The concept of pre-diabetes has led to provision of measures to reduce disease progression through identification of subjects at risk of diabetes. We previously considered the idea of pre-asthma in relation to allergic asthma and considered that, in addition to the need to improve population health via multiple measures, including reduction of exposure to allergens and pollutants and avoidance of obesity, there are several possible specific means to reduce asthma development in those most at risk (pre- asthma). The most obvious is allergen immunotherapy (AIT), which when given for allergic rhinitis (AR) has reasonable evidence to support asthma prevention in children (2) but also needs further study as primary prevention. In this second paper we explore the possibilities for similar actions in late onset eosinophilic asthma.

• Klíčová slova
• S. aureus biofilm, chronic rhinosinusitis with nasal polyps, eosinophils, late onset asthma, mast cells, non-allergic rhinitis, virulence genes,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Allergen specific immunotherapy (AIT) is the only causal therapeutic option for allergic airway diseases including asthma and allergic rhinitis. AIT has been shown to restore the allergen immune tolerance, can modify both the early and late-onset allergen-specific airway hyperreactivity, helps to achieve disease control/remission and prevents new sensitisations. Recent real life data on long-term effectiveness of house dust mite (HDM) AIT in a large group of patients with HDM-driven asthma further underscored its unique therapeutic potential as well as confirmed previous data with pollen AIT. More widespread use of this causal treatment in select patient populations should further move this promising therapeutic field. In this mini-review, we discuss updates on new insights based on real world patient data.

• Klíčová slova
• Allergen immunotherapy, Asthma, Clinical effectiveness, Disease modification, Disease remission, Mechanisms, Prevention,
• MeSH
• alergeny MeSH
• alergická rýma * farmakoterapie   MeSH
• antigeny roztočů domácího prachu terapeutické užití   MeSH
• bronchiální astma * etiologie   MeSH
• desenzibilizace imunologická MeSH
• lidé MeSH
• pyl MeSH
• Pyroglyphidae MeSH
• sublinguální imunoterapie * MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• alergeny MeSH
• antigeny roztočů domácího prachu MeSH

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.

• Klíčová slova
• asthma, asthma natural history, pre-asthma, predisposition, quality of life, risk factors,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: Common variable immunodeficiency (CVID) is one of the most frequent primary immunodeficiencies and is characterized by disturbed immunoglobulin production and dysregulation of the immune system. Results of previous studies suggest a higher prevalence of bronchial asthma (BA) in CVID patients than in the general population. We initiated this study to evaluate lung functions and identify risk factors for BA and bronchial hyperresponsiveness (BHR) in patients with CVID. METHODS: Twenty-three patients with CVID were included in this study. In all of them, spirometry and a metacholine bronchoprovocation test were performed. We also investigated the role of atopy, eosinophilic inflammation, and potential risk factors such as gender, age, or immunoglobulin levels at the time of diagnosis. RESULTS: BHR was confirmed in 12 patients (52%), all of whom had normal FEV1 and FEV1/FVC. However, BHR-positive patients had significantly decreased MEF25. BHR-positive patients had also more symptoms related to bronchial obstruction, with 8 of them (35%) being suspected of having BA at the end of the study. A higher prevalence of BHR was found in females, with a relative risk of 2.89. CONCLUSIONS: An increased prevalence of BHR and BA was detected in CVID patients compared to the general population. BA may develop despite the disturbed immunoglobulin production, and the majority of patients display nonatopic and noneosinophilic properties. These results suggest a limited role of atopy and eosinophilic inflammation in the pathogenesis of BA in CVID patients.

• Klíčová slova
• Bronchial asthma, Bronchial hyperresponsiveness, Bronchoprovocation, Common variable immunodeficiency, Risk factors,
• MeSH
• běžná variabilní imunodeficience komplikace   MeSH
• biologické markery MeSH
• bronchiální astma diagnóza   etiologie   MeSH
• bronchiální hyperreaktivita diagnóza   etiologie   MeSH
• bronchoprovokační testy MeSH
• fenotyp MeSH
• imunoglobulin G krev   imunologie   MeSH
• imunoglobulin M krev   imunologie   MeSH
• kožní testy MeSH
• lidé MeSH
• podskupiny lymfocytů imunologie   metabolismus   MeSH
• průzkumy a dotazníky MeSH
• respirační funkční testy MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické markery MeSH
• imunoglobulin G MeSH
• imunoglobulin M MeSH

The paper evaluates the contemporary health status in 115 former child asthmatics, investigated in the past at the allergological department of the First Paediatric Clinic and Faculty Policlinic in Prague-Motol. The data were obtained by processing of a questionnaire and retrospective analysis of the patients' health records. The mean age of the investigated group is 26 years (21-37) incl. 77 men and 38 women. Of these 85, i.e. 74%, still suffer from asthma in adult age, incl. almost half (55 patients) who suffer from the milder form, only one quarter suffers from the more severe form (30 patients) and in one quarter the quiescent stage has been reached. In those where asthma persists there is concurrent eczema (26%), pollinosis (44%), other forms of allergy (43%). Where asthma is in the quiescent stage, eczema is present in 10%, pollinosis in 33% and other allergies in 27% of the investigated subjects. A greater probability of favourable development is in boys as compared with girls and in those without a family-history of allergy and where the disease developed only during late childhood and the patients themselves do not suffer from any other allergosis. A positive family-history of allergy, early onset of the disease and concurrent eczema signalize a poorer prognosis.

• MeSH
• bronchiální astma patofyziologie   MeSH
• dospělí MeSH
• lidé MeSH
• následné studie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH