Exposure to house dust endotoxin and allergic sensitization in allergic and nonallergic children living in Adana, Turkey.

It has been suggested that exposure to elevated levels of endotoxin decreases the risk of allergic sensitization. The objective of our study was to analyze associations between house dust endotoxin levels and allergic sensitization in children. One hundred children with self-reported allergic diseases and 100 healthy children were randomly selected from a list of a previous prevalence study in school children. These children attended the study center again to complete a detailed questionnaire and medical examination including skin prick test and pulmonary function test. Of these children, 65 had allergen sensitization. Parents of a total 100 children (50 allergic and 50 healthy) agreed to house dust sampling in their homes. Thirty-five allergic children had asthma and 25 had rhinitis. Thirteen allergic and 14 healthy children lived in rural areas. The endotoxin content was quantified using a chromogenic kinetic Limulus amoebocyte lysate test. Endotoxin was at a detectable level in all dust samples. Endotoxin levels ranged from 0.05 to 309 EU/ml, with a geometric mean of 61.8 (confidence interval [CI] %) (50-73) EU/ml. There were no differences in house dust endotoxin levels between allergic and nonallergic children (p=0.153). On the whole, the mean level of endotoxin in rural homes was higher than that of urban homes, but this was not statistically significant (p=0.354). The highest endotoxin level was found in the homes of nonallergic children living in the rural areas and the lowest level in the homes of allergic children living in an urban area; however, this was not important statistically (p=0.320). Exposure to endotoxin was not associated with a risk of allergic sensitization (odds ratio [OR]=0.98; 95% CI: 0.91-1.05, p=0.609). In conclusion, supposing that the current level of endotoxin may reflect that in the past, the levels of endotoxin in living room floor dust of homes of allergic and nonallergic children in our study population were not associated with allergic sensitization. Further studies are needed on this topic.

Exhaled breath condensate MMP-9 levels in children with bronchiectasis.

Bronchiectasis (BE) is still an important cause of chronic supurative respiratory diseases in developing countries. Neutrophil-derived proteases such as neutrophil elastase and matrix metalloproteases (MMPs) are implicated in causing airway damage in chronic pulmonary disease. In this study, we aimed to evaluate the MMP-9 and its natural tissue inhibitors of metalloproteinases (TIMP-1) levels utilizing the exhaled breath condensate (EBC) method and their relationship with radiological findings and pulmonary functions in children with BE.Thirty-eight children with BE and 12 healthy children were included: Group 1 (cystic fibrosis [CF] BE), Group 2 (non-CF BE), Group 3 (control group). High-resolution computerized tomography (HRCT) scores were calculated according to the anatomic extent of BE. Pulmonary function tests were performed, and MMP-9 and TIMP-1 levels in EBC were analyzed by ELISA.Exhaled breath condensate MMP-9 level was 48.9 +/- 26.8 ng/ml for Group 1, and for Group 2, 42.8 +/- 18.1 ng/ml; and for Group 3, 30 +/- 3.7 ng/ml. Although no statistically significant difference was found between the Groups 1 and 2, a significant difference was detected between these groups and controls. No statistically significant difference was found in TIMP-1 levels regarding all groups. EBC MMP-9 levels were inversely correlated with pulmonary functions test, and positively with HRCT scores and annual number of pulmonary infections.In conclusion, this study showed that EBC of children with both CF BE and non-CF BE contained higher levels of MMP-9 in comparison to controls. We suggest that EBC MMP-9 level may be a useful marker of airway injury in patients with BE however prospective studies are needed.

The clinical and genetical features of 124 children with Familial Mediterranean fever: experience of a single tertiary center.

The aim of the present study was to evaluate the clinical features of childhood-onset Familial Mediterranean fever (FMF) patients and to assess the phenotype-genotype correlation. The study included patients with childhood-onset FMF that followed up over a period of 18 years in the Division of Pediatric Allergy and Immunology clinic. Twelve MEFV mutations were investigated in all patients. The patients were classified into four groups according to mutations: 1, M694V homozygote; 2, M694V heterozygote; 3, compound heterozygote for M694V; and 4, other-other gene mutation group. The following parameters were evaluated: gender, age of onset, age at diagnosis, time interval between disease onset and diagnosis, fever, abdominal pain, chest pain, arthralgia, arthritis, myalgia, vomiting, diarrhea, constipation, headache, erysipela-like erythema, protracted febrile myalgia, splenomegaly, hepatomegaly, consanguinity, number of attacks before and after treatment, severity score, response to colchicine treatment. Of the 124 patients included in the study, 105 had at least one MEFV gene mutation. M694V homozygosity was the most common mutation, followed by M694V heterozygotes and M694V-M680I compound heterozygotes. Severity score was found significantly higher in patients with M694V homozygote and compound heterozygote for M694V compared with other groups. The data supported the findings in literature that FMF patients with M694V homozygote and compound heterozygote for M694V gene mutations experience a more severe clinical course.

Effect of outdoor fungus concentrations on symptom severity of children with asthma and/or rhinitis monosensitized to molds.

Although the relationship between asthma severity and exposure to airborne fungi has been well studied, little is known about the contribution of outdoor molds to the symptoms of children monosensitized to molds. In this study, we aimed to investigate the effect of outdoor mold spore concentrations on daily asthma and/or rhinitis scores in children monosensitized to molds. Nineteen children with asthma and/or rhinitis sensitized only to molds recorded their daily symptoms and PEF values to the diaries, from February 2005 to January 2006. Additionally, mold spores were measured daily using a Burkard 7-day recording volumetric spore trap in city atmosphere and compared with meteorological data. Total number of mold spores in atmosphere was found to be 352,867 spore/m3 during the study period. Cladosporium (53%) was the most common encountered outdoor fungi, followed by Altemaria (29%) and 1-septate Ascospore (3%). Outdoor fungi concentrations were significantly correlated with mean monthly rhinitis score (r = 0.877, p < 0.001) and mean monthly asthma score (r = 0.831, p = 0.001), and mean monthly morning PEF (r = -0.741, p = 0.006) and evening PEF (r = -0.720, p = 0.008), and climatic conditions. The effect of outdoor fungi was highly evident on the symptoms of our patients with asthma and/or rhinitis monosensitized to molds.

Juvenile idiopathic arthritis profile in Turkish children.

BACKGROUND: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of disorders. Publications from different countries point to differences in the disease manifestation of JIA among different populations. The aim of the present paper was to evaluate the clinical and laboratory features of JIA in Turkish children. METHODS: A total of 196 JIA patients who fulfilled International League of Associations for Rheumatology (ILAR) diagnostic criteria were included in this retrospective study. The data collected were age, gender, age at disease onset and at diagnosis, and follow-up duration. Antinuclear antibody (ANA), rheumatoid factor (RF), and human leukocyte antigen B-27 were evaluated for each patient. RESULTS: There were 102 boys and 94 girls with a mean duration of disease of 4.1 years. The mean age at the first visit was 8.8 years, and the mean age at onset of disease was 6.8 years (range, 8 months-15 years). Polyarticular JIA was the most frequent onset type (37.2%). Other subtypes included oligoarthritis (34.2%), systemic arthritis (15.3%), psoriatic arthritis (1%), enthesitis-related arthritis (9.7%), and other arthritis (2.2%). ANA was positive in 28 patients (14.2%). Chronic uveitis occurred in two patients with oligoarthritis; and two patients with enthesitis-related arthritis had acute uveitis. Three patients (1.4%) developed amyloidosis. CONCLUSION: Compared to reports from Western countries, remarkably different features of JIA were found in Turkish children, which included higher frequency of polyarticular JIA, higher prevalence among boys, lower rate of ANA positivity and uveitis. Further studies are required to understand how genetic and environmental differences affect JIA expression.

Effect of indoor mold concentrations on daily symptom severity of children with asthma and/or rhinitis monosensitized to molds.

Little is known about the contribution of indoor molds to the symptoms of asthma and/or rhinitis in children monosensitized to molds. We aimed to investigate the effect of indoor mold spore concentrations on daily symptoms of asthma and/or rhinitis in children monosensitized to molds. Nineteen children with asthma and/or rhinitis sensitized only to molds recorded their daily symptoms and peak expiratory flow (PEF) values to the diaries, from February 2005 to January 2006. In this study period, indoor mold concentrations were measured monthly from the living rooms/bedrooms. The median indoor mold concentration was 37.5 CFU/m(3). Most commonly recovered indoor molds were Cladosporium (26.4%), Penicillium (24.7%), and Aspergillus (7%). Significant correlation was not found between indoor mold concentrations and daily rhinitis score (r = -0.021, p = 0.932), daily asthma score (r = 0.155, p = 0.554), daily morning PEF (r = -0.056, p = 0.475), and evening PEF (r = -0.057, p = 0.471). The effect of indoor molds is not evident on the symptoms of our patients with asthma and/or rhinitis monosensitized to molds.