Fungus is one of common allergens in allergic disease that affects the susceptibility, severity, and disease control of allergic airway disease in children.A spectrum of respiratory diseases associated with fungal sensitization has been described as allergic fungal airway disease (AFAD), including severe asthma with fungal sensitization, allergic bronchopulmonary aspergillosis, thunderstorm asthma, and allergic fungal rhinosinusitis.Glucocorticoids, biologics, antifungal therapy, and immunotherapy can reduce the airway inflammation, fungal burden, and tissue damage associated with AFAD.This review introduced fungus, the mechanism of fungal sensitization and the detection, as well as the scope and treatment of AFAD in children, aiming to improve the understanding of AFAD among pediatricians.

Trained immunity has been a novel term in immunology for over a decade, referring to the memory immunity produced by the innate immune system upon re-stimulation.Non-specific training of the immune system enhances the immune defense function and is also involved in allergic inflammation and autoimmune diseases.An increasing number of researchers are focusing on the role of immune training in the prevention, treatment, onset and progression of diseases.This review explains the definition, mechanism, and inducers of immune training and its impact on children′s health and disease, in order to enhance pediatricians′ comprehension of trained immunity.

Since 2022, there has been an increasing trend in the incidence of scarlet fever and deaths due to Group A Streptococcus (GAS) in the UK and some European countries, with the paediatric population particularly affected, a phenomenon that has attracted widespread international attention.The author believes that GAS has not received sufficient attention and that there are significant national differences in early surveillance, treatment strategies, management and control.Here, author present professional insights on the unresolved scientific issues related to GAS infections, with a view to attracting the attention of domestic colleagues and jointly promoting GAS-related research, prevention and control.

Group A Streptococcus (GAS) are important human pathogens.In recent years, the M1 UK strain has attracted widespread attention in the United Kingdom and other countries because it has been associated with a surge in scarlet fever and an increase in invasive GAS infections.Author conducted a whole-genome sequencing study of 42 GAS strains from 2016 to 2018 in Shenzhen, and found that a GAS strain isolated from a child with scarlet fever in Shenzhen area in 2018 was homologous to M1 UK, which is the first strain of M1 UK confirmed in the mainland of China.For this reason, hereby publish it with a view to attracting the attention of our domestic counterparts and safeguarding public health safety.

Objective:To analyze the influence of meteorological factors on children and adolescents with asthma of different characteristics.Methods:This study was a retrospective study.A total of 2 600 children and adolescents with asthma who used the electronic version of the China Children's Asthma Action Plan（CCAAP）from June 2021 to June 2022 were enrolled.This study collected the basic information，symptoms and environmental monitoring data of children and adolescents with asthma.The influence of air quality index（AQI），temperature and humidity on children and adolescents with asthma were analyzed.Results:From June 2021 to June 2022，a total of 49 107 daily symptoms were recorded.Among them，the symptoms of "yellow zone" and "red zone" were 3 274 times.Multivariate Logistic regression analysis showed that compared with excellent AQI grade，the occurrence of asthma symptoms increased when the AQI grade was good（ OR=1.270，95% CI：1.162-1.389， P<0.05）and polluted（ OR=1.640，95% CI：1.436-1.873， P<0.05）；compared with the daily temperature of 21-30 ℃，the occurrence of asthma symptoms increased when the daily temperature was 11-20 ℃（ OR=1.545，95% CI：1.400-1.706， P<0.05），1-10 ℃（ OR=1.583，95% CI：1.415-1.770， P<0.05）and more than 30℃（ OR=1.393，95% CI：1.122-1.730， P<0.05）；compared with the air humidity of 41%-60%，the occurrence of asthma symptoms increased when the air humidity was 0-20%（ OR=1.767，95% CI：1.381-2.259， P<0.05）and 21%-40%（ OR=1.456，95% CI：1.273-1.665， P<0.05）.The occurrence of asthma symptoms decreased with increasing age（ OR=0.916，95% CI：0.903-0.930， P<0.05）and adherence of using the electronic version of CCAAP（ OR=0.930，95% CI：0.927-0.933， P<0.05）.Among the single self-reported triggers in children and adolescents with asthma，the most common trigger was respiratory infection accounting for 56.03%，climate change accounted for 23.99%，and air pollution accounted for 5.08%.The comparison between groups showed that children and adolescents with asthma who were adolescent，living in North China，and obese were more susceptible to air pollution.Children and adolescents with asthma living in East China，Southern China and Central China were more susceptible to climate change. Conclusion:Poor air quality，low temperature，high temperature，low air humidity，younger age and decreased compliance with electronic CCAAP were risk factors for the occurrence of asthma symptoms.

As a common respiratory disease in children, asthma affects children′s physical and mental health and increases the burden on families and society.Patients with asthma can have one or more comorbidities, and these asthma comorbidities not only make the diagnosis of asthma more difficult, but also affect the control and treatment and outcome of the disease.However, asthma comorbidities are often under-recognized and poorly-managed.Therefore, it is important to improve the understanding of asthma comorbidities and to correctly identify, diagnose and treat them.Asthma in children contains a variety of comorbidities.This article reviews the research progress of epidemiology, impact on asthma and the treatment of these common comorbidities of asthma in children.

Bronchial asthma and anaphylaxis are two conditions related to the sensitization state of the body that can coexist with each other in children.Asthma is a common chronic respiratory disease in children, while anaphylaxis is a rapid onset emergency involving multiple systems of the body.The two diseases can affect each other.Poor asthma control can increase the risk of anaphylaxis, and there is a risk of misdiagnosis during symptom onset.Both diseases need prompt and appropriate acute treatment as well as long term management.This review summarizes the various associations and differences between asthma and anaphylaxis, as well as management tools and strategies, in order to provide reference for enhancing disease awareness and optimizing disease management.

Recently, the number of children with asthma reported after thunderstorm weather in China has increased rapidly, which has aroused the public concern.At present, there are 28 documented episodes of epidemic thunderstorm asthma in the world, which can be life-threatening in severe cases.Children with allergic rhinitis or uncontrolled asthma were more susceptible to thunderstorm asthma.This article introduces the epidemiology, mechanism, risk factors, manifestations, management strategies and prevention of thunderstorm asthma, in order to improve pediatricians′ understanding of thunderstorm asthma and reduce the impact of it.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Type 2 immunity involves Th2 cells, type 2 innate lymphoid cells(ILC2), and type 2 cytokines such as interleukin (IL)-4, IL-5, and IL-13.Invasion by allergens or harmful substances can cause an excessive type 2 immune response, resulting in type 2 inflammation characterized by the increase in type 2 cytokines, eosinophils, and serum total IgE/specific IgE.Type 2 cytokines are the core of type 2 inflammation, of which production and secretion involve Th2 cells and ILC2.Disruption of barrier function can activate type 2 inflammation and contribute to the vicious cycle.Type 2 inflammation is a common pathophysiological mechanism in many diseases, especially allergic diseases.Type 2 inflammatory disease in children mostly affects the skin, respiratory tract, and gastrointestinal tract.Multiple type 2 inflammatory diseases often co-exist, increasing the disease burden in children.With deepening research on the mechanism of type 2 inflammation, the biotherapy has gained more and more attention.This paper focused on the mechanism, identification and biologics of type 2 inflammation in order to improve clinicians′ understanding of type 2 inflammatory diseases in children.