Journal of Paediatric Medicine & Surgery
Open Access

Pediatric immunology; Allergic disorders; Asthma; Food allergies; Autoimmune diseases; Immune system; Atopic dermatitis; Diagnosis; Treatment; Early intervention

Introduction

Immunological and allergic disorders in children present a significant public health challenge, with an increasing incidence of conditions such as asthma, food allergies, and autoimmune diseases. These disorders not only affect the quality of life of affected children but also place a substantial burden on healthcare systems. The immune system plays a crucial role in the development of these conditions, and understanding its mechanisms is key to developing effective treatments and preventive measures [1,2].

Background

The immune system in children

The immune system in children undergoes rapid development during early life. The immature immune response can predispose children to infections, allergies, and autoimmune disorders. The two main arms of the immune system, the innate and adaptive immune responses, must work in concert to protect against pathogens while maintaining tolerance to non-harmful substances.

Allergic disorders

Allergic disorders occur when the immune system mistakenly identifies harmless substances (allergens) as threats, leading to an exaggerated immune response. Common pediatric allergic disorders include asthma, atopic dermatitis, and food allergies. In these conditions, immunoglobulin E (IgE) plays a critical role in mediating allergic reactions, triggering the release of histamines and other inflammatory mediators from mast cells and basophils [3].

Autoimmune disorders

In contrast to allergies, autoimmune disorders result from the immune system attacking the body’s own tissues. In children, common autoimmune disorders include type 1 diabetes, juvenile idiopathic arthritis (JIA), and celiac disease. The underlying cause is often a breakdown in self-tolerance, where the immune system fails to recognize its own cells as "self" and mounts an immune response against them [4].

Methods

This article is based on a comprehensive review of existing literature on pediatric immunological and allergic disorders. A detailed search of databases such as PubMed, Scopus, and Web of Science was performed, focusing on studies published in the last decade. Inclusion criteria included studies that evaluated the epidemiology, pathophysiology, diagnosis, and management of pediatric allergic and immunological disorders.

Results

1. Asthma and atopic disorders

Asthma is the most common chronic disease in children, affecting around 8-10% of the global pediatric population. It is characterized by chronic inflammation of the airways, leading to episodic wheezing, coughing, and shortness of breath. Studies show that early exposure to environmental allergens, viral infections, and pollution increases the risk of developing asthma.

Atopic dermatitis, a chronic skin condition, is closely linked with asthma and other allergic disorders. It often manifests in early infancy and can be associated with food allergies and asthma later in life (the "atopic march") [5,6].

2. Food allergies

Food allergies in children have risen dramatically in recent decades. The most common allergens include cow’s milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish. Severe allergic reactions, such as anaphylaxis, can be life-threatening and require immediate treatment with epinephrine.

Recent research emphasizes the importance of early introduction of allergenic foods (such as peanuts) to infants to reduce the risk of developing food allergies, as evidenced by the Learning Early About Peanut Allergy (LEAP) study [7].

3. Autoimmune disorders

Type 1 diabetes is a prototypical autoimmune disorder in children, where immune cells destroy insulin-producing beta cells in the pancreas. Genetic predisposition, viral infections, and early exposure to cow’s milk proteins have been implicated in its development.

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children, affecting joints and potentially leading to disability if not treated early. Advances in biological therapies targeting tumor necrosis factor (TNF) and interleukin (IL)-6 have improved outcomes for many children with JIA [8].

Discussion

The rising incidence of immunological and allergic disorders in children underscores the need for a better understanding of their pathophysiology and contributing factors. Genetic predisposition combined with environmental exposures early in life appears to play a crucial role. In the case of allergic disorders, the hygiene hypothesis suggests that reduced microbial exposure due to modern sanitation and antibiotic use has led to an increase in allergic diseases. However, more research is needed to explore this hypothesis fully. Treatment approaches for pediatric immunological disorders vary. For allergic disorders, management typically involves avoiding allergens, using antihistamines or corticosteroids, and administering emergency epinephrine in cases of anaphylaxis. New therapies such as allergen immunotherapy and biologics targeting specific immune pathways are promising but require further study to assess their long-term efficacy and safety in children [9,10]. For autoimmune disorders, treatment focuses on controlling immune activity and reducing inflammation. Early diagnosis and treatment with immunosuppressive drugs or biological agents can prevent long-term damage and improve quality of life for affected children. For instance, in JIA, early intervention with TNF inhibitors has significantly improved outcomes.

Conclusion

Immunological and allergic disorders in children are complex, multifactorial conditions that require a multidisciplinary approach to diagnosis and treatment. Early detection and intervention are crucial in managing these disorders and improving long-term outcomes. Advances in immunology and molecular biology have led to the development of targeted therapies, offering hope for more effective treatments in the future. Ongoing research is essential to further our understanding of these conditions and to develop strategies to prevent their onset and progression.

1. Lezin N, Rolleri L, Bean S, Taylor J (2004)Parent-child connectedness: Implications for research, interventions and positive impacts on adolescent health. Santa Cruz, CA: ETR Associates.

Indexed at, Google Scholar

2. Namisi FS, Flisher AJ, Overland S, Bastien S, Onya H, et al. (2009)Sociodemographic variations in communication on sexuality and HIV/AIDS with parents, family members and teachers among in-school adolescents: a multi-site study in Tanzania and South Africa. Scand J Public Health 37: 65-74.

Indexed at, Google Scholar, Crossref

3. Babalola S, Tambashe BO, Vondrasek C (2005)Parental factors and sexual risk-taking among young people in Côte d'Ivoire. AJRH 9: 49-65.

Google Scholar

4. Biddlecom A, Awusabo-Asare K, Bankole A (2009)Role of parents in adolescent sexual activity and contraceptive use in four African countries. Int Perspect Sex Reprod Health 35: 72-81.

Indexed at, Google Scholar, Crossref

5. Taylor Seehafer RL (2000)Risky Sexual Behavior Among Adolescent Women. J Specia Pedia Nurs 5: 15-25.

Indexed at, Google Scholar, Crossref

6. Keating DP (2004)Cognitive and Brain Development. NJ: John Wiley & Sons.

Google Scholar, Crossref

7. Olugbenga-Bello AI, Adebimpe WO, Abodunrin OL (2009)Sexual risk behaviour among in-school adolescents in Public Secondary schools in a Southwestern City in Nigeria. Int J Health Res 2: 243-251.

Indexed at, Google Scholar, Crossref

8. Lloyd CB (2007).The role of schools in promoting sexual and reproductive health among adolescents in developing countries. In: Poverty, Gender, and Youth Working Papers (6). New York: Population Council.

Google Scholar

9. Izugbara CO (2008)Home-based sexuality education: Nigerian parents discussing sex with their children. Youth Society 39: 575-600.

Google Scholar, Crossref

10. Singh S, Bankole A, Woog V (2005)Evaluating the need for sex education in developing countries: sexual behavior, knowledge of preventing sexually transmitted infections/HIV and unplanned pregnancy. Sex Edu 5: 3007-3331.

Google Scholar