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Special Issue "Diagnosis and Prevention of Asthma in Children"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Children's Health".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 10151

Special Issue Editors

Dr. João Cavaleiro Rufo
E-Mail Website
Guest Editor
Department of Epidemiology, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
Interests: asthma; breathomics; indoor air quality; multivariate analysis; occupational health
Dr. Luís Delgado
E-Mail Website
Guest Editor
Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal
Interests: allergy and clinical immunology; interstitial lung disease; exercise immunology; drug allergy; ocular allergy

Special Issue Information

Dear Colleagues,

The high prevalence of asthma is still a worldwide concern. Although the disease may eventually be controlled by appropriate treatment, asthma is still having a significant impact on quality of life and absenteeism in affected patients and health costs. On the other hand, some phenotypes of asthma are difficult to diagnose, which may lead to an inappropriate therapy prescription and consequent uncontrolled symptoms. Diagnosis is especially challenging in children, not only due to the fact that up to 50% of children up to 6 years old present any sort of wheezing, but also due to the associated lower reproducibility in spirometry tests. Therefore, further research is needed to promote asthma diagnosis and prevention. On one side, we must look into novel biomarkers and clinical technologies to improve asthma monitoring, preferably for a point-of-care assessment. Further solutions are also needed to predict therapy responsiveness, not only to corticosteroid therapy, but also to the relatively recent Th2 inflammation-inhibiting biologicals. On the perspective for disease prevention, we need to further explore the determinants and triggers of asthma in children, such as the impact of the environment, biodiversity, and diet on the immune system. This Special Issue invites the most experienced researchers on the field to contribute to asthma prevention and diagnosis in children by providing their research findings and high academic outputs, hence tackling the heavy burden that asthma presents in our society.

Dr. João Cavaleiro Rufo
Dr. Luís Delgado
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 100 words) can be sent to the Editorial Office for announcement on this website.

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. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly 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 2500 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

  • Asthma diagnosis
  • Biomarkers
  • Children
  • Diet and asthma
  • Emerging issues in environmental health and diseases
  • Environmental education and public health
  • Environmental exposure
  • Health risk assessment and management
  • Indoor exposure
  • Therapy monitoring

Published Papers (5 papers)

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Research

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Article
Lack of Consistent Association between Asthma, Allergic Diseases, and Intestinal Helminth Infection in School-Aged Children in the Province of Bengo, Angola
Int. J. Environ. Res. Public Health 2021, 18(11), 6156; https://doi.org/10.3390/ijerph18116156 - 07 Jun 2021
Viewed by 1158
Abstract
Epidemiological studies have shown conflicting findings on the relationship between asthma, atopy, and intestinal helminth infections. There are no such studies from Angola; therefore, we aimed to evaluate the relationship between asthma, allergic diseases, atopy, and intestinal helminth infection in Angolan schoolchildren. We [...] Read more.
Epidemiological studies have shown conflicting findings on the relationship between asthma, atopy, and intestinal helminth infections. There are no such studies from Angola; therefore, we aimed to evaluate the relationship between asthma, allergic diseases, atopy, and intestinal helminth infection in Angolan schoolchildren. We performed a cross-sectional study of schoolchildren between September and November 2017. Five schools (three urban, two rural) were randomly selected. Asthma, rhinoconjunctivitis, and eczema were defined by appropriate symptoms in the previous 12 months: atopy was defined by positive skin prick tests (SPT) or aeroallergen-specific IgE; intestinal helminths were detected by faecal sample microscopy. In total, 1023 children were evaluated (48.4% female; 57.6% aged 10–14 years; 60.5% urban). Asthma, rhinoconjunctivitis, or eczema were present in 9%, 6%, and 16% of the studies children, respectively. Only 8% of children had positive SPT, but 64% had positive sIgE. Additionally, 40% were infected with any intestinal helminth (A. lumbricoides 25.9%, T. trichiura 7.6%, and H. nana 6.3%). There were no consistent associations between intestinal helminth infections and asthma, allergic diseases, or atopy, except for A. lumbricoides, which was inversely associated with rhinoconjuctivitis and directly associated with aeroallergen-specific IgE. We concluded that, overall, intestinal helminth infections were not consistently associated with allergic symptoms or atopy. Future, preferably longitudinal, studies should collect more detailed information on helminth infections as part of clusters of environmental determinants of allergies. Full article
(This article belongs to the Special Issue Diagnosis and Prevention of Asthma in Children)
Article
The Influence of Eating at Home on Dietary Diversity and Airway Inflammation in Portuguese School-Aged Children
Int. J. Environ. Res. Public Health 2021, 18(5), 2646; https://doi.org/10.3390/ijerph18052646 - 05 Mar 2021
Viewed by 1597
Abstract
Considering the negative impact of a lack of dietary diversity on children’s nutritional status, we aimed to describe dietary variety according to eating at home frequency and assessed its association with respiratory outcomes in school-aged children. This cross-sectional study included 590 children (49% [...] Read more.
Considering the negative impact of a lack of dietary diversity on children’s nutritional status, we aimed to describe dietary variety according to eating at home frequency and assessed its association with respiratory outcomes in school-aged children. This cross-sectional study included 590 children (49% girls) aged 7 to 12 years from 20 public schools located in city of Porto, Portugal. Daily frequency of eating at home groups were calculated and dietary diversity was calculated using a 10-food group score from a 24 h recall questionnaire. Spirometry and exhaled nitric oxide levels (eNO; <35 and ≥35 ppb) were assessed. The comparison of diet diversity according to the groups was performed by ANOVA and ANCOVA. The association between dietary diversity and respiratory outcomes was examined using regression models. In multivariate analysis, children in the highest group of eating at home episodes (≥4 occasions) obtained the lowest dietary diversity mean score, while the lowest group (<2) had the highest mean score (p-value 0.026). After adjustment for confounders, higher diet diversity (≥5 food groups) significantly decreased the odds of having an eNO ≥35. Diet diversity might decrease the chance of airway inflammation among children. However, having more eating episodes at home could be a barrier to a more diverse diet. Full article
(This article belongs to the Special Issue Diagnosis and Prevention of Asthma in Children)
Article
Profiling Persistent Asthma Phenotypes in Adolescents: A Longitudinal Diagnostic Evaluation from the INSPIRERS Studies
Int. J. Environ. Res. Public Health 2021, 18(3), 1015; https://doi.org/10.3390/ijerph18031015 - 24 Jan 2021
Cited by 1 | Viewed by 1468
Abstract
We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13–17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was [...] Read more.
We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13–17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk. Full article
(This article belongs to the Special Issue Diagnosis and Prevention of Asthma in Children)
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Article
Effects of Exercise on the Skin Epithelial Barrier of Young Elite Athletes-Swimming Comparatively to Non-Water Sports Training Session
Int. J. Environ. Res. Public Health 2021, 18(2), 653; https://doi.org/10.3390/ijerph18020653 - 14 Jan 2021
Cited by 2 | Viewed by 1302
Abstract
The benefits of swimming have been extensively assessed. However, swimming pools contain chlorine and other irritating chemicals that may induce contact dermatitis. To evaluate the effect of a swimming training session on transepidermal water loss (TWEL) in swimmers compared to football players, elite [...] Read more.
The benefits of swimming have been extensively assessed. However, swimming pools contain chlorine and other irritating chemicals that may induce contact dermatitis. To evaluate the effect of a swimming training session on transepidermal water loss (TWEL) in swimmers compared to football players, elite swimmers and football players were invited to participate (58 athletes) in the study, where TEWL was measured before, immediately after, and 30 min after a 2 h training session. The probe was held on the dorsum of the hand, volar forearm, and on the antecubital flexure for 1 min. The volar forearm, antecubital flexure, and hand dorsum showed a significant increase in TEWL in swimmers in both measurements after training compared to baseline (p < 0.001). In football players, an increase in TEWL was observed on the hands’ dorsum between baseline and after training measurements. The variations on TEWL levels before and immediately after the training session were higher among swimmers on the volar forearm (p = 0.002) and antecubital flexure (p = 0.019). Our findings support the effect of the training environment—swimming pool versus outdoor sports—on the skin barrier function, with an increase of transepidermal water loss immediately after exercise. Exposure to a swimming pool environment in a 2 h training session may lead to changes in skin barrier function. Full article
(This article belongs to the Special Issue Diagnosis and Prevention of Asthma in Children)
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Review

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Review
COVID-19 and Pediatric Asthma: Clinical and Management Challenges
Int. J. Environ. Res. Public Health 2021, 18(3), 1093; https://doi.org/10.3390/ijerph18031093 - 26 Jan 2021
Cited by 18 | Viewed by 3749
Abstract
Asthma is the most frequent chronic condition in childhood and a current concern exists about asthma in the pediatric population and its risk for severe SARS-CoV-2 infection. Although all ages can be affected, SARS-CoV-2 infection has lower clinical impact on children and adolescents [...] Read more.
Asthma is the most frequent chronic condition in childhood and a current concern exists about asthma in the pediatric population and its risk for severe SARS-CoV-2 infection. Although all ages can be affected, SARS-CoV-2 infection has lower clinical impact on children and adolescents than on adults. Fever, cough and shortness of breath are the most common symptoms and signs in children; wheezing has not been frequently reported. Published studies suggest that children with asthma do not appear to be disproportionately more affected by COVID-19. This hypothesis raises two issues: is asthma (and/or atopy) an independent protective factor for COVID-19? If yes, why? Explanations for this could include the lower IFN-α production, protective role of eosinophils in the airway, and antiviral and immunomodulatory proprieties of inhaled steroids. Additionally, recent evidence supports that allergic sensitization is inversely related to ACE2 expression. Obesity is a known risk factor for COVID-19 in adults. However, in the childhood asthma–obesity phenotype, the classic atopic Th2 pattern seems to predominate, which could hypothetically be a protective factor for severe SARS-CoV-2 infection in children with both conditions. Finally, the return to school activities raises concerns, as asymptomatic children could act as vectors for the spread of the disease. Although this is still a controversial topic, the identification and management of asymptomatic children is an important approach during the SARS-CoV-2 epidemic. Focus on asthma control, risk stratification, and medication adherence will be essential to allow children with asthma to return safely to school. Full article
(This article belongs to the Special Issue Diagnosis and Prevention of Asthma in Children)
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