Skin Staphylococcus aureus Colonization is Associated with Persistent Moderate-to-severe Atopic Dermatitis in Children (original) (raw)
Effects of environment on atopic status and respiratory disorders in children
Journal of Allergy and Clinical Immunology, 1993
We investigated whether living in areas with higher air pollution levels increases the prevalence of positive skin reactivity in children and the possible synergic effect of air pollution exposure and atopy on respiratory disorders. This cross-sectional study was conducted in an urban area, in an industrialized area, and in a rural control area in the Latium region of Italy. A total of 2226 subjects, aged 7 to 11 years, were studied. The prevalence of children with positive skin test results did not vary significantly over the areas (urban area = 21.0%, industrialized area = 22.0%, rural area = 20.2%). Children living in polluted areas experienced significantly more cough and phlegm (odds ratio [OR] = 1.5), rhinitis (OR = 1.7), pneumonia (OR = 1.7), and early respiratory infections (OR = 1.4) than control subjects. The pattern of the odds ratios for atopy and air pollution suggested that the two factors were probably additive in affecting asthma and early respiratory infections (synergy index [SI] = 1.04 and 1.27, respectively), whereas they seemed to act synergically in regard to cough and phlegm (SI = 1.59), rhinitis (SI = 3.01), and pneumonia (SI = 2.75). Environmental air pollution seems not to increase the prevalence of atopic status; it seems, however, to enhance the development of clinical symptoms among already sensitized subjects.
Adult atopic dermatitis and exposure to air pollutantsda nationwide population-based study
Background: There is a trend toward an increased worldwide prevalence of allergic diseases. It is speculated that industrialization with resultant air pollution plays a role. However, there are sparse epidemiologic data on the relation between air pollution and atopic dermatitis (AD) in adults. Objective: To investigate the relation between exposure to air pollutants and adult AD in a cross-sectional study based on data from the National Health Insurance Research Database in Taiwan. Methods: We identified 1,023 adult patients with AD and 4,092 age-and sex-matched controls without allergic diseases in 2011. Using data from 71 Environmental Protection Agency monitoring stations across Taiwan, levels of exposure to air pollutants were determined by the location of a subject's place of residence. Multivariate logistic regression analysis, adjusted for age, sex, levels of urbanization, and family income, was performed.
Respiratory Medicine, 2013
Respiratory Medicine (2013) 107, 1763e1772 air pollution estimates, we used the Community Multiscale Air Quality (CMAQ) model to increase the representation of rural participants in our sample. Logistic regression with population-based sampling weights was used to calculate adjusted prevalence odds ratios per 10 ppb increase in O 3 and NO 2 , per 10 mg/m 3 increase in PM 10 , and per 5 mg/m 3 increase in PM 2.5 adjusting for race, gender, age, socioeconomic status, smoking, and urban/rural status. Results: Using CMAQ data, increased levels of NO 2 were associated with positive IgE to any (OR 1.15, 95% CI 1.04, 1.27), inhalant (OR 1.17, 95% CI 1.02, 1.33), and indoor (OR 1.16, 95% CI 1.03, 1.31) allergens. Higher PM 2.5 levels were associated with positivity to indoor allergen-specific IgE (OR 1.24, 95% CI 1.13, 1.36). Effect estimates were similar using monitored data. Conclusions: Increased ambient NO 2 was consistently associated with increased prevalence of allergic sensitization. ª
Communications medicine, 2024
Background Atopic dermatitis (AD) is a chronic, inflammatory disease characterized by dry, pruritic skin. In the U.S., the prevalence of AD has increased over three-fold since the 1970s. We previously reported a geographic association between isocyanate-containing air pollution and AD as well as mechanistic data demonstrating that isocyanates induce skin dysbiosis and activate the host itch receptor TRPA1. However, non-spatial models are susceptible to spatial confounding and may overlook other meaningful associations. Methods We added spatial analysis to our prior model, contrasting pollution data with clinical visits. In addition, we conducted a retrospective case-control survey of childhood exposure to BTEX-related products. Finally, we assessed implicated compounds, in pure form and as part of synthetic fabric, for their effect on the growth and metabolism of skin commensal bacteria. Results Spatial analysis implicate benzene, toluene, ethylbenzene, and, most significantly, xylene (BTEX) compounds. Survey odds ratios for AD were significant for xylene-derived polyester bed sheets (OR = 9.5; CI 2.2-40.1) and diisocyanate-containing wallpaper adhesive (OR = 6.5; CI 1.5-27.8). Staphylococcus aureus lives longer on synthetic textiles compared to natural textiles. Meanwhile, synthetic fabric exposure shifts the lipid metabolism of health-associated commensals (Roseomonas mucosa and S. epidermidis) away from therapeutic pathways. Conclusions We propose that BTEX chemicals in their raw forms and in synthetic products represent a unifying hypothesis for environmentally induced AD flares through their ability to create dysbiosis in the skin microbiota and directly activate TRPA1. Unequal distribution of these pollutants may also influence racial disparities in AD rates. Atopic dermatitis (AD) is a chronic, inflammatory disease characterized by dry, pruritic skin. Descriptions of AD's clinical presentation written 3500 years ago are remarkably similar to those written today 1 . However, the prevalence of AD has increased 3-6-fold since an inflection point circa 1970 2 . There is mounting evidence linking environmental exposures, particularly during early childhood, to the development of AD and other allergic diseases. Today, children immigrating from a developing to an industrialized country before the age of 6 have a higher risk of asthma, allergies, and AD, while those immigrating later in life do not show an increased risk . Taken together, these epidemiologic findings suggest that the biology of AD has remained historically consistent while exposure to AD-inducing chemicals has gone from natural-but-rare to synthetic-andcommon. Many associations between AD and patient-reported triggers, such as topical products, wildfires, industrial environments, foods, and clothing have been documented , but few controlled studies have investigated the mechanism by which these triggers potentiate disease. Combining a geographic analysis with cell and mouse modeling, we previously demonstrated that (di)isocyanate exposure correlates with
Science of The Total Environment
Short-term exposure to air pollution has been associated with exacerbation of respiratory diseases such as asthma. Substantial heterogeneity in effect estimates has been observed between previous studies. This study aims to quantify the local burden of daily asthma symptoms in asthmatic children in a medium-sized city. Air pollution exposure was estimated using the nearest sensor in a fine resolution urban air quality sensor network in the city of Eindhoven, the Netherlands. Bayesian estimates of the exposure response function were obtained by updating a priori information from a meta-analysis with data from a panel study using a daily diary. Five children participated in the panel study, resulting in a total of 400 daily diary records. Positive associations between NO 2 and lower respiratory symptoms and medication use were observed. The odds ratio for any lower respiratory symptoms was 1.07 (95% C.I. 0.92, 1.28) expressed per 10 μg m −3 for current day NO 2 concentration, using data from the panel study only (uninformative prior). Odds ratios for dry cough and phlegm were close to unity. The pattern of associations agreed well with the updated meta-analysis. The meta-analytic random effects summary estimate was 1.05 (1.02, 1.07) for LRS. Credible intervals substantially narrowed when adding prior information from the meta-analysis. The odds ratio for lower respiratory symptoms with an informative prior was 1.06 (0.99, 1.14). Burden of disease maps showed a strong spatial variability in the number of asthmatic symptoms associated with ambient NO 2 derived from a regression kriging model. In total, 70 cases of asthmatic symptoms can daily be associated with NO 2 exposure in the city of Eindhoven. We conclude that Bayesian estimates are useful in estimation of specific local air pollution effect estimates and subsequent local burden of disease calculations. With the fine resolution air quality network, neighborhood-specific burden of asthmatic symptoms was assessed.
Effect of outdoor and indoor nitrogen dioxide on respiratory symptoms in schoolchildren
International journal of epidemiology, 2000
Background Nitrogen dioxide (NO 2), an oxidant gas that contaminates both outdoor and indoor air, is considered to be a potential risk factor for asthma. We investigated concurrently the effects of outdoor and indoor NO 2 on the prevalence and incidence of respiratory symptoms among children. Methods A cohort study was carried out over 3 years on 842 schoolchildren living in seven different communities in Japan. Indoor NO 2 concentrations over 24 hours were measured in both winter and summer in the homes of the subjects, and a 3-year average of the outdoor NO 2 concentration was determined for each community. Respiratory symptoms were evaluated every year from responses to questionnaires. Results The prevalence of bronchitis, wheeze, and asthma significantly increased with increases of indoor NO 2 concentrations among girls, but not among boys. In neither boys nor girls were there significant differences in the prevalence of respiratory symptoms among urban, suburban, and rural districts. The incidence of asthma increased among children living in areas with high concentrations of outdoor NO 2. Multiple logistic regression analysis showed that a 10 parts per billion (ppb) increase of outdoor NO 2 concentration was associated with an increased incidence of wheeze and asthma (odds ratios [OR] = 1.76, 95% CI : 1.04-3.23 and OR = 2.10, 95% CI : 1.10-4.75, respectively), but that no such associations were found with indoor NO 2 concentration (OR = 0.73, 95% CI : 0.45-1.14 and OR = 0.87, 95% CI : 0.51-1.43, respectively). Conclusions These findings suggest that outdoor NO 2 air pollution may be particularly important for the development of wheeze and asthma among children. Indoor NO 2 concentrations were associated with the prevalence of respiratory symptoms only among girls. Girls may be more susceptible to indoor air pollution than boys.
Ambient exposure and nasal inflammation in adults and children – a preliminary analysis
International Journal of Hygiene and Environmental Health, 2002
The epidemiological evidence that ambient exposure, including particulate matter (PM) is related to adverse health outcomes continues to mount. Inflammation and disease of the upper respiratory tract are commonly suggested as effects of ambient exposure. Therefore we studied both ambient exposure and nasal effects in a 4-months cross-sectional survey in Nordrhein-Westfalen (Germany). At 4 locations in 3 different cities ambient exposure to TSP (total suspended particles), O 3 , NO x and SO 2 was derived from compliance measurements by governmental offices, and 884 subjects (501 mothers and 383 children, 6 ± 7 years old) were screened using nasal lavage, with success rates of 90 and 75%, respectively. No differences in total cell counts or percentage of neutrophils were found between mothers or children from the 4 different locations, despite small but significant differences in ambient exposure to TSP, SO 2, O 3 , and NO x during this period. A higher epithelial cell count in mothers and children from one city might be related to general higher ambient pollution in that location. Interestingly, total cells and interleukin-8 levels in children were higher than in mothers and possibly reflect their increased susceptibility to effects of air pollution. Future analysis will concentrate on temporal relations between inflammation and exposure, including individual risk factors such as allergy, smoking and the presence of disease.
Indoor air pollutants (PM10, PM2.5 and NO2) have been known to pose great risks to the human respiratory system. A slight airway inflammatory response in the adult might produce a potentially significant obstruction in the airway of a preschool child. The main objective of this study is to determine the association between indoor air pollutants (PM10, PM2.5, and NO2) and airway inflammation among preschool children. A cross sectional comparative study was conducted among healthy preschool children selected from 3 preschools in industrial (n=62) and 3 preschools in sub-urban (n=62) areas. Questionnaires were used to determine reported respiratory symptoms among respondents. Indoor exposures to PM10, PM2.5 and NO2 in classes were measured using DustTrak DRX Aerosol Monitor and LaMotte Air Sampler. Meanwhile, Fractional exhaled Nitric Oxide (FeNO) was measured using NIOX MINO device. There were significant differences (p<0.05) in measurements of indoor air pollutants (PM10, PM2.5 and NO2) between both study areas. Concentration of indoor PM10 [87.00 (59.00) µg/m3], PM2.5 [75.0 (47.0) µg/m3] and NO2 [0.14 (0.14) ppm] in preschools at the industrial area were significantly higher than the preschools at the sub-urban area (Z=-8.517, p=0.001). A significant difference (p<0.05) was found in measurements between the two areas. Indoor PM10, PM2.5 and NO2 were found to be significantly associated with the concentration levels of Fractional exhaled Nitric Oxide (FeNO) measured in both areas (p<0.05). Preschool children living near an industrial area are highly exposed to indoor air pollutants as compared to those in the sub-urban area. Exposure to indoor PM10, PM2.5 and NO2 were associated with concentration levels of Fractional exhaled Nitric Oxide in both areas. Therefore, it was suggested that greater exposure to PM10, PM2.5 and NO2 may increase the chances of airway inflammation occurrences among those exposed
PLOS ONE, 2021
ObjectivesThe purpose of this study was to examine the association of allergic rhinitis with air pollutant concentrations using the follow-up data of elementary school children in Ulsan, Korea.MethodsAll students of four elementary schools in Ulsan, South Korea were surveyed at two-year intervals. The survey used data collected five times, over a nine-year period from June 2009 to April 2018. The questionnaire used in the survey was a modified version of the ISAAC (International society of asthma and allergy of children) questionnaire. A skin prick test (SPT) was performed with 24 standard antigens. To estimate the levels of exposure to outdoor air pollution, the concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), and particulate matter 10 μm or less in diameter (PM10) were used. As a dependent variable, a history of allergic rhinitis diagnosed by a doctor during the last 1-year was considered. Logistic regression analysis was used to se...