The Medline search engine was used to find articles in the PubMed database, with the search terms “childhood asthma”, “allergic sensitisation”, “longitudinal cohort studies”, and “asthma risk factors”. In addition to this search, we looked for articles relevant to the Review. We did not use any selection or rejection criteria.
ReviewEarly identification of atopy in the prediction of persistent asthma in children
Section snippets
Asthma-related phenotypes in childhood
International research over the past 20 years has established gene–environment interactions as the basis of the most common form of asthma, atopic asthma.1 Current treatment strategies do not alter the long-term prospects for children with asthma, despite controlling symptoms and improving quality of life,2 therefore implying that a different approach is necessary.
Several epidemiologically distinct wheezing phenotypes have been identified in childhood,3 the most common being: transient
The role of the environment: a differential response to allergen and bacterial products
A recent prospective cohort study30 assessed postnatal development of lung function in children at high risk of persistent asthma raised in conventional household environments in the UK (control) versus those raised under strict environmental control to reduce exposure to indoor allergens and airborne irritants. Although controlled environments did not improve sensitisation rates, children living in these environments had better lung function at 3 years of age than children in the control
Respiratory viral infections: direct and atopy-dependent roles in asthma development
Most wheezing episodes in the first few years of life are due to viral infection. Acute lower respiratory infections, including bronchiolitis, resulting from rhinoviruses and respiratory syncytial virus, account for most admissions to hospital of children younger than 3 years.20, 38 The mechanisms underlying wheeze-promoting effects of these infections are only partly understood, but are associated with the spread of infections to the lower airways and subsequent intensification, possibly
Early identification of children at risk of persistent asthma: new clinical indicators
Several attempts have been made to produce models or clinical indicators of risk of persistent asthma at young age.32, 72, 73 These models have used asthma risk factors identified in epidemiological studies including: parental history of asthma and atopy; history of wheeze; presence of other atopic conditions, such as eczema, rhinoconjunctivitis, or food allergy; increased serum concentrations of IgE; and in-vitro cytokine production. Although children identified with these models have a high
Potential benefits of early identification of children at high risk of persistent asthma
A substantial proportion of children who develop persistent asthma are not identified until their disease has already consolidated; thus, any potential benefits of early intervention are not achieved. But are these potential benefits real or imagined? One argument supporting the existence of real benefits is the Hawthorne effect, which is seen in the control group of intervention studies and in observational studies—notably, the improved disease outcomes (relative to the community) that are
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Markers of impaired growth of pulmonary function in children and adolescents
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Early senstization to allergens and development of respiratory symptoms
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Skin prick test can identify eczematous infants at risk of asthma and allergic rhinitis
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Long-lasting sensitization to food during the first two years precedes allergic airway disease. The MAS Study Group, Germany
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Early-onset atopy is associated with enhanced lymphocyte cytokine responses in 11-year-old children
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Changes in indoor allergen and fungal levels predict changes in asthma activity among young adults
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Severity of asthma is related to endotoxin in house dust
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Sensitization to airborne environmental allergens: unresolved issues
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