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Article: Environmental Influences and Allergic Diseases in the Asia-Pacific Region: What Will Happen in Next 30 Years?

Xing, Yuhan / Wong, Gary Wing-Kin

2022 Volume 14, Issue 1, Page(s) 21–39

Abstract: Asia-Pacific is a populous region with remarkable variations in socioeconomic development and environmental exposure among countries. The prevalence rates of asthma and allergic rhinitis appear to have recently reached a plateau in Western countries, ... ...

Abstract	Asia-Pacific is a populous region with remarkable variations in socioeconomic development and environmental exposure among countries. The prevalence rates of asthma and allergic rhinitis appear to have recently reached a plateau in Western countries, whereas they are still increasing in many Asian countries. Given the large population in Asia, even a slight increase in the prevalence rate will translate into an overwhelming number of patients. To reduce the magnitude of the increase in allergic diseases in next few decades in Asia, we must understand the potential factors leading to the occurrence of these disorders and the development of potential preventive strategies. The etiology of allergic disorders is likely due to complex interactions among genetic, epigenetic, and environmental factors for the manifestations of inappropriate immune responses. As urbanization and industrialization inevitably progress in Asia, there is an urgent need to curtail the upcoming waves of the allergy epidemic. Potentially modifiable risk exposure, such as air pollution, should be minimized through timely implementation of effective legislations. Meanwhile, re-introduction of protective factors that were once part of the traditional farming lifestyle might give new insight into primary prevention of allergy.
Language	English
Publishing date	2022-01-04
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	2545725-1
ISSN	2092-7363 ; 2092-7355
ISSN (online)	2092-7363
ISSN	2092-7355
DOI	10.4168/aair.2022.14.1.21
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Article ; Online: From preschool wheezing to asthma: Environmental determinants.

Xing, Yuhan / Leung, Agnes Sze-Yin / Wong, Gary Wing-Kin

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

2023 Volume 34, Issue 11, Page(s) e14049

Abstract: Wheezing is common among preschool children, representing a group of highly heterogeneous conditions with varying natural history. Several phenotypes of wheezing have been proposed to facilitate the identification of young children who are at risk of ... ...

Abstract	Wheezing is common among preschool children, representing a group of highly heterogeneous conditions with varying natural history. Several phenotypes of wheezing have been proposed to facilitate the identification of young children who are at risk of subsequent development of asthma. Epidemiological and immunological studies across different populations have revealed the key role of environmental factors in influencing the progression from preschool wheezing to childhood asthma. Significant risk factors include severe respiratory infections, allergic sensitization, and exposure to tobacco smoke. In contrast, a farming/rural environment has been linked to asthma protection in both human and animal studies. Early and intense exposures to microorganisms and microbial metabolites have been demonstrated to alter host immune responses to allergens and viruses, thereby driving the trajectory away from wheezing illness and asthma. Ongoing clinical trials of candidate microbes and microbial products have shown promise in shaping the immune function to reduce episodes of viral-induced wheezing. Moreover, restoring immune training may be especially important for young children who had reduced microbial exposure due to pandemic restrictions. A comprehensive understanding of the role of modifiable environmental factors will pave the way for developing targeted prevention strategies for preschool wheezing and asthma.
MeSH term(s)	Animals ; Humans ; Child, Preschool ; Infant ; Child ; Respiratory Sounds/etiology ; Asthma/epidemiology ; Asthma/etiology ; Asthma/prevention & control ; Risk Factors ; Allergens ; Respiratory Tract Infections
Chemical Substances	Allergens
Language	English
Publishing date	2023-11-28
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1057059-7
ISSN	1399-3038 ; 0905-6157 ; 0906-5784
ISSN (online)	1399-3038
ISSN	0905-6157 ; 0906-5784
DOI	10.1111/pai.14049
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Article ; Online: COVID-19: lessons to date from China.

Lu, Xiaoxia / Xing, Yuhan / Wong, Gary Wing-Kin

Archives of disease in childhood

2020 Volume 105, Issue 12, Page(s) 1146–1150

Abstract: The pandemic due to a novel coronavirus has been sweeping across different regions of the globe since January 2020. Early reports of this infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) consisted of mostly adult patients. As ...

Abstract	The pandemic due to a novel coronavirus has been sweeping across different regions of the globe since January 2020. Early reports of this infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) consisted of mostly adult patients. As the outbreak spreads rapidly beyond the epicentre of Wuhan, it becomes clear that infants and children of all ages are susceptible to this infection. In China, there have been more than 1200 paediatric cases. Most paediatric patients acquire the infection through household contact with infected adults. The disease in children is usually self-limiting and most infected children will recover uneventfully within 7-10 days. Other than symptoms of the respiratory tract, many children may present with gastrointestinal symptoms. Older children are more likely to have asymptomatic infection. Although deaths related to SARS-CoV-2 are rarely reported in the paediatric age group, young children and those with underlying medical conditions are more likely to develop severe illness. Only a small fraction of neonates born to infected mother would acquire the virus by vertical transmission. Because a large proportion of children and adolescents may have asymptomatic or mildly symptomatic infection, children are likely to play an important role in community transmission of this infection. Screening of children who have a definitive contact history will facilitate early diagnosis and isolation of all infected children. This review summarises the lessons learned in China with regard to the current understanding of SARS-CoV-2 infection in the paediatric population.
MeSH term(s)	Adolescent ; Asymptomatic Infections/epidemiology ; COVID-19/epidemiology ; COVID-19/physiopathology ; COVID-19/transmission ; Child ; China/epidemiology ; Communicable Disease Control/methods ; Community-Acquired Infections/epidemiology ; Community-Acquired Infections/transmission ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; SARS-CoV-2/isolation & purification
Keywords	covid19
Language	English
Publishing date	2020-05-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	524-1
ISSN	1468-2044 ; 0003-9888 ; 1359-2998
ISSN (online)	1468-2044
ISSN	0003-9888 ; 1359-2998
DOI	10.1136/archdischild-2020-319261
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Article ; Online: Immune modulation by rural exposures and allergy protection.

Xing, Yuhan / Tsang, Miranda Sin-Man / Yang, Zhaowei / Wang, Maggie Haitian / Pivniouk, Vadim / Leung, Agnes Sze-Yin / Leung, Ting-Fan / Roponen, Marjut / Schaub, Bianca / Vercelli, Donata / Wong, Chun-Kwok / Li, Jing / Wong, Gary Wing-Kin

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

2024 Volume 35, Issue 2, Page(s) e14086

Abstract: Background: Growing up on traditional farms protects children from the development of asthma and allergies. However, we have identified distinct asthma-protective factors, such as poultry exposure. This study aims to examine the biological effect of ... ...

Abstract	Background: Growing up on traditional farms protects children from the development of asthma and allergies. However, we have identified distinct asthma-protective factors, such as poultry exposure. This study aims to examine the biological effect of rural exposure in China. Methods: We recruited 67 rural children (7.4 ± 0.9 years) and 79 urban children (6.8 ± 0.6 years). Depending on the personal history of exposure to domestic poultry (DP), rural children were further divided into those with DP exposure (DP Results: There was a stepwise increase in the percentage of eosinophils (%) from rural DP Conclusions: Immune responses of rural children were dampened compared to urban children and those exposed to DP had further downregulated immune responsiveness. DP dust extracts ameliorated Th2-driven allergic airway inflammation in mice. Determining active protective components in the rural environment may provide directions for the development of primary prevention of asthma.
MeSH term(s)	Child ; Humans ; Animals ; Mice ; Lipopolysaccharides/adverse effects ; Hypersensitivity ; Asthma ; Allergens ; Cytokines/metabolism ; Dust ; Inflammation ; Disease Models, Animal ; Immunity ; Mice, Inbred BALB C ; Ovalbumin/adverse effects
Chemical Substances	Lipopolysaccharides ; Allergens ; Cytokines ; Dust ; Ovalbumin (9006-59-1)
Language	English
Publishing date	2024-02-14
Publishing country	England
Document type	Journal Article
ZDB-ID	1057059-7
ISSN	1399-3038 ; 0905-6157 ; 0906-5784
ISSN (online)	1399-3038
ISSN	0905-6157 ; 0906-5784
DOI	10.1111/pai.14086
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Article ; Online: Disparities in pediatric anaphylaxis triggers and management across Asia.

Leung, Agnes Sze Yin / Tham, Elizabeth Huiwen / Pacharn, Punchama / Xing, Yuhan / Trinh, Hoang Kim Tu / Lee, Sooyoung / Ahn, Kangmo / Chatchatee, Pantipa / Sato, Sakura / Ebisawa, Motohiro / Lee, Bee Wah / Wong, Gary Wing Kin

Allergy

2024

Abstract: Background: The epidemiology and management of anaphylaxis are not well-reported in Asia.: Methods: A regional pediatric anaphylaxis registry was established by the Asia-Pacific Research Network for Anaphylaxis (APRA), using standardized protocols ... ...

Abstract	Background: The epidemiology and management of anaphylaxis are not well-reported in Asia. Methods: A regional pediatric anaphylaxis registry was established by the Asia-Pacific Research Network for Anaphylaxis (APRA), using standardized protocols for prospective data collection, to evaluate the triggers and management of anaphylaxis in the Asia-Pacific region. Pediatric patients below 18 years presenting with anaphylaxis across four Asian countries/cities (Thailand, Singapore, Hong Kong (HK), and Qingdao) were included. Allergen triggers, symptoms, anaphylaxis severity, and management were compared. Results: Between 2019 and 2022, 721 anaphylaxis episodes in 689 patients from 16 centers were identified. The mean age at anaphylaxis presentation was 7.0 years (SD = 5.2) and 60% were male. Food was the most common trigger (62%), particularly eggs and cow's milk in children aged 3 years and below. In school-age children, nut anaphylaxis was most common in HK and Singapore, but was rare in the other countries, and wheat was the top allergen in Bangkok. Shellfish anaphylaxis was most common in children aged 7-17. Adrenaline was administered in 60% of cases, with 9% given adrenaline before hospital arrival. Adrenaline devices were prescribed in up to 82% of cases in Thailand but none in Qingdao. Conclusions: The APRA identified food as the main trigger of anaphylaxis in children, but causative allergens differed even across Asian countries. Fewer than two-thirds of cases received adrenaline treatment, pre-hospital adrenaline usage was low, and adrenaline device prescription remained suboptimal. The registry recognizes an unmet need to strengthen anaphylaxis care and research in Asia-Pacific.
Language	English
Publishing date	2024-03-10
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	391933-x
ISSN	1398-9995 ; 0105-4538
ISSN (online)	1398-9995
ISSN	0105-4538
DOI	10.1111/all.16098
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Article: Allergic diseases in the Asia Pacific: path into the future.

Wong, Gary Wing-Kin

Asia Pacific allergy

2013 Volume 3, Issue 4, Page(s) 207–208

Language	English
Publishing date	2013-10-31
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2614800-6
ISSN	2233-8268 ; 2233-8276
ISSN (online)	2233-8268
ISSN	2233-8276
DOI	10.5415/apallergy.2013.3.4.207
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Article ; Online: Prospective study of disease persistence and lung function trajectories of childhood asthma.

Tang, Man Fung / Leung, Agnes Sze Yin / Ngai, Noelle Anne / Chan, Oi Man / Wong, Gary Wing Kin / Leung, Ting Fan

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

2022 Volume 33, Issue 2, Page(s) e13726

Abstract: Background: A proportion of asthmatic children outgrow their disease by adulthood, but there are limited data on predictors for asthma persistence. This prospective study characterized the trajectory of spirometric indices and identified predictors for ... ...

Abstract	Background: A proportion of asthmatic children outgrow their disease by adulthood, but there are limited data on predictors for asthma persistence. This prospective study characterized the trajectory of spirometric indices and identified predictors for the persistence of childhood asthma. Methods: Chinese asthmatic children aged 6-15 years from pediatric allergy clinic underwent annual visits for ≥5 years and until their adulthood. Pre-bronchodilator spirometry and anti-asthma medications were recorded at baseline and then at least annually. Asthma resolution was defined when patients were free from asthma symptoms and use of anti-asthma drugs for ≥2 years. Logistic regression was used to identify predictors for asthma persistence. Generalized estimating equation was used to analyze longitudinal changes in lung function parameters in relation to asthma persistence. Results: 181 asthmatic children aged [mean (SD)] 10.0 (2.7) years were followed for [mean (SD)] 12.5 (2.8) years. One third of them outgrew asthma during follow-up. Female was 3.36 times more likely to have persistent asthma. Inhaled corticosteroid (ICS) treatment ever and frequent asthma exacerbation (AE) predicted asthma persistence with respective odds ratios of 3.19 (95% confidence interval [CI] 1.44-7.09) and 3.05 (95% CI 1.39-6.68). Persistent asthma was inversely associated with baseline forced expiratory volume in 1-second (FEV Conclusions: Female, ICS ever, and frequent AE predicted persistent asthma. Patients with persistent asthma had lower forced expiratory indices and poorer lung function growth into adulthood.
MeSH term(s)	Administration, Inhalation ; Adolescent ; Adrenal Cortex Hormones/adverse effects ; Adrenal Cortex Hormones/therapeutic use ; Adult ; Aged ; Anti-Asthmatic Agents/adverse effects ; Anti-Asthmatic Agents/therapeutic use ; Asthma/diagnosis ; Asthma/drug therapy ; Asthma/epidemiology ; Child ; Female ; Forced Expiratory Volume ; Humans ; Lung ; Prospective Studies
Chemical Substances	Adrenal Cortex Hormones ; Anti-Asthmatic Agents
Language	English
Publishing date	2022-02-24
Publishing country	England
Document type	Journal Article
ZDB-ID	1057059-7
ISSN	1399-3038 ; 0905-6157 ; 0906-5784
ISSN (online)	1399-3038
ISSN	0905-6157 ; 0906-5784
DOI	10.1111/pai.13726
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Article: COVID-19: lessons to date from China

Lu, Xiaoxia / Xing, Yuhan / Wong, Gary Wing-Kin

Arch. dis. child

Abstract	The pandemic due to a novel coronavirus has been sweeping across different regions of the globe since January 2020. Early reports of this infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) consisted of mostly adult patients. As the outbreak spreads rapidly beyond the epicentre of Wuhan, it becomes clear that infants and children of all ages are susceptible to this infection. In China, there have been more than 1200 paediatric cases. Most paediatric patients acquire the infection through household contact with infected adults. The disease in children is usually self-limiting and most infected children will recover uneventfully within 7-10 days. Other than symptoms of the respiratory tract, many children may present with gastrointestinal symptoms. Older children are more likely to have asymptomatic infection. Although deaths related to SARS-CoV-2 are rarely reported in the paediatric age group, young children and those with underlying medical conditions are more likely to develop severe illness. Only a small fraction of neonates born to infected mother would acquire the virus by vertical transmission. Because a large proportion of children and adolescents may have asymptomatic or mildly symptomatic infection, children are likely to play an important role in community transmission of this infection. Screening of children who have a definitive contact history will facilitate early diagnosis and isolation of all infected children. This review summarises the lessons learned in China with regard to the current understanding of SARS-CoV-2 infection in the paediatric population.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32398322
Database	COVID19

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Article: Whole-Genome Shotgun Sequencing for Nasopharyngeal Microbiome in Pre-school Children With Recurrent Wheezing.

Song, Yuping / Hou, Jinpao / Kwok, Jamie Sui Lam / Weng, Haoyi / Tang, Man Fung / Wang, Maggie Haitian / Leung, Agnes Sze Yin / Tao, Kin Pong / Wong, Gary Wing Kin / Chan, Renee Wan Yi / Tsui, Stephen Kwok Wing / Leung, Ting Fan

Frontiers in microbiology

2022 Volume 12, Page(s) 792556

Abstract: Microbiome mediates early life immune deviation in asthma development. Recurrent wheeze (RW) in pre-school years is a risk factor for asthma diagnosis in school-age children. Dysbiosis exists in asthmatic airways, while its origin in pre-school years and ...

Abstract	Microbiome mediates early life immune deviation in asthma development. Recurrent wheeze (RW) in pre-school years is a risk factor for asthma diagnosis in school-age children. Dysbiosis exists in asthmatic airways, while its origin in pre-school years and relationship to RW is not clearly defined. This study investigated metagenomics of nasopharyngeal microbiome in pre-school children with RW. We applied whole-genome shotgun sequencing and human rhinovirus (HRV) detection on nasopharyngeal samples collected from three groups of pre-school children: (i) RW group: 16 children at-risk for asthma who were hospitalized for RW, (ii) inpatient control (IC): 18 subjects admitted for upper respiratory infection, and (iii) community control (CC): 36 children without respiratory syndromes. Sequence reads were analyzed by MetaPhlAn2 and HUMAnN2 algorithm for taxonomic and functional identification. Linear discriminant analysis effect size (LEfSe) analysis was used to identify discriminative features. We identified that
Language	English
Publishing date	2022-02-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587354-4
ISSN	1664-302X
ISSN	1664-302X
DOI	10.3389/fmicb.2021.792556
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Article ; Online: Temporal Dynamics of the Nasopharyngeal Microbiome and its Relationship with Childhood Asthma Exacerbation.

Hou, Jinpao / Song, Yuping / Leung, Agnes Sze Yin / Tang, Man Fung / Shi, Mai / Wang, Evy Yiwei / Tsun, Joseph Gar Shun / Chan, Renee Wan Yi / Wong, Gary Wing Kin / Tsui, Stephen Kwok-Wing / Leung, Ting Fan

Microbiology spectrum

2022 Volume 10, Issue 3, Page(s) e0012922

Abstract: Despite distinct nasopharyngeal microbiome (NPM) profiles between asthmatics and healthy subjects, little is known about the NPM dynamics and its relation to childhood asthma exacerbation (AE). We investigated NPM changes by longitudinally collecting 135 ...

Abstract	Despite distinct nasopharyngeal microbiome (NPM) profiles between asthmatics and healthy subjects, little is known about the NPM dynamics and its relation to childhood asthma exacerbation (AE). We investigated NPM changes by longitudinally collecting 135 flocked nasopharyngeal swabs (FNPSs) from 33 school-age asthmatic children at six time points (2 to 4-week intervals) from September to December 2017 in Hong Kong. Subjects were categorized into AE and stable asthma (AS) groups according to whether they experienced any exacerbation during follow-up. One-off FNPSs from nine nonasthmatic children were included as controls. Microbiota profiles were analyzed using 16S rRNA gene sequencing. All 144 NPMs were classified into six microbiome profile groups (MPGs), each dominated by
MeSH term(s)	Asthma ; Child ; Corynebacterium/genetics ; Humans ; Microbiota/genetics ; Moraxella/genetics ; Nasopharynx/microbiology ; Prospective Studies ; RNA, Ribosomal, 16S/genetics
Chemical Substances	RNA, Ribosomal, 16S
Language	English
Publishing date	2022-05-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2807133-5
ISSN	2165-0497 ; 2165-0497
ISSN (online)	2165-0497
ISSN	2165-0497
DOI	10.1128/spectrum.00129-22
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