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  • 1.
    Aranda, Carolina S.
    et al.
    Univ Fed Sao Paulo, Sao Paulo, Brazil..
    Cocco, Renata R.
    Univ Fed Sao Paulo, Sao Paulo, Brazil..
    Pierotti, Felipe F.
    Univ Fed Sao Paulo, Sao Paulo, Brazil..
    Mallozi, Marcia Carvalho
    Univ Fed Sao Paulo, Sao Paulo, Brazil.;Fac Med ABC, Santo Andre, Brazil..
    Franco, Jackeline M.
    Univ Fed Sergipe, Aracaju, Brazil..
    Porto, Arnaldo
    Univ Passo Fundo, Passo Fundo, Brazil..
    Goudouris, Ekaterini
    Univ Fed Rio de Janeiro, Rio De Janeiro, Brazil..
    Moraes, Lilian
    Univ Fed Mato Grosso, Cuiaba, Brazil..
    Rosario, Nelson
    Univ Fed Parana, Curitiba, Parana, Brazil..
    Wandalsen, Neusa Falbo
    Fac Med ABC, Santo Andre, Brazil..
    Pastorino, Antonio
    Univ Sao Paulo, Sao Paulo, Brazil..
    Sarinho, Emanuel
    Univ Fed Pernambuco, Recife, PE, Brazil..
    Sano, Flavio
    Nipo Brasileiro Hosp, Sao Paulo, Brazil..
    Chavarria, Maria Leticia
    Univ Fed Goias, Goiania, Go, Brazil..
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research. Thermo Fisher Sci, Uppsala, Sweden..
    Sole, Dirceu
    Univ Fed Sao Paulo, Sao Paulo, Brazil..
    Increased sensitization to several allergens over a 12-year period in Brazilian children2018In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 29, no 3, p. 321-324Article in journal (Other academic)
  • 2.
    Bjerg, Anders
    et al.
    Univ Gothenburg, Krefting Res Ctr, Dept Internal Med & Clin Nutr, SE-40530 Gothenburg, Sweden.;Umea Univ, Dept Publ Hlth & Clin Med, OLIN Unit, Occupat & Environm,Med, Umea, Sweden..
    Winberg, Anna
    Umea Univ, Dept Clin Sci, OLIN Unit, Pediat, Umea, Sweden..
    Berthold, Malin
    ThermoFisher Sci, Uppsala, Sweden..
    Mattsson, Lars
    ThermoFisher Sci, Uppsala, Sweden..
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. ThermoFisher Sci, Uppsala, Sweden..
    Ronmark, Eva
    Univ Gothenburg, Krefting Res Ctr, Dept Internal Med & Clin Nutr, SE-40530 Gothenburg, Sweden.;Umea Univ, Dept Publ Hlth & Clin Med, OLIN Unit, Occupat & Environm,Med, Umea, Sweden..
    A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren2015In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 6, p. 557-563Article in journal (Refereed)
    Abstract [en]

    BackgroundAnimal sensitization is a major determinant of asthma in children. Component-resolved studies of unselected pediatric populations are lacking. The aim was to describe sensitization to animal components and the association with asthma and rhinitis in animal-sensitized schoolchildren. MethodsA random sample of 696 children (11-12years) from a Swedish population-based cohort was tested for sensitization to cat, dog, and horse dander using ImmunoCAP. Sera from animal-sensitized children were further analyzed by microarray including three allergen components from cat, four from dog, and two from horse. The parents completed an expanded ISAAC questionnaire. ResultsOf 259 animal-sensitized children (0.1 kU(A)/l), 51% were sensitized to all three, 23% to two, and 25% to one species. Current asthma and asthma symptoms following contact with cats were associated with co-sensitization to Fel d 1 and Fel d 4. This association was seen already at moderate-level sensitization (1-15 ISU) to Fel d 4, at which level most children were sensitized to Fel d 1, as well. In dog-sensitized children, the majority was sensitized to more than one dog component, and co-sensitization to Can f 5 and Can f 1/f 2 conferred the greatest risk for asthma. Sensitization to the highly cross-reactive serum albumins was uncommon and not associated with asthma. ConclusionsAmong schoolchildren in northern Sweden, where mite allergy is uncommon, furry animals were the primary perennial sensitizers. Asthma was associated with higher levels of component sensitization, and sensitization to more than one component from the same animal conferred the greatest risk.

  • 3.
    Brandstrom, Josef
    et al.
    Soder Sjukhuset, Sachs Children & Youth Hosp, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci & Educ, Sodersjukhuset, Stockholm, Sweden..
    Lilja, Gunnar
    Soder Sjukhuset, Sachs Children & Youth Hosp, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci & Educ, Sodersjukhuset, Stockholm, Sweden..
    Nilsson, Caroline
    Soder Sjukhuset, Sachs Children & Youth Hosp, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci & Educ, Sodersjukhuset, Stockholm, Sweden..
    Ingemarsson, Niklas
    Thermo Fisher Sci, ImmunoDiagnost, R&D, Uppsala, Sweden..
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Thermo Fisher Sci, ImmunoDiagnost, R&D, Uppsala, Sweden..
    Brostedt, Peter
    Thermo Fisher Sci, ImmunoDiagnost, R&D, Uppsala, Sweden..
    Englund, Hillevi
    Thermo Fisher Sci, ImmunoDiagnost, R&D, Uppsala, Sweden..
    IgE to novel citrus seed allergens among cashew-allergic children2016In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 27, no 5, p. 550-553Article in journal (Refereed)
  • 4.
    Cai, Gui-Hong
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Hashim, Jamal Hisham
    Hashim, Zailina
    Ali, Faridah
    Bloom, Erica
    Larsson, Lennart
    Lampa, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Fungal DNA, allergens, mycotoxins and associations with asthmatic symptoms among pupils in schools from Johor Bahru, Malaysia2011In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 22, no 3, p. 290-297Article in journal (Refereed)
    Abstract [en]

    P>While there is a large variation of prevalence of asthma symptoms worldwide, what we do know is that it is on the rise in developing countries. However, there are few studies on allergens, moulds and mycotoxin exposure in schools in tropical countries. The aims were to measure selected fungal DNA, furry pet allergens and mycotoxins in dust samples from schools in Malaysia and to study associations with pupils' respiratory health effects. Eight secondary schools and 32 classrooms in Johor Bahru, Malaysia were randomly selected. A questionnaire with standardized questions was used for health assessment in 15 randomly selected pupils from each class. The school buildings were inspected and both indoor and outdoor climate were measured. Dust samples were collected by cotton swabs and Petri dishes for fungal DNA, mycotoxins and allergens analysis. The participation rate was 96% (462/480 invited pupils), with a mean age of 14 yr (range 14-16). The pupils mostly reported daytime breathlessness (41%), parental asthma or allergy (22%), pollen or pet allergy (21%) and doctor-diagnosed asthma (13%) but rarely reported night-time breathlessness (7%), asthma in the last 12 months (3%), medication for asthma (4%) or smoking (5%). The inspection showed that no school had any mechanical ventilation system, but all classrooms had openable windows that were kept open during lectures. The mean building age was 16 yr (range 3-40) and the mean indoor and outdoor CO2 levels were 492 ppm and 408 ppm, respectively. The mean values of indoor and outdoor temperature and relative humidity were the same, 29 degrees C and 70% respectively. In cotton swab dust samples, the Geometric Mean (GM) value for total fungal DNA and Aspergillus/Penicillium (Asp/Pen) DNA in swab samples (Cell Equivalents (CE)/m2) was 5.7*108 and 0.5*108, respectively. The arithmetic mean (CE/m2) for Aspergillus versicolor DNA was 8780, Stachybotrys chartarum DNA was 26 and Streptomyces DNA was 893. The arithmetic means (pg/m2) for the mycotoxins sterigmatocystin and verrucarol were 2547 and 17, respectively. In Petri dish dust samples, the GM value for total fungal DNA and Asp/Pen DNA (CE/m2 per day) was 9.2*106 and 1.6*106, respectively. The arithmetic mean (CE/m2 per day) for A. versicolor DNA was 1478, S. chartarum DNA was 105 and Streptomyces DNA was 1271, respectively. The GM value for cat (Fel d1) allergen was 5.9 ng/m2 per day. There were positive associations between A. versicolor DNA, wheeze and daytime breathlessness and between Streptomyces DNA and doctor-diagnosed asthma. However, the associations were inverse between S. chartarum DNA and daytime breathlessness and between verrucarol and daytime breathlessness. In conclusion, fungal DNA and cat allergen contamination were common in schools from Malaysia and there was a high prevalence of respiratory symptoms among pupils. Moreover, there were associations between levels of some fungal DNA and reported respiratory health in the pupils.

  • 5.
    Dreborg, Sten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    When should adrenaline be given and by whom?2013In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 24, no 1, p. 97-98Article in journal (Refereed)
  • 6.
    Dreborg, Sten
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Roberts, G.
    Lau, S.
    Santos, A. F.
    Halken, S.
    Høst, A.
    The history of pediatric allergy in Europe: From a working group to ESPACI and SP-EAACI2013In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 24, no 1, p. 88-96Article, review/survey (Refereed)
    Abstract [en]

    A Working Group on Pediatric Allergology was formed in 1984, which rapidly developed to become the European Society on Pediatric Allergology and Clinical Immunology (ESPACI) in 1988 with its own journal, Pediatric Allergology and Immunology. ESPACI worked together with the European Academy of Allergology and Clinical Immunology (EAACI) to form a Section of Pediatrics within EAACI (SP-EAACI) in 1996. The ESPACI and the SP-EAACI formally merged in 2001. Within the EAACI organization, the Pediatric Section has continued to grow. The Pediatric Section is working to develop pediatric allergology across Europe, focusing on postgraduate education, facilitating the research agenda and advocating for children and adolescents with allergies.

  • 7. Ebisawa, Motohiro
    et al.
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Sato, Sakura
    Maruyama, Nobuyuki
    Borres, Magnus P.
    Komata, Takatsugu
    Measurement of Ara h 1-, 2-, and 3-specific IgE antibodies is useful in diagnosis of peanut allergy in Japanese children2012In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 23, no 6, p. 573-581Article in journal (Refereed)
    Abstract [en]

    Background: Food challenges are time-consuming, expensive, and not always possible to perform. Therefore, new tools to diagnose food allergy are desired. The aim was to evaluate IgE antibodies to peanut allergens in the diagnosis of peanut allergy in Japanese children using ImmunoCAP (R) and IgE immunoblotting.

    Methods: The study included 213-yr-old consecutive patients (n = 57) referred to our specialist clinic for investigation of current peanut allergy using food challenge. All children had a previous doctors diagnosis of peanut allergy and were on elimination diet. Serum samples were analyzed for IgE reactivity to peanut, recombinant (r) Ara h 1, 2, 3, 5, 8, and 9. IgE immunoblotting (n = 23) was performed using extracts from raw and roasted peanut.

    Results: Twenty-six of the children failed (allergic group), and 31 passed the peanut challenge (tolerant group). The rAra h 2 ImmunoCAP test was superior in its ability to differentiate between children in the allergic and tolerant groups with a sensitivity and specificity of 88% and 84%, respectively (cutoff, 0.35 kUA/l). The combination of rAra h 1, 2, and 3 resulted in a higher specificity (94%) when IgE to all of them was the criteria for positivity. ImmunoCAP generally showed a good agreement with immunoblotting using both raw and roasted peanut for IgE reactivity to Ara h 1, 2, and 3.

    Conclusions: Measurement of IgE antibodies to rAra h 1, 2, and 3 is useful in the diagnosis of peanut allergy and in the investigation of reactions to raw and roasted peanut.

  • 8. Glaumann, S.
    et al.
    Nilsson, C.
    Asarnoj, A.
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Johansson, S. G. O.
    Borres, M. P.
    Lilja, G.
    Nopp, A.
    IgG(4) antibodies and peanut challenge outcome in children IgE-sensitized to peanut2015In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 4, p. 386-389Article in journal (Refereed)
  • 9. Hederos, Carl-Axel
    et al.
    Hasselgren, Mikael
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Hedin, Gunilla
    Bornehag, Carl-Gustaf
    Comparison of clinically diagnosed asthma with parental assessment of children's asthma in a questionnaire2007In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 18, no 2, p. 135-141Article in journal (Refereed)
    Abstract [en]

    Epidemiological evaluations of the prevalence of asthma are usually based on written questionnaires (WQs) in combination with validation by clinical investigation. In the present investigation, we compared parental assessment of asthma among their preschool children in response to a WQ with the corresponding medical records in the same region. An International Study of Asthma and Allergies in Childhood (ISAAC)-based WQ was answered by 75% of the parents of 6295 children aged 1–6 yr. Clinically diagnosed asthma, recorded in connection with admissions to the hospital or a visit to any of the outpatient clinics in the same region, were analysed in parallel. Finally, a complementary WQ was sent to the parents of children identified as asthmatic by either or both of this approaches. In response to the WQ 5.9% were claimed to suffer from asthma diagnosed by a doctor. According to the medical records, the prevalence of clinically diagnosed asthma was 4.9%. The estimated prevalence among children requiring treatment for their asthma was 4.4%. The sensitivity of the WQ was 77%, the specificity 97.5%. In the 1–2 yr age group the sensitivity was only 22%. This WQ was able to identify 54% of the children with a medical record of asthma. Forty percent of the children claimed by their parents to be asthmatic had no medical record of asthma. An ISAAC-based parentally completed WQ provided an acceptable estimation of the prevalence of asthma in children 2–6 yr of age, although only half of the individual patients identified in this manner are the same as those identified clinically.

  • 10.
    Heijkenskjöld-Rentzhog, Charlotte
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Kalm-Stephens, Pia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Nordvall, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Alving, Kjell
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    New method for single-breath fraction of exhaled nitric oxide measurement with improved feasibility in preschool children with asthma2015In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 7, p. 662-667Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Respiratory societies recommend use of standardized methodologies for fraction of exhaled nitric oxide (FeNO) measurements in adults and children, but in preschoolers, feasibility remains a problem. The exhalation time needed to obtain steady-state FeNO is unclear. Our primary aim was to study the feasibility of an adapted single-breath FeNO method with age-adjusted exhalation times. We also studied the association between time to steady-state NO level and height, as well as FeNO in relation to asthma and current treatment with inhaled corticosteroids (ICS).

    METHODS: Sixty-three children aged 3-10 years performed FeNO measurements with a hand-held electrochemical device with a newly developed flow-control unit. Exhalation times were pre-adapted to age. Exhaled air was simultaneously sampled to a chemiluminescence analyzer to measure time to steady-state NO level.

    RESULTS: Eighty-one percent of the children achieved at least one approved measurement. From 4 years upwards, success rate was high (96%). Time to steady-state [NO] (median and interquartile range) was 2.5 s (2.4-3.5) at the age of 3-4 years and 3.5 s (2.7-3.8) at the age of 5-6 years. Height was associated with time to steady state (r(2)  = 0.13, p = 0.02). FeNO (geometric mean [95% CI]) was higher in ICS-naïve asthmatic children (n = 19): 15.9 p.p.b. (12.2-20.9), than in both healthy controls (n = 8) 9.1 p.p.b. (6.6-12.4) and asthmatic subjects on treatment (n = 24) 11.5 p.p.b. (9.7-13.6).

    CONCLUSION: We found this adapted single-breath method with age-adjusted exhalation times highly feasible for children aged 4-10 years. ICS-naïve asthmatic children had FeNO levels under the current guideline cutoff level (20 p.p.b.), highlighting the importance of taking age into account when setting reference values.

  • 11. Konradsen, Jon R.
    et al.
    Nordlund, Bjoern
    Onell, Annica
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Gronlund, Hans
    Hedlin, Gunilla
    Severe childhood asthma and allergy to furry animals: Refined assessment using molecular-based allergy diagnostics2014In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 25, no 2, p. 187-192Article in journal (Refereed)
    Abstract [en]

    Background Infants born prematurely are often treated with supplemental oxygen, which can increase their risk for airway hyper-responsiveness (AHR), asthma, reduced lung function, and altered responses to respiratory viral infections later in childhood. Likewise, exposure of newborn mice to hyperoxia alters baseline pulmonary mechanics and the host response to influenza A virus infection in adult mice. Here, we use this mouse model to test the hypothesis that neonatal hyperoxia also promotes AHR and exacerbated allergen-induced symptoms in adult mice. Methods Baseline lung mechanics and AHR measured by methacholine provocation were assessed in adult male and female mice exposed to room air or 100% oxygen (hyperoxia) between post-natal days 0-4. AHR and lung inflammation were evaluated after adult female mice were sensitized with ovalbumin (OVA) plus alum and challenged with aerosolized OVA. Results Baseline lung compliance increased and resistance decreased in adult female, but not male, mice exposed to neonatal hyperoxia compared with siblings exposed to room air. Neonatal hyperoxia significantly enhanced methacholine-induced AHR in female mice, but did not affect allergen-induced AHR to methacholine or lung inflammation. Conclusion Increased incidence of AHR and asthma is reported in children born prematurely and exposed to supplemental oxygen. Our findings in adult female mice exposed to hyperoxia as neonates suggest that this AHR reported in children born prematurely may reflect non-atopic wheezing due to intrinsic structural changes in airway development.

  • 12.
    Konradsen, Jon R
    et al.
    Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Skantz, Elizabeth
    Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Nordlund, Björn
    Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Lidegran, Marika
    Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
    James, Anna
    Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.
    Ono, Junya
    Shino-Test Co, Ltd., Sagamihara, Japan.
    Ohta, Shoichiro
    Department of Laboratory Medicine, Saga Medical School, Sagamihara, Japan.
    Izuhara, Kenji
    Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Sagamihara, Japan.
    Dahlén, Sven-Erik
    Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.
    Alving, Kjell
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Hedlin, Gunilla
    Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Predicting asthma morbidity in children using proposed markers of Th2-type inflammation.2015In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 8, p. 772-779Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Assessment of inflammation is becoming a common practice in the clinical work-up of children with persistent asthma. Biomarkers of Th2-mediated inflammation include blood eosinophils (B-Eos), exhaled nitric oxide (FeNO), total serum IgE (S-IgE), and serum periostin. The aim of this study was to investigate the associations between asthma morbidity and increased levels of these biomarkers in pediatric asthma.

    METHODS: School-age children (n = 96) with various manifestations of persistent asthma were included in this nationwide Swedish study. The protocol included the asthma control test, Juniper's quality of life questionnaire (QoL), assessment of pulmonary function, bronchial hyperresponsiveness, height-adjusted FeNO, blood sampling for S-IgE, B-Eos, and periostin, and high-resolution computed tomography (HRCT) of the lungs.

    RESULTS: Children with both high levels of height-adjusted FeNO and B-Eos were younger (p = 0.001), had more often severe asthma (p = 0.015), were more allergic (p < 0.001), had a reduced asthma control (p = 0.035), reduced QoL (p = 0.035), more exacerbations (p = 0.004), reduced FEV1/FVC (p = 0.001), and increased bronchial hyperresponsiveness (p < 0.001) as well as greater bronchial wall thickening on HRCT (p = 0.022) compared to those with low levels of both biomarkers. Grouping children according to high and low serum periostin levels did not relate to differences in clinical characteristics and biomarkers.

    CONCLUSIONS: Assessment of both local and systemic Th2-mediated inflammation by the analysis of easily attainable biomarkers such as exhaled NO and blood eosinophils has a high predictive value for the identification of children with the highest asthma morbidity. Adjusting FeNO values according to the individual child's height increases the clinical usefulness of this biomarker.

  • 13.
    Mew, Ruth
    et al.
    Ashford & St Peters Hosp NHS Fdn Trust, Surrey, England..
    Borres, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Uppsala Univ, Thermo Fisher Sci, Uppsala, Sweden..
    Sjölander, Sigrid
    Uppsala Univ, Thermo Fisher Sci, Uppsala, Sweden..
    du Toit, George
    Kings Coll London, MRC & Asthma UK Ctr Allerg Mech Asthma, Kings Hlth Partners, London, England.;Guys & St Thomas NHS Fdn Trust, Dept Paediat Allergy, London, England.;HCA Healthcare, Portland Hosp Women & Children, London, England..
    A retrospect study into the utility of allergen components in walnut allergy2016In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 27, no 7, p. 750-752Article in journal (Refereed)
  • 14. Mikkelsen, Andrea
    et al.
    Mehlig, Kirsten
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Oxelmark, Lena
    Bjorkelund, Cecilia
    Lissner, Lauren
    Monitoring the impact of cow's milk allergy on children and their families with the FLIP questionnaire - a six-month follow-up study2015In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 5, p. 409-415Article in journal (Refereed)
    Abstract [en]

    BackgroundMany children with cow's milk allergy (CMA) develop tolerance, but, challenges in daily life may remain. Using the Food hypersensitivity famiLy ImPact questionnaire (FLIP), we sought to monitor changes in the impact of CMA over time. MethodsFamilies of children with CMA, who participated in the validation of the FLIP, were re-approached 6months later for follow-up. Change in reported difficulties was assessed by paired sample t-test and mixed models, stratifying by outgrown vs. persistent CMA. ResultsImpact on families with children who had outgrown CMA (n=20) decreased in the FLIP's total score (p=0.0001) and in two subscales; Health and Emotions (p=0.0001) and Everyday Life (p=0.0001). In contrast, no significant improvements were registered in nutritional concerns. Impact on the group with persistent CMA (n=57) was unchanged at follow-up except for more impact on Everyday Life (p=0.001). In the final analysis comparing longitudinal changes in the groups, the strongest differences were observed for the subscales Health & Emotions and Everyday Life; for the Nutrition subscale, the between-group changes also differed, but to lesser extent. ConclusionsWe have documented the varying impact of CMA on parents and children over time. Families who were still affected continued to experience impact in daily life. Despite development of tolerance, families who were no longer affected revealed continuing nutritional concerns. Follow-ups should be offered even after outgrown CMA to encourage progression to unrestricted diet, to prevent eating disorders and to promote healthy growth.

  • 15.
    Neuman, Åsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Bergstrom, Anna
    Gustafsson, Per
    Thunqvist, Per
    Andersson, Niklas
    Nordvall, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Kull, Inger
    Wickman, Magnus
    Infant wheeze, comorbidities and school age asthma2014In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 25, no 4, p. 380-386Article in journal (Refereed)
    Abstract [en]

    Background: Factors associated with early onset of wheeze have been described, but there is limited knowledge on which of these infant wheezers who will have developed asthma in school age. The aim was to identify clinical risk factors for asthma in the 8-yr-old children that wheezed during infancy in a population-based setting. Methods: Three thousand two hundred and fifty-one children from a population-based birth cohort followed prospectively from infancy until age 8 yr were included in the study. Data were analyzed using multivariate logistic regression analysis. Results: Parents reported any wheeze episode before age 2 yr in 823 subjects (25%). Infant wheezers had an almost fourfold risk of asthma at age 8 [adjusted odds ratio (aOR) 3.68, 95% CI 2.74-4.96], equivalent to an asthma prevalence of 14% compared with 4% among non-wheezers (p < 0.001). After adjustments for sex, exposure to tobacco smoke and indoor dampness/mould, allergic heredity (aOR 1.53, 95% CI 1.02-2.30), increased frequency of wheeze (aOR 3.41, 95% CI 2.09-5.56 for children with >= 3 episodes compared with <= 2 episodes during the first 2 yr of life), infant eczema (aOR 2.31, 95% CI 1.52-3.49), and recurrent abdominal pain (aOR 2.33, 95% CI 1.30-4.16) remained risk factors for school age asthma in the infant wheezing group. Conclusions: Among infant wheezers, allergic heredity, increased severity of wheeze, infant eczema, and recurrent abdominal pain were independent risk factors for asthma at age 8 yr. Among children with three or four of these risk factors, 38% had asthma at school age.

  • 16.
    Nilsson, Caroline
    et al.
    Sachs Childrens Hosp, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci & Educ, Stockholm, Sweden..
    Brostedt, Peter
    Thermo Fisher Sci, R&D ImmunoDiagnost, Uppsala, Sweden..
    Hidman, Johanna
    Thermo Fisher Sci, R&D ImmunoDiagnost, Uppsala, Sweden..
    van Odijk, Jenny
    Univ Gothenburg, Sahlgrenska Acad, Resp Med & Allergol, Gothenburg, Sweden..
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Thermo Fisher Sci, R&D ImmunoDiagnost, Uppsala, Sweden..
    Sjolander, Sigrid
    Thermo Fisher Sci, R&D ImmunoDiagnost, Uppsala, Sweden..
    Englund, Hillevi
    Thermo Fisher Sci, R&D ImmunoDiagnost, Uppsala, Sweden..
    Recognition pattern of kiwi seed storage proteins in kiwifruit-allergic children2015In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 8, p. 817-820Article in journal (Refereed)
  • 17. Nilsson, Nora
    et al.
    Sjolander, Sigrid
    Baar, Alexandra
    Berthold, Malin
    Pahr, Sandra
    Vrtala, Susanne
    Valenta, Rudolf
    Morita, Eishin
    Hedlin, Gunilla
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Nilsson, Caroline
    Wheat allergy in children evaluated with challenge and IgE antibodies to wheat components2015In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 2, p. 119-125Article in journal (Refereed)
    Abstract [en]

    IntroductionWheat sensitization is common but IgE antibodies (IgE-abs) to wheat are not predictive of clinical symptoms in children with suspected wheat allergy. Wheat allergen components other than -5gliadin have not been well studied. Our aim was to characterize the clinical profile and investigate the value of adding measurements of IgE-abs to wheat components in a group of children with a doctor's diagnosed wheat allergy. MethodSixty-three children with a doctor's diagnosis of wheat allergy confirmed sensitization to wheat and, on a wheat elimination diet, went through oral wheat challenges or had a convincing recent history of wheat allergy. IgE-ab to -5 gliadin, low molecular weight glutenin (LMW-glutenin), high molecular weight glutenin (HMW-glutenin) and a native gliadin preparation containing -, -, -, and -gliadin (gliadin) were analyzed. ResultsTwenty-six children were positive in challenge, while six children were regarded as wheat allergic due to recent anaphylactic reactions. The IgE-ab levels to all four wheat components were significantly higher in the group with wheat allergy compared to the group with no wheat allergy (p<0.0001). Also, the severity of symptoms at challenge correlated with the IgE-ab levels to all four components (p<0.05). IgE-ab levels to -5 gliadin correlated best with challenge outcome, and by additional analysis of gliadin, HMW- and LMW-glutenin IgE-abs all challenge positive children could be identified. ConclusionMany children diagnosed as wheat allergic have outgrown their allergy and are unnecessarily on a wheat-free diet. The levels of IgE-ab to wheat gluten-derived components correlated well with wheat challenge outcome and severity.

  • 18. Nozawa, Asako
    et al.
    Okamoto, Yoshihisa
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Kurihara, Kazuyunki
    Monitoring Ara h 1, 2 and 3-sIgE and sIgG4 antibodies in peanut allergic children receiving oral rush immunotherapy2014In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 25, no 4, p. 323-328Article in journal (Refereed)
    Abstract [en]

    Background: The aim was to study the clinical efficacy and safety of rush oral immunotherapy (OIT) for severe peanut-allergic children and to measure the antibody responses. Methods: Eighteen Japanese children were enrolled after a positive double-blind, placebo-controlled food challenge (DBPCFC). The patients ingested peanuts up to 3-5 times a day every 30 min, increasing the dose by 20% every time. The goal dose was 3.5-7 g. IgE, IgG, and IgG4 antibody levels to peanut, and peanut allergen components were measured during up to 3 yr of maintenance treatment. Results: Two children dropped out due to side effects. Sixteen patients (14 boys and two girls, median: 9 yr range: 5-14 yr) achieved the goal dose after a median of 11 days (range: 4-19 days). Their median threshold dose at DBPCFC was 0.20 g (range: 0.015-1.0 g). All were sensitized to Ara h 2. Fourteen of them had a history of previous anaphylaxis. In total, 173 adverse events were observed during the treatment (27% of the total ingestions) of which 74 needed medications. The median IgE, IgG, and IgG4 antibody levels to peanut increased during rush OIT. The IgG4 levels were high during the whole maintenance phase. IgE and IgG4 antibodies to Ara h 2 dominated the serological response during the treatment. Conclusions: The present rush OIT protocol for children with severe peanut allergy was effective and relatively safe. A sustained Ara h 2-specific IgG4 antibody response characterized the treatment.

  • 19.
    Savolainen, Johannes
    et al.
    Univ Turku, Dept Pulm Dis & Clin Allergol, Turku, Finland;Turku Univ Hosp, Turku, Finland.
    Mascialino, Barbara
    Thermo Fisher Sci, Uppsala, Sweden.
    Pensamo, Elina
    Univ Turku, Dept Pulm Dis & Clin Allergol, Turku, Finland;Turku Univ Hosp, Turku, Finland.
    Aberg, K. Magnus
    Thermo Fisher Sci, Uppsala, Sweden;Stockholm Univ, Dept Environm Sci & Analyt Chem, Stockholm, Sweden.
    Silvan, Maija
    Harkatie Primary Care Ctr, Lieto, Finland.
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research. Thermo Fisher Sci, Uppsala, Sweden.
    Korhonen, Krista
    Harkatie Primary Care Ctr, Lieto, Finland.
    Structured intervention plan including component-resolved diagnostics helps reducing the burden of food allergy among school-aged children2019In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 30, no 1, p. 99-106Article in journal (Refereed)
    Abstract [en]

    Background Food allergies can substantially burden patients and families by negatively affecting finances, social relationships, and personal perceptions of health. This study was performed under the Finnish Allergy Programme aimed at reducing avoidance diets to foods in schoolchildren by 50%. The main goal of this study was to investigate how many children could be freed from diet restrictions in a Finnish school district through a diagnostic algorithm including component-resolved diagnostics and food challenge. The secondary aim was to provide a crude estimate of the burden of the elimination food diets in the region, and the savings associated with the proposed intervention. Methods A total of 205 children on a food avoidance diet according to the school register because of food allergy were invited into the study. One hundred and fifty-seven children were interviewed, tested for IgE to extracts and allergen components and food challenged in respective order. Results After two years, 12 children still had an avoidance diet and three of them were treated successfully with sOTI; the rest suspended their avoidance diet (n = 134) or dropped out of the study (n = 11). The cost of the elimination diets was estimated in 172 700euro per year at start and 13 200euro per year at the end of the study; total savings were 128 400euro yearly. Conclusions The results demonstrate a 65% reduction of avoidance diets to foods in school-aged children, exceeding the 50% aim of the Finnish Allergy Programme. Therefore, it is possible to actively reduce the number of food allergy diagnoses that remain unmonitored in the society through a tailored diagnostic work-up.

  • 20. Senouf, Avigael H. Benhamou
    et al.
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Eigenmann, Philippe A.
    Native and denatured egg white protein IgE tests discriminate hen's egg allergic from egg-tolerant children2015In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 1, p. 12-17Article in journal (Refereed)
    Abstract [en]

    BackgroundAccurate diagnosis of egg allergy by IgE testing is challenged by a large number of atopic subjects sensitized, but clinically tolerant to eggs. In addition, discrimination between allergy to raw only, or raw and cooked egg allergy is important. In this study, we investigate the diagnostic performance of IgE tests to native and denatured egg proteins. MethodsAccording to food challenges and clinical tolerance, study subjects were randomized to the following groups: (Group A) sensitized but clinically tolerant to egg, (Group B) allergic to raw egg only, or (Group C) allergic to raw and cooked egg. Serum-specific IgE to native or reduced and oxidized egg white, ovomucoid, and ovalbumin were measured. ResultsIncreasing titers of specific IgE to the various proteins were found according to the degree of the egg allergy. Cut-off values for IgE testing to native egg could be determined to distinguish between raw egg allergic and egg-tolerant subjects (1.6kU/l), as well as raw and cooked egg allergic and egg-tolerant subjects (4.1kU/l). ROC curves analysis showed that native ovalbumin was the best test for the diagnosis of allergy to raw and cooked egg, and native ovomucoid was best to distinguish between allergy to raw only, and allergy to raw and cooked egg. Sequential testing improved the diagnosis, when in addition to IgE to native egg white, IgE to native ovalbumin was tested for the diagnosis of raw and cooked egg allergy, and IgE to native ovomucoid for the discrimination between allergy to raw only, or to raw and cooked eggs. ConclusionThe diagnosis of egg allergy can be significantly improved using a panel of IgE tests to egg proteins in the native or denatured form. The accuracy can be improved using combined IgE testing.

  • 21. Simoni, Marzia
    et al.
    Cai, Gui-Hong
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Annesi-Maesano, Isabella
    Lavaud, François
    Sigsgaard, Torben
    Wieslander, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Nystad, Wenche
    Canciani, Mario
    Viegi, Giovanni
    Sestini, Piersante
    Total viable molds and fungal DNA in classrooms and association with respiratory health and pulmonary function of European schoolchildren2011In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 22, no 8, p. 843-852Article in journal (Refereed)
    Abstract [en]

    Indoor molds are associated with adverse respiratory effects in children. Although schools are important exposure sources of molds, objective measurements were more often taken in homes. Our aim was to assess indoor molds in schools and related effects on schoolchildren health. The Health Effects of the School Environment study (HESE) included 21 schools (46 classrooms) in Italy, Denmark, Sweden, Norway, and France and 654 schoolchildren (mean age 10 yr). Information on schoolchildren was collected by standardized questionnaires. Measurements of total viable molds (VM, colony-forming units, cfu/m(3) ) and total/specific fungal DNA (cell equivalents, CE/g dust) were taken inside all classrooms in the cold season during normal activities, using the same standardized methodology. Pulmonary function tests were performed on 244 pupils. VM (mean, 320 cfu/m(3) ) and total fungal DNA (geometric mean, 2.2 × 10(5)  ± 2.1 CE/g dust) were detectable in all classrooms. The levels were significantly higher in buildings with mold/dampness problems. VM, but not fungal DNA, were inversely related to ventilation rate. VM exceeded the maximum standard of 300 cfu/m(3) in 33% of the classrooms. In the past 12 months, dry cough at night (34%) and rhinitis (32%) were the mostly reported. Children exposed to VM levels ≥300 cfu/m(3) , compared with those exposed to lower levels, showed higher risk for past year dry cough at night (odds ratio, OR: 3.10, 95% confidence interval, CI: 1.61-5.98) and rhinitis (OR: 2.86, 95% CI: 1.65-4.95), as well as for persistent cough (OR: 3.79, 95% CI: 2.40-5.60). Aspergillus/Penicillium DNA was significantly positively associated with wheeze, and Aspergillus versicolor DNA with wheeze, rhinitis, and cough. There were significant inverse associations of Aspergillus versicolor DNA with forced vitality capacity (FVC) and Streptomyces DNA with both FEV(1) and FVC. In conclusion, indoor VM and fungal DNA were commonly found in monitored European schools and adversely related to respiratory health. Schools should be routinely tested through both culturable and non-culturable methods for global indoor molds' evaluation.

  • 22.
    Swartz, Jackie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Lindblad, Frank
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Arinell, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Theorell, Töres
    Alm, Johan
    Anthroposophic lifestyle and salivary cortisol are associated with a lower risk of sensitization during childhood2015In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 2, p. 153-160Article in journal (Refereed)
    Abstract [en]

    Background

    Infants from anthroposophic families have low cortisol levels and low risk of IgE-sensitization during first 2 years of life. Our aim is to study the impact of an anthroposophic lifestyle and cortisol levels at 6 months on allergy sensitization up to age 5 years.

    Methods

    507 families participated from maternal health care centers. Parental lifestyle was categorized as Anthroposophic, Partly anthroposophic or Non-anthroposophic. Blood samples for analyzes of sensitization were obtained from parents at inclusion and from children at 6, 12, 24 and 60 months. Salivary samples were collected at home at 6 months.

    Results

    Sensitization increased from 2.9 to 26.0% in the anthroposophic group, from 8.4 to 26.8% in the partly anthroposophic group and from 19.1 to 44.1% in the non-anthroposophic group. Children from anthroposophic families had lower cortisol levels in the morning, afternoon and evening. The odds ratio (OR) for anthroposophic lifestyle was always <1 and lowest at 12 months (OR, 0.10; 95% CI, 0.03-0.36). Adjusting for cortisol levels at 6 months increased these ORs at 12 and 24 months. At the same ages ORs for sensitization were elevated also for cortisol levels at 6 months. Analyzes in children not sensitized at 6 months confirmed the cortisol-related risk of sensitization.

    Conclusions

    Children from families with an anthroposophic lifestyle have lower risk than comparisons of developing sensitization up to 5 years. This risk is partially explained by low cortisol levels during infancy. High cortisol levels at 6 months predict sensitization up to 24 months.

  • 23.
    Yanagida, Noriyuki
    et al.
    Sagamihara Natl Hosp, Dept Pediat, Sagamihara, Kanagawa, Japan..
    Sato, Sakura
    Sagamihara Natl Hosp, Dept Allergy, Clin Res Ctr Allergy & Rheumatol, Sagamihara, Kanagawa, Japan..
    Asaumi, Tomoyuki
    Sagamihara Natl Hosp, Dept Pediat, Sagamihara, Kanagawa, Japan..
    Ogura, Kiyotake
    Sagamihara Natl Hosp, Dept Pediat, Sagamihara, Kanagawa, Japan..
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Thermo Fisher Sci, Uppsala, Sweden.
    Ebisawa, Motohiro
    Sagamihara Natl Hosp, Dept Allergy, Clin Res Ctr Allergy & Rheumatol, Sagamihara, Kanagawa, Japan..
    Safety and feasibility of heated egg yolk challenge for children with egg allergies2017In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 28, no 4, p. 348-354Article in journal (Refereed)
    Abstract [en]

    Background: Hen's egg allergy is a frequent cause of childhood food allergy. Egg yolk is used in various commonly consumed foods; if children with allergy to hen's egg could eat heated egg yolk, their quality of life (QOL) would improve. No reports exist regarding oral food challenges (OFCs) for heated egg yolk. We aimed to clarify whether pediatric patients allergic to hen's egg could consume heated egg yolk.

    Methods: Data from pediatric patients who had undergone OFCs for heated egg yolk were evaluated retrospectively.

    Results: Among 919 patients, positive OFC results were obtained in 17.0% of patients; seven presented with severe symptoms. Older age, high specific IgEvalue for ovomucoid, low total IgE levels, and history of anaphylaxis related to food other than hen's egg were risk factors for positive OFC results. Specific IgE values for eggwhite, ovomucoid, and egg yolk, indicative of a negative predictive value > 95%, were 0.71, 0.41, and 0.17 kU(A)/l, respectively. Aspecific IgE to ovomucoidlevels of 100 kU(A)/l predictedheated egg yolk-positive OFCs for 38.3% of patients. Among 763 patients with a negative OFC, seven (0.9%) reacted to heated egg yolk at home, and 756 (99.1%) consumed hen's egg yolk safely.

    Conclusions: Most pediatric patients allergic to heated hen's egg safely consumed heated egg yolk. Heated egg yolk OFCs rarely provoked severe symptoms and may be recommended for improving the QOL of children with allergy to hen's egg.

  • 24. Yektaei-Karin, Elham
    et al.
    Moshfegh, Ali
    Lundahl, Joachim
    Berggren, Veronica
    Hansson, Lars-Olof
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Marchini, Giovanna
    The stress of birth enhances in vitro spontaneous and IL-8-induced neutrophil chemotaxis in the human newborn2007In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 18, no 8, p. 643-651Article in journal (Refereed)
    Abstract [en]

    The birth process induces fetal stress. Stress has profound effects on the immune system, also by acting on the trafficking of leukocytes, a process in which adhesion and chemotaxis are primordial and critical events for the development of effective antimicrobial defenses. The newborn is rapidly challenged by a microflora at the epithelia linings and therefore depending on early, innate immunity onset. The objective of the study was to investigate the immune response in cord blood from newborns in relation to different degrees of fetal stress, with focus on neutrophil chemotaxis. We analyzed in vitro transmigration ability of neutrophils and their CD11b expression, measured total white blood count (WBC) and the major leukocyte populations, interleukin (IL)-8, interferon (IFN)-gamma, and soluble E-Selectin, as well as relevant immuno-modulating hormones in infants born at term after Cesarean section prior to the start of labor (n = 55), normal vaginal delivery (n = 87), and assisted delivery (n = 26). Arterial pH and lactate were used as stress markers. We found that spontaneous and IL-8-induced transmigration ability of neutrophils from newborns after normal delivery was significantly higher compared with that of neutrophils from Cesarean section or from adults. With a progressive increase in fetal stress, there were significant elevations in total WBC, in particular neutrophils and monocytes, as well as an enhanced IL-8 and soluble E-Selectin level. Assisted delivery, associated with the highest degree of fetal stress in addition had an enhanced lymphocyte and monocytes count as well as an increased IFN-gamma level. There were significant direct correlations between neutrophils and monocytes, respectively, with cortisol, beta-endorphin, and prolactin. Interferon-gamma was directly related to dopamine, as well as to the lymphocyte and monocyte count. The setting of the HPA-axis at birth is a promoter of an alarm response and a surge of neuroendocrine immuno-modulating factors that enhances antimicrobial defenses of the newborn. We speculate that IL-8 induced by normal labor may be a priming factor for an increased neutrophil chemotaxis through the pre-activated endothelium of the fetus. Assisted delivery may trigger excessive recruitment of additional inflammatory cells and IFN-gamma release.

  • 25.
    Zhao, Zhuohui
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Sebastian, Aleksandra
    Larsson, Lennart
    Wang, Zhuanhua
    Zhang, Zheng
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Asthmatic symptoms among pupils in relation to microbial dust exposure in schools in Taiyuan, China2008In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 19, no 5, p. 455-465Article in journal (Refereed)
    Abstract [en]

    Microbial exposure has been indicated as significant in the development of asthma and allergy among children. The aim of the study was to test whether microbial exposure and allergens in the school environment are associated with asthmatic symptoms in pupils. Data on asthmatic symptoms and respiratory infections were collected through a questionnaire survey among 1993 pupils aged 11-15 yr in 10 randomly selected schools in Taiyuan, China. Settled dust in classrooms was analysed using tandem gas chromatography-mass spectrometry for 3-hydroxy fatty acids, marker of lipopolysaccharide (LPS) from endotoxin, muramic acid (MuA), marker of bacteria and ergosterol (Erg) for fungi, quantifying both culturable and non-culturable microbes. A total of 29.8% reported daytime attacks of breathlessness, 8.4% wheeze and 1.2% had doctor's diagnosed asthma. Generally, MuA was negatively associated with wheeze and daytime attacks of breathlessness, the latter of which was negatively associated with Erg to a weaker extent. Total concentration of LPS was positively associated with daytime attacks of breathlessness, but shorter lengths of LPS, C10, C12 and C14 LPS were negatively associated with either wheezing or daytime attacks of breathlessness. For MuA and C10 and C12 of LPS, the associations were independent of airborne allergens and classroom crowdedness, and even independent of the other two microbial markers for MuA. Microbial exposure indicated by certain chemical markers (e.g. MuA) could be protective for asthmatic symptoms, but for LPS (endotoxin), the picture is more complex, varying by different lengths of fatty acids of LPS.

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