Jarosław Komorowski

Filaggrin Gene Defects Are Independent Risk Factors for Atopic Asthma in a Polish Population: A Study in ECAP Cohort

Background FLG null variants of which 2282del4 and R501X are the most frequent in Caucasians are established risk factors for atopic dermatitis (AD) with an effect probably mediated through impairment of epidermal barrier. Among subjects with AD FLG defects are also consistently associated with asthma and allergic rhinitis (AR) but it is less clear to what extent these associations are also present independently from skin disease. The aim of the present study was to evaluate the role of 2282del4 and R501X in predisposing to these allergic phenotypes in a Polish population. Methodology 2282del4 and R501X were typed among 3,802 participants of the Epidemiology of Allergic Diseases in Poland (ECAP) survey, a cross-sectional population-based study using ECRHS II and ISAAC questionnaires, and ambulatory examination. Principal Findings The FLG null variants were associated with AD (OR = 2.01, CI: 1.20–3.36, P = 0.007), allergic rhinitis (in particular persistent form, OR = 1.69, CI:1.12–2.54, P = 0.011), and asthma (in particular atopic asthma, OR = 2.22, CI:1.24–3.96, P = 0.006). Association with atopic asthma (but not persistent allergic rhinitis) was also present in the absence of AD, (OR = 2.02, CI: 1.07–3.81, P = 0.027) as well as in the absence of AD and history of broadly defined inflammatory skin disease (OR = 2.30, CI: 1.07–4.93, P = 0.03). Association to atopic asthma would have not been found if diagnosis was made by questionnaire only (OR = 1.15, CI: 0.58–2.32, P = 0.8). We did not observe an association between FLG variants and allergic sensitizations (P = 0.8) or total IgE. (P = 0.6). Conclusions/Significance In a Polish population FLG 2282del4 and R501X carriage increases risk for development of AD and atopic asthma (also in the absence of AD or history thereof). This suggests that interventions aimed at restoring epidermal barrier may have a general role in asthma prophylaxis/treatment.

Prevalence of rhinitis in Polish population according to the ECAP (Epidemiology of Allergic Disorders in Poland) study

UNLABELLED The prevalence of allergic disorders, especially allergic rhinitis (AR), has dramatically increased in the past few decades and multicentre, standardized, randomized epidemiological studies are required to quantify this phenomenon in Poland. AIM The aim of the study was to estimate the prevalence of rhinitis and allergic rhinitis in Poland. MATERIAL AND METHOD The ECAP study was conducted using the ECRHS II and ISAAC questionnaires translated into the Polish language and validated, in selected nine regions of Poland, including eight cities and one rural area. The respondents within the regions were selected by means of multistage proportional stratified random sampling based on the identity number (PESEL) as the operat. The survey was conducted in 20,454 subjects (response rate of 41.9%) and 18,617 questionnaires were valid. Approximately 25% of the subjects (n=4783) were subsequently evaluated by clinicians (response rate of 43.4%). RESULTS Rhinitis was self-reported by 36.08% of the respondents (37.8% of 6- 7-year-olds, 34.5% of 13- 14-year-olds, and 36.0% of adults). The lowest prevalence rate was in the rural region (22.9%). Allergic rhinitis (AR) was self-reported by 22.54% of the respondents (23.6% of 6- 7-year-olds, 24.6% of 13- 14-year-olds, and 21.0% of adults). Again, the lowest prevalence rate was in the rural region (16.0%). AR was more frequent in males (24.0%) than in females (21.2%) (OR = 1.079; 95% CI: 1.044-1.116). AR was actually diagnosed by a clinician in 28.9%, including intermittent AR in 47.7% and persistent AR in 52.3%. Seasonal AR was diagnosed in 15.55%, and perennial rhinitis in 15.2%. CONCLUSION Allergic rhinitis is common in Poland as it affects nearly 25% of the population and it is a major social problem. Standards of early detection and prevention of allergic rhinitis should be introduced.

Obesity--a risk factor for asthma, but not for atopic dermatitis, allergic rhinitis and sensitization.

OBJECTIVE To analyse the relationship between obesity and overweight and the prevalence of allergic diseases and sensitization, and the impact of gender and place of residence. DESIGN Questionnaire based on those used in ISAAC (International Study of Asthma and Allergies in Childhood) and ECRHS (European Community Respiratory Health Survey). SETTING Our study involved populations of the eight largest cities and one rural region in Poland (each with over 150,000 inhabitants). SUBJECTS The study included 18,617 participants (24·2% aged 6-7 years, 25·4% aged 13-14 years, 50·4% adults aged 20-44 years) in eight cities and one rural area. The out-patient study involved 4783 patients (25·7%); we performed skin prick testing with fifteen aeroallergens. RESULTS Overweight was found in 16·13% of participants (9·11% of 6-7-year-olds, 4·90% of 13-14-year-olds and 25·61% of adults), obesity in 6·41% (7·16%, 2·45% and 8·36%, respectively). In adults, overweight (OR=1·34) and obesity (OR=1·80) increased the prevalence of asthma, especially in women (OR=1·53, OR=2·01). Among 13-14-year-olds the prevalence was higher only in the obese (OR=1·76). Overweight (OR=1·99) and obesity (OR=2·17) affected the incidence of doctor-diagnosed asthma in 6-7-year-olds. Overweight (OR=0·81) and obesity (OR=0·76) reduced the prevalence of allergic rhinitis in men. There was no relationship between BMI and asthma in people from rural areas. Obesity and overweight did not affect the frequency of sensitization to aeroallergens. CONCLUSIONS Overweight and obesity increased the prevalence of symptomatic asthma in adults, especially in women. In 13-14-year-olds, only obesity increased the prevalence of asthma. In children, overweight was associated with increased prevalence of clinically diagnosed and declared asthma and a trend towards atopy. Higher BMI was negatively associated with the prevalence of allergic rhinitis in overweight and obese man. There was no correlation between BMI and sensitization to aeroallergens.

The relationship between antibiotic therapy in early childhood and the symptoms of allergy in children aged 6–8 years — the questionnaire study results

IntroductionStudies based on the ISAAC questionnaire suggest a correlation between the use of antibiotics and the prevalence of asthma and allergy in children aged 6–7 years. The number of courses of antibiotic therapy is an important factor.ObjectivesTo investigate the relationship between the use of antibiotics during the first years of life and the prevalence of allergy and asthma among children (aged 6–8 years) in the urban population of Poland.Materials and MethodsA survey-based study with a self-completed questionnaire. The respondents were parents of children aged 6-8 years living in Warszawa, Poland. 1461 completed questionnaires were collected.ResultsAsthma was declared in 4.3% of the children. Wheezing and/or sibilant rhonchi within 12 months before the study was observed in 13.5% of the cases. Asthma medication was taken by 21.8% of the children. Allergic rhinitis was declared in 18.7% of the children. Problems with sneezing, rhinorrhea, and nasal congestion not associated with cold or fever were observed in 40.7% of the children. The analysis of the odds ratios between the use of antibiotics and the symptoms of allergic diseases revealed a clear correlation. The highest odds ratio was observed between the completion of over three courses of antibiotic therapy prior to the age of 12 months and the declaration of one of the following: asthma (OR = 5.59, 95% CI: 2.6–12.01), wheezing and/or sibilant rhonchi (OR = 4.68, 95% CI: 3.01–7.27) and taking medicines for breathlessness (OR = 5.12, 95% CI: 3.42–7.68).ConclusionsThere is a direct relationship between antibiotic use in the first 3 years of life and asthma and allergy symptoms in children aged 6–8 years old.

Atopic dermatitis is a serious health problem in Poland. Epidemiology studies based on the ECAP study

Introduction Global epidemiological studies have revealed considerable geographical differences in prevalence of atopic dermatitis (AD). Aim To present the epidemiology of AD, risk factors and co-occurrence of allergic diseases in the Polish population. Material and methods The present paper is a part of the Epidemiology of Allergic Disorders in Poland study. We studied 22 703 participants by ECRHS/ISAAC questionnaire; 18 617 (53.8% female, 24.2% 6–7 y.o., 25.4% 13–14 y.o., 50.4% 20–44 y.o.) completed questionnaires were accepted. Four thousand seven hundred and eighty-three participants (25.7%) have undergone a medical examination. Results Atopic dermatitis was diagnosed in 3.91% (6–7 y.o. 5.34%, 13–14 y.o. 4.3%, adults 3.02%), more often in females (OR = 1.52; 95% CI: 0.56–0.77), in the cities (OR = 2.23; 95% CI: 1.61–3.09), in mothers (OR = 2.07; 95% CI: 1.72–2.48) and fathers (OR = 2.00; 95% CI: 1.61–2.49) with atopy, higher education (OR = 1.61; 95% CI: 1.11–2.32) and economic status (OR = 1.35; 95% CI: 1.04–1.74). The highest prevalence was found in Katowice (4.89%) and lowest in rural areas (1.9%). Coexisting AD and allergic rhinitis (AR) was found in 26.17%, AR and asthma in 9.09% and AD, AR and asthma in 14.6%. Atopic dermatitis was diagnosed by allergologists in 6.5% (6–7 y.o. 8.7%, 13–14 y.o. 9.0%, adults 3.6%). Most diagnoses were made in Poznan (16.76%) and smallest in rural area (3.67%). 78.8% of subjects were diagnosed with AD for the first time although they had earlier experienced its symptoms. Conclusions Atopic dermatitis prevalence in Poland is below the mean rate for Europe, but the risk factor profile is similar to other countries. Atopic dermatitis is more frequent in well-educated females with atopic parents and high socioeconomic status and who live in a city.