Evaluation of the Profile and Treatment Results for Allergic Children

Rana Ali Othman, Thaer Ali Hussein

Abstract


Background: The majority of allergy sufferers produce IgE antibodies, which are antigen-specific antibodies; the term sensitivity addresses the clinical articulation of IgE-intervened unfavorably susceptible sickness.

Methods: This retrospective analytical study was carried out in the Pediatric Allergy and Immunology Unit, Muhammad Al-Mousawi Children's Hospital. The data included were those of 422 patients (286 males and 136 females). Their age ranged from  0 to 8.6 years (mean 0.97 ± 1.33) years and 0.6 to 13 years (mean 4.31 ± 2.93) years respectively. Data regarding bronchial asthma, course of the disease, treatment received and outcome at last visit were obtained from the patients' records. The ultimate objective was to evaluate the current epidemiologic and clinical profile as well as risk factors and the therapeutic responses of allergic diseases in our community.

Results:  According to a statistical analysis of the patient records, allergic diseases were more prevalent in males than in females (ratio 2.1: 1) and in metropolitan than rural and rustic regions. Positive family background of other atopic sicknesses to be specific unfavorably susceptible rhinitis and atopic dermatitis was higher than positive family background of bronchial asthma in our series. The most common causes of bronchial asthma were environmental and viral factors. Dyspnea, hack and were the most regular side effects for asthma fuel. Outright bosom taking care of didn't appear to safeguard against the improvement of bronchial asthma. The prevalence of mild and moderate cases was higher than that of severe cases. Eosinophils and serum total IgE were both elevated in the laboratory, and the most common treatment in this investigation was inhaled corticosteroids.

Conclusion: The procedure can be used in other facilities and pertinent investigations, but these results are particular to our unit and should not be interpreted generally. The sample size and retrospective design of the study limit the validity of the findings and conclusions.

Editorial Expression of Concern

20 June 2025: Following publication of this paper, the internal audit (consequent to concerns on quality raised by Web of Science) notified Advancements in Life Sciences about insufficient peer review. By this Editorial Expression of Concern, we alert the scientific community of this incidence as we asses if the reported scientific findings are reliable.

Retraction in Process

26 June 2025: Following a detailed post-publication review, significant ethical, methodological, and analytical concerns have been identified in this article. Specifically, the study retrospectively analyzed clinical data from 422 pediatric patients without any declaration of institutional ethical approval or documentation of informed consent, which constitutes a serious breach of ethical standards for human subject research. In addition, multiple methodological and statistical deficiencies were observed including but not limited to internal contradictions in reported findings (e.g., sex-based prevalence). These deficiencies make the findings scientifically unreliable. A formal retraction process has therefore been initiated in accordance with COPE guidance and established publishing standards. The retraction process will conclude upon receiving responses from the corresponding authors. In the meantime, the full text of the article shall remain inaccessible for citation. A show cause notice has also been issued to the responsible editorial team member for the evident oversight during the peer-review and editorial decision process.

Rescinded: Editorial Expression of Concern

23 July 2025: Editorial expression of concern issued on 20 June 2025 is hereby rescinded on account of authors' following justifications of the found technical shortcomings in light of COPE guidelines. An institutional ethical approval statement has also been provided by the authors to address research ethics concern.

1. Justification for the Retrospective Study Design:
This study was designed as a retrospective analysis because it allowed assessment of a large patient population over an extended period within limited resources. Retrospective studies are valuable for identifying epidemiological trends, clinical features, and treatment responses in real-world settings, especially in specialized units such as pediatric allergy clinics.
Moreover, retrospective data are often the first step before conducting prospective, longitudinal studies to generate hypotheses and detect local patterns.

2. Justification for Limited Generalizability:
We clearly stated that the results are specific to our unit and patient population and may not be generalized broadly. Our unit primarily serves urban and suburban populations, and referral patterns, environmental exposures, and healthcare accessibility likely influence the findings.
However, these results still provide a reliable baseline for future research in similar settings or populations.

3. Justification for Sex and Location Differences:
The observed male predominance (2.1:1 ratio) and higher urban prevalence are consistent with many global studies, particularly in pediatric populations where males are biologically more prone to wheezing illnesses early in life, likely due to anatomical and immunological differences.
Urban predominance may reflect greater exposure to pollution, indoor allergens, viral infections, and differing healthcare-seeking behaviors compared to rural areas.

4. Justification for Feeding Type Analysis:
The analysis of breastfeeding vs. artificial feeding is included because early feeding patterns are frequently studied for their impact on immune system development. While exclusive breastfeeding is generally considered protective, some studies have shown conflicting results in high-risk populations, particularly when strong genetic predisposition or environmental triggers are present. Our findings align with some reports showing no consistent protective effect against asthma in certain populations.

5. Justification for Using Total IgE and Eosinophil Counts:
Total IgE and eosinophil counts are commonly used clinical markers in the diagnosis and monitoring of allergic diseases. While they are not highly specific, elevated levels are often associated with allergic asthma, and their use is justified as part of routine allergy workups, particularly in resource-limited settings where advanced molecular testing is not feasible.

6. Justification for Outcome Classification:
Our classification of active vs. remission state was based on clear, clinically relevant criteria using patient symptoms and medication use. This approach provides a pragmatic method to assess treatment outcomes in real-world clinical settings and is suitable for retrospective studies.

7. Justification for the Role of Environmental Factors and Viral Triggers:
The inclusion of viral infections, cold air, indoor allergens, fumes, foods, puberty, and psychological stress as precipitating factors reflects both the clinical reality and the literature showing that asthma exacerbations often have multiple, overlapping triggers. The statistical analysis helped us identify which factors were associated with active or remission states in our cohort.

8. Justification for Use of Inhaled Corticosteroids (ICS) as Primary Therapy:
ICS remains the mainstay of asthma management worldwide according to global guidelines (e.g., GINA). Our finding that most patients received ICS aligns with best-practice recommendations, reinforcing the validity of our treatment protocols.

9. Justification for Small Sample in Some Subgroups (e.g., Sulfonamide Reactions):
Some subgroups, such as reactions to specific drugs, had small sample sizes due to their rarity in the pediatric population. Despite small numbers, we presented these results for completeness and transparency.

10. Justification for Limitations:
We openly acknowledged the limitations of our study, including its retrospective nature, sample size, and single-center setting. However, these limitations are inherent to many hospital-based epidemiological studies and do not diminish the value of identifying local clinical patterns.



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References


Strinnholm Å, Hedman L, Winberg A, Jansson SA, Lindh V, Rönmark E. Health Related Quality of Life among schoolchildren aged 12–13 years in relation to food hypersensitivity phenotypes: a population-based study. Clinical and Translational Allergy, (2017); 7(1): 1-10.

Phipatanakul W. Environmental allergies. Pediatrics, (2013); 32(1): 40-48.

Protudjer JL, Jansson SA, Östblom E, Arnlind MH, Bengtsson U, Dahlén SE, Kallström‐Bengtsson I, Marklund B, Middelveld RJ, Rentzos G, Sundqvist AC. Health‐related quality of life in children with objectively diagnosed staple food allergy assessed with a disease‐specific questionnaire. Acta Paediatrica, (2015); 104(10): 1047-1054.

Hamid Q, Tulic MK, Liu MC, Moqbel R. Inflammatory cells in asthma: mechanisms and implications for therapy. Journal of Allergy and Clinical Immunology, (2003); 111(1): S5-17.

Van JP, Gerth R, Vergouwe Y, Steyerberg EW, Reitsma M, Wichers HJ, Savelkoul HF, Vlieg‐Boerstra B, de Groot H, Dubois AE, de Jong NW. sIgE Ana o 1, 2, and 3 accurately distinguish tolerant from allergic children sensitized to cashew nuts. Clinical & Experimental Allergy, (2017); 47(1): 113-120.

Waserman S, Bégin P, Watson W. IgE-mediated food allergy. Allergy, Asthma & Clinical Immunology, (2018); 14: 1-10.

Robinson DS. The role of the mast cell in asthma: induction of airway hyperresponsiveness by interaction with smooth muscle. Journal of allergy and clinical immunology, (2004); 114(1): 58-65

Blumchen K, Trendelenburg V, Ahrens F, Gruebl A, Hamelmann E, Hansen G, Heinzmann A, Nemat K, Holzhauser T, Roeder M, Rosenfeld L. Efficacy, safety, and quality of life in a multicenter, randomized, placebo-controlled trial of low-dose peanut oral immunotherapy in children with peanut allergy. The Journal of Allergy and Clinical Immunology: In Practice, (2019); 17(2): 479-491.

ondon SJ, Gauderman WJ, Avol E . Family history and the risk of early onset persistent, early onset transient and late onset asthma. Epidemiology, (2001); 12: 577-583.

Paaso EM, Jaakkola MS, Rantala AK . Allergic diseases and asthma in the family predict the persistence and onset-age of asthma: a prospective cohort study. Respiratory research, (2014); 15: 1-9.

Paiva LK, Paiva LA, Monteiro T. Combined allergic rhinitis and asthma syndrome (CARAS). International Immunopharmacology, (2019); 74: 105718.

Sun W, Pan L, Yu Q. The Skin Prick Test Response after Allergen Immunotherapy in Different Levels of tIgE Children with Mite Sensitive Asthma/Rhinitis in South China. Human vaccines & immunotherapeutics, (2018);

: 2510-2515.

Vidal C, Enrique E, Gonzalo A. Diagnosis and allergen immunotherapy treatment of polysensitised patients with respiratory allergy in Spain: an Allergists’ Consensus.Clinical and Translational Allergy, (2014); 4: 36.

Remes ST, Koskela HO, Iivanainen K, Pekkanen J. Allergen‐specific sensitization in asthma and allergic diseases in children: the study on farmers' and non‐farmers' children. Clinical & Experimental Allergy, (2005); 35(2): 160-166.

Lam DS, Leung SP, So KT. Age of Onset of Asthma Symptoms 哮喘的發病年齡. Hong Kong Journal of Paediatrics (new series), (2007); 12(1): 11-14.

Bjerg A, Hedman L, Perzanowski MS, Platts-Mills T, Lundbäck B, Rönmark E. Family history of asthma and atopy: in-depth analyses of the impact on asthma and wheeze in 7-to 8-year-old children. Pediatrics, (2007)1; 120(4): 741-748.

Tsai HJ, Tsai AC. The association of diet with respiratory symptoms and asthma in schoolchildren in Taipei, Taiwan. Journal of Asthma, (2007); 44(8): 599-603.

Beausoleil JL, Fiedler J, Spergel JM. Food Intolerance and childhood asthma: what is the link. Pediatric Drugs, (2007); 9: 157-63.




DOI: http://dx.doi.org/10.62940/als.v10i0.1981

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