Asthma and Allergies in the School Environment
AbstractThe school is a complex microenvironment of indoor allergens, pollutants, and other exposures. The school represents an occupational model for children and exposures in this environment have a significant health effect. Current research establishes an association between school exposure and asthma morbidity in children. This review will focus on common school environmental exposures (cockroach, rodents, cat, dog, classroom pets, dust mite, fungus, and pollution) and their impact on children with allergies and asthma. Understanding and evaluation of school-based environments is needed to help guide school-based interventions. School-based interventions have the potential for substantial benefit to the individual, school, community, and public health. However, there is a paucity data on school-based environmental interventions and health outcomes. The studies performed to date are small and cross-sectional with no control for home exposures. Randomized controlled school-based environmental intervention trials are needed to assess health outcomes and the cost-effectiveness of these interventions. The School Inner-City Asthma Intervention Study (SICAS 2), a NIH/NIAID randomized controlled clinical trial using environmental interventions modeled from successful home-based interventions, is currently underway with health outcome results pending. If efficacious, these interventions could potentially help further guide school-based interventions potentially with policy implic...
ConclusionsThe benefits of FENO-based management are attenuated among obese mothers and those with excess GWG, indicating the importance of weight management in contributing to improved asthma management in pregnancy.
In Project Viva, a pre-birth cohort study, we identified potential protective prenatal nutrients (Vitamin D, n-3 PUFAs), as well as adverse prenatal pro-oxidant exposures that may alter risk of asthma and allergic disease into adolescence.
Febrile lower respiratory infections trigger uniquely potent/complex immunoinflammatory responses in infants, which enhance both immune maturation and asthma development. Characterization of underlying fever-associated transcriptomic profiles may unmask previously hidden clues regarding mechanisms driving asthma initiation.
This article explores the most relevant issues facing the role of e-Health and its sub-category—mobile health (mHealth)—in promoting treatment adherence in childhood asthma, focusing on current evidence gaps and limitations, and future research perspectives.
ConclusionsPrognosis in patients with CRSwNP was inferior to that in patients with CRSsNP. Asthma was the only factor that increased the chance of recurrence in patients with either CRSsNP or CRSwNP.
This study supports a positive benefit-risk profile for long-term mepolizumab treatment in these patients.
Publication date: Available online 14 August 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Maxime Cormier, Simone Chaboillez, Catherine Lemière
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Neutrophilic inflammation in asthma is associated with interleukin (IL)-17A, corticosteroid-insensitivity and bronchodilator-induced forced expiratory volume in 1 s (FEV1) reversibility. IL-17A synergises with tumour necrosis factor (TNF)-α in the production of the neutrophil chemokine CXCL-8 by primary bronchial epithelial cells (PBECs). We hypothesised that local neutrophilic inflammation in asthma correlates with IL-17A and TNF-α-induced CXCL-8 production by PBECs from asthma patients. PBECs from most asthma patients displayed an exaggerated CXCL-8 production in response to TNF-α and IL-17A, but n...