Department of Health Sciences, University of Florence, Florence, Italy.
Pediatric Outpatient Service, Bergamo, Italy.
Ital J Pediatr. 2024 Mar 6;50(1):42. doi: 10.1186/s13052-023-01492-x.
Asthma is one of the most common non-communicable diseases, and its prevalence and morbidity are influenced by a wide array of factors that are only partially understood. In addition to individual predisposition linked to genetic background and early life infections, environmental factors are crucial in determining the impact of asthma both on an individual patient and on a population level.Several studies have examined the role of the environment where asthmatic subjects live in the pathogenesis of asthma. This review aims to investigate the differences in the prevalence and characteristics of asthma between the pediatric population residing at higher altitudes and children living at lower altitudes, trying to define factors that potentially determine such differences. For this purpose, we reviewed articles from the literature concerning observational studies assessing the prevalence of pediatric asthma in these populations and its characteristics, such as spirometric and laboratory parameters and associated sensitization to aeroallergens.Despite the heterogeneity of the environments examined, the hypothesis of a beneficial effect of residing at a higher altitude on the prevalence of pediatric asthma could be confirmed, as well as a good profile on airway inflammation in asthmatic children. However, the possibility of a higher hospitalization risk for asthma in children living at higher altitudes was demonstrated. Moreover, a positive association between residing at a higher altitude and sensitization to pollens and between lower altitude and sensitization to house dust mites could be confirmed in some pediatric patients, even if the results are not homogeneous, probably due to the different geographical and climatic regions considered. Nonetheless, further studies, e.g., extensive and international works, need to be conducted to better understand the complex interplay between different environmental factors, such as altitude, and the pathogenesis of asthma and how its prevalence and characteristics could vary due to climate change.
哮喘是最常见的非传染性疾病之一，其患病率和发病率受多种因素的影响，这些因素部分尚未被完全了解。除了与遗传背景和早期感染有关的个体易感性外，环境因素在确定哮喘对个体患者和人群水平的影响方面至关重要。许多研究已经探讨了哮喘患者生活环境在哮喘发病机制中的作用。本综述旨在研究生活在高海拔地区和低海拔地区的儿科人群中哮喘的患病率和特征差异，并试图确定潜在决定这些差异的因素。为此，我们回顾了有关观察性研究的文献文章，这些研究评估了这些人群中儿科哮喘的患病率及其特征，例如肺功能和实验室参数以及与气传过敏原的相关致敏情况。尽管所研究的环境存在异质性，但可以证实生活在高海拔地区对儿科哮喘患病率的有益影响，以及哮喘儿童气道炎症的良好特征。然而，已经证明生活在高海拔地区的儿童哮喘住院风险更高。此外，在一些儿科患者中，可以证实生活在高海拔地区与对花粉的致敏之间以及生活在低海拔地区与对屋尘螨的致敏之间存在正相关关系，尽管结果并不一致，这可能是由于所考虑的不同地理和气候区域所致。尽管如此，仍需要开展进一步的研究，例如广泛的国际合作研究，以更好地了解不同环境因素（如海拔）与哮喘发病机制之间的复杂相互作用，以及哮喘的患病率和特征如何因气候变化而发生变化。
