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Children
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Allergic Diseases in Children: From Pathophysiological Mechanisms to Management
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Allergic Diseases in Children: From Pathophysiological Mechanisms to Management

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Allergy and Immunology".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 2444

Special Issue Editors

Dr. Giulio Dinardo

E-Mail Website
Guest Editor
Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via Luigi de Crecchio 4, Naples, Italy
Interests: pulmonology; pediatrics; allergology; food science; immunology
Special Issues, Collections and Topics in MDPI journals
Dr. Angela Klain

E-Mail Website
Guest Editor
Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via Luigi de Crecchio 4, Naples, Italy
Interests: pulmonology; pediatrics; allergology; food science; immunology
Special Issues, Collections and Topics in MDPI journals
Dr. Cristiana Indolfi

E-Mail Website
Guest Editor
Department of Woman, Child and General and Specialized Surgery, University of Campania ‘Luigi Vanvitelli’, 80138 Naples, Italy
Interests: children; asthma; respiratory allergy; food allergy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Atopic disorders, such as asthma, atopic dermatitis, and allergic rhinitis, represent the most prevalent chronic conditions in children and often coexist within the same patient, following the trajectory of the so-called “atopic march.” This Special Issue aims to explore the complex pathophysiological mechanisms, diagnostic approaches, and evolving treatment strategies for pediatric allergic diseases. We welcome original research, reviews, and clinical studies addressing immunological insights, biomarker discovery, precision medicine, and advances in pharmacological and non-pharmacological interventions. Contributions focusing on early identification, prevention strategies, and long-term outcomes are particularly encouraged.

Dr. Giulio Dinardo
Dr. Angela Klain
Dr. Cristiana Indolfi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pediatric allergy
  • asthma
  • atopic dermatitis
  • allergic rhinitis
  • atopic march
  • immunopathology
  • biomarkers
  • precision medicine
  • prevention
  • pediatric immunology

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Published Papers (4 papers)

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Research

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18 pages, 1210 KB  
Article
An Observational Study of the Role of Adiponectin and Vitamin D in Pediatric Asthma and Obesity
by Jelena Knežević, Olga Malev, Marcel Lipej, Ivana Banić and Mirjana Turkalj
Children 2026, 13(4), 514; https://doi.org/10.3390/children13040514 - 7 Apr 2026
Viewed by 305
Abstract
Background/Objectives: The co-occurrence of asthma and obesity presents a significant clinical challenge, but the underlying mechanisms remain unclear. Reduced adiponectin and vitamin D levels have been associated with both conditions, suggesting that their potential modulatory roles warrant further investigation. This study aimed to [...] Read more.
Background/Objectives: The co-occurrence of asthma and obesity presents a significant clinical challenge, but the underlying mechanisms remain unclear. Reduced adiponectin and vitamin D levels have been associated with both conditions, suggesting that their potential modulatory roles warrant further investigation. This study aimed to evaluate whether vitamin D and adiponectin levels differ among pediatric groups defined by their asthma and obesity status, to better characterize the metabolic and inflammatory profile of the obesityasthma phenotype. Methods: A total of 120 participants aged 6–18 were enrolled and categorized into four groups: Asthma (n = 30), Obesity (n = 30), Asthma + Obesity (n = 30), and Control group (n = 30). All participants underwent lung function testing, anthropometric assessment and measurement of fraction of exhaled nitric oxide (FeNO). Participants were further categorized according to BMI percentiles. Adiponectin levels were measured using ELISA, while vitamin D levels were detected using HPLC. Results: Vitamin D levels and lung function parameters did not differ across groups, although deficiency was most prevalent in the obesity group. FeNO was elevated in asthmatics relative to obese children (p = 0.038) and in obese asthmatics compared with both controls (p = 0.040) and obese children (p = 0.021). Adiponectin levels were lower in obese asthmatic children compared to the controls (p = 0.024). A similar difference was observed between the controls and obese asthmatics among children with low vitamin D levels (p = 0.014). Conclusions: The dominant mechanisms underlying the obesity–asthma phenotype remain unclear; however, our findings indicate a link between adiponectin dysregulation and heightened airway inflammation, as evidenced by increased FeNO levels, though the precise pathways involved are still not well-understood. The role of vitamin D appears less consistent. These results highlight the need for further research to clarify the interplay between metabolic and inflammatory pathways and to support more personalized management strategies in children with obesity-related asthma. Full article
(This article belongs to the Special Issue Allergic Diseases in Children: From Pathophysiological Mechanisms to Management)
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19 pages, 2167 KB  
Article
Perceiving the Invisible Threat: Are Allergic Individuals Aware of the Health Risks of Micro- and Nanoplastics?
by Ana Kujavec, Manuela Oroz, Jan Pantlik, Ivana Banić, Sandra Mijač, Ana Vukić, Petra Anić, Ana-Marija Genc, Antonija Piškor, Maja Šutić, Marcel Lipej, Željka Vlašić Lončarić, Milan Jurić, Ivana Marić, Vlatka Drinković, Tin Kušan, Rajka Lulić Jurjević and Mirjana Turkalj
Children 2026, 13(4), 470; https://doi.org/10.3390/children13040470 - 28 Mar 2026
Viewed by 473
Abstract
Background: Micro- and nanoplastics (MNPs) are widespread environmental contaminants with growing evidence linking them to adverse health effects, including progression and worsening of allergic diseases. As allergies are rapidly increasing among youth (affecting almost 30% of children), this demographic represents a vulnerable population [...] Read more.
Background: Micro- and nanoplastics (MNPs) are widespread environmental contaminants with growing evidence linking them to adverse health effects, including progression and worsening of allergic diseases. As allergies are rapidly increasing among youth (affecting almost 30% of children), this demographic represents a vulnerable population facing emerging environmental threats. Since no prior study has investigated MNP risks perceptions in an allergic population, this study aimed to assess public awareness and risk perception of MNP in Croatian youth, focusing on the influence of urbanicity, education, and allergy status. Methods: A total of 1155 participants (aged 6–18 years) were recruited from three Croatian regions as part of the EU Horizon 2020 IMPTOX and the Horizon Europe EDIAQI studies. Allergy status was determined via skin prick tests (SPT), and standardized questionnaires were used to collect data on MNP awareness and perception. Results: Awareness was significantly higher among allergic individuals (89.5% vs. non-allergic 79%, FDR p value= 0.036) and those with university-level education (88.3% vs. elementary 63.3%, FDR p value = 0.050). Allergic participants were also more concerned about food contamination by MNPs (87.7%) compared to non-allergic individuals (79.2%), FDR p value = 0.005). Media and social media were the primary sources of information regarding MNPs (FDR p value = 0.026). Conclusions: Education and allergy status are the strongest predictors of MNP awareness and related risk perceptions in the Croatian population. Targeted public health communication and educational strategies are needed to translate basic awareness into informed behavioral and policy engagement. Full article
(This article belongs to the Special Issue Allergic Diseases in Children: From Pathophysiological Mechanisms to Management)
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15 pages, 931 KB  
Article
Diagnostic Value of In Vitro Tests for Peanut Allergy in Children Without Clinical Exposure: A High-Specificity Rule-In Decision Pathway—Preliminary Findings from a Single-Center Study in Polish Children
by Julia Tworowska, Kinga Lis, Zbigniew Bartuzi and Aneta Krogulska
Children 2026, 13(1), 90; https://doi.org/10.3390/children13010090 - 7 Jan 2026
Viewed by 593
Abstract
Background: Diagnosing peanut allergy (PA) in children without known exposure remains challenging due to the need to distinguish true clinical allergy from asymptomatic sensitization. This study aimed to evaluate the diagnostic performance of individual and combined in vitro markers, particularly sIgE to Ara [...] Read more.
Background: Diagnosing peanut allergy (PA) in children without known exposure remains challenging due to the need to distinguish true clinical allergy from asymptomatic sensitization. This study aimed to evaluate the diagnostic performance of individual and combined in vitro markers, particularly sIgE to Ara h 2, and to develop a multistage decision pathway that may reduce reliance on oral food challenge (OFC). Methods: Eighty children with suspected peanut allergy were prospectively enrolled. All participants, including healthy controls, underwent skin prick testing (SPT), measurement of sIgE to peanut and Ara h 2, and basophil activation testing (BAT). A multistage diagnostic algorithm incorporating these markers was constructed, and its performance was assessed using ROC analysis, predictive values, and likelihood ratios. A secondary analysis evaluated a simplified decision pathway excluding BAT. Results: sIgE to Ara h 2 demonstrated excellent individual performance (AUC 0.889), with 96.6% PPV at the optimal cut-off. The full multistage decision pathway (SPT + sIgE + BAT when interpretable) achieved 100% specificity and avoided OFC in 28.6% of children. However, BAT feasibility was limited; over 25% of results were uninterpretable. The simplified decision pathway (SPT + sIgE to Ara h 2) preserved 100% specificity and enabled the avoidance of OFC in 27.5% of cases, with slightly lower sensitivity. Conclusions: A structured in vitro diagnostic approach using sIgE to Ara h 2 and SPT can reliably identify peanut allergy in selected pediatric patients, particularly those without a reliable peanut exposure history. BAT enhances specificity but should be considered a confirmatory tool due to feasibility limitations. Full article
(This article belongs to the Special Issue Allergic Diseases in Children: From Pathophysiological Mechanisms to Management)
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18 pages, 318 KB  
Systematic Review
Integrating Digital Health into School Nursing for Food Allergy Management: A Systematic Review
by Rita Nocerino, Flavia Lotito, Emma Montella and Roberto Berni Canani
Children 2026, 13(1), 159; https://doi.org/10.3390/children13010159 - 22 Jan 2026
Viewed by 632
Abstract
Background: Food allergy [FA] is a growing public health concern among school-age children, with schools and childcare/daycare settings representing high-risk environments for accidental exposure and anaphylaxis. Objective: To systematically review evidence on digital health interventions supporting FA education, prevention, and management in school [...] Read more.
Background: Food allergy [FA] is a growing public health concern among school-age children, with schools and childcare/daycare settings representing high-risk environments for accidental exposure and anaphylaxis. Objective: To systematically review evidence on digital health interventions supporting FA education, prevention, and management in school settings. Methods: A systematic search of PubMed, Scopus, Web of Science, and CINAHL was conducted to identify studies published between January 2015 and December 2025 [PROSPERO CRD420251185553]. Eligible studies evaluated e-learning, mHealth, or web-based programs targeting school staff, parents, or students. Results: Sixteen studies met inclusion criteria. Digital health emerged as a catalyst for professional development, interprofessional communication, and health equity within school communities. Interventions consistently improved knowledge, preparedness, and self-efficacy in anaphylaxis management among school staff, strengthened parental empowerment and communication with schools, and supported coping and inclusion among allergic children. Evidence on clinical outcomes; however, remains limited. Conclusions: Digital health can meaningfully enhance school preparedness and reduce inequalities in allergy management. Integrating digital tools into national school health frameworks—particularly where school nursing is not yet institutionalized—may represent a pivotal step toward safer, more equitable inclusion of children with food allergy. Full article
(This article belongs to the Special Issue Allergic Diseases in Children: From Pathophysiological Mechanisms to Management)
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