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Atopy

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Paul Cullinan – 1st expert on this subject based on the ideXlab platform

  • Atopy and allergic respiratory disease in rural poland before and after accession to the european union
    The Journal of Allergy and Clinical Immunology, 2014
    Co-Authors: Barbara Sozanska, Neil Pearce, Mateusz Blaszczyk, Paul Cullinan

    Abstract:

    Background In 2003, we recorded a striking difference in the prevalence of Atopy between village and small-town populations in southwest Poland. Nine years later, we undertook a second survey of the same area. Objective We sought to assess whether rapid changes in farming practices, driven by accession to the European Union in 2004, were accompanied by an increase in Atopy, asthma, and hay fever in these villages. Methods In 2012, we surveyed 1730 inhabitants older than 5 years (response rate, 85%); 560 villagers and 348 town inhabitants who had taken part in the earlier survey. Participants completed a questionnaire on farm-related exposures and symptoms of asthma and hay fever. Atopy was assessed by using skin prick tests. Results In 2012, far fewer villagers had contact with cows (4% vs 24.3% in 2003) or pigs (14% vs 33.5%), milked cows (2.7% vs 12.7%), or drank unpasteurized milk (9% vs 35%). Among the villagers, there was a significant increase at all ages in the prevalence of Atopy between 2003 and 2012 both in the total population (7.3% vs 19.6%, P P Conclusions We report a substantial increase in Atopy at all ages and in a remarkably short period of time in a Polish population whose farm-related exposures were dramatically reduced after their country’s accession to the European Union.

  • consumption of unpasteurized milk and its effects on Atopy and asthma in children and adult inhabitants in rural poland
    Allergy, 2013
    Co-Authors: Barbara Sozanska, Neil Pearce, K Dudek, Paul Cullinan

    Abstract:

    BACKGROUND: Consumption of unpasteurized cow’s milk has been identified as a possible protective factor for Atopy and asthma. Most studies have been conducted among children and in farming populations. We investigated the effects of consumption of unpasteurized milk in early life on Atopy, asthma, and rhinitis in village and town inhabitants in a region of Poland and assessed whether any protective effects of milk consumption differed according to place of residence and farming status. METHODS: We surveyed the inhabitants (aged >5 years) of a small town and seven nearby villages in southwest Poland (n = 1700, response rate 88%). Participants (or their parents for those <16 years of age) completed a questionnaire on farm exposures and symptoms of asthma and rhinitis. In particular, information was collected on unpasteurized milk consumption in early life. Atopy was assessed using skin prick tests. RESULTS: Consumption of unpasteurized milk in the first year of life was inversely associated with Atopy and asthma both among town and village inhabitants – town: adjusted odds ratio (aOR) for Atopy 0.46 [95% confidence interval (CI) 0.37-0.52] asthma 0.51 (0.32-0.74); villages: Atopy 0.59 (0.44-0.70) and asthma 0.59 (0.42-0.74). For Atopy, the protective effect was more clearly seen among nonfarmers (0.42; 0.34-0.46) than in farmers (0.82; 0.54-1.11). For doctor-diagnosed hay fever and current rhinitis symptoms, the protective effect was only observed among town inhabitants and/or nonfarmers. CONCLUSIONS: Early-life exposure to unpasteurized milk may protect against Atopy, asthma, and related conditions, independently of place of residence and farming status, and in both children and adults.

  • Temporal changes in UK birth order and the prevalence of Atopy.
    Allergy, 2010
    Co-Authors: S Upchurch, Jessica M Harris, Paul Cullinan

    Abstract:

    To cite this article: Upchurch S, Harris JM, Cullinan P. Temporal changes in UK birth order and the prevalence of Atopy. Allergy 2010; 65: 1039–1041.

    Abstract

    Background:  Many studies have reported an inverse association between birth order and the risk of respiratory allergic disease. In recent decades, the prevalence of Atopy has increased alongside reductions in fertility rates.

    Aims of the study:  To quantitate how much of the increased prevalence of Atopy, measured by skin prick test or specific IgE, can be attributed to temporal changes in family size in the United Kingdom.

    Methods:  Through a systematic literature review (MEDLINE, 1965–2009), five studies of UK populations were identified and their data were included in the calculation of a summary odds ratio for the risk of Atopy for each birth order. Information on changes in UK family sizes between 1960 and 2001 was obtained from Eurostat. On this basis, expected increases in the prevalence of Atopy were calculated by weighting the proportion in each birth order category for 1960 and 2001 by the summary odds ratio for that category and then calculating the relative risk of Atopy in 2001 compared with 1960.

    Results:  The pooled summary odds ratios for Atopy were 0.90, 0.69 and 0.69 for those born second, third and fourth (or higher), respectively. The expected relative increase in the prevalence of Atopy resulting from a change in family size between 1960 and 2001 was 3%.

    Conclusions:  Despite the strong associations between birth order and Atopy, reductions in family size in the last 40 years account for little of the increase in Atopy.

Neil Pearce – 2nd expert on this subject based on the ideXlab platform

  • Atopy and allergic respiratory disease in rural poland before and after accession to the european union
    The Journal of Allergy and Clinical Immunology, 2014
    Co-Authors: Barbara Sozanska, Neil Pearce, Mateusz Blaszczyk, Paul Cullinan

    Abstract:

    Background In 2003, we recorded a striking difference in the prevalence of Atopy between village and small-town populations in southwest Poland. Nine years later, we undertook a second survey of the same area. Objective We sought to assess whether rapid changes in farming practices, driven by accession to the European Union in 2004, were accompanied by an increase in Atopy, asthma, and hay fever in these villages. Methods In 2012, we surveyed 1730 inhabitants older than 5 years (response rate, 85%); 560 villagers and 348 town inhabitants who had taken part in the earlier survey. Participants completed a questionnaire on farm-related exposures and symptoms of asthma and hay fever. Atopy was assessed by using skin prick tests. Results In 2012, far fewer villagers had contact with cows (4% vs 24.3% in 2003) or pigs (14% vs 33.5%), milked cows (2.7% vs 12.7%), or drank unpasteurized milk (9% vs 35%). Among the villagers, there was a significant increase at all ages in the prevalence of Atopy between 2003 and 2012 both in the total population (7.3% vs 19.6%, P P Conclusions We report a substantial increase in Atopy at all ages and in a remarkably short period of time in a Polish population whose farm-related exposures were dramatically reduced after their country’s accession to the European Union.

  • consumption of unpasteurized milk and its effects on Atopy and asthma in children and adult inhabitants in rural poland
    Allergy, 2013
    Co-Authors: Barbara Sozanska, Neil Pearce, K Dudek, Paul Cullinan

    Abstract:

    BACKGROUND: Consumption of unpasteurized cow’s milk has been identified as a possible protective factor for Atopy and asthma. Most studies have been conducted among children and in farming populations. We investigated the effects of consumption of unpasteurized milk in early life on Atopy, asthma, and rhinitis in village and town inhabitants in a region of Poland and assessed whether any protective effects of milk consumption differed according to place of residence and farming status. METHODS: We surveyed the inhabitants (aged >5 years) of a small town and seven nearby villages in southwest Poland (n = 1700, response rate 88%). Participants (or their parents for those <16 years of age) completed a questionnaire on farm exposures and symptoms of asthma and rhinitis. In particular, information was collected on unpasteurized milk consumption in early life. Atopy was assessed using skin prick tests. RESULTS: Consumption of unpasteurized milk in the first year of life was inversely associated with Atopy and asthma both among town and village inhabitants – town: adjusted odds ratio (aOR) for Atopy 0.46 [95% confidence interval (CI) 0.37-0.52] asthma 0.51 (0.32-0.74); villages: Atopy 0.59 (0.44-0.70) and asthma 0.59 (0.42-0.74). For Atopy, the protective effect was more clearly seen among nonfarmers (0.42; 0.34-0.46) than in farmers (0.82; 0.54-1.11). For doctor-diagnosed hay fever and current rhinitis symptoms, the protective effect was only observed among town inhabitants and/or nonfarmers. CONCLUSIONS: Early-life exposure to unpasteurized milk may protect against Atopy, asthma, and related conditions, independently of place of residence and farming status, and in both children and adults.

  • how much asthma is really attributable to Atopy
    Thorax, 1999
    Co-Authors: Neil Pearce, J Pekkanen, Richard Beasley

    Abstract:

    In recent decades it has become routine to describe asthma as an atopic disease. A theoretical paradigm has evolved in which allergen exposure produces atopic sensitisation and continued exposure leads to clinical asthma through the development of airways inflammation, bronchial hyperresponsiveness, and reversible airflow obstruction. As Martinez1 notes, this paradigm has been used with particular insistence with regard to house dust mite allergens,2 3 but other allergens (cat, cockroach, dog) are also believed to be important. The importance of Atopy is most widely accepted for asthma in children whereas, among adults, asthma has traditionally been divided into “extrinsic” and “intrinsic” asthma, although this also has been challenged.4 It is acknowledged that not all cases of asthma fit this paradigm—for example, some occupational causes of asthma do not appear to involve Atopy—but these are regarded as interesting minor anomalies that do not threaten the dominant paradigm.

    In this review we assess the extent to which the development of asthma is attributable to Atopy (we do not consider the separate issue of the extent to which the development of Atopy itself is attributable to allergen exposure, although this is also the subject of debate1). We start by considering definitions of asthma and Atopy and then review evidence on their association in random population surveys. We do not intend to argue that Atopy does not play an important role in the development of a significant proportion of asthma cases. However, our concern is that the proportion of asthma cases attributable to Atopy may have been overestimated, and that other possible aetiological mechanisms and risk factors for asthma may therefore have been neglected.

    The definition of asthma is still controversial but an appropriate definition is a precondition for addressing the issues considered in this paper. The term “asthma” encompasses a …

Juan C Celedon – 3rd expert on this subject based on the ideXlab platform

  • obesity and adiposity indicators asthma and Atopy in puerto rican children
    The Journal of Allergy and Clinical Immunology, 2014
    Co-Authors: Erick Forno, Edna Acostaperez, John M Brehm, Maria Alvarez, Angel Colonsemidey, Glorisa Canino, Juan C Celedon

    Abstract:

    Background Whether adiposity indicators other than body mass index (BMI) should be used in studies of childhood asthma is largely unknown. The role of Atopy in “obese asthma” is also unclear. Objectives To examine the relationship among adiposity indicators, asthma, and Atopy in Puerto Rican children, and to assess whether Atopy mediates the obesity-asthma association. Methods In a study of Puerto Rican children with (n = 351) and without (n = 327) asthma, we measured BMI, percent of body fat, waist circumference, and waist-to-hip ratio. The outcomes studied included asthma, lung function, measures of Atopy, and, among cases, indicators of asthma severity or control. We performed mediation analysis to assess the contribution of Atopy to the relationship between adiposity and asthma. Results BMI, percent of body fat, and waist circumference were associated with increased odds of asthma. Among cases, all 3 measures were generally associated with lung function, asthma severity/control, and Atopy; however, there were differences depending on the adiposity indicator analyzed. Atopy considerably mediated the adiposity-asthma association in this population: allergic rhinitis accounted for 22% to 53% of the association with asthma, and sensitization to cockroach mediated 13% to 20% of the association with forced vital capacity and 29% to 42% of the association with emergency department visits for asthma. Conclusions Adiposity indicators are associated with asthma, asthma severity/control, and Atopy in Puerto Rican children. Atopy significantly mediates the effect of adiposity on asthma outcomes. Longitudinal studies are needed to further investigate the causal role, if any, of adiposity distribution and Atopy on “obese asthma” in childhood.

  • birth by cesarean section allergic rhinitis and allergic sensitization among children with a parental history of Atopy
    The Journal of Allergy and Clinical Immunology, 2008
    Co-Authors: Juan C Celedon, Michael Pistiner, Diane R Gold, H Abdulkerim, Ellaine Hoffman

    Abstract:

    Background Cesarean delivery can alter neonatal immune responses and increase the risk of Atopy. Studies of the relation between cesarean delivery and allergic diseases in children not selected on the basis of a family history of Atopy have yielded inconsistent findings. Objective We sought to examine the relation between birth by cesarean delivery and Atopy and allergic diseases in children at risk for Atopy. Methods We examined the relation between mode of delivery and the development of Atopy and allergic diseases among 432 children with a parental history of Atopy followed from birth to age 9 years. Asthma was defined as physician-diagnosed asthma and wheeze in the previous year, and allergic rhinitis was defined as physician-diagnosed allergic rhinitis and naso-ocular symptoms apart from colds in the previous year. Atopy was considered present at school age if there was 1 or more positive skin test response or specific IgE to common allergens. Stepwise logistic regression was used to study the relation between cesarean delivery and the outcomes of interest. Results After adjustment for other covariates, children born by cesarean section had 2-fold higher odds of Atopy than those born by vaginal delivery (odds ratio, 2.1; 95% CI, 1.1-3.9). In multivariate analyses birth by cesarean section was significantly associated with increased odds of allergic rhinitis (odds ratio, 1.8; 95% CI, 1.0-3.1) but not with asthma. Conclusions Our findings suggest that cesarean delivery is associated with allergic rhinitis and Atopy among children with a parental history of asthma or allergies. This could be explained by lack of contact with the maternal vaginal/fecal flora or reduced/absent labor during cesarean delivery.

  • exposure to dust mite allergen and endotoxin in early life and asthma and Atopy in childhood
    The Journal of Allergy and Clinical Immunology, 2007
    Co-Authors: Juan C Celedon, Donald K Milton, Clare Ramsey, Augusto A Litonjua, Louise Ryan, Thomas A E Plattsmills, Diane R Gold

    Abstract:

    Background There has been no longitudinal study of the relation between concurrent exposure to dust mite allergen and endotoxin in early life and asthma and Atopy at school age. Objectives To examine the relation between exposure to dust mite allergen and endotoxin at age 2 to 3 months and asthma, wheeze, and Atopy in high-risk children. Methods Birth cohort study of 440 children with parental history of Atopy in the Boston metropolitan area. Results In multivariate analyses, early exposure to high levels of dust mite allergen (≥10 μg/g) was associated with increased risks of asthma at age 7 years (odds ratio [OR], 3.0; 95% CI, 1.1-7.9) and late-onset wheeze (OR, 5.0; 95% CI, 1.5-16.4). Exposure to endotoxin levels above the lowest quartile at age 2 to 3 months was associated with reduced odds of Atopy at school age (OR, 0.5; 95% CI, 0.2-0.9). In contrast with its inverse association with Atopy, endotoxin exposure in early life was associated with an increased risk of any wheeze between ages 1 and 7 years that did not change significantly with time (hazard ratio for each quartile increment in endotoxin levels, 1.23; 95% CI, 1.07-1.43). Conclusion Among children at risk of Atopy, early exposure to high levels of dust mite allergen is associated with increased risks of asthma and late-onset wheeze. In these children, endotoxin exposure is associated with a reduced risk of Atopy but an increased risk of wheeze. Clinical implications Early endotoxin exposure may be a protective factor against Atopy but a risk factor for wheeze in high-risk children.