Browsing by Author "Ansotegui, IJ"
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- Global change, climate change, and asthma in children: Direct and indirect effects - A WAO Pediatric Asthma Committee ReportPublication . Le Souëf, PN; Adachi, Y; Anastasiou, E; Ansotegui, IJ; Badellino, HA; Banzon, T; Beltrán, CP; D'Amato, G; El-Sayed, ZA; Gómez, RM; Hossny, E; Kalayci, Ö; Morais-Almeida, M; Nieto-Garcia, A; Peden, DB; Phipatanakul, W; Wang, JY; Wan, IJ; Wong, G; Xepapadaki, P; Papadopoulos, NGThe twenty-first century has seen a fundamental shift in disease epidemiology with anthropogenic environmental change emerging as the likely dominant factor affecting the distribution and severity of current and future human disease. This is especially true of allergic diseases and asthma with their intimate relationship with the natural environment. Climate change-related variables including increased ambient temperature, heat waves, extreme weather events, air pollution, and rainfall distribution, all can directly affect asthma in children, but each of these variables also indirectly affects asthma via alterations in pollen production and release, outdoor allergen exposure or the microbiome. Air pollution, with its many and varied respiratory consequences, is likely to have the greatest effect, as it has increased globally due to rapid increases in fossil fuel combustion, global population, crowding, and megacities, as well as forest burning and trees succumbing to an increasingly hostile environment. Human activities have also caused substantial deterioration of the global microbiome with reductions in biodiversity for molds, bacteria, and viruses. Reduced microbiome diversity has, in turn, been associated with increases in Th2 allergic responses and allergic disease. The collective effect of these changes has already shifted allergy and asthma disease patterns. Given that changes in climate have been relatively small to date, the unavoidable, much greater shifts in climate in the future are concerning. Determining the relative scale of the direct versus indirect effects of climate change variables is needed if effective avoidance and adaptive measures are to be implemented. This would also require much more basic, epidemiological, and clinical research to understand the causal mechanisms, the most relevant climate factors involved, the regions most affected and, most importantly, effective and actionable adaptation measures. We suggest that allergy and respiratory health workers should follow current guidance to reduce present risks related to climate change and watch for new recommendations to reduce future risks. Since the respiratory system is the one most affected by climate change, they also need to call for more research in this area and show strong leadership in advocating for urgent action to protect children by reducing or reversing factors that have led to our deteriorating climate.
- Global change, climate change, and asthma in children: Direct and indirect effects - A WAO Pediatric Asthma Committee ReportPublication . Le Souëf, PN; Adachi, Y; Anastasiou, E; Ansotegui, IJ; Badellino, HA; Banzon, T; Beltrán, CP; D'Amato, G; El-Sayed, ZA; Gómez, RM; Hossny, E; Kalayci, Ö; Morais-Almeida, M; Nieto-Garcia, A; Peden, DB; Phipatanakul, W; Wang, JY; Wan, IJ; Wong, G; Xepapadaki, P; Papadopoulos, NGThe twenty-first century has seen a fundamental shift in disease epidemiology with anthropogenic environmental change emerging as the likely dominant factor affecting the distribution and severity of current and future human disease. This is especially true of allergic diseases and asthma with their intimate relationship with the natural environment. Climate change-related variables including increased ambient temperature, heat waves, extreme weather events, air pollution, and rainfall distribution, all can directly affect asthma in children, but each of these variables also indirectly affects asthma via alterations in pollen production and release, outdoor allergen exposure or the microbiome. Air pollution, with its many and varied respiratory consequences, is likely to have the greatest effect, as it has increased globally due to rapid increases in fossil fuel combustion, global population, crowding, and megacities, as well as forest burning and trees succumbing to an increasingly hostile environment. Human activities have also caused substantial deterioration of the global microbiome with reductions in biodiversity for molds, bacteria, and viruses. Reduced microbiome diversity has, in turn, been associated with increases in Th2 allergic responses and allergic disease. The collective effect of these changes has already shifted allergy and asthma disease patterns. Given that changes in climate have been relatively small to date, the unavoidable, much greater shifts in climate in the future are concerning. Determining the relative scale of the direct versus indirect effects of climate change variables is needed if effective avoidance and adaptive measures are to be implemented. This would also require much more basic, epidemiological, and clinical research to understand the causal mechanisms, the most relevant climate factors involved, the regions most affected and, most importantly, effective and actionable adaptation measures. We suggest that allergy and respiratory health workers should follow current guidance to reduce present risks related to climate change and watch for new recommendations to reduce future risks. Since the respiratory system is the one most affected by climate change, they also need to call for more research in this area and show strong leadership in advocating for urgent action to protect children by reducing or reversing factors that have led to our deteriorating climate.
- IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paperPublication . Ansotegui, IJ; Melioli, G; Canonica, GW; Caraballo, L; Villa, E; Ebisawa, M; Passalacqua, G; Savi, E; Ebo, DJ; Gómez, RM; Luengo Sánchez, O; Oppenheimer, JJ; Jensen-Jarolim, E; Fischer, DA; Haahtela, T; Antila, M; Bousquet, JJ; Cardona, V; Chiang, WC; Demoly, PM; DuBuske, LM; Ferrer Puga, M; Gerth van Wijk, R; González Díaz, SN; Gonzalez-Estrada, A; Jares, E; Kalpaklioğlu, AF; Kase Tanno, L; Kowalski, ML; Ledford, DK; Monge Ortega, OP; Morais Almeida, M; Pfaar, O; Poulsen, LK; Pawankar, R; Renz, HE; Romano, AG; Rosário Filho, NA; Rosenwasser, L; Sánchez Borges, MA; Scala, E; Senna, GE; Sisul, JC; Tang, MK; Thong, By; Valenta, R; Wood, RA; Zuberbier, TCurrently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen.