Asthma, which affects some 300 million people worldwide and caused 455,000 deaths in 2019, is a significant burden to suffers and to society. It is the most common chronic disease in children and represents one of the major causes for years lived with disability. Significant efforts are made by organizations such as WHO in improving the diagnosis, treatment and monitoring of asthma. However asthma prevention has been less studied. Currently there is a concept of pre- diabetes which allows a reduction in full blown diabetes if diet and exercise are undertaken. Similar predictive states are found in Alzheimer's and Parkinson's diseases. In this paper we explore the possibilities for asthma prevention, both at population level and also investigate the possibility of defining a state of pre-asthma, in which intensive treatment could reduce progression to asthma. Since asthma is a heterogeneous condition, this paper is concerned with allergic asthma. A subsequent one will deal with late onset eosinophilic asthma.

Allergy Royal Brompton Hospital London United Kingdom

Chair of ORL University of Barcelona Barcelona Spain

Department Clinical Pharmacy and Pharmacology University of Groningen University Medical Center Groningen Groningen Netherlands

Department of Allergy and Rhinology Royal National ENT Hospital London United Kingdom

Department of Allergy Inflammation Center Helsinki University Hospital and University of Helsinki Helsinki Finland

Department of Allergy La Paz University Hospital IdiPAZ Madrid Spain

Department of Clinical Immunology and Allergology University Teaching Hospital in Martin Martin Slovakia

Department of Dermatology Bispebjerg Hospital University of Copenhagen Copenhagen Denmark

Department of Dermatology University Hospital of Zurich Zurich Switzerland

Department of Dermatology University of Zurich Zurich Switzerland

Department of Otolaryngology Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill NC United States

Department of Otorhinolaryngology Head and Neck Surgery and Audiology Rigshospitalet Copenhagen University Copenhagen Denmark

Department of Otorhinolaryngology Head and Neck Surgery University Hospitals Leuven Belgium

Department of Otorhinolaryngology Kuopio University Hospital and University of Eastern Finland Kuopio Finland

Department of Otorhinolarynogology and Head Neck Surgery Amsterdam University Medical Centres Location AMC University of Amsterdam Amsterdam Netherlands

Department of Paediatrics Jessenius Faculty of Medicine in Martin Comenius University in Bratislava University Teaching Hospital in Martin Martin Slovakia

Department of Pulmonology and Phthisiology Jessenius Faculty of Medicine in Martin Comenius University in Bratislava University Teaching Hospital in Martin Martin Slovakia

Department of Pulmonology STZ Centre of Excellence for Asthma COPD and Respiratory Allergy Franciscus Gasthuis and Vlietland Rotterdam Netherlands

Department of Respiratory Medicine 1st Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic

Department of Respiratory Medicine and Allergology Institute for Clinical Science Skane University Hospital Lund University Lund Sweden

Department of Rhinology and Skull Base Surgery Guy's and St Thomas' Hospital NHS Foundation Trust London United Kingdom

Deptarment of Microbiology Immunology and Transplantation KU Leuven Catholic University of Leuven Leuven Belgium

Division of Applied Health Sciences Centre of Academic Primary Care University of Aberdeen Aberdeen United Kingdom

Division of Immunity and Infection University College London United Kingdom

Former Head of the Department for Pediatric Pneumology and Immunology Charite University Medicine Berlin Germany

Head of ORL Deptartment Clinic Barcelona Barcelona Spain

Kidsallergy Centre Cape Town South Africa

Laboratory of Allergy and Clinical Immunology University Hospitals Leuven Leuven Belgium

Observational and Pragmatic Research Institute Singapore Singapore

Otolaryngology Head and Neck Surgery A Gemelli University Hospital Foundation IRCCS Rome Italy

Paediatric Allergist Red Cross Children's Hospital and University of Cape Town Cape Town South Africa

Rhinology Unit and Smell Clinic ENT Department Hospital Clínic FRCB IDIBAPS Universitat de Barcelona CIBERES Barcelona Spain

The Allergy Clinic Blairgowrie Randburg South Africa

The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members Brussels Belgium

Upper Airways Research Laboratory Department of Head and Skin Ghent University Ghent Belgium

Zobrazit více v PubMed

Davie CA. A review of Parkinson’s disease. Br Med Bull. (2008) 86:109–27. 10.1093/bmb/ldn013 PubMed DOI

Aisen PS, Cummings J, Jack CR, Jr, Morris JC, Sperling R, Frölich L, et al. On the path to 2025: understanding the Alzheimer’s disease continuum. Alzheimers Res Ther. (2017) 9(1):60. 10.1186/s13195-017-0283-5 PubMed DOI PMC

Gao E, Hercun J, Heller T, Vilarinho S. Undiagnosed liver diseases. Transl Gastroenterol Hepatol. (2021) 6:28. 10.21037/tgh.2020.04.04 PubMed DOI PMC

Ejerblad E, Fored CM, Lindblad P, Fryzek J, McLaughlin JK, Nyrén O. Obesity and risk for chronic renal failure. J Am Soc Nephrol. (2006) 17(6):1695–702. 10.1681/ASN.2005060638 PubMed DOI

DeTure MA, Dickson DW. The neuropathological diagnosis of Alzheimer’s disease. Mol Neurodegener. (2019) 14(1):32. 10.1186/s13024-019-0333-5 PubMed DOI PMC

Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. (2002) 346(6):393–403. 10.1056/NEJMoa012512 PubMed DOI PMC

Hamman RF, Wing RR, Edelstein SL, Lachin JM, Bray GA, Delahanty L, et al. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care. (2006) 29(9):2102–7. 10.2337/dc06-0560 PubMed DOI PMC

International Diabetes Federation IDF Diabetes Atlas. 8th ed Brussels, Belgium: International Diabetes Federation; (2017). Available online at: http://www.diabetesatlas.org

Glechner A, Keuchel L, Affengruber L, Titscher V, Sommer I, Matyas N, et al. Effects of lifestyle changes on adults with prediabetes: a systematic review and meta-analysis. Prim Care Diabetes. (2018) 12(5):393–408. 10.1016/j.pcd.2018.07.003 PubMed DOI

Shea D, Colasurdo E, Smith A, Paschall C, Jayadev S, Keene CD, et al. SOBA: development and testing of a soluble oligomer binding assay for detection of amyloidogenic toxic oligomers. Proc Natl Acad Sci U S A. (2022) 119(50):e2213157119. 10.1073/pnas.2213157119 PubMed DOI PMC

Alalayah KM, Senan EM, Atlam HF, Ahmed IA, Shatnawi HSA. Automatic and early detection of Parkinson’s disease by analyzing acoustic signals using classification algorithms based on recursive feature elimination method. Diagnostics (Basel). (2023) 13(11):1924. 10.3390/diagnostics13111924 PubMed DOI PMC

Mortimer K, Reddel HK, Pitrez PM, Bateman ED. Asthma management in low and middle income countries: case for change. Eur Respir J. (2022) 60(3):2103179. 10.1183/13993003.03179-2021 PubMed DOI PMC

Asher MI, Rutter CE, Bissell K, Chiang CY, El Sony A, Ellwood E, et al. Worldwide trends in the burden of asthma symptoms in school-aged children: Global Asthma Network Phase I cross-sectional study. Lancet. (2021) 398(10311):1569–80. 10.1016/S0140-6736(21)01450-1 PubMed DOI PMC

Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. (2023). Updated May, 2023. Available online at: www.ginasthma.org

Colicino S, Munblit D, Minelli C, Custovic A, Cullinan P. Validation of childhood asthma predictive tools: a systematic review. Clin Exp Allergy. (2019) 49(4):410–18. 10.1111/cea.13336 PubMed DOI

https://www.who.int/news-room/fact-sheets/detail/asthma# Available online at:

Tliba O, Panettieri RA, Jr. Paucigranulocytic asthma: uncoupling of airway obstruction from inflammation. J Allergy Clin Immunol. (2019) 143(4):1287–94. 10.1016/j.jaci.2018.06.008 PubMed DOI PMC

Arshad SH, Kurukulaaratchy RJ, Fenn M, Matthews S. Early life risk factors for current wheeze, asthma, and bronchial hyperresponsiveness at 10 years of age. Chest. (2005) 127(2):502–8. 10.1378/chest.127.2.502 PubMed DOI

ten Brinke A. Risk factors associated with irreversible airflow limitation in asthma. Curr Opin Allergy Clin Immunol. (2008) 8(1):63–9. 10.1097/ACI.0b013e3282f3b5b5 PubMed DOI

Kurowski M, Seys S, Bonini M, Del Giacco S, Delgado L, Diamant Z, et al. Physical exercise, immune response, and susceptibility to infections-current knowledge and growing research areas. Allergy. (2022) 77(9):2653–64. 10.1111/all.15328 PubMed DOI

Dharmage SC, Perret JL, Custovic A. Epidemiology of asthma in children and adults. Front Pediatr. (2019) 7:246. 10.3389/fped.2019.00246 PubMed DOI PMC

Akdis CA. The epithelial barrier hypothesis proposes a comprehensive understanding of the origins of allergic and other chronic noncommunicable diseases. J Allergy Clin Immunol. (2022) 149(1):41–4. 10.1016/j.jaci.2021.11.010 PubMed DOI

Clatworthy J, Price D, Ryan D, Haughney J, Horne R. The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control. Prim Care Respir J. (2009) 18(4):300–5. 10.4104/pcrj.2009.00037 PubMed DOI PMC

Chaudhuri R, Livingston E, McMahon AD. Cigarette smoking impairs the therapeutic response to oral corticosteroids in chronic asthma. Am J Respir Crit Care Med. (2003) 168(11):1308–11. 10.1164/rccm.200304-503OC PubMed DOI

Westergaard CG, Munck C, Helby J, Porsbjerg C, Hansen LH, Backer V. Predictors of neutrophilic airway inflammation in young smokers with asthma. J Asthma. (2014) 51(4):341–7. 10.3109/02770903.2014.880718 PubMed DOI

Harmsen L, Gottlieb V, Makowska Rasmussen L, Backer V. Asthma patients who smoke have signs of chronic airflow limitation before age 45. J Asthma. (2010) 47(4):362–6. 10.3109/02770901003692819 PubMed DOI

Eguiluz-Gracia I, Mathioudakis AG, Bartel S, Vijverberg SJH, Fuertes E, Comberiati P, et al. The need for clean air: The way air pollution and climate change affect allergic rhinitis and asthma. Allergy. (2020) 75(9):2170–84. 10.1111/all.14177 PubMed DOI

Ciaccio CE, Gentile D. Effects of tobacco smoke exposure in childhood on atopic diseases. Curr Allergy Asthma Rep. (2013) 13(6):687–92. 10.1007/s11882-013-0389-1 PubMed DOI PMC

Rasmussen F, Siersted HC, Lambrechtsen J, Hansen HS, Hansen NC. Impact of airway lability, atopy, and tobacco smoking on the development of asthma-like symptoms in asymptomatic teenagers. Chest. (2000) 117(5):1330–5. 10.1378/chest.117.5.1330 PubMed DOI

Bjerg A, Hedman L, Perzanowski M, Lundbäck B, Rönmark E. A strong synergism of low birth weight and prenatal smoking on asthma in schoolchildren. Pediatrics. (2011) 127(4):e905–12. 10.1542/peds.2010-2850 PubMed DOI PMC

Ulrik CS, Lange P. Cigarette smoking and asthma. Monaldi Arch Chest Dis. (2001) 56(4):349–53. PubMed

Tiotiu A, Ioan I, Wirth N, Romero-Fernandez R, González-Barcala FJ. The Impact of Tobacco Smoking on Adult Asthma Outcomes. Int J Environ Res Public Health. (2021) 18(3):992. 10.3390/ijerph18030992 PubMed DOI PMC

Tomlinson JE, McMahon AD, Chaudhuri R, Thompson JM, Wood SF, Thomson NC. Efficacy of low and high dose inhaled corticosteroid in smokers versus non-smokers with mild asthma. Thorax. (2005) 60(4):282–7. 10.1136/thx.2004.033688 PubMed DOI PMC

Zheng X, Guan W, Zheng J, Ye P, Liu S, Zhou J, et al. Smoking influences response to inhaled corticosteroids in patients with asthma: a meta-analysis. Curr Med Res Opin. (2012) 28(11):1791–8. 10.1185/03007995.2012.722991 PubMed DOI

Toppila-Salmi S, Luukkainen AT, Xu B, Lampi J, Auvinen J, Dhaygude K, et al. Maternal smoking during pregnancy affects adult onset of asthma in offspring: a follow up from birth to age 46 years. Eur Respir J. (2020) 55(6):1901857. 10.1183/13993003.01857-2019 PubMed DOI

Hauck AS, Buchwald I, Watz H, Trinkmann F, Söling C, Rabenstein A, et al. Impact of chewing bags, E-cigarettes, and combustible cigarettes on arterial stiffness and small airway function in healthy students. Toxics. (2023) 11(1):77. 10.3390/toxics11010077 PubMed DOI PMC

Gudnadóttir AÝ, Ólafsdóttir IS, Middelveld R, Ekerljung L, Forsberg B, Franklin K, et al. An investigation on the use of snus and its association with respiratory and sleep-related symptoms: a cross-sectional population study. BMJ Open. (2017) 7(5):e015486. 10.1136/bmjopen-2016-015486 PubMed DOI PMC

Lin W, Brunekreef B, Gehring U. Meta-analysis of the effects of indoor nitrogen dioxide and gas cooking on asthma and wheeze in children. Int J Epidemiol. (2013) 42(6):1724–37. 10.1093/ije/dyt150 PubMed DOI

Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet. (2006) 368(9537):733–43. 10.1016/S0140-6736(06)69283-0. Erratum in: Lancet. (2007) 370(9593):1128. PubMed DOI

Abrams EM. Cleaning products and asthma risk: a potentially important public health concern. CMAJ. (2020) 192(7):E164–5. 10.1503/cmaj.200025 PubMed DOI PMC

Folletti I, Siracusa A, Paolocci G. Update on asthma and cleaning agents. Curr Opin Allergy Clin Immunol. (2017) 17(2):90–5. 10.1097/ACI.0000000000000349 PubMed DOI

Kabata H, Artis D. Neuro-immune crosstalk and allergic inflammation. J Clin Invest. (2019) 129(4):1475–82. 10.1172/JCI124609 PubMed DOI PMC

Sivapalan P, Diamant Z, Ulrik CS. Obesity and asthma: current knowledge and future needs. Curr Opin Pulm Med. (2015) 21(1):80–5. 10.1097/MCP.0000000000000119 PubMed DOI

Wood LG, Garg ML, Gibson PG. A high-fat challenge increases airway inflammation and impairs bronchodilator recovery in asthma. J Allergy Clin Immunol. (2011) 127(5):1133–40. 10.1016/j.jaci.2011.01.036 PubMed DOI

Bantulà M, Arismendi E, Tubita V, Roca-Ferrer J, Mullol J, de Hollanda A, et al. Effect of obesity on the expression of genes associated with severe asthma-A pilot study. J Clin Med. (2023) 12(13):4398. 10.3390/jcm12134398 PubMed DOI PMC

Chen E, Miller GE. Stress and inflammation in exacerbations of asthma. Brain Behav Immun. (2007) 21(8):993–9. 10.1016/j.bbi.2007.03.009 PubMed DOI PMC

Sharma V, Ricketts HC, McCombie L, Brosnahan N, Crawford L, Slaughter L, et al. A total diet replacement weight management program for difficult-to-treat asthma associated with obesity: a randomized controlled feasibility trial. Chest. (2023) 163(5):1026–37. 10.1016/j.chest.2023.01.015 PubMed DOI PMC

Johnson O, Gerald LB, Harvey J, Roy G, Hazucha H, Large C, et al. An online weight loss intervention for people with obesity and poorly controlled asthma. J Allergy Clin Immunol Pract. (2022) 10(6):1577–86.e3. 10.1016/j.jaip.2022.02.040 PubMed DOI PMC

Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, et al. Determinants of weight loss success utilizing a meal replacement plan and/or exercise, in overweight and obese adults with asthma. Respirology. (2015) 20(2):243–50. 10.1111/resp.12423 PubMed DOI

Busse W, Bartels C, Rosenkranz M. Brain-airway interactions in asthma. Adv Exp Med Biol. (2023) 1426:185–214. 10.1007/978-3-031-32259-4_9 PubMed DOI

Mikkelsen H, Landt EM, Benn M, Nordestgaard BG, Dahl M. Causal risk factors for asthma in Mendelian randomization studies: a systematic review and meta-analysis. Clin Transl Allergy. (2022) 12(11):e12207. 10.1002/clt2.12207 PubMed DOI PMC

Ferreira MA, Vonk JM, Baurecht H, Marenholz I, Tian C, Hoffman JD, et al. Shared genetic origin of asthma, hay fever and eczema elucidates allergic disease biology. Nat Genet. (2017) 49(12):1752–57. 10.1038/ng.3985 PubMed DOI PMC

Marenholz I, Esparza-Gordillo J, Rüschendorf F, Bauerfeind A, Strachan DP, Spycher BD, et al. Meta-analysis identifies seven susceptibility loci involved in the atopic march. Nat Commun. (2015) 6:8804. 10.1038/ncomms9804 PubMed DOI PMC

Ravn NH, Halling AS, Berkowitz AG, Rinnov MR, Silverberg JI, Egeberg A, et al. How does parental history of atopic disease predict the risk of atopic dermatitis in a child? A systematic review and meta-analysis. J Allergy Clin Immunol. (2020) 145(4):1182–93. 10.1016/j.jaci.2019.12.899 PubMed DOI

Hernandez-Pacheco N, Kere M, Melén E. Gene-environment interactions in childhood asthma revisited; expanding the interaction concept. Pediatr Allergy Immunol. (2022) 33(5):e13780. 10.1111/pai.13780 PubMed DOI PMC

Ravnborg N, Ambikaibalan D, Agnihotri G, Price S, Rastogi S, Patel KR, et al. Prevalence of asthma in patients with atopic dermatitis: a systematic review and meta-analysis. J Am Acad Dermatol. (2021) 84(2):471–8. 10.1016/j.jaad.2020.02.055 PubMed DOI

Halling AS, Rinnov MR, Ruge IF, Gerner T, Ravn NH, Knudgaard MH, et al. Skin TARC/CCL17 increase precedes the development of childhood atopic dermatitis. J Allergy Clin Immunol. (2023) 151(6):1550–57.e6. 10.1016/j.jaci.2022.11.023 PubMed DOI

Scadding GK. Further marches: allergic and non-allergic. Clin Exp Allergy. (2007) 37(4):485–7. 10.1111/j.1365-2222.2007.02675.x PubMed DOI

Antó JM, Sunyer J, Basagaña X, Garcia-Esteban R, Cerveri I, de Marco R, et al. Risk factors of new-onset asthma in adults: a population-based international cohort study. Allergy. (2010) 65(8):1021–30. 10.1111/j.1398-9995.2009.02301.x PubMed DOI

Cullinan P, Muñoz X, Suojalehto H, Agius R, Jindal S, Sigsgaard T, et al. Occupational lung diseases: from old and novel exposures to effective preventive strategies. Lancet Respir Med. (2017) 5(5):445–55. 10.1016/S2213-2600(16)30424-6. Erratum in: Lancet Respir Med. (2017) 5(6):e22. PubMed DOI

Kousha A, Mahdavi Gorabi A, Forouzesh M, Hosseini M, Alexander M, Imani D, et al. Interleukin 4 gene polymorphism (-589C/T) and the risk of asthma: a meta-analysis and met-regression based on 55 studies. BMC Immunol. (2020) 21(1):55. 10.1186/s12865-020-00384-7 PubMed DOI PMC

Ober C, Tsalenko A, Parry R. Genetics of asthma and allergic disease. In Middleton’s Allergy Principles and Practice. 6th ed. Mosby; (2000). pp. 719–27.

Zhang JH, Zhang M, Wang YN, Zhang XY. Correlation between IL-4 and IL-13 gene polymorphisms and asthma in Uygur children in Xinjiang. Exp Ther Med. (2019) 17(2):1374–82. 10.3892/etm.2018.7096 PubMed DOI PMC

Liao M, Shi D, Wang Y, Zhang K, Chen X, Gao Y, et al. Genome-wide scan on total serum IgE levels identifies no common variants in a healthy Chinese male population. Immunogenetics. (2013) 65(8):561–8. 10.1007/s00251-013-0706-9 PubMed DOI

Holgate ST. The epidemic of allergy and asthma. Nature. (1999) 402(6760):B2–4. 10.1038/35037000 PubMed DOI

Kabesch M, Hoefler C, Carr D, Leupold W, Weiland SK, von Mutius E. Glutathione S transferase deficiency and passive smoking increase childhood asthma. Thorax. (2004) 59(7):569–73. 10.1136/thx.2003.016667 PubMed DOI PMC

Kormann MS, Depner M, Hartl D, Klopp N, Illig T, Adamski J, et al. Toll-like receptor heterodimer variants protect from childhood asthma. J Allergy Clin Immunol. (2008) 122(1):86–92; 92.e1-8. 10.1016/j.jaci.2008.04.039 PubMed DOI

Bu X, Zhao H, Wang Y, Wu D, Chen Q. ORM1 Gene polymorphisms and childhood asthma susceptibility. Allergy. (2017) 72(6):879–84.

Almomani BA, Al-Obeidi A, Al-Sarayreh SA, Al-Qutob M, Shudiefat R. Association between ORM1 gene polymorphism and tobacco smoke exposure in the risk of asthma in Jordanian children. Eur Respir J. (2017) 50(suppl 61), PA3988.

Kormann MS, Carr D, Klopp N, Illig T, Leupold W, Fritzsch C, et al. G-Protein-coupled receptor polymorphisms are associated with asthma in a large German population. Am J Respir Crit Care Med. (2005) 171(12):1358–62. 10.1164/rccm.200410-1312OC PubMed DOI

Gaertner VD, Michel S, Curtin JA, Pulkkinen V, Acevedo N, Söderhäll C, et al. Nocturnal asthma is affected by genetic interactions between RORA and NPSR1. Pediatr Pulmonol. (2019) 54(6):847–57. 10.1002/ppul.24292 PubMed DOI

Moffatt MF, Gut IG, Demenais F, Strachan DP, Bouzigon E, Heath S, et al. A large-scale, consortium-based genomewide association study of asthma. N Engl J Med. (2010) 363(13):1211–21. 10.1056/NEJMoa0906312 PubMed DOI PMC

Rice NE, Patel BD, Lang IA, Kumari M, Frayling TM, Murray A, et al. Filaggrin gene mutations are associated with asthma and eczema in later life. J Allergy Clin Immunol. (2008) 122(4):834–6. 10.1016/j.jaci.2008.07.027 PubMed DOI PMC

Reyman M, van Houten MA, van Baarle D, Bosch AATM, Man WH, Chu MLJN, et al. Impact of delivery mode-associated gut microbiota dynamics on health in the first year of life. Nat Commun. (2019) 10(1):4997. 10.1038/s41467-019-13014-7. Erratum in: Nat Commun. (2019) 10(1):5352. PubMed DOI PMC

Thompson AL. Caesarean delivery, immune function and inflammation in early life among Ecuadorian infants and young children. J Dev Orig Health Dis. (2019) 10(5):555–62. 10.1017/S2040174419000047 PubMed DOI PMC

Rusconi F, Zugna D, Annesi-Maesano I, et al. Mode of delivery and asthma at school age in 9 European birth cohorts. Am J Epidemiol. (2017) 185(6):465–73. 10.1093/aje/kwx021 PubMed DOI

Davidson R, Roberts SE, Wotton CJ, et al. Influence of maternal and perinatal factors on subsequent hospitalisation for asthma in children: evidence from the Oxford record linkage study. BMC Pulm Med. (2010) 10(14). 10.1186/1471-2466-10-14 PubMed DOI PMC

Roduit C, Scholtens S, de Jongste JC, Wijga AH, Gerritsen J, Postma DS, et al. Asthma at 8 years of age in children born by caesarean section. Thorax. (2009) 64(2):107–13. 10.1136/thx.2008.100875 PubMed DOI

McEvoy CT, Le Souef PN, Martinez FD. The role of lung function in determining which children develop asthma. J Allergy Clin Immunol Pract. (2023) 11(3):677–83. 10.1016/j.jaip.2023.01.014 PubMed DOI PMC

Fernandez-Rodriguez B, Gomez AR, Jimenez Moreno BS, de Alba C, Galindo A, Villalain C, et al. Smoking influence on early and late fetal growth. J Perinat Med. (2021) 50(2):200–206. 10.1515/jpm-2021-0226 PubMed DOI

Jartti T, Gern JE. Role of viral infections in the development and exacerbation of asthma in children. J Allergy Clin Immunol. (2017) 140(4):895–906. 10.1016/j.jaci.2017.08.003 PubMed DOI PMC

Rosas-Salazar C, Chirkova T, Gebretsadik T, Chappell JD, Peebles RS, Jr, Dupont WD, et al. Respiratory syncytial virus infection during infancy and asthma during childhood in the USA (INSPIRE): a population-based, prospective birth cohort study. Lancet. (2023) 401(10389):1669–80. 10.1016/S0140-6736(23)00811-5 PubMed DOI PMC

Shan J, Britton PN, King CL, Booy R. The immunogenicity and safety of respiratory syncytial virus vaccines in development: a systematic review. Influenza Other Respir Viruses. (2021) 15(4):539–51. 10.1111/irv.12850 PubMed DOI PMC

Do LAH, Toh ZQ, Licciardi PV, Mulholland EK. Can early measles vaccination control both measles and respiratory syncytial virus infections? Lancet Glob Health. (2022) 10(2):e288–92. 10.1016/S2214-109X(21)00464-2 PubMed DOI PMC

Mina MJ. Measles, immune suppression and vaccination: direct and indirect nonspecific vaccine benefits. J Infect. (2017) 74(Suppl 1):S10–7. 10.1016/S0163-4453(17)30185-8 PubMed DOI

Di Cicco M, D'Elios S, Peroni DG, Comberiati P. The role of atopy in asthma development and persistence. Curr Opin Allergy Clin Immunol. (2020) 20(2):131–7. 10.1097/ACI.0000000000000627 PubMed DOI

Zhong C, Guo J, Tan T, Wang H, Lin L, Gao D, et al. Increased food diversity in the first year of life is inversely associated with allergic outcomes in the second year. Pediatr Allergy Immunol. (2022) 33(1):e13707. 10.1111/pai.13707 PubMed DOI

Stampfli M, Frei R, Divaret-Chauveau A, Schmausser-Hechfellner E, Karvonen AM, Pekkanen J, et al. Inverse associations between food diversity in the second year of life and allergic diseases. Ann Allergy Asthma Immunol. (2022) 128(1):39–45. 10.1016/j.anai.2021.10.005 PubMed DOI

Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. (2015) 372(9):803–13. 10.1056/NEJMoa1414850. Erratum in: N Engl J Med. (2016) 375(4):398. PubMed DOI PMC

Perkin MR, Logan K, Bahnson HT, Marrs T, Radulovic S, Craven J, et al. Efficacy of the enquiring about tolerance (EAT) study among infants at high risk of developing food allergy. J Allergy Clin Immunol. (2019) 144(6):1606–14.e2. 10.1016/j.jaci.2019.06.045 PubMed DOI PMC

Rook GA, Lowry CA, Raison CL. Microbial ‘old friends’, immunoregulation and stress resilience. Evol Med Public Health. (2013) 2013(1):46–64. 10.1093/emph/eot004 PubMed DOI PMC

Dogaru CM, Nyffenegger D, Pescatore AM, Spycher BD, Kuehni CE. Breastfeeding and childhood asthma: systematic review and meta-analysis. Am J Epidemiol. (2014) 179(10):1153–67. 10.1093/aje/kwu072 PubMed DOI

Geba GP, Li D, Xu M, Mohammadi K, Attre R, Ardeleanu M, et al. Attenuating the atopic march: meta-analysis of the dupilumab atopic dermatitis database for incident allergic events. J Allergy Clin Immunol. (2023) 151(3):756–66. 10.1016/j.jaci.2022.08.026 PubMed DOI

Stikker BS, Hendriks RW, Stadhouders R. Decoding the genetic and epigenetic basis of asthma. Allergy. (2023) 78(4):940–56. 10.1111/all.15666 PubMed DOI

Bieli C, Eder W, Frei R, Braun-Fahrländer C, Klimecki W, Waser M, et al. A polymorphism in CD14 modifies the effect of farm milk consumption on allergic diseases and CD14 gene expression. J Allergy Clin Immunol. (2007) 120(6):1308–15. 10.1016/j.jaci.2007.07.034 PubMed DOI

Kothalawala DM, Kadalayil L, Curtin JA, Murray CS, Simpson A, Custovic A, et al. Integration of genomic risk scores to improve the prediction of childhood asthma diagnosis. J Pers Med. (2022) 12(1):75. 10.3390/jpm12010075 PubMed DOI PMC

Kothalawala DM, Murray CS, Simpson A, Custovic A, Tapper WJ, Arshad SH, et al. Development of childhood asthma prediction models using machine learning approaches. Clin Transl Allergy. (2021) 11(9):e12076. 10.1002/clt2.12076 PubMed DOI PMC

Lee HJ, Lee NR, Jung M, Kim DH, Choi EH. Atopic March from atopic dermatitis to asthma-like lesions in NC/Nga mice is accelerated or aggravated by neutralization of stratum corneum but partially inhibited by acidification. J Invest Dermatol. (2015) 135(12):3025–33. 10.1038/jid.2015.333 PubMed DOI

Forno E, Young OM, Kumar R, Simhan H, Celedón JC. Maternal obesity in pregnancy, gestational weight gain, and risk of childhood asthma. Pediatrics. (2014) 134(2):e535–46. 10.1542/peds.2014-0439 PubMed DOI PMC

Peroni DG, Nuzzi G, Trambusti I, Di Cicco ME, Comberiati P. Microbiome composition and its impact on the development of allergic diseases. Front Immunol. (2020) 11:700. 10.3389/fimmu.2020.00700 PubMed DOI PMC

Gao Y, Stokholm J, O'Hely M, Ponsonby AL, Tang MLK, Ranganathan S, et al. Gut microbiota maturity mediates the protective effect of siblings on food allergy. J Allergy Clin Immunol. (2023) 152(3):667–75. 10.1016/j.jaci.2023.02.034 PubMed DOI

Julia V, Macia L, Dombrowicz D. The impact of diet on asthma and allergic diseases. Nat Rev Immunol. (2015) 15(5):308–22. 10.1038/nri3830 PubMed DOI

Venter C, Agostoni C, Arshad SH, Ben-Abdallah M, Du Toit G, Fleischer DM, et al. Dietary factors during pregnancy and atopic outcomes in childhood: a systematic review from the European academy of allergy and clinical immunology. Pediatr Allergy Immunol. (2020) 31(8):889–912. 10.1111/pai.13303 PubMed DOI PMC

Venter C, Palumbo MP, Glueck DH, Sauder KA, O'Mahony L, Fleischer DM, et al. The maternal diet index in pregnancy is associated with offspring allergic diseases: the healthy start study. Allergy. (2022) 77(1):162–172. 10.1111/all.14949 PubMed DOI PMC

Dehlink E, Yen E, Leichtner AM, Hait EJ, Fiebiger E. First evidence of a possible association between gastric acid suppression during pregnancy and childhood asthma: a population-based register study. Clin Exp Allergy. (2009) 39(2):246–53. 10.1111/j.1365-2222.2008.03125.x PubMed DOI

Loewen K, Monchka B, Mahmud SM, ‘t Jong G, Azad MB. Prenatal antibiotic exposure and childhood asthma: a population-based study. Eur Respir J. (2018) 52(1):1702070. 10.1183/13993003.02070-2017 PubMed DOI

Momen NC, Liu X. Maternal antibiotic use during pregnancy and asthma in children: population-based cohort study and sibling design. Eur Respir J. (2021) 57(1):2000937. 10.1183/13993003.00937-2020 PubMed DOI

Lodge CJ, Tan DJ, Lau MX, Dai X, Tham R, Lowe AJ, et al. Breastfeeding and asthma and allergies: a systematic review and meta-analysis. Acta Paediatr. (2015) 104(467):38–53. 10.1111/apa.13132 PubMed DOI

Boudry G, Charton E, Le Huerou-Luron I, Ferret-Bernard S, Le Gall S, Even S, et al. The relationship between breast milk components and the infant gut microbiota. Front Nutr. (2021) 8:629740. 10.3389/fnut.2021.629740 PubMed DOI PMC

Trambusti I, Nuzzi G, Costagliola G, Verduci E, D'Auria E, Peroni DG, et al. Dietary interventions and nutritional factors in the prevention of pediatric asthma. Front Pediatr. (2020) 8:480. 10.3389/fped.2020.00480 PubMed DOI PMC

Shimizu M, Kato T, Adachi Y, Wada T, Murakami S, Ito Y, et al. Maternal dietary vitamin D intake during pregnancy is associated with allergic disease symptoms in children at 3 years old: the Japan environment and children’s study. Int Arch Allergy Immunol. (2023) 184(11):1106–15. 10.1159/000531970 PubMed DOI

Talaei M, Sdona E, Calder PC, Jones LR, Emmett PM, Granell R, et al. Intake of n-3 polyunsaturated fatty acids in childhood, FADS genotype and incident asthma. Eur Respir J. (2021) 58(3):2003633. 10.1183/13993003.03633-2020 PubMed DOI PMC

Rose MA, Stieglitz F, Köksal A, Schubert R, Schulze J, Zielen S. Efficacy of probiotic lactobacillus GG on allergic sensitization and asthma in infants at risk. Clin Exp Allergy. (2010) 40(9):1398–405. 10.1111/j.1365-2222.2010.03560.x PubMed DOI

Wawryk-Gawda E, Markut-Miotła E, Emeryk A. Postnatal probiotics administration does not prevent asthma in children, but using prebiotics or synbiotics may be the effective potential strategies to decrease the frequency of asthma in high-risk children—a meta-analysis of clinical trials. Allergol Immunopathol (Madr). (2021) 49(4):4–14. 10.15586/aei.v49i4.69 PubMed DOI

Afify SM, Regner A, Pacios LF, et al. Micronutritional supplementation with a holoBLG-based FSMP (food for special medical purposes)-lozenge alleviates allergic symptoms in BALB/c mice: imitating the protective farm effect. Clin Exp Allergy. (2022) 52:426–41. 10.1111/cea.14050 PubMed DOI

Afify SM, Pali-Schöll I, Hufnagl K, Hofstetter G, El-Bassuoni MA, Roth-Walter F, et al. Bovine holo-beta-lactoglobulin cross-protects against pollen allergies in an innate manner in BALB/c mice: potential model for the farm effect. Front Immunol. (2021) 12:611474. 10.3389/fimmu.2021.611474 PubMed DOI PMC

Roth-Walter F, Afify SM, Pacios LF, et al. Cow’s milk protein β-lactoglobulin confers resilience against allergy by targeting complexed iron into immune cells. J Allergy Clin Immunol. (2021) 147(1):321–334.e4. 10.1016/j.jaci.2020.05.023 PubMed DOI

Bergmann KC, Raab J, Graessel A, Zwingers T, Becker S, Kugler S, et al. The holo beta-lactoglobulin lozenge reduces symptoms in cat allergy-evaluation in an allergen exposure chamber and by titrated nasal allergen challenge. Clin Transl Allergy. (2023) 13(7):e12274. 10.1002/clt2.12274 PubMed DOI PMC

Illi S, Depner M, Genuneit J, Horak E, Loss G, Strunz-Lehner C, et al. Protection from childhood asthma and allergy in alpine farm environments-the GABRIEL advanced studies. J Allergy Clin Immunol. (2012) 129(6):1470–7.e6. 10.1016/j.jaci.2012.03.013 PubMed DOI

Riedler J, Braun-Fahrländer C, Eder W, Schreuer M, Waser M, Maisch S, et al. Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey. Lancet. (2001) 358(9288):1129–33. 10.1016/S0140-6736(01)06252-3 PubMed DOI

Roduit C, Wohlgensinger J, Frei R, Bitter S, Bieli C, Loeliger S, et al. Prenatal animal contact and gene expression of innate immunity receptors at birth are associated with atopic dermatitis. J Allergy Clin Immunol. (2011) 127(1):179–85; 185.e1. 10.1016/j.jaci.2010.10.010 PubMed DOI

Braun-Fahrländer C, Riedler J, Herz U, Eder W, Waser M, Grize L, et al. Environmental exposure to endotoxin and its relation to asthma in school-age children. N Engl J Med. (2002) 347(12):869–77. 10.1056/NEJMoa020057 PubMed DOI

Stein MM, Hrusch CL, Gozdz J, Igartua C, Pivniouk V, Murray SE, et al. Innate immunity and asthma risk in amish and hutterite farm children. N Engl J Med. (2016) 375(5):411–21. 10.1056/NEJMoa1508749 PubMed DOI PMC

Bisgaard H, Hermansen MN, Buchvald F, et al. Childhood asthma after bacterial colonization of the airway in neonates. N Engl J Med. (2007) 357(15):1487–95. 10.1056/NEJMoa052632 PubMed DOI

Bisgaard H, Hermansen MN, Bønnelykke K, Stokholm J, Baty F, Skytt NL, et al. Association of bacteria and viruses with wheezy episodes in young children: prospective birth cohort study. BMJ. (2010) 341:c4978. 10.1136/bmj.c4978 PubMed DOI PMC

Zou Z, Liu W, Huang C, Sun C, Zhang J. First-year antibiotics exposure in relation to childhood asthma, allergies, and airway illnesses. Int J Environ Res Public Health. (2020) 17(16):5700. 10.3390/ijerph17165700 PubMed DOI PMC

Huang YJ, Porsche C, Kozik AJ, Lynch SV. Microbiome-Immune interactions in allergy and asthma. J Allergy Clin Immunol Pract. (2022) 10(9):2244–51. 10.1016/j.jaip.2022.05.038 PubMed DOI PMC

Li S, Chen F, Huang C, Huang G, Cheng Y, Li T, et al. Relationships between antibiotic exposure and asthma in adults in the United States: results of the national health and nutrition examination survey between 1999 and 2018. Front Public Health. (2023) 11:1123555. 10.3389/fpubh.2023.1123555 PubMed DOI PMC

Moulson AJ, Av-Gay Y. BCG Immunomodulation: from the ‘hygiene hypothesis’ to COVID-19. Immunobiology. (2021) 226(1):152052. 10.1016/j.imbio.2020.152052 PubMed DOI PMC

Zhao K, Miles P, Jiang X, Zhou Q, Cao C, Lin W, et al. BCG vaccination in early childhood and risk of atopic disease: a systematic review and meta-analysis. Can Respir J. (2021) 2021:5434315. 10.1155/2021/5434315 PubMed DOI PMC

Zolkipli Z, Roberts G, Cornelius V, Clayton B, Pearson S, Michaelis L, et al. Randomized controlled trial of primary prevention of atopy using house dust mite allergen oral immunotherapy in early childhood. J Allergy Clin Immunol. (2015) 136(6):1541–47.e11. 10.1016/j.jaci.2015.04.045 PubMed DOI

Illi S, von Mutius E, Lau S, Nickel R, Grüber C, Niggemann B, et al. The natural course of atopic dermatitis from birth to age 7 years and the association with asthma. J Allergy Clin Immunol. (2004) 113(5):925–31. 10.1016/j.jaci.2004.01.778 PubMed DOI

Simpson EL, Chalmers JR, Hanifin JM, Thomas KS, Cork MJ, McLean WH, et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol. (2014) 134(4):818–23. 10.1016/j.jaci.2014.08.005 PubMed DOI PMC

Chalmers JR, Haines RH, Bradshaw LE, Montgomery AA, Thomas KS, Brown SJ, et al. Daily emollient during infancy for prevention of eczema: the BEEP randomised controlled trial. Lancet. (2020) 395(10228):962–72. 10.1016/S0140-6736(19)32984-8 PubMed DOI PMC

Haspeslagh E, Vanheerswynghels M, Deswarte K, Van Moorleghem J, Jacquet A, Lambrecht BN, et al. Prophylactic allergen immunotherapy with Der p 2 prevents murine asthma by regulating lung GM-CSF. J Allergy Clin Immunol. (2019) 143(6):2307–11.e5. 10.1016/j.jaci.2019.02.007. Erratum in: J Allergy Clin Immunol. (2019) 144(4):1142. PubMed DOI PMC

Shaaban R, Zureik M, Soussan D, Neukirch C, Heinrich J, Sunyer J, et al. Rhinitis and onset of asthma: a longitudinal population-based study. Lancet. (2008) 372(9643):1049–57. 10.1016/S0140-6736(08)61446-4 PubMed DOI

Rochat MK, Illi S, Ege MJ, Lau S, Keil T, Wahn U, et al. Allergic rhinitis as a predictor for wheezing onset in school-aged children. J Allergy Clin Immunol. (2010) 126(6):1170–5.e2. 10.1016/j.jaci.2010.09.008 PubMed DOI

Lee E, Lee SH, Kwon JW, et al. A rhinitis phenotype associated with increased development of bronchial hyperresponsiveness and asthma in children. Ann Allergy Asthma Immunol. (2016) 117(1):21–28.e1. 10.1016/j.anai.2016.04.016.E PubMed DOI

Olonisakin TF, Moore JA, Barel S, Uribe B, Parker DM, Bowers EMR, et al. Fractional exhaled nitric oxide as a marker of mucosal inflammation in chronic rhinosinusitis. Am J Rhinol Allergy. (2022) 36(4):465–72. 10.1177/19458924221080260 PubMed DOI

Braunstahl GJ, Overbeek SE, Kleinjan A, Prins JB, Hoogsteden HC, Fokkens WJ. Nasal allergen provocation induces adhesion molecule expression and tissue eosinophilia in upper and lower airways. J Allergy Clin Immunol. (2001) 107(3):469–76. 10.1067/mai.2001.113046 PubMed DOI

Corren J. The connection between allergic rhinitis and bronchial asthma. Curr Opin Pulm Med. (2007) 13(1):13–8. 10.1097/MCP.0b013e328010d0db PubMed DOI

Crystal-Peters J, Neslusan C, Crown WH, Torres A. Treating allergic rhinitis in patients with comorbid asthma: the risk of asthma-related hospitalizations and emergency department visits. J Allergy Clin Immunol. (2002) 109(1):57–62. 10.1067/mai.2002.120554 PubMed DOI

Lindqvist M, Leth-Møller KB, Linneberg A, Kull I, Bergström A, Georgellis A, et al. Natural course of pollen-induced allergic rhinitis from childhood to adulthood: A 20-year follow up. Allergy. (2023). 10.1111/all.15927 PubMed DOI

Devillier P, Molimard M, Ansolabehere X, Bardoulat I, Coulombel N, Maurel F, et al. Immunotherapy with grass pollen tablets reduces medication dispensing for allergic rhinitis and asthma: a retrospective database study in France. Allergy. (2019) 74(7):1317–26. 10.1111/all.13705 PubMed DOI

Wahn U, Bachert C, Heinrich J, Richter H, Zielen S. Real-world benefits of allergen immunotherapy for birch pollen-associated allergic rhinitis and asthma. Allergy. (2019) 74(3):594–604. 10.1111/all.13598 PubMed DOI PMC

Zielen S, Devillier P, Heinrich J, Richter H, Wahn U. Sublingual immunotherapy provides long-term relief in allergic rhinitis and reduces the risk of asthma: a retrospective, real-world database analysis. Allergy. (2018) 73(1):165–77. 10.1111/all.13213 PubMed DOI PMC

Schmitt J, Schwarz K, Stadler E, Wüstenberg EG. Allergy immunotherapy for allergic rhinitis effectively prevents asthma: results from a large retrospective cohort study. J Allergy Clin Immunol. (2015) 136(6):1511–6. 10.1016/j.jaci.2015.07.038 PubMed DOI

Fritzsching B, Contoli M, Porsbjerg C, Buchs S, Larsen JR, Elliott L, et al. Long-term real-world effectiveness of allergy immunotherapy in patients with allergic rhinitis and asthma: Results from the REACT study, a retrospective cohort study. Lancet Reg Health Eur. (2021) 13:100275. 10.1016/j.lanepe.2021.100275 PubMed DOI PMC

Kristiansen M, Dhami S, Netuveli G, Halken S, Muraro A, Roberts G, et al. Allergen immunotherapy for the prevention of allergy: a systematic review and meta-analysis. Pediatr Allergy Immunol. (2017) 28(1):18–29. 10.1111/pai.12661 PubMed DOI

Möller C, Dreborg S, Ferdousi HA, Halken S, Høst A, Jacobsen L, et al. Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis (the PAT-study). J Allergy Clin Immunol. (2002) 109(2):251–6. 10.1067/mai.2002.121317 PubMed DOI

Niggemann B, Jacobsen L, Dreborg S, Ferdousi HA, Halken S, Høst A, et al. Five-year follow-up on the PAT study: specific immunotherapy and long-term prevention of asthma in children. Allergy. (2006) 61(7):855–9. 10.1111/j.1398-9995.2006.01068.x PubMed DOI

Jacobsen L, Niggemann B, Dreborg S, Ferdousi HA, Halken S, Høst A, et al. Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy. (2007) 62(8):943–8. 10.1111/j.1398-9995.2007.01451.x PubMed DOI

Valovirta E, Petersen TH, Piotrowska T, Laursen MK, Andersen JS, Sørensen HF, et al. Results from the 5-year SQ grass sublingual immunotherapy tablet asthma prevention (GAP) trial in children with grass pollen allergy. J Allergy Clin Immunol. (2018) 141(2):529–38.e13. 10.1016/j.jaci.2017.06.014 PubMed DOI

Diamant Z, van Maaren M, Muraro A, Jesenak M, Striz I. Allergen immunotherapy for allergic asthma: the future seems bright. Respir Med. (2023) 210:107125. 10.1016/j.rmed.2023.107125 PubMed DOI

Martinez FD. New insights into the natural history of asthma: primary prevention on the horizon. J Allergy Clin Immunol. (2011) 128(5):939–45. 10.1016/j.jaci.2011.09.020 PubMed DOI PMC

Van Mason J, Portnoy JM. Immunologic strategies for prevention of asthma. J Allergy Clin Immunol Pract. (2020) 8(3):834–47. 10.1016/j.jaip.2019.11.029 PubMed DOI

Haahtela T, Valovirta E, Saarinen K, Jantunen J, Lindström I, Kauppi P, et al. The finnish allergy program 2008–2018: society-wide proactive program for change of management to mitigate allergy burden. J Allergy Clin Immunol. (2021) 148(2):319–26.e4. 10.1016/j.jaci.2021.03.037 PubMed DOI

Beasley R, Semprini A, Mitchell EA. Risk factors for asthma: is prevention possible? Lancet. (2015) 386(9998):1075–85. 10.1016/S0140-6736(15)00156-7 PubMed DOI

Wahn U, Lau S, Eigenmann P, Melen E, Krauss-Etschmann S, Lex C, et al. Early priming of asthma and respiratory allergies: future aspects of prevention: a statement by the European forum for education and research in allergy and airway disease (EUFOREA) and the EAACI-Clemens von pirquet foundation. Pediatr Allergy Immunol. (2022) 33(4):e13773. 10.1111/pai.13773 PubMed DOI

Nieto A, Mazón A, Nieto M, Calderón R, Calaforra S, Selva B, et al. Bacterial mucosal immunotherapy with MV130 prevents recurrent wheezing in children: a randomized, double-blind, placebo-controlled clinical trial. Am J Respir Crit Care Med. (2021) 204(4):462–72. 10.1164/rccm.202003-0520OC PubMed DOI PMC

Twohig H, Hodges V, Mitchell C. Pre-diabetes: opportunity or overdiagnosis? Br J Gen Pract. (2018) 68(669):172–3. 10.3399/bjgp18X695369 PubMed DOI PMC

Caudri D, Wijga AH, Hoekstra MO, Kerkhof M, Koppelman GH, Brunekreef B, et al. Prediction of asthma in symptomatic preschool children using exhaled nitric oxide, Rint and specific IgE. Thorax. (2010) 65(9):801–7. 10.1136/thx.2009.126912 PubMed DOI

Sunyer J, Jarvis D, Pekkanen J, Chinn S, Janson C, Leynaert B, et al. Geographic variations in the effect of atopy on asthma in the European community respiratory health study. J Allergy Clin Immunol. (2004) 114(5):1033–9. 10.1016/j.jaci.2004.05.072 PubMed DOI

Durham SR, Penagos M. Sublingual or subcutaneous immunotherapy for allergic rhinitis? J Allergy Clin Immunol. (2016) 137(2):339–349.e10. 10.1016/j.jaci.2015.12.1298 PubMed DOI

Demoly P, Leroyer C, Serrano E, Le Maux A, Magnier G, Chartier A. The SQ HDM SLIT-tablet is safe and well tolerated in patients with house dust mite allergic rhinitis with or without asthma: a “real-life” French study. Clin Transl Allergy. (2022) 12(3):e12129. 10.1002/clt2.12129 PubMed DOI PMC

House Dust Mite Allergy Trial In Children (MATIC) clinicaltrials.gov. Available online at: Available at: https://clinicaltrials.gov › show › NCT04145219.

Pfaar O, Fritzsching B, Wolf H, Woehlk C, Wüstenberg E. How does allergen immunotherapy-induced tolerance improve the airway epithelial barrier function: a mechanistical-driven hypothesis. Allergy. (2023) 78(10):2577–80. 10.1111/all.15835 PubMed DOI

Scadding GK, Smith PK, Blaiss M, Roberts G, Hellings PW, Gevaert P, et al. Allergic rhinitis in childhood and the new EUFOREA algorithm. Front Allergy. (2021) 2:706589. 10.3389/falgy.2021.706589 PubMed DOI PMC

Mohebbi A, Dehghani Firouzabadi F, Dehghani Firouzabadi M, Roomiani M. Effect of the tongue-in-groove technique on the smile form. Rhinology. (2020) 58(6):626–28. 10.4193/Rhin20.246 PubMed DOI

Hellings PW, Lau S, Scadding GK, Bjermer L, Backer V, Chaker AM, et al. EUFOREA summit in Brussels 2023: inspiring the future of allergy & respiratory care. Front Allergy. (2023) 4:1236977. 10.3389/falgy.2023.1236977 PubMed DOI PMC

Pre-asthma: a useful concept? A EUFOREA paper. Part 2-late onset eosinophilic asthma