue Pediatric Allergy and Respiratory Diseases)
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8 pages, 413 KiB  
Article
Effects of Supplementation in Vitamin D3 Deficient or Insufficient Children with Allergic Diseases
by Andjelka Stojkovic, Katerina Dajic, Jasmina Milovanovic, Slobodan M. Jankovic, Nenad V. Markovic and Andrijana Kostic
Medicina 2021, 57(10), 1052; https://doi.org/10.3390/medicina57101052 - 1 Oct 2021
Cited by 1 | Viewed by 1704
Abstract
Background and Objectives: Although vitamin D insufficiency or deficiency is prevalent in children with allergic diseases, recommendations for supplementation dosing regimens are imprecise and variable in the literature, because clinical trials aiming to determine optimal doses were scarce in the past. This [...] Read more.
Background and Objectives: Although vitamin D insufficiency or deficiency is prevalent in children with allergic diseases, recommendations for supplementation dosing regimens are imprecise and variable in the literature, because clinical trials aiming to determine optimal doses were scarce in the past. This study aimed to investigate supplementation of vitamin D3 that may achieve therapeutically effective but not toxic serum levels in a subpopulation of children with allergic diseases and concomitant hypovitaminosis D. Materials and Methods: The retrospective, observational study with a cross-sectional design included 94 children suffering from allergic diseases and having vitamin D deficiency/insufficiency who were prescribed high-dose vitamin D3 supplementation by a pediatrician for at least 6 weeks and not more than 9 weeks. Serum levels of the major metabolite of vitamin D (25-(OH)D) were determined in all children twice: before and two weeks after the end of vitamin D3 supplementation. Results: An increase in serum level of the 25-(OH)D after supplementation was significant. However, if the subjects had higher serum levels of the 25-(OH)D before the supplementation, and if the supplementation lasted 8 instead of 6 weeks, the absolute increase in serum level of the 25-(OH)D was lower. Patients taking corticosteroids as inhalation or intranasally had a more intense effect of vitamin D3 supplementation, i.e., the absolute increase in levels of 25-(OH)D was higher than in patients not using such medication. Conclusions: Vitamin D deficiency and insufficiency in children with allergic diseases can be treated with maximal recommended doses of vitamin D3 for a short period of time, especially if they were prescribed with inhalation or intranasal corticosteroids. Full article
(This article belongs to the Special Issue Pediatric Allergy and Respiratory Diseases)
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Review

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15 pages, 382 KiB  
Review
An Overview of Off-Label Use of Humanized Monoclonal Antibodies in Paediatrics
by Roberto Bernardini, Gaia Toschi Vespasiani and Arianna Giannetti
Medicina 2022, 58(5), 625; https://doi.org/10.3390/medicina58050625 - 29 Apr 2022
Cited by 3 | Viewed by 2870
Abstract
In recent years, off-label and unlicensed drug use has extensively developed in the paediatric population. For a long time, clinical trials in the paediatric population were considered complicated to perform because of ethical problems, causing frequent off-label use. Off-label drug use remains an [...] Read more.
In recent years, off-label and unlicensed drug use has extensively developed in the paediatric population. For a long time, clinical trials in the paediatric population were considered complicated to perform because of ethical problems, causing frequent off-label use. Off-label drug use remains an important public health issue, especially for children with rare conditions or with diseases not responsive to conventional treatments. The present paper is a narrative review of the literature of off-label drug use in children. The aim of our study is to summarize the main works dealing with the off-label use of biological drugs in paediatrics. Further studies analyzing their efficacy, safety, and cost–benefit ratios are needed to extend the use of biological therapies to the paediatric population. Full article
(This article belongs to the Special Issue Pediatric Allergy and Respiratory Diseases)
11 pages, 1780 KiB  
Review
Radiocontrast Media Hypersensitivity Reactions in Children
by Francesca Saretta, Silvia Caimmi, Francesca Mori, Annamaria Bianchi, Paolo Bottau, Giuseppe Crisafulli, Fabrizio Franceschini, Lucia Liotti, Claudia Paglialunga, Giampaolo Ricci and Carlo Caffarelli
Medicina 2022, 58(4), 517; https://doi.org/10.3390/medicina58040517 - 5 Apr 2022
Cited by 3 | Viewed by 2548
Abstract
Hypersensitivity reactions to radiocontrast media seem to be rare in children. Furthermore, the use of radiocontrast media in children remains quite safe in terms of the severity of reactions. Since pediatric guidelines are lacking, the diagnostic workup employed in adults could be adapted [...] Read more.
Hypersensitivity reactions to radiocontrast media seem to be rare in children. Furthermore, the use of radiocontrast media in children remains quite safe in terms of the severity of reactions. Since pediatric guidelines are lacking, the diagnostic workup employed in adults could be adapted to children, taking into account that results have not yet been validated in this age group. Specific protocols for risk stratification and management of severe reactions have been proposed so far. Full article
(This article belongs to the Special Issue Pediatric Allergy and Respiratory Diseases)
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11 pages, 2618 KiB  
Review
Host Defenses to Viruses: Lessons from Inborn Errors of Immunity
by Lucia Leonardi, Beatrice Rivalta, Fabrizio Leone, Caterina Cancrini, Carlo Caffarelli, Gian Luigi Marseglia and Fabio Cardinale
Medicina 2022, 58(2), 248; https://doi.org/10.3390/medicina58020248 - 7 Feb 2022
Cited by 5 | Viewed by 6671
Abstract
The constant battle between viruses and their hosts leads to their reciprocal evolution. Viruses regularly develop survival strategies against host immunity, while their ability to replicate and disseminate is countered by the antiviral defense mechanisms that host mount. Although most viral infections are [...] Read more.
The constant battle between viruses and their hosts leads to their reciprocal evolution. Viruses regularly develop survival strategies against host immunity, while their ability to replicate and disseminate is countered by the antiviral defense mechanisms that host mount. Although most viral infections are generally controlled by the host’s immune system, some viruses do cause overt damage to the host. The outcome can vary widely depending on the properties of the infecting virus and the circumstances of infection but also depends on several factors controlled by the host, including host genetic susceptibility to viral infections. In this narrative review, we provide a brief overview of host immunity to viruses and immune-evasion strategies developed by viruses. Moreover, we focus on inborn errors of immunity, these being considered a model for studying host response mechanisms to viruses. We finally report exemplary inborn errors of both the innate and adaptive immune systems that highlight the role of proteins involved in the control of viral infections. Full article
(This article belongs to the Special Issue Pediatric Allergy and Respiratory Diseases)
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15 pages, 753 KiB  
Review
Selective IgA Deficiency and Allergy: A Fresh Look to an Old Story
by Bianca Laura Cinicola, Federica Pulvirenti, Martina Capponi, Marta Bonetti, Giulia Brindisi, Alessandra Gori, Giovanna De Castro, Caterina Anania, Marzia Duse and Anna Maria Zicari
Medicina 2022, 58(1), 129; https://doi.org/10.3390/medicina58010129 - 15 Jan 2022
Cited by 17 | Viewed by 7174
Abstract
Selective IgA deficiency (SIgAD) is the most common human primary immune deficiency (PID). It is classified as a humoral PID characterized by isolated deficiency of IgA (less than 7 mg/dL but normal serum IgG and IgM) in subjects greater than 4 years of [...] Read more.
Selective IgA deficiency (SIgAD) is the most common human primary immune deficiency (PID). It is classified as a humoral PID characterized by isolated deficiency of IgA (less than 7 mg/dL but normal serum IgG and IgM) in subjects greater than 4 years of age. Intrinsic defects in the maturation of B cells and a perturbation of Th cells and/or cytokine signals have been hypothesized to contribute to SIgAD pathogenesis. The genetic basis of IgA deficiency remains to be clarified. Patients with SIgAD can be either asymptomatic or symptomatic with clinical manifestations including allergy, autoimmunity and recurrent infections mainly of the respiratory and gastrointestinal tract. Studies analyzing allergy on SIgAD patients showed prevalence up to 84%, supporting in most cases the relationship between sIgAD and allergic disease. However, the prevalence of allergic disorders may be influenced by various factors. Thus, the question of whether allergy is more common in SIgAD patients compared to healthy subjects remains to be defined. Different hypotheses support an increased susceptibility to allergy in subjects with SIgAD. Recurrent infections due to loss of secretory IgA might have a role in the pathogenesis of allergy, and vice versa. Perturbation of microbiota also plays a role. The aim of this review is to examine the association between SIgAD and atopic disease and to update readers on advances over time at this important interface between allergy and SIgAD. Full article
(This article belongs to the Special Issue Pediatric Allergy and Respiratory Diseases)
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