Monitoring is a major component of asthma management in children. Regular monitoring allows for diagnosis confirmation, treatment optimization, and natural history review. Numerous factors that may affect disease activity and patient well-being need to be monitored: response and adherence to treatment, disease control, disease progression, comorbidities, quality of life, medication side-effects, allergen and irritant exposures, diet and more. However, the prioritization of such factors and the selection of relevant assessment tools is an unmet need. Furthermore, rapidly developing technologies promise new opportunities for closer, or even "real-time," monitoring between visits. Following an approach that included needs assessment, evidence appraisal, and Delphi consensus, the PeARL Think Tank, in collaboration with major international professional and patient organizations, has developed a set of 24 recommendations on pediatric asthma monitoring, to support healthcare professionals in decision-making and care pathway design.

• Klíčová slova
• asthma management, biomarkers, childhood, consensus, diagnosis, guidelines, therapy,
• MeSH
• antiastmatika terapeutické užití   MeSH
• bronchiální astma * diagnóza   terapie   MeSH
• delfská metoda MeSH
• dítě MeSH
• kvalita života MeSH
• lidé MeSH
• monitorování fyziologických funkcí metody   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• směrnice pro lékařskou praxi MeSH
• Názvy látek
• antiastmatika MeSH

• Klíčová slova
• Asthma comorbidities, Asthma diagnosis, Asthma management, Asthma treatment algorithm,
• MeSH
• bronchiální astma * diagnóza   terapie   MeSH
• lidé MeSH
• pacienti MeSH
• praktičtí lékaři * MeSH
• stupeň vzdělání MeSH
• zdravotničtí záchranáři MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

"Epidemiology of comorbidities and their association with asthma control" (Tomisa, G., Horváth, A., Sánta, B. et al. Epidemiology of comorbidities and their association with asthma control. Allergy Asthma Clin Immunol 17, 95 (2021). https://doi.org/10.1186/s13223-021-00598-3 ) is an interesting paper reflecting data collection from more than 12,000 asthmatic patients in Hungary regarding their condition and associated comorbidities. We found it valuable that the paper provides an overview of asthma comorbidities not usually considered in similar reports. Nevertheless, we believe that chronic rhinosinusitis (CRS) with or without nasal polyps (CRSwNP or CRSsNP) should have been listed due to its high incidence and prevalence, its association with asthma which is also endorsed in both GINA and EPOS, as well as in several peer-reviewed scientific papers, and to reflect the role of this comorbidity in poor control and a most severe presentation of asthma for the patient. Consequently, several targeted therapies (especially monoclonal antibodies) used for several years in severe forms of asthma are now indicated also for the effective treatment of nasal polyps.

• Klíčová slova
• Allergic rhinitis, Asthma, Chronic rhinosinusitis with nasal polyps, Chronic rhinosinusitis without nasal polyps, Comorbidities,
• Publikační typ
• dopisy MeSH

• Klíčová slova
• allergic rhinitis, asthma, immunotherapy, precision medicine,
• Publikační typ
• časopisecké články MeSH

BACKGROUND: It is unclear whether asthma may affect susceptibility or severity of coronavirus disease 2019 (COVID-19) in children and how pediatric asthma services worldwide have responded to the pandemic. OBJECTIVE: To describe the impact of the COVID-19 pandemic on pediatric asthma services and on disease burden in their patients. METHODS: An online survey was sent to members of the Pediatric Asthma in Real Life think tank and the World Allergy Organization Pediatric Asthma Committee. It included questions on service provision, disease burden, and the clinical course of confirmed cases of COVID-19 infection among children with asthma. RESULTS: Ninety-one respondents, caring for an estimated population of more than 133,000 children with asthma, completed the survey. COVID-19 significantly impacted pediatric asthma services: 39% ceased physical appointments, 47% stopped accepting new patients, and 75% limited patients' visits. Consultations were almost halved to a median of 20 (interquartile range, 10-25) patients per week. Virtual clinics and helplines were launched in most centers. Better than expected disease control was reported in 20% (10%-40%) of patients, whereas control was negatively affected in only 10% (7.5%-12.5%). Adherence also appeared to increase. Only 15 confirmed cases of COVID-19 were reported among the population; the estimated incidence is not apparently different from the reports of general pediatric cohorts. CONCLUSIONS: Children with asthma do not appear to be disproportionately affected by COVID-19. Outcomes may even have improved, possibly through increased adherence and/or reduced exposures. Clinical services have rapidly responded to the pandemic by limiting and replacing physical appointments with virtual encounters.

• Klíčová slova
• Adherence, Asthma, COVID-19, Children, Control, SARS-CoV2, Virus,
• MeSH
• adherence k farmakoterapii MeSH
• Betacoronavirus MeSH
• bronchiální astma epidemiologie   patofyziologie   terapie   MeSH
• časové faktory MeSH
• celosvětové zdraví MeSH
• COVID-19 MeSH
• dítě MeSH
• koronavirové infekce epidemiologie   MeSH
• lidé MeSH
• pandemie MeSH
• SARS-CoV-2 MeSH
• schůzky a rozvrhy MeSH
• stupeň závažnosti nemoci MeSH
• telemedicína organizace a řízení   statistika a číselné údaje   MeSH
• virová pneumonie epidemiologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The selection of pharmacotherapy for patients with allergic rhinitis aims to control the disease and depends on many factors. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines have considerably improved the treatment of allergic rhinitis. However, there is an increasing trend toward use of real-world evidence to inform clinical practice, especially because randomized controlled trials are often limited with regard to the applicability of results. The Contre les Maladies Chroniques pour un Vieillissement Actif (MACVIA) algorithm has proposed an allergic rhinitis treatment by a consensus group. This simple algorithm can be used to step up or step down allergic rhinitis treatment. Next-generation guidelines for the pharmacologic treatment of allergic rhinitis were developed by using existing GRADE-based guidelines for the disease, real-world evidence provided by mobile technology, and additive studies (allergen chamber studies) to refine the MACVIA algorithm.

• Klíčová slova
• Allergic Rhinitis and Its Impact on Asthma, Allergic rhinitis, Development and Evaluation, Grading of Recommendations Assessment, guidelines, real-world evidence,
• MeSH
• alergická rýma * diagnóza   imunologie   terapie   MeSH
• algoritmy * MeSH
• bronchiální astma * diagnóza   imunologie   terapie   MeSH
• lékařská praxe založená na důkazech * MeSH
• lidé MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

The European Academy of Allergy and Clinical Immunology (EAACI) organized the first European Strategic Forum on Allergic Diseases and Asthma. The main aim was to bring together all relevant stakeholders and decision-makers in the field of allergy, asthma and clinical Immunology around an open debate on contemporary challenges and potential solutions for the next decade. The Strategic Forum was an upscaling of the EAACI White Paper aiming to integrate the Academy's output with the perspective offered by EAACI's partners. This collaboration is fundamental for adapting and integrating allergy and asthma care into the context of real-world problems. The Strategic Forum on Allergic Diseases brought together all partners who have the drive and the influence to make positive change: national and international societies, patients' organizations, regulatory bodies and industry representatives. An open debate with a special focus on drug development and biomedical engineering, big data and information technology and allergic diseases and asthma in the context of environmental health concluded that connecting science with the transformation of care and a joint agreement between all partners on priorities and needs are essential to ensure a better management of allergic diseases and asthma in the advent of precision medicine together with global access to innovative and affordable diagnostics and therapeutics.

• Klíčová slova
• allergic diseases, asthma, big data, environmental health, exposome, implementation science, quality criteria, translational research,
• MeSH
• alergie diagnóza   epidemiologie   etiologie   terapie   MeSH
• big data MeSH
• bioinženýrství MeSH
• bronchiální astma diagnóza   epidemiologie   terapie   MeSH
• environmentální zdraví MeSH
• implementační věda MeSH
• informační technologie MeSH
• kapitálové financování * MeSH
• lidé MeSH
• management nemoci MeSH
• translační biomedicínský výzkum * ekonomika   zákonodárství a právo   metody   organizace a řízení   MeSH
• vyvíjení léků MeSH
• výzkum * MeSH
• zapojení pacienta MeSH
• zdravotní politika MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including healthcare professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow-up of patients.

• Klíčová slova
• allergen immunotherapy, asthma, children, mHealth, rhinitis, stratification,
• MeSH
• alergeny aplikace a dávkování   imunologie   MeSH
• alergická rýma epidemiologie   imunologie   terapie   MeSH
• analýza nákladů a výnosů MeSH
• biologické markery MeSH
• bronchiální astma epidemiologie   imunologie   terapie   MeSH
• desenzibilizace imunologická * škodlivé účinky   metody   MeSH
• individualizovaná medicína metody   MeSH
• klinické rozhodování MeSH
• komorbidita MeSH
• kritické cesty * MeSH
• lidé MeSH
• management nemoci MeSH
• náchylnost k nemoci MeSH
• osobní újma zaviněná nemocí MeSH
• postoj zdravotnického personálu MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• výsledek terapie MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• alergeny MeSH
• biologické markery MeSH

Genetic association studies have identified 21 loci associated with atopic dermatitis risk predominantly in populations of European ancestry. To identify further susceptibility loci for this common, complex skin disease, we performed a meta-analysis of >15 million genetic variants in 21,399 cases and 95,464 controls from populations of European, African, Japanese and Latino ancestry, followed by replication in 32,059 cases and 228,628 controls from 18 studies. We identified ten new risk loci, bringing the total number of known atopic dermatitis risk loci to 31 (with new secondary signals at four of these loci). Notably, the new loci include candidate genes with roles in the regulation of innate host defenses and T cell function, underscoring the important contribution of (auto)immune mechanisms to atopic dermatitis pathogenesis.

• MeSH
• atopická dermatitida etnologie   genetika   patologie   MeSH
• celogenomová asociační studie * MeSH
• etnicita genetika   MeSH
• genetická predispozice k nemoci * MeSH
• genetické lokusy * MeSH
• genetické markery genetika   MeSH
• jednonukleotidový polymorfismus genetika   MeSH
• lidé MeSH
• přirozená imunita genetika   MeSH
• rizikové faktory MeSH
• studie případů a kontrol MeSH
• T-lymfocyty cytologie   imunologie   metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• genetické markery MeSH

BACKGROUND: Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results. OBJECTIVES: We performed an individual participant data meta-analysis for 147,252 children of 31 birth cohort studies to determine the associations of birth and infant growth characteristics with the risks of preschool wheezing (1-4 years) and school-age asthma (5-10 years). METHODS: First, we performed an adjusted 1-stage random-effect meta-analysis to assess the combined associations of gestational age, birth weight, and infant weight gain with childhood asthma. Second, we performed an adjusted 2-stage random-effect meta-analysis to assess the associations of preterm birth (gestational age <37 weeks) and low birth weight (<2500 g) with childhood asthma outcomes. RESULTS: Younger gestational age at birth and higher infant weight gain were independently associated with higher risks of preschool wheezing and school-age asthma (P < .05). The inverse associations of birth weight with childhood asthma were explained by gestational age at birth. Compared with term-born children with normal infant weight gain, we observed the highest risks of school-age asthma in children born preterm with high infant weight gain (odds ratio [OR], 4.47; 95% CI, 2.58-7.76). Preterm birth was positively associated with an increased risk of preschool wheezing (pooled odds ratio [pOR], 1.34; 95% CI, 1.25-1.43) and school-age asthma (pOR, 1.40; 95% CI, 1.18-1.67) independent of birth weight. Weaker effect estimates were observed for the associations of low birth weight adjusted for gestational age at birth with preschool wheezing (pOR, 1.10; 95% CI, 1.00-1.21) and school-age asthma (pOR, 1.13; 95% CI, 1.01-1.27). CONCLUSION: Younger gestational age at birth and higher infant weight gain were associated with childhood asthma outcomes. The associations of lower birth weight with childhood asthma were largely explained by gestational age at birth.

• Klíčová slova
• Gestational age, asthma, children, cohort studies, epidemiology, infant growth, low birth weight, wheezing,
• MeSH
• bronchiální astma * epidemiologie   patologie   patofyziologie   MeSH
• gestační stáří * MeSH
• hmotnostní přírůstek * MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• porodní hmotnost * MeSH
• předčasný porod * epidemiologie   patologie   patofyziologie   MeSH
• rizikové faktory MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH