Nonatopic asthma is associated with helminth infections and bronchiolitis in poor children.

Asthma is common in urban centres in Latin America, but atopic asthma may not be the main phenotype among children. Helminth infections are highly prevalent in poor populations, and it was hypothesised that they attenuate allergic asthma, whereas other factors are related to the expression of a nonatopic wheeze/asthma phenotype. A total of 1,982 children from Southern Brazil with a mean+/-sd age of 10.1+/-0.76 yrs completed asthma questionnaires, and 1,011 were evaluated for intestinal parasites and atopy using skin-prick tests (SPTs). Wheeze in the previous 12 months was reported by 25.6%, and 9.3% showed current asthma; 13% were SPT-positive and 19.1% were positive for any helminths. Most children with either wheeze or asthma were SPT-negative; however, severe wheeze was more prevalent among the atopic minority. Helminth infections were inversely associated with positive SPT results. Bronchiolitis before the age of 2 yrs was the major independent risk factor for asthma at age 10 yrs; high-load Ascaris infection, a family history of asthma and positive SPT results were also asthma risk factors. Most asthma and wheeze are of the nonatopic phenotype, suggesting that some helminths may exert an attenuating effect on the expression of the atopic portion of the disease, whereas viral bronchiolitis predisposes more specifically to recurrent airway symptoms.

Association between Helicobacter pylori and recurrent aphthous stomatitis in children and adolescents.

BACKGROUND: The recurrent aphthous stomatitis (RAS) is a common disease with unknown etiology. Helicobacter pylori has been shown to be the causative factor in peptic ulcers. Considering the similarities of histologic features between gastric and oral ulceration, we studied the possible involvement of H. pylori in the development of RAS. METHODS: A total of 105 children and adolescents were investigated--53 patients with RAS (case group) and 52 patients without lesions (control group). Specimens obtained by swabbing RAS lesions, intact oral mucosa, and dental plaque were submitted to a polymerase chain reaction (PCR)-based assay. RESULTS: Helicobacter pylori was present in six patients of the case group (11.3%) and in three of the control group (5.8%). When the site of infection was studied, 9.4% of the RAS lesions were PCR positives. In the case group and control group, 5.7 and 1.9% of the specimens from dental plaque, respectively, and 5.7 and 3.8% of the specimens from the intact oral mucosa, respectively, were PCR positives. CONCLUSION: There was no association between RAS lesions and infection of the oral cavity by H. pylori in children and adolescents (P = 0.254).