Browsing by Subject "Asthma"

Now showing 1 - 13 of 13
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    A plant proteinase inhibitor from Enterolobium contortisiliquum attenuates airway hyperresponsiveness, inflammation and remodeling in a mouse model of asthma
    (Universidad de Murcia. Departamento de Biología Celular e Histología, 2019) Dias Rodrigues, Adriana Palmeira; Santos Bortolozzo, Anelize Sartori; Arantes Costa, Fernanda Magalhães; Saraiva Romanholo, Beatriz Mangueira; Castro Ribas de Souza, Flávia; Brüggemann, Thayse Regina; Roncon Santana, Fernanda Paula; Vilela de Brito, Marlon; Ramalho Bonturi, Camila; Neto dos Santos Nunes, Natalia; Máximo Prado, Carla; Leick, Edna Aparecida; Vilela Oliva, Maria Luiza; de Arruda Martins, Milton; Fraga Righetti, Renato; Lopes Calvo Tibério, Iolanda de Fátima
    Introduction. Proteinase inhibitors have been associated with anti-inflammatory and antioxidant activities and may represent a potential therapeutic treatment for asthma. Purpose. The aim of the present study was to evaluate the effects of Enterolobium contortisiliquum trypsin inhibitor (EcTI) on pulmonary mechanical function, eosinophilic recruitment, inflammatory cytokines, remodeling and oxidative stress in an experimental model of chronic allergic pulmonary inflammation. Methods. BALB/c mice were divided into 4 groups: C (saline i.p and inhalations with saline), OVA (ovalbumin i.p and inhalations with ovalbumin); C+EC (saline i.p, inhalations with s aline and treatment with EcTI); OVA+EC (ovalbumin i.p, inhalations with ovalbumin and treatment with EcTI). On day 29, we performed the following tests: resistance (Rrs) and elastance (Ers) of the respiratory system; (b) quantify eosinophils, 8-ISO-PGF2α, collagen and elastic fiber volume fractions; (c) IFN-γ, IL-4, IL-5, IL-13, MMP-9, TIMP-1, TGF-β, iNOS and p65-NFκB-positive cells in the airway and alveolar walls. Results. In OVA+EC group, there was an attenuation of the Rrs and Ers, reduction of eosinophils, IL-4, IL-5, IL-13, IFN-γ, iNOS and p65-NF κB-positive cells compared to OVA group. The 8-ISO-PGF2α, elastic and collagen fibers volume fractions as well as the positive cells for MMP-9, TIMP1 and TGF-β positive cells were decreased in OVA+EC compared to the OVA group. Conclusion. EcTI attenuates bronchial hyperresponsiveness, inflammation, remodeling and oxidative stress activation in this experimental mouse model of asthma.
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    Allergic Diseases and Impaired Lung Function in Children Exposed and Unexposed to Artisanal Brick Production
    (MDPI, 2026-05-25) Linares Segovia, Benigno; Bermúdez Pérez, Rocío Stephanie; Monroy-Torres, Rebeca; Jiménez Garza, Octavio Alejandro; Amador Licona, Norma; Guízar-Mendoza, Juan M.; del Río Hidalgo, Rodrigo Francisco; Ortega García, Juan Antonio; Claudio, Luz; Cirugía, Pediatría y Obstetricia y Ginecología; Facultades de la UMU::Facultad de Medicina
    Background: During the firing stage of artisanal brick production, particulate matter and other pollutants are released into the air, to which children are particularly vulnerable. Objective: To compare the frequency of allergic diseases and impaired lung function among children exposed and unexposed to artisanal brick production. Methods: A cross-sectional comparative study was conducted among 386 children aged 6 to 14 years, recruited from a primary and a secondary school in Guanajuato, Mexico. Participants were classified as exposed (n = 193) or unexposed (n = 193) to artisanal brick production. Once parents and children voluntarily consented to participate, study procedures were initiated. Forced spirometry and anthropometric measurements were performed, and the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was administered. We assessed the frequency of respiratory symptoms, allergic diseases, and lung function abnormalities. We measured the frequency of respiratory symptoms, allergic diseases, and lung function abnormalities. Results: The mean age of the 386 children was 9.7 ± 1.7 years. Each group consisted of 103 girls and 90 boys. The most important risk factors for impaired lung function were living in the brickyard (OR = 6.9, 95% CI: 4.3–11.1; p = 0.001) and being male (OR = 3.6, 95% CI:2.3–5.7; p = 0.001). The prevalence of impaired lung function was 13.5% in exposed and 4.1% in unexposed children (OR = 3.6, 95% CI: 1.5–8.1; p = 0.001). Most of the respiratory symptoms observed were obstructive and we found no difference in the frequency of allergic diseases, but respiratory symptoms were more frequent in exposed children. Conclusions: Respiratory symptoms and obstructive abnormalities in pulmonary function are more prevalent among children living in brickyards. Male sex and residence in the brickyard were the principal risk factors for impaired lung function.
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    Anti-inflammatory and antifibrotic effects of resveratrol in the lung
    (F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología, 2015) Conte, Enrico; Fagone, Evelina; Fruciano, Mary; Gili, Elisa; Iemmolo, Maria; Vancheri, Carlo
    Resveratrol, a natural polyphenolic molecule with several biological activities, is a well recognized anti-oxidant, anti-aging and cancer chemopreventive agent. Moreover, resveratrol anti-inflammatory and antifibrotic properties have been demonstrated both in vitro and in different animal models of inflammatory pathologies, including bowel and liver diseases. We review the evidence of resveratrol protective role in respiratory diseases such as acute lung injury, asthma, chronic obstructive pulmonary disease and lung fibrosis. We conclude that resveratrol and its derivatives may act as a therapeutic agents in respiratory diseases and pertinent clinical trials should be performed.
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    Comparación de los parámetros de cristalización urinaria entre pacientes asmáticos y pacientes sanos
    (Universidad de Murcia, 2021-03-12) Enjuanes Llovet, Jaume; Escribano Subías, Joaquín; Valverde Molina, José; Escuela Internacional de Doctorado
    Resumen Introducción: aunque la litiasis urinaria es una entidad infrecuente en la edad pediátrica, su incidencia está aumentando de forma rápida a lo largo de las últimas décadas. Aparte de los cambios en el estilo de vida y la dieta de la población, serían responsables de ello otros factores como por ejemplo el aumento de la prevalencia de enfermedades que predisponen a su aparición. Recientemente un estudio ha encontrado una posible asociación entre el asma y la enfermedad litiásica, cuya asociación no había sido previamente descrita y cuyo vínculo es desconocido. Objetivo: el objetivo principal es determinar si existen diferencias en la composición urinaria de los niños asmáticos con respecto a la de los sanos, ya sea en los niveles de excreción de los moduladores de la litiasis o en los valores de sobresaturación urinaria. Los objetivos secundarios son determinar los valores de referencia en orina de 12h para los parámetros analizados, investigar la posible influencia de la dieta y del uso de fármacos en la composición urinaria e investigar la posibilidad de eliminar el efecto de la fluctuación de la diuresis en los valores de sobresaturación urinaria mediante el uso de un procedimiento de estandarización. Material y métodos: estudio observacional transversal en el que se compararon distintos parámetros urinarios entre una cohorte de pacientes sanos y una cohorte de pacientes asmáticos, definidos como tales en base a los criterios de la Global International Network for Asthma. Los participantes recogieron toda la orina emitida a lo largo de un período de 12 horas que incluía el descanso nocturno y la aportaron para su análisis. En la muestra se determinó el volumen urinario, el pH y la concentración de sodio, potasio, cloro, calcio, fósforo, magnesio, oxalato, citrato, ácido úrico y urea. A partir de estos datos se calculó la excreción total de dichos solutos, que se normalizó en función de la superficie corporal del paciente, y se estimaron los valores de sobresaturación de varias sales urinarias de las familias de los oxalatos cálcicos, fosfatos cálcicos y uratos mediante el programa informático JESS Urine Expert. Se realizaron múltiples comparaciones en función del grupo al que pertenecía el paciente y también en función de la medicación que recibían. Resultados: la muestra comprendió la recolección de orina de 45 niños asmáticos y 44 niños sanos de características similares. La orina del grupo de los asmáticos no presentó diferencias estadísticamente significativas con respecto a la de los pacientes sanos ni en los niveles de moduladores de la litiasis ni en los niveles de sobresaturación calculados. Se encontraron las siguientes asociaciones entre parámetros urinarios y medicación: la citraturia se correlacionó con la dosis de corticoides (βstd = 0,496, p = 0,05) y con el uso de β2 agonistas de acción larga (βstd = -0,487, p = 0,001). La natriuria se correlacionó con el uso de β2 agonistas de acción larga (βstd = 0,424, p = 0,001) y con el uso de montelukast (βstd = -0,585, p = 0,028). El uso de LABA se correlacionó con la excreción de ácido úrico, aunque no se alcanzó la significación estadística (βstd = -0,361, p = 0,053). Los “parámetros urinarios que estiman características de la dieta” muestran correlaciones similares a las previamente descritas con los alimentos que representan. En función del parámetro estudiado, la dieta explicaría entre el 9,1 y el 44% de su variabilidad. En función del valor de sobresaturación estudiado, la diuresis explica entre el 22,3 y 42,6% de su variabilidad. Discusión: los parámetros de cristalización urinaria de los niños asmáticos son similares a los de los niños sanos. La medicación utilizada para el control del asma podría influir en la composición urinaria, aunque su incidencia sobre el riesgo litógeno sería poco relevante. Las características de la dieta de los pacientes, estimada a través de distintos parámetros urinarios, parece tener una elevada repercusión sobre la composición urinaria de los participantes. La diuresis tiene una considerable influencia en los niveles de sobresaturación, lo cual dificulta la comparación entre pacientes. La estandarización de la sobresaturación podría ser una herramienta que ayude a eliminar este problema, aunque hacen falta más estudios para delimitar adecuadamente su utilidad.
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    Contaminación atmosférica urbana e ingresos hospitalarios por asma y enfermedades respiratorias agudas en la ciudad de Murcia (España)
    (Elsevier, 2020-02-27) Martínez Hernández, Indra; Boldo, Elena; Cárceles Álvarez, Alberto; Solano Navarro, Carmen; Ramis, Rebeca; Aguilar Ros, Estefanía; Sánchez Solís, Manuel; López Hernández, Fernando; Ortega García, Juan Antonio; Cirugía, Pediatría y Obstetricia y Ginecología
    Introducción: La contaminación atmosférica urbana es una amenaza principal para la salud infantojuvenil. Los niños son más vulnerables a sus efectos asociando mayor morbimortalidad de enfermedades agudas y crónicas, especialmente respiratorias. Pretendemos estudiar los efectos de la contaminación atmosférica urbana en la tasa de ingresos hospitalarios por causa aguda respiratoria. Pacientes y métodos: Estudio ecológico durante 2015 de las visitas con patología respiratoria (CIE-9) de urgencias hospitalarias en menores de 17 años en el municipio de la ciudad de Murcia. Regresión logística para el riesgo de ingreso hospitalario entre las consultas en relación con los niveles promedios diarios de contaminantes ambientales (NO2, O3, PM10, SO2) obtenidas de la Red de Vigilancia y Control de la Calidad del Aire de la Región de Murcia. Otras variables de control: sexo, edad, temperatura ambiental media diaria, y estación del año. Resultados: Un total de 12354 niños consultaron en urgencias por patología respiratoria, 56% niños y 44% niñas. Ingresaron el 3,5%, con edad media de 2,54 (IC95% 2,16-2,91) años. Para el riesgo de ingreso hospitalario por enfermedades respiratorias: NO2 1,02 (IC95% 1,01-1,04; p < 0,01), O3 1,01 (IC95% 1,00-1,03; p < 0,01) sexo masculino 1,4 (IC95% 1,11-1,79; p < 0,01) e invierno 2,10 (IC95% 1,40-3,21; p < 0,01). Ingresos por asma: PM10 1,02 (IC95% 1,01-1,04; p < 0,05), O3 1,04 (IC95% 1,01-1,06; p < 0,01). Ingresos por bronquiolitis: edad 0,69 (IC95% 0,48-0,99; p < 0,05); NO2 1,03(IC95% 1,01-1,05; p < 0,01). Conclusiones: La contaminación atmosférica urbana aumenta los ingresos hospitalarios en pediatría por patología aguda respiratoria, especialmente por crisis de asma y bronquiolitis. Poner en marcha medidas preventivas, ampliar las series temporales y estudios colaborativos con datos en abierto ayudarían a mejorar la salud pública y la calidad del aire en las ciudades.
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    Diet: a specific part of the western lifestyle pack in the asthma epidemic
    (MDPI, 2020-07-01) Frontela Saseta, María del Carmen; García-Marcos Álvarez, Luis Vicente; González Bermúdez, Carlos Alberto; Tecnología de Alimentos, Nutrición y Bromatología
    The Western lifestyle is a complex concept that includes the diet as the main axis of di erent factors which contribute to a detrimental e ect on health, lower life expectancy and low quality-of-life. This type of diet is characterized by being high in calories, mainly provided by saturated fats, and rich in sugars that can lead to changes in immune cells and their responsiveness, by di erent mechanisms that have yet to be totally clarified. Inflammatory processes are perpetuated through di erent pathways, in which adipose tissue is a major factor. High fat stores in overweight and obesity accumulate energy but the endocrine function is also producing and releasing diferent bioactive compounds, adipokines, known to be pro-inflammatory and which play an important role in the pathogenesis of asthma. This review therefore explores the latest evidence regarding the adverse e ect of theWestern diet on adipose tissue inflammation and its causative e ect on the asthma epidemic.
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    Histopathological classification of refractory chronic rhinosinusitis with nasal polips
    (Universidad de Murcia. Departamento de Biología Celular e Histología, 2015) Mortuaire, G.; Leroy, Xavier; Gengler, I.; Chevalier, D.; Prin, L.; Picry, A.
    Objective: To delineate the histopathological characteristics of nasal mucosa in refractory chronic rhinosinusitis with nasal polyps (CRSwNP) in order to demonstrate subtypes of nasal polyps and their potential relation with lower airway comorbidity. Study Design: Clinical- and pathological-based cross-sectional study. Methods: Nasal polyp specimens were prospectively collected from patients with refractory CRSwNP referred to our institution for endoscopic sinus surgery. Oral and topical steroids were stopped 1 month before surgery. The pathological analysis was conducted by 2 independent reviewers with light microscopy on Hematoxylin-Eosin-Saffron stained slides. Each observer fulfilled a standardized protocol with cell count and stromal characterization on the most representative field. Mean grading scores were established. Morphological aspects were compared with the cell distribution and the clinical conditions. Results: Among 36 patients, three subtypes of nasal polyps were depicted: eosinophilic edematous (64%), fibrous (9%) and intermediate with mixed edematous and collagen stromal structure (27%). Basement membrane thickening and seromucous gland hyperplasia were observed in the fibrosis sub-type (p<0.03). Eosinophilic mucosal infiltrate was significantly increased (p=0.026) in patients with concomitant pulmonary disease (n=21). Nasal polyp distribution was not influenced by asthma, allergy, previous surgery and smoking. Conclusion: Our 3-subtype classification of refractory CRSwNP in Caucasian population shows a predominant edematous structure whatever the clinical conditions may have been. Eosinophilia as a major factor of adaptive immune response in nasal inflammation is a feature of concomitant pulmonary disease. Further studies concerning mucosal remodelling and outcome assessment after sinus surgery are required to evaluate the impact of our classification on a daily basis.
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    Long noncoding RNAs in respiratory diseases
    (Universidad de Murcia. Departamento de Biología Celular e Histología, 2018) Zhang, Jiaxiang; Zhu, Yong; Wang, Ruilan
    Recently developed RNA microarrays and high-throughput sequencing techniques have demonstrated that long non-coding RNAs (lncRNAs) play important roles in a wide range of biological processes. Emerging evidence has confirmed the relevance of lncRNAs to diverse types of human disease, including cancer and cardiovascular disease. In this review, we discuss the important functions of lncRNAs in respiratory diseases. Because the reviewed studies have mainly focused on non-small cell lung cancer, future work will need to extend the studies into other respiratory diseases. From a clinical perspective, targeting lncRNAs as a novel therapeutic strategy in respiratory diseases will require further study to further clarify their biological functions.
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    Prenatal vitamin D status and respiratory and allergic outcomes in childhood: A meta-analysis of observational studies
    (2018-05) Pacheco-González, Rosa M.; Morales Bartolomé, Eva; García-Marcos Álvarez, Luis Vicente; Ciencias Sociosanitarias
    Background: Prenatal vitamin D status may influence offspring’s respiratory and allergic outcomes; however, evidence is inconclusive. A systematic review and metaanalysis were conducted on the association between 25-hydroxyvitamin D [25(OH) D] levels in maternal blood in pregnancy or cord blood at birth with the risk of offspring’s respiratory and allergic conditions. Methods: Two independent researchers conducted systematic searches for observational studies published until May 2017 using defined keywords on vitamin D and health outcomes, including respiratory tract infections (RTIs), wheeze, asthma, atopic eczema, allergic rhinitis, allergic sensitization, and lung function. Random-effects meta-analyses were conducted. Results: A total of 34 from 547 retrieved articles were included. Increased prenatal exposure to 25(OH)D was inversely associated with risk of RTIs. Comparing the highest with the lowest category of 25(OH)D levels, the pooled odds ratio was 0.64 (95% CI 0.47, 0.87). A positive borderline association was found for lung function at school age (FEV1 z-score coefficient 0.07, 95% CI -0.01, 0.15). No associations were found for wheeze, asthma, atopic eczema, allergic rhinitis, and allergic sensitization. Conclusion: The introduction of public health measures to tackle vitamin D status in pregnancy may reduce the burden of RTIs in offspring. Current evidence does not support an impact on asthma and allergy.
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    The early appearance of asthma and its relationship with gut microbiota: a narrative review
    (MDPI, 2024-07-19) Suárez Martínez, Clara; Santaella-Pascual, Marina; Yagüe Guirao, Genoveva; García-Marcos Álvarez, Luis Vicente; Ros Berruezo, Gaspar; Martínez Gracia, Carmen; Tecnología de Alimentos, Nutrición y Bromatología; Facultad de Veterinaria
    Asthma is, worldwide, the most frequent non-communicable disease affecting both children and adults, with high morbidity and relatively low mortality, compared to other chronic diseases. In recent decades, the prevalence of asthma has increased in the pediatric population, and, in general, the risk of developing asthma and asthma-like symptoms is higher in children during the first years of life. The “gut–lung axis” concept explains how the gut microbiota influences lung immune function, acting both directly, by stimulating the innate immune system, and indirectly, through the metabolites it generates. Thus, the process of intestinal microbial colonization of the newborn is crucial for his/her future health, and the alterations that might generate dysbiosis during the first 100 days of life are most influential in promoting hypersensitivity diseases. That is why this period is termed the “critical window”. This paper reviews the published evidence on the numerous factors that can act by modifying the profile of the intestinal microbiota of the infant, thereby promoting or inhibiting the risk of asthma later in life. The following factors are specifically addressed in depth here: diet during pregnancy, maternal adherence to a Mediterranean diet, mode of delivery, exposure to antibiotics, and type of infant feeding during the first three months of life.
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    The Nutrition in Early Life and Asthma (NELA) birth cohort study: Rationale, design, and methods
    (2022) Alcantara-Lopez, Maria V.; Cabezas-Herrera, Juan; Jimenez-Guerrero, Pedro; Larqué, Elvira; Lopez-Soler, Concepción; Martinez-Gracia, Carmen; Martinez-Torres, Antonela; Salvador-Garcia, Carme; Yagüe-Guirao, Genoveva; Zornoza-Moreno, Matilde; Santaella-Pascual, Marina; Diego Puente, Teresa de; Martín-Orozco Santiago, María Elena; Noguera Velasco, José Antonio; Hernández Caselles, Trinidad; Sola Martínez, Rosa Alba; Mendiola Olivares, Jaime; Morales Bartolomé, Eva; Pérez Fernández, Virginia; Torres Cantero, Alberto Manuel; García-Marcos Álvarez, Luis Vicente; Nieto Díaz, Anibal; Prieto Sánchez, María Teresa; Sánchez-Solís de Querol, Manuel; Ciencias Sociosanitarias
    Background: Primary prevention strategies for asthma are lacking. Its inception probably starts in utero and/or during the early postnatal period as the developmental origins of health and disease (DOHaD) paradigm suggests. Objectives: The main objective of Nutrition in Early Life and Asthma (NELA) cohort study is to unravel whether the following factors contribute causally to the developmental origins of asthma: (1) maternal obesity/adiposity and foetal growth; (2) maternal and child nutrition; (3) outdoor air pollution; (4) endocrine disruptors; and (5) maternal psychological stress. Maternal and offspring biological samples are used to assess changes in offspring microbiome, immune system, epigenome and volatilome as potential mechanisms influencing disease susceptibility. Population: Randomly selected pregnant women from three health areas of Murcia, a south-eastern Mediterranean region of Spain, who fulfilled the inclusion criteria were invited to participate at the time of the follow-up visit for routine foetal anatomy scan at 19–22 weeks of gestation, at the Maternal-Fetal Medicine Unit of the “Virgen de la Arrixaca” University Clinical Hospital over a 36-month period, from March 2015 to April 2018. Design: Prospective, population-based, maternal-child, birth cohort study. Methods: Questionnaires on exposures and outcome variables were administered to mothers at 20–24 gestation week; 32–36 gestation week; and delivery. Children were surveyed at birth, 3 and 18 months of age and currently at 5 years. Furthermore, physical examinations were performed; and different measurements and biological samples were obtained at these time points. Preliminary results: Among the 1350 women invited to participate, 738 (54%) were finally enrolled in the study and 720 of their children were eligible at birth. The adherence was high with 612 children (83%) attending the 3 months’ visit and 532 children (72%) attending the 18 months’ visit. Conclusion: The NELA cohort will add original and unique knowledge to the developmental origins of asthma.
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    The Nutrition in Early Life and Asthma (NELA) birth cohort study: Rationale, design, and methods.
    (Wiley, 2021-09-19) Cabezas Herrera, Juan; Jiménez Guerrero, Pedro; Larque Daza, Elvira; Martinez Gracia, María del Carmen; Martinez Torres, Antonela; Salvador García, Carme; Sánchez Solís De Querol, Manuel; Yagüe Guirao, Genoveva; Zornoza Moreno, Matilde; López Soler, Concepción; Santaella-Pascual, Marina; Diego Puente, Teresa de; Hernández Caselles, Trinidad; Martín-Orozco Santiago, María Elena; Sola Martínez, Rosa Alba; Noguera Velasco, José Antonio; Mendiola Olivares, Jaime; Morales Bartolomé, Eva; Pérez Fernández, Virginia; Torres Cantero, Alberto Manuel; García-Marcos Álvarez, Luis Vicente; Nieto Díaz, Anibal; Prieto Sánchez, María Teresa; Bioquímica y Biología Molecular B e Inmunología
    Background: Primary prevention strategies for asthma are lacking. Its inception probably starts in utero and/or during the early postnatal period as the developmental origins of health and disease (DOHaD) paradigm suggests. Objectives: The main objective of Nutrition in Early Life and Asthma (NELA) cohort study is to unravel whether the following factors contribute causally to the developmental origins of asthma: (1) maternal obesity/adiposity and foetal growth; (2) maternal and child nutrition; (3) outdoor air pollution; (4) endocrine disruptors; and (5) maternal psychological stress. Maternal and offspring biological samples are used to assess changes in offspring microbiome, immune system, epigenome and volatilome as potential mechanisms influencing disease susceptibility. Population: Randomly selected pregnant women from three health areas of Murcia, a south-eastern Mediterranean region of Spain, who fulfilled the inclusion criteria were invited to participate at the time of the follow-up visit for routine foetal anatomy scan at 19–22 weeks of gestation, at the Maternal-Fetal Medicine Unit of the “Virgen de la Arrixaca” University Clinical Hospital over a 36-month period, from March 2015 to April 2018. Design: Prospective, population-based, maternal-child, birth cohort study. Methods: Questionnaires on exposures and outcome variables were administered to mothers at 20–24 gestation week; 32–36 gestation week; and delivery. Children were surveyed at birth, 3 and 18 months of age and currently at 5 years. Furthermore, physical examinations were performed; and different measurements and biological samples were obtained at these time points. Preliminary results: Among the 1350 women invited to participate, 738 (54%) were finally enrolled in the study and 720 of their children were eligible at birth. The adherence was high with 612 children (83%) attending the 3 months’ visit and 532 children (72%) attending the 18 months’ visit. Conclusion: The NELA cohort will add original and unique knowledge to the developmental origins of asthma.
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    Worldwide impact of human development and inequality on the prevalence of asthma, rhinoconjunctivitis and eczema. Global Asthma Network's Ecological Study
    (Wiley, 2026-06-04) García-Marcos Álvarez, Luis Vicente; Chiang, Chen-Yuan; Asher, Innes; Marks, Guy B.; El Sony, Asma; Masekela, Refiloe; Bissell, Karen; Ellwood, Eamon; Ellwood, Philippa; Pearce, Neil; Strachan, David P.; Martínez-Torres, A. Elena; Sánchez-Solís de Querol, Manuel; Mortimer, Kevin; Morales Bartolomé, Eva; Global Asthma Network Phase I Study Group; Ciencias Sociosanitarias
    Background: Lower-income countries have lower asthma prevalence. However, how differences in human development and inequality can explain changes in the prevalence of asthma and allergic diseases is not known. Methods: The Global Asthma Network Phase I study reported prevalence of asthma and allergic diseases in children (6–7 years), adolescents (13–14 years), and their parents/guardians in 16, 25 and 17 countries. Gini inequality index (GinI) and human development index (HDI), together with mean annual relative humidity and temperature, and latitude, were used as potential explanatory factors of prevalence differences using meta-regression models, fitted values and heatmaps of prevalence. Results: GinI and HDI explained some proportion of asthma prevalence variability, which was highest in children (up to ~70% for disease indicators such as current wheeze or symptoms of severe asthma) and lowest in adolescents (~22% for symptoms of severe asthma or asthma ever). Rhinoconjunctivitis prevalence variability was poorly explained by covariates (from ~53% for current rhinoconjunctivitis among children—an exception—to none). Eczema indicators were explained in a range from ~60% in children (current eczema symptoms and symptoms of severe eczema) to ~12% in adolescents (current eczema symptoms). Overall, heatmaps showed areas of higher prevalence in the intersection of high GinI and high HDI values. Conclusions: HDI and Gini explain part of the worldwide variability in the prevalence of asthma, rhinoconjunctivitis, and eczema. This explanatory power is highest for asthma and lowest for rhinoconjunctivitis. Lower-resourced communities in highly developed countries show the greatest hazard, particularly for asthma.