Pınar Uysal

Current state and future of pediatric allergology in Europe: A road map

The history of pediatric allergology (PA) in Europe is relatively youthful, dating back to 1984, when a small group of pediatricians founded the European Working Group on Pediatric Allergy and Immunology—later giving rise to ESPACI (European Society on Pediatric Allergology and Clinical Immunology). In 1990, the first dedicated journal, Pediatric Allergy and Immunology (PAI), was founded. There are striking differences across Europe, and even within European countries, in relation to the training pathways for doctors seeing children with allergic disease(s). In 2016, the EAACIClemens von Pirquet Foundation (CvP) organized and sponsored a workshop with the European Academy of Allergy and Clinical Immunology (EAACI) Pediatric Section. This collaboration focussed on the future of PA and specifically on education, research, and networking/ advocacy. The delegates representing many countries across Europe have endorsed the concept that optimal care of children with allergic diseases is delivered by pediatricians who have received dedicated training in allergy, or allergists who have received dedicated training in pediatrics. In order to meet the needs of children and families with allergic disease(s), the pediatric allergist is highly encouraged to develop several networks. Our challenge is to reinforce a clear strategic approach to scientific excellence to across our member base and to ensure and enhance the relevance of European pediatric research in allergy. With research opportunities in basic, translational, clinical, and epidemiologic trials, more trainees and trained specialists are needed and it is an exciting time to be a pediatric allergologist.

Dynamic thiol/disulfide homeostasis in children with attention deficit hyperactivity disorder and its relation with disease subtypes

BACKGROUND The aim of this study was to evaluate a novel oxidative stress marker (thiol/disulfide homeostasis) in attention deficit hyperactivity disorder (ADHD) children for the first time in literature. METHODS Ninety children with ADHD diagnosed according to DSM-V and as control group, 65 healthy children were included to the study. Native thiol, total thiol, disulfide, disulfide/native thiol, disulfide/total thiol were compared between the groups. RESULTS Total and native thiol levels were significantly higher whereas the disulfide/native thiol ratios were significantly lower in children with ADHD. ADHD combined type appeared to have higher disulfide, disulfide/native thiol and disulfide/total thiol ratios compared to other subtypes. Disulfide levels of the males with ADHD were significantly higher than those of the females with ADHD. CONCLUSION This study suggests that thiol/disulfide homeostasis is abnormal in children with ADHD. It may be used as a novel OS marker in ADHD children because it is easy, practical, fully automated and relatively inexpensive.

High-dose anti-histamine use and risk factors in children with urticaria

AIM The drugs of choice in the treatment of urticaria in children are H1-antihistamines. The aim of the study was to evaluate children with urticaria and define risk factors for requirement of high-dose H1-antihistamines in children with urticaria. MATERIAL AND METHODS The medical data of children who were diagnosed as having urticaria admitted to our outpatient clinic between January 2014 and January 2016 were searched. The medical histories, concomitant atopic diseases, parental atopy histories, medications, treatment responses, blood eosinophil and basophil counts, and serum total IgE levels were recorded. In addition, the urticaria activity score for seven days, autoimmune antibody tests, and skin prick test results were evaluated in children with chronic urticaria. RESULTS The numbers of the children with acute and chronic urticaria were 138 and 92, respectively. The age of the children with chronic urticaria was higher than that of those with acute urticaria (p<0.0001). There was no difference between the two groups in terms of blood eosinophil and basophil counts, and serum total IgE levels (p>0.05). There was a negative correlation between blood eosinophil count and the UAS7 score in children with chronic urticaria (r=-0.276, p=0.011). Chronic urticaria and requirement of high dose H1-antihistamines were significant in children aged ≥10 years (p<0.001, p=0.015). High UAS7 score (OR: 1.09; CI 95%: [1.03-1.15]) and basopenia (OR: 6.77; CI 95%: [2.01-22.75]) were associated with the requirement of high-dose H1-AH in children with chronic urticaria. CONCLUSION The requirement of high-dose H1-antihistamines was higher with childrens increasing age. Disease severity and basopenia were risk factors for the requirement of high-dose H1-antihistamines.

Mothers’ emotional states and attitudes regarding their children with asthma

Abstract Objectives: The aim of this study was to investigate the associations of asthma with the psychological profile (depression and anxiety) of children with asthma and their mothers as well as the attitudes of these mothers toward their children and their family relationships. Methods: Sixty-four children with asthma, 60 healthy children and their mothers were included in the study. The Children’s Depression Inventory (CDI) and Childhood Anxiety Sensitivity Index (CASI) were applied to the children. All mothers completed the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Parental Attitude Research Instrument and the Family Assessment Device. Results: CASI scores were significantly higher in children with asthma (p < 0.001) than in healthy children. The increasing duration and severity of asthma were associated with increasing anxiety levels in children with asthma. Depression and anxiety scores were significantly higher in the mothers of children with asthma than in the comparison group. The mothers of children with asthma did not have supportive and friendly relationships with their children. In addition, these mothers had significantly higher Attitude of Hostility and Rejection, Attitude of Over-parenting and Authoritarian Attitude scores than those of the comparison group. Increasing duration and severity of asthma influenced family functions and the attitude of the mothers of children with asthma. There was a correlation between an increasing number of emergency department visits and increasing depression in the mothers of children with asthma. Conclusions: This cross-sectional study revealed that the disease may negatively affect the lives of children with asthma and their mothers and their family relationships.

Association of oxidative stress and dynamic thiol-disulphide homeostasis with atopic dermatitis severity and chronicity in children: a prospective study

Oxidative stress (OS) has an important effect on the pathogenesis of atopic dermatitis (AD). Thiols are antioxidants that regulate intracellular redox metabolism and protect keratinocytes against OS damage in the stratum corneum.

P58 - The role of osteopontin and vitamin D in school-age asthmatic children for predicting asthma exacerbation

Results OPN levels (ng/ml) were significantly higher in asthmatics in exacerbation period when compared to nonexacerbation period, and controls [30,61±3,21 vs. 28,7 ±3,71 vs. 27,62±3,91, respectively; p<.001]. There was no significant difference among OPN levels between asthmatics and controls, (p=.094). 25(OH)D levels (ng/ml) were significantly lower in asthmatics in exacerbation period when compared to non-exacerbation period, and controls [30,15±5,11 vs. 32,23±5,80 vs. 34,16±5,86, respectively; p<.001]. There was no significant difference among 25(OH)D levels between asthmatics and controls, (p=.051).There was a correlation for both OPN and 25 (OH)D levels among asthmatics in exacerbation period and non-exacerbation period, respectively (r=0,40, p<,001 and r=0,62, p<.001). But, no correlation between OPN and 25(OH)D levels among asthmatics in exacerbation and non-exacerbation periods (r=-0,78, p=,481; r=0,10, p=,448, respectively).

PD40 - A successful desensitisation to cat in a child with anaphylaxis

Allergic sensitization to airborne cat allergens is common and mostly related with asthma and allergic rhinitis. Anaphylactic reactions due to exposure to cats have not been reported. Herein, we report the case of 8-year-old boy who had experienced anaphylaxis after contact with cats and successfully desensitized in the first year of immunotherapy.