Atopic disorders

  • 文章类型: Systematic Review
    背景:慢性荨麻疹(CU)与几种系统性和自身免疫性疾病有关。然而,与特应性疾病的联系是有争议的。这项研究的目的是进行系统评价和荟萃分析,以评估CU与特应性疾病之间的关联:特应性皮炎(AD)。哮喘,和过敏性鼻结膜炎(ARC)。
    方法:从PubMed搜索命中,Embase,科克伦图书馆,和WebofScience进行了系统的审查。从2000年至今的英语论文,包含关联的原始数据(患病率,发病率,或风险)CU和任何特应性疾病之间,包括在内。使用随机效应模型计算具有95%置信区间的汇集点患病率和OR。
    结果:共筛选并审查了8,108个搜索命中。38项研究符合所有纳入标准。估计的AD合并点患病率,哮喘,CU中的ARC为7%(5-11%,I2=99%),12%(9-15%,I2=100%),和22%(16-29%,I2=100%),分别。AD的合并OR估计为2.75(2.05-3.68,I2=94%),1.87(1.01-3.45,I2=100%)用于哮喘,ARC为2.94(1.84-4.68,I2=100%)。
    结论:CU中特应性疾病的汇总点患病率与普通人群相当。然而,将患病率与来自相同人群的对照组进行比较的研究均发现CU中特应性疾病的风险显著增加.然而,应谨慎解释结果,因为在所有分析中都发现了高异质性。
    BACKGROUND: Chronic urticaria (CU) has been associated with several systemic and autoimmune disorders. The association with atopic disorders is however controversial. The objective of this study was to perform a systematic review and meta-analysis to assess the association between CU and the atopic disorders: atopic dermatitis (AD), asthma, and allergic rhinoconjunctivitis (ARC).
    METHODS: Search hits from PubMed, Embase, Cochrane Library, and Web of Science were systematically reviewed. English papers from 2000 to present, containing original data of the association (prevalence, incidence, or risk) between CU and any atopic disorder(s), were included. Pooled point prevalence and OR with 95% confidence intervals were calculated with a random effects model.
    RESULTS: A total of 8,108 search hits were screened and reviewed. Thirty-eight studies met all inclusion criteria. The estimated pooled point prevalence of AD, asthma, and ARC in CU was 7% (5-11%, I2 = 99%), 12% (9-15%, I2 = 100%), and 22% (16-29%, I2 = 100%), respectively. Pooled ORs were estimated to 2.75 (2.05-3.68, I2 = 94%) for AD, 1.87 (1.01-3.45, I2 = 100%) for asthma, and 2.94 (1.84-4.68, I2 = 100%) for ARC.
    CONCLUSIONS: Pooled point prevalences of atopic disorders in CU were comparable to the general population. However, studies that compared prevalences with controls from the same population all found a significantly increased risk of atopic disorders in CU. Results should however be interpreted with caution as high heterogeneity was found in all analyses.
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  • 文章类型: Journal Article
    酸奶是一种发酵乳制品,其特征在于具有活的和活的细菌培养物的特殊营养成分。很少有研究分析了在儿科年龄食用酸奶对健康结果的益处。最近的流行病学研究评估了酸奶的营养影响,证明了它对儿童营养摄入的重要贡献。因此,食用酸奶是实现推荐营养摄入量和更健康饮食选择的策略,对儿童肥胖和心脏代谢结局有潜在影响。酸奶对儿科传染病的影响,胃肠道疾病和特应性相关疾病归因于施用的特定益生菌菌株。有趣的是,食用酸奶的好处很可能是由于肠道微生物群介导的作用以及先天和适应性免疫反应的增强。因此,用益生菌菌株补充标准酸奶培养物可能有助于促进不同儿科年龄的健康,尽管关于毒株相关效应及其在儿科免疫系统中的相互作用还需要更多的证据.
    Yogurt is a fermented milk product characterised by a peculiar nutritional composition with live and viable cultures of bacteria. Few studies have analysed the benefits of yogurt consumption on health outcomes during paediatric age. Recent epidemiological studies evaluating the nutritional impact of yogurt have demonstrated its significant contribution to nutrients intakes among children. Thus, consuming yogurt is a strategy to achieve recommended nutrient intake and healthier dietary choices, with potential impact on obesity and cardiometabolic outcome in children. Yogurt\'s effects on paediatric infectious diseases, gastrointestinal diseases and atopic-related disorders are ascribed to the specific probiotic strain administered. Interestingly, the benefits of yogurt consumption are most likely due to effects mediated through the gut microbiota and the enhancement of innate and adaptive immune responses. Therefore, supplementing standard yogurt cultures with probiotic strains could be useful to promote health at different paediatric ages, although more evidence is needed regarding the strain-related effects and their interplay within the paediatric immune system.
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  • 文章类型: Journal Article
    扑热息痛是妊娠期最常用的解热镇痛药。在新生儿重症监护病房中,它也越来越多地用于标签外。尽管经常使用扑热息痛,对新生儿给药方案的高变异性和早期暴露的长期安全性提出了担忧.
    目的研究产前和新生儿服用扑热息痛的长期安全性的现有证据。
    我们对OvidMedline电子数据库进行了系统搜索,OvidEmbase和WebofScience从成立到2021年8月,用于任何设计的原始研究研究,这些设计描述了对乙酰氨基酚在产前或新生儿(生命的前四周)中的使用,并检查了神经发育的发生,出生时或出生后的特应性或生殖不良结局。
    我们确定了1313篇独特的文章,并在最终审查中纳入了30项研究。在所有的研究中,27(90%),两个(7%)和一个(3%)对产前的长期安全性,新生儿以及产前和新生儿暴露,分别。十三(46%),11项(39%)和四项(15%)研究检查了神经发育,特应性和生殖结果。11(100%),11(100%),三项(27%)产前暴露研究报告了不良的神经发育,特应性和生殖结果。只有一项研究发现新生儿对乙酰氨基酚暴露与长期不良结局之间可能存在相关性。
    现有证据,虽然有限,提示产前扑热息痛暴露与神经发育风险增加之间可能存在关联,特应性和生殖不良结局。迫切需要有关产前和新生儿时期对乙酰氨基酚暴露的长期安全性的可靠数据。
    Paracetamol is the most commonly used antipyretic and analgesic in pregnancy. It is also increasingly used off-label in the neonatal intensive care unit. Despite the frequent use of paracetamol, concerns have been raised regarding the high variability in neonatal dosing regimens and the long-term safety of early life exposure.
    To investigate the available evidence on the long-term safety of prenatal and neonatal paracetamol exposure.
    We conducted a systematic search of the electronic databases Ovid Medline, Ovid Embase and Web of Science from inception to August 2021 for original research studies of any design that described the use of paracetamol in the prenatal or neonatal (within the first four weeks of life) periods and examined the occurrence of neurodevelopmental, atopic or reproductive adverse outcomes at or beyond birth.
    We identified 1313 unique articles and included 30 studies in the final review. Of all studies, 27 (90%), two (7%) and one (3%) were on the long-term safety of prenatal, neonatal and both prenatal and neonatal exposure, respectively. Thirteen (46%), 11 (39%) and four (15%) studies examined neurodevelopmental, atopic and reproductive outcomes. Eleven (100%), 11 (100%), and three (27%) studies on prenatal exposure reported adverse neurodevelopmental, atopic and reproductive outcomes. Only one study found a possible correlation between neonatal paracetamol exposure and long-term adverse outcomes.
    The available evidence, although limited, suggests a possible association between prenatal paracetamol exposure and an increased risk of neurodevelopmental, atopic and reproductive adverse outcomes. There is an immediate need for robust data on the long-term safety of paracetamol exposure in the prenatal and neonatal periods.
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  • 文章类型: Journal Article
    BACKGROUND: Currently, 1 in 25 children born in Australia are conceived through ARTs such as IVF and ICSI. Worldwide over 8 million children have been born after ART. There is evidence that these children are at an increased risk of congenital malformations, preterm birth, low birth weight and neonatal morbidity. However, studies on long-term health outcomes of offspring conceived after ART are lacking. Atopic disorders, such as asthma, atopic dermatitis and various allergies are increasingly common within society, and concerns have been raised that ART increases the risk of atopy amongst offspring.
    UNASSIGNED: The aim of this study was to systematically summarise and quantify the risk of atopic disorders in offspring conceived with ART compared to those conceived without ART.
    METHODS: A systematic review was conducted according to the PRISMA guidelines. Several systematic searches were performed in the following international databases: Medline, Embase, Cinahl, PsychINFO, AMED, Global Health and ISI Web of Science. Search terms utilised were all terms pertaining to ART, IVF, ICSI, asthma, atopic dermatitis and allergies. The search period was 1978-2021. Included observational studies stated a primary outcome of asthma or allergies in offspring conceived after ART, with a comparison group conceived without ART. Individual studies were scored on quality and risk of bias, using the Newcastle-Ottawa scale (NOS).
    RESULTS: There were 26 studies which met the inclusion criteria; of these, 24 studies investigated asthma in offspring conceived after ART. While 10 studies, including the two largest population-based studies, reported a significantly increased risk of asthma in offspring conceived after ART (adjusted odds ratio (aOR) range: 1.20-2.38), 14 smaller cohort studies found no difference (aOR range 0.70-1.27). In the meta-analysis of the 14 highest-quality studies (NOS ≥ 7), a modest yet significantly increased risk of asthma was demonstrated in offspring conceived after ART [risk ratio (RR) 1.28 (1.08-1.51)]. Although heterogeneity in these 14 studies was high (I2 = 85%), the removal of outliers and high weight studies significantly reduced heterogeneity (I2 = 0% and I2 = 34% respectively) while still demonstrating a significantly increased risk [RR 1.19 (1.10-1.28) and RR 1.31 (1.03-1.65), respectively]. The increased asthma risk was also observed in most subgroup and sensitivity analyses. The allergy rates were not increased in offspring conceived after ART in 9 of 12 studies (aOR range 0.60-1.30). In summary, the findings of this systematic review and meta-analysis suggest a trend towards a significantly increased risk of asthma, but not allergies, in offspring conceived after ART. There was no evidence of publication bias in the asthma studies and minimal evidence of publication bias in the allergy studies (both P > 0.05).
    UNASSIGNED: Asthma brings considerable burden to the quality of life of individuals and to society. Hence, it is of great importance to untangle potential causal pathways. Although ART use is common, knowledge about its long-term health effects is required to provide evidence-based advice to couples considering ART, and to be vigilant for any potential adverse health effects on offspring conceived after ART.
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  • 文章类型: Journal Article
    BACKGROUND: Atopic disorders have been reported in CHARGE syndrome, but the prevalence and underlying mechanisms are not known.
    METHODS: We performed a retrospective study of atopic disorders in 23 individuals with CHARGE syndrome, and reviewed other published reports of atopic disorders in CHARGE syndrome. We assayed for enrichment of atopic disorders in CHARGE syndrome based on gender and presence of a CHD7 pathogenic variant.
    RESULTS: In our cohort, 65% (15/23) of individuals with CHARGE syndrome were found to have a pathogenic CHD7 variant. Overall, 65% (15/23) of individuals with CHARGE had atopic disorders. Among the 23 individuals with CHARGE, 22% (5/23) had food allergy, 26% (6/23) exhibited drug allergy, 22% (5/23) had contact allergy, 9% (2/23) had allergic rhinitis, and 22% (5/23) had asthma. In our cohort, the proportion of males to females with CHARGE and atopic disorders was 11:4 (P < 0.01), and there was no significant difference between atopic disorders in individuals with CHD7 pathogenic variants and those without CHD7 pathogenic variants (P > 0.05).
    CONCLUSIONS: In our cohort of 23 individuals with CHARGE syndrome, 15 (65%) exhibited atopic disorders, with a slight male predominance.
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  • 文章类型: Journal Article
    BACKGROUND: A growing number of studies suggest that maternal stress during pregnancy promotes atopic disorders in the offspring. This is the first systematic review to address prenatal maternal stress (PNMS) and the subsequent risk of atopy-related outcomes in the child.
    METHODS: The review was performed in accordance to the PRISMA criteria. We searched and selected studies in PubMed, Scopus, Embase and PsychINFO until November 2014.
    RESULTS: Sixteen (with 25 analyses) of 426 identified articles met the review criteria. Five main PNMS exposures (negative life events, anxiety/depression, bereavement, distress and job strain) and five main atopic outcomes (asthma, wheeze, atopic dermatitis, allergic rhinitis and IgE) were assessed across the studies. Overall, 21 of the 25 analyses suggested a positive association between PNMS and atopic outcomes. Of the 11 exposure-response analyses reported, six found statistically significant trends.
    CONCLUSIONS: This systematic review suggests a relationship between maternal stress during pregnancy and atopic disorders in the child. However, the existing studies are of diverse quality. The wide definitions of often self-reported stress exposures imply a substantial risk for information bias and false-positive results. Research comparing objective and subjective measures of PNMS exposure as well as objective measures for atopic outcome is needed.
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