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Risk factors for non-atopic asthma/wheeze in children and adolescents: a systematic review
Agostino Strina1, Mauricio L Barreto1, Philip J Cooper2
1Universidade Federal da Bahia, Instituto de Saude Coletiva, Rua Basilio da Gama s/n, 40110-040 Salvador, Bahia, Brazil.
Insights
Identifying risk factors for non-atopic asthma in children is crucial. Consistent associations were found with family history, household dampness, and childhood respiratory infections, though more research is needed.
Area of Science:
- Pediatric respiratory health
- Environmental and genetic factors in asthma
Background:
- Distinguishing non-atopic asthma from atopic asthma is a recent research area.
- Previous studies on non-atopic asthma risk factors have yielded inconsistent findings.
- Research has often focused on single risk factors, lacking a comprehensive approach.
Purpose of the Study:
- To systematically review and synthesize evidence on factors associated with non-atopic asthma or wheeze in children and adolescents.
- To identify consistent risk factors across diverse studies.
Main Methods:
- Systematic review of studies investigating risk factors for non-atopic asthma/wheeze.
- Inclusion criteria required a non-asthmatic comparison group and atopy assessment via skin-prick test or allergen-specific IgE.
- Analysis of 30 potential risk factors across 43 studies.
Main Results:
- Only three factors consistently associated with non-atopic asthma/wheeze: family history (asthma/rhinitis/eczema), household dampness/mold, and childhood lower respiratory tract infections.
- Breastfeeding duration showed less consistent associations.
- Overweight/obesity and psychosocial factors demonstrated consistent associations in limited studies.
- A novel graphical method was used to visualize complex risk factor patterns.
Conclusions:
- Standardized methodologies are essential for future research into the causes of non-atopic asthma.
- Further investigation is required to fully understand the etiology of non-atopic asthma in pediatric populations.
Background:
The study of non-atopic asthma/wheeze in children separately from atopic asthma is relatively recent. Studies have focused on single risk factors and had inconsistent findings.
Objective:
To review evidence on factors associated with non-atopic asthma/wheeze in children and adolescents.
Methods:
A review of studies of risk factors for non-atopic asthma/wheeze which had a non-asthmatic comparison group, and assessed atopy by skin-prick test or allergen-specific IgE.
Results:
Studies of non-atopic asthma/wheeze used a wide diversity of definitions of asthma/wheeze, comparison groups and methods to assess atopy. Among 30 risk factors evaluated in the 43 studies only 3 (family history of asthma/rhinitis/eczema, dampness/mold in the household, and lower respiratory tract infections in childhood) showed consistent associations with non-atopic asthma/wheeze. No or limited period of breastfeeding was less consistently associated with non-atopic asthma/wheeze. The few studies examining the effects of overweight/obesity and psychological/social factors showed consistent associations. We used a novel graphical presentation of different risk factors for non-atopic asthma/wheeze, allowing a more complete perception of the complex pattern of effects.
Conclusions:
More research using standardized methodology is needed on the causes of non-atopic asthma.
