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Background:
Atopic diseases, such as atopic dermatitis, allergic rhinitis, and asthma, are inflammatory diseases common in pediatric patients. This study investigated whether these inflammatory atopic diseases were associated with anemia in pediatrics.
Methods:
A cross-sectional study was conducted using a pediatric dataset from the Health Insur...
Contexts in source publication
Context 1
... included atopic dermatitis, allergic rhinitis, and asthma as atopic disease based on the presence of the diagnostic code corresponding to one or more of these diseases. Diagnostic codes for these diseases and covariate diseases (see below) are based on The Korean Standard Classification of Disease and Cause of Death-7 (KCD-7) was used for definition of disease (Additional file 1: Table S1). The KCD-7 reflects the update of the International Classification of Diseases 10th Revision (ICD-10) and refines the Korean subtypes of disease and rare diseases. ...Context 2
... steroids, cyclosporine, and methotrexate were included as covariates for medications. Specific diseases and corresponding KCD-7 codes are listed in Additional file 1: Table S1. ...Context 3
... = 0.006) relative to patients under health insurance program. All covariates, including systemic infection, mental disorder, CKD, chronic inflammation, cancer, and medication (steroid, methotrexate, and cyclosporine) indicated significantly higher ORs of IDA ( Table 1). ...Citations
... Rhew K. et al. investigated the possible connection between anemia in pediatric patients and inflammatory atopic illnesses, such as atopic dermatitis, allergic rhinitis, and asthma. A cross-sectional analysis was carried out using a pediatric dataset from the Health Insurance Review and Assessment Service (HIRA) of South Korea from 2016 [20]. A multivariable logistic regression approach was utilized to control for demographic variables and investigate the correlation between iron deficiency anemia (IDA) and atopic disorders. ...
... A multivariable logistic regression approach was utilized to control for demographic variables and investigate the correlation between iron deficiency anemia (IDA) and atopic disorders. The analysis showed a strong correlation between IDA and atopic illnesses, with patients having multiple atopic conditions displaying higher prevalence rates of IDA, pointing to a possible link between IDA in pediatric patients and atopic illnesses [20]. Additionally, a study conducted by Palma-Carlos examined the prevalence of asthma in people with hemoglobinopathies who had dust mite allergies, with a particular emphasis on thalassemia and sickle cell trait patients [21]. ...
Asthma, a prevalent chronic respiratory condition characterized by inflammation of the airways and bronchoconstriction, has demonstrated a potential association with hemoglobinopathies such as thalassemia and sickle cell disease (SCD). Numerous studies have highlighted a higher prevalence of asthma among thalassemia patients compared to the general population, with rates ranging around 30%. Similarly, asthma frequently coexists with SCD, affecting approximately 20–48% of patients. Children with SCD often experience heightened lower airway obstruction and airway hyper-reactivity. Notably, the presence of asthma in SCD exacerbates respiratory symptoms and increases the risk of severe complications like acute chest syndrome, stroke, vaso-occlusive episodes, and early mortality. Several studies have noted a decrease in various cytokines such as IFN-γ and IL-10, along with higher levels of both IL-6 and IL-8, suggesting an overactivation of pro-inflammatory mechanisms in patients with hemoglobinopathies, which could trigger inflammatory conditions such as asthma. The exact mechanisms driving this association are better elucidated but may involve factors such as chronic inflammation, oxidative stress, and immune dysregulation associated with thalassemia-related complications like chronic hemolytic anemia and iron overload. This review aims to comprehensively analyze the relationship between asthma and hemoglobinopathies, with a focus on thalassemia and SCD. It emphasizes the importance of interdisciplinary collaboration among pulmonologists, hematologists, and other healthcare professionals to effectively manage this complex interplay. Understanding this link is crucial for improving care and outcomes in affected individuals.
... [14][15][16][17][18][19] This principle may open up novel dietary management strategies for allergy, 16 as in humans, micronutrient deficient conditions and anaemia are associated with atopy and development of allergic diseases especially in the paediatric population. [20][21][22][23][24][25] In our previous studies with other allergenic proteins we concentrated on vitamin A and its main metabolite retinoic acid (RA) as ligand, which, next to vitamin D, is a key component for the development and homeostasis of the immune system. RA has a high counter-regulatory impact on inflammation and oxidative stress, two key factors in the clinical manifestation of allergic diseases. ...
Background
We investigated the biological function of the mould allergen Alt a 1 as a carrier of micronutrients, such as the vitamin A metabolite retinoic acid (RA) and the influence of RA binding on its allergenicity in vitro and in vivo.
Methods
Alt a 1‐RA complex formation was analyzed in silico and in vitro. PBMCs from Alternaria‐allergic donors were stimulated with Alt a 1 complexed with RA (holo‐Alt a 1) or empty apo‐Alt a 1 and analyzed for cytokine production and CD marker expression. Serum IgE‐binding and crosslinking assays to apo‐ and holo‐protein were correlated to B‐cell epitope analysis. Female BALB/c mice already sensitized to Alt a 1 were intranasally treated with apo‐Alt a 1, holo‐Alt a 1 or RA alone before measuring anaphylactic response, serum antibody levels, splenic cytokines and CD marker expression.
Results
In silico docking calculations and in vitro assays showed that the extent of RA binding depended on the higher quaternary state of Alt a 1. Holo‐Alt a 1 loaded with RA reduced IL‐13 released from PBMCs and CD3+CD4+CRTh2 cells. Complexing Alt a 1 to RA masked its IgE B‐cell epitopes and reduced its IgE‐binding capacity. In a therapeutic mouse model of Alternaria allergy nasal application of holo‐Alt a 1, but not of apo‐Alt a 1, significantly impeded the anaphylactic response, impaired splenic antigen‐presenting cells and induced IL‐10 production.
Conclusion
Holo‐Alt a 1 binding to RA was able to alleviate Th2 immunity in vitro, modulate an ongoing Th2 response and prevent anaphylactic symptoms in vivo, presenting a novel option for improving allergen‐specific immunotherapy in Alternaria allergy.
... Many studies have shown a correlation between elevated blood eosinophil levels and acute asthma exacerbations and asthma severity (10). There are many documents showing that the probability of anemia in patients with asthma is significantly increased (11)(12)(13). Iron is one of the important trace elements that is essential for many biological processes, including the regulation of enzyme activity, oxygen transport, and immune function (14,15), anemia affects a decrease in the strength of the respiratory muscles, including the diaphragm, and reduces lung function (16), which may be a mechanism affecting asthma. Dietary iron supplementation has been reported to reduce airway eosinophilia in animal models to reduce the severity of allergic asthma (17). ...
... Our findings are consistent with a large number of observational studies from different countries that report on the relationship between anemia and asthma (13,(30)(31)(32). However, some observational studies have reported that asthma increases the risk of anemia (11,30,33), but we believe that the causal relationship we found may be more reliable than the results of observational studies because MR analysis is less susceptible to confounding or effects of reverse causation. ...
... Numerous studies have shown that IDA is a common phenomenon in asthma (11)(12)(13). Previous studies have shown that immune dysfunction also plays a crucial role in the development and of asthma (44). ...
Background
Observational studies have suggested an association between iron deficiency anemia (IDA) and asthma, which may affect the occurrence of asthma. However, whether IDA is a new management goal for asthma remains to be determined.
Objective
We conducted a two-sample Mendelian randomization(MR)analysis to assess the association between IDA and asthma.
Methods
We performed a two-sample MR study to assess a causal relationship between IDA (ncase = 12,434, ncontrol = 59,827) and asthma (ncase = 20,629, ncontrol = 135,449). Inverse variance weighted (IVW) was used as the primary method for the analyses. Furthermore, we used weighted medians and MR-Egger to enhance robustness. Data linking genetic variation to IDA and asthma were combined to assess the impact of IDA on asthma risk.
Results
There are five single nucleotide polymorphisms (SNPs) were used as genetic tool variables for exposure factors. Genetically determined IDA was significantly associated with an increased risk of asthma (OR = 1.37, 95% CI: 1.09–1.72, p = 0.007). There was little heterogeneity in the MR studies and no evidence of level pleiotropy was found.
Conclusions
In our MR study, our findings emphasize that IDA may be associated with a high risk of asthma, indicating a potential role for IDA in the development of asthma. Future research needs to elucidate its potential mechanisms to pave the way for the prevention and treatment of asthma.
... Several prevalence studies on large cohorts have highlighted a correlation between iron deficiency anemia and the development of atopy [89][90][91][92]. According to Shaheen et al., routine iron supplementation may reduce the risk of asthma in offspring, potentially offering a primary prevention strategy [93]. ...
Food allergy represents a global health problem impacting patients’ and caregivers’ quality of life and contributing to increased healthcare costs. Efforts to identify preventive measures starting from pregnancy have recently intensified. This review aims to provide an overview of the role of maternal factors in food allergy prevention. Several studies indicate that avoiding food allergens during pregnancy does not reduce the risk of developing food allergies. International guidelines unanimously discourage avoidance diets due to potential adverse effects on essential nutrient intake and overall health for both women and children. Research on probiotics and prebiotics during pregnancy as preventive measures is promising, though evidence remains limited. Consequently, guidelines lack specific recommendations for their use in preventing food allergies. Similarly, given the absence of conclusive evidence, it is not possible to formulate definitive conclusions on the supplementation of vitamins, omega-3 fatty acids (n-3 PUFAs), and other antioxidant substances. A combination of maternal interventions, breastfeeding, and early introduction of foods to infants can reduce the risk of food allergies in the child. Further studies are needed to clarify the interaction between genetics, immunological pathways, and environmental factors
... Therefore, nutrition plays a key role. Atopy in children has been associated with deficiencies of micronutrients such as iron (164,165). Iron deficiency leads to immune cell activation (166). A study reported that when mothers were supplemented for both iron and folic acid, their children had a 4-fold decreased risk for AD (42). ...
The prevalence and severity of allergic diseases have increased over the last 30 years. Understanding the mechanisms responsible for these diseases is a major challenge in current allergology, as it is crucial for the transition towards precision medicine, which encompasses predictive, preventive, and personalized strategies. The urge to identify predictive biomarkers of allergy at early stages of life is crucial, especially in the context of major allergic diseases such as food allergy and atopic dermatitis. Identifying these biomarkers could enhance our understanding of the immature immune responses, improve allergy handling at early ages and pave the way for preventive and therapeutic approaches. This minireview aims to explore the relevance of three biomarker categories (proteome, microbiome, and metabolome) in early life. First, levels of some proteins emerge as potential indicators of mucosal health and metabolic status in certain allergic diseases. Second, bacterial taxonomy provides insight into the composition of the microbiota through high-throughput sequencing methods. Finally, metabolites, representing the end products of bacterial and host metabolic activity, serve as early indicators of changes in microbiota and host metabolism. This information could help to develop an extensive identification of biomarkers in AD and FA and their potential in translational personalized medicine in early life.
... Increased systemic iron doses were reported to dramatically reduce airway eosinophilia and Th2 cytokines, block AHR, and improve allergic asthma symptoms in a number of animal models (33)(34)(35). Moreover, numerous clinical studies have demonstrated and the connection between the level of iron within the human body and the occurrence of asthma (36)(37)(38)(39)(40)(41)(42). ...
Background
So far, quite a few studies have revealed that systemic iron levels are related to asthmatic inflammatory reactions. And most studies have focused on the correlation between systemic iron levels and asthma, with inconsistent findings. Yet, few studies have investigated the connection between serum iron and blood eosinophil counts. Hence, we have explored the connection between serum iron and blood eosinophil counts in asthmatics by utilizing data from NHANES.
Methods
A total of 2549 individuals were included in our study after screening NHANES participants from 2011 to 2018. The linear regression model and XGBoost model were used to discuss the potential connection. Linear or nonlinear association was further confirmed by the generalized additive model and the piecewise linear regression model. And we also performed stratified analyses to figure out specific populations.
Results
In the multivariable linear regression models, we discovered that serum iron levels were inversely related to blood eosinophil counts in asthmatic adults. Simultaneously, we found that for every unit increase in serum iron (umol/L), blood eosinophil counts reduced by 1.41/uL in model 3, which adjusted for all variables excluding the analyzed variables. Furthermore, the XGBoost model of machine learning was applied to assess the relative importance of chosen variables, and it was determined that vitamin C intake, age, vitamin B12 intake, iron intake, and serum iron were the five most important variables on blood eosinophil counts. And the generalized additive model and piecewise linear regression model further verify this linear and inverse association.
Conclusion
Our investigation discovered that the linear and inverse association of serum iron with blood eosinophil counts in asthmatic adults, indicating that serum iron might be related to changes in the immunological state of asthmatics. Our work offers some new thoughts for next research on asthma management and therapy. Ultimately, we hope that more individuals become aware of the role of iron in the onset, development, and treatment of asthma.
... 12 In this regard, a substantial mass of studies documented an association between iron deficiency, primarily anemia, and allergic diseases. [13][14][15][16] The more allergic diseases a person suffers, the greater the likelihood of having sideropenic anemia. However, the exact mechanisms contributing to this association have yet to be entirely understood. ...
... 17 Moreover, it has been reported that iron deficiency worsens allergic symptoms and promotes allergy development. [13][14][15] Consistently, iron supplementation improved allergic symptoms and ameliorated response to allergen-specific immunotherapy. 18 Based on this background, we tested the hypothesis about a possible relationship between iron metabolism biomarkers and peripheral eosinophils in an unselected population undergoing a blood test. ...
... In particular, there is evidence that sideropenic anemia is related to allergic diseases concerning prevalence and severity. [13][14][15][16] Consistently, iron supplementation may improve allergic issues. [17][18] However, these studies examined the selected populations composed of allergic patients. ...
Iron is a primary component of the human body and exerts many functions, mainly concerning red cells and the immune system. In addition, there is evidence that iron-deficiency anemia is associated with allergic diseases. Type 2 inflammation characterizes allergic diseases. Peripheral eosinophils are a reliable biomarker for type 2 inflammation. Therefore, the present study investigated the possible relationship between iron metabolism and peripheral eosinophils in a large population. Eosinophils also play important roles in immune and tissue homeostasis. A growing body of data suggests tissue eosinophils represent a plastic and heterogeneous population of functional sub-phenotypes, shaped by environmental (systemic and local) factors. The retrospective study included 2795 subjects who were afferent to the Clinical Chemistry Analysis Laboratory during the year 2022. Men had higher peripheral eosinophil count than women (p<0.001). Furthermore, stratifications for sex, eosinophil, and hemoglobin cut-offs showed that men had more eosinophil counts than women. However, there was no correlation between iron biomarkers and peripheral eosinophils. The present study did not demonstrate a clear relationship between iron deficiency and peripheral eosinophil count. Even if this large population may include allergic subjects and patients with different diseases, it seems that iron does not directly affect eosinophil count.
... However, only holoAlt a 1 carrying iron complexes induced TNFα and IL10, whereas apoAlt a 1 incubation was rather associated with a Th2 signature and elevated IL5 [83]. The iron scavenging features of apoAlt a 1 were associated with a Th2-milieu, which is in accordance with the literature showing that iron deficiency is associated in vitro [84][85][86] and in human clinical studies with Th2 inflammation [20,[87][88][89][90][91][92][93]. To stress out the importance of iron, reduced immunogenicity has also been shown upon iron-binding with Arah1, Arah3/Arah4 allergens [94], ovotransferrin [95], beta-lactoglobuline [21], and Bet v 1 [17]. ...
Alternaria alternata is a common fungus strongly related with severe allergic asthma, with 80% of affected individuals being sensitized solely to its major allergen Alt a 1. Here, we assessed the function of Alt a 1 as an innate defense protein binding to micronutrients, such as iron-quercetin complexes (FeQ2), and its impact on antigen presentation in vitro. Binding of Alt a 1 to FeQ2 was determined in docking calculations. Recombinant Alt a 1 was generated, and binding ability, as well as secondary and quaternary structure, assessed by UV-VIS, CD, and DLS spectroscopy. Proteolytic functions were determined by casein and gelatine zymography. Uptake of empty apo- or ligand-filled holoAlt a 1 were assessed in human monocytic THP1 cells under the presence of dynamin and clathrin-inhibitors, activation of the Arylhydrocarbon receptor (AhR) using the human reporter cellline AZ-AHR. Human PBMCs were stimulated and assessed for phenotypic changes in monocytes by flow cytometry. Alt a 1 bound strongly to FeQ2 as a tetramer with calculated Kd values reaching pico-molar levels and surpassing affinities to quercetin alone by a factor of 5000 for the tetramer. apoAlt a 1 but not holoAlta 1 showed low enzymatic activity against casein as a hexamer and gelatin as a trimer. Uptake of apo- and holo-Alt a 1 occurred partly clathrin-dependent, with apoAlt a 1 decreasing labile iron in THP1 cells and holoAlt a 1 facilitating quercetin-dependent AhR activation. In human PBMCs uptake of holoAlt a 1 but not apoAlt a 1 significantly decreased the surface expression of the costimulatory CD86, but also of HLADR, thereby reducing effective antigen presentation. We show here for the first time that the presence of nutritional iron complexes, such as FeQ2, significantly alters the function of Alt a 1 and dampens the human immune response, thereby supporting the notion that Alt a 1 only becomes immunogenic under nutritional deprivation.
... Of particular note among these are iron and zinc deficiency, but also folic acid deficiency. Anaemia has been significantly linked Allergy to the cat-from diagnosis to management K review to the risk of developing atopy and subsequent allergic symptoms in international studies [54][55][56]. Often it is not a matter of classic anaemia characterized by lower erythrocyte counts, haemoglobin associated with impaired iron parameters in the laboratory test results, but of a so-called "functional iron deficiency", which particularly affects immune cells [57]. Functional iron deficiency is much more difficult to detect in the laboratory, as confirmed by current guidelines [58]. ...
Background
In allergology practice, efficient counselling of cat owners is often frustrating because the topic of allergen avoidance is mostly a “no-go” and there are only few studies on allergen immunotherapy that prove its efficacy. In the end, what patients are mostly offered in allergy consultations are allergen reduction measures and symptomatic therapy.
Results
Sensitisation to the main cat allergen Fel d 1 occurs more frequently in atopic conditions and then represents a risk for allergic rhinitis and asthma. Current guidelines are therefore cautious about the first-time acquisition of a cat in the first months of life in atopic families. However, sensitisation occurs in many cases even without contact with an own cat at home.
Conversely, it has been observed in adult patients that in the case of high Fel d 1 exposure immunological tolerance can also develop through the induction of specific IgG4. The fact that many cat allergic patients keep their animals despite diagnosis is, however, partly due to the psychological phenomenon of coping.
Conclusion
In this review, we present current literature and facts that should make everyday life easier for patients, even without giving up the animal. We also review best practices in the management of cat allergy and present new management options and concepts from the development pipeline that our patients are eagerly awaiting.
... In addition, different investigations have also revealed the manifestation of anemia in bronchial asthmatic patients [25]. Similarly, different studies reported that the prevalence of anemia was high in asthmatic patients [26,27]. ...
Background
Asthma is a heterogeneous disease characterized by chronic airway inflammation. The pathophysiologic processes of asthma can disrupt iron homeostasis, resulting in anemia. However, the association between asthma and anemia among adult asthma patients remains limited. Therefore, the main aim of this study was to determine the prevalence and factors associated with anemia among adult asthmatic patients from May to August 2021.
Methods
An institution-based, cross-sectional study was conducted among 291 asthmatic patients in Northwest Ethiopia. A pre-tested structured questionnaire and checklist were used to collect sociodemographic and clinical data. A blood specimen was collected from asthmatic patients for a complete blood count analysis and morphology assessment. The data were entered into the Epi data software and exported to the statistical package for social science version 20 software for analysis. Non-parametric Mann-Whitney U test was used to compare red blood cell parameters among groups with acute and chronic exacerbations. Binary logistic regression models were used to determine the factors associated with anemia. A p-value less than 0.05 was considered statistically significant.
Result
The overall prevalence of anemia in this study was 11% (95% CI: 7.2–14.8%). Acutely exacerbated asthmatic patients had significantly lower median values of red blood cell parameters such as red blood cell count, hemoglobin, and mean cell hemoglobin when compared to chronic exacerbations. In addition, using systemic corticosteroids (AOR = 4.07, 95% CI: 1.126–14.71, p = 0.032) and being hospitalized in the emergency department (AOR = 3.74, 95% CI: 1.26–11.07, p = 0.017) were found to be significantly associated with anemia.
Conclusion
This study demonstrated that anemia was predominant in adult asthma patients. Red blood cell number, hemoglobin level, and mean corpuscular hemoglobin were significantly lower in acute asthma exacerbations. Therefore, appropriate intervention strategies should be undertaken to reduce the prevalence of anemia among adult asthma patients to reduce further complications and provide better monitoring of asthma patients.
