The pathophysiology of asthma has been intensively studied, but its underlying mechanisms such as airway inflammation, control of airway tone, and bronchial reactivity are still not completely explained. There is an urgent need to implement novel, non-invasive diagnostic tools that can help to investigate local airway inflammation and connect the molecular pathways with the broad spectrum of clinical manifestations of asthma. The new biomarkers of different asthma endotypes could be used to confirm diagnosis, predict asthma exacerbations, or evaluate treatment response. In this paper, we briefly describe the characteristics of exhaled breath condensate (EBC) that is considered to be an interesting source of biomarkers of lung disorders. We look at the composition of EBC, some aspects of the collection procedure, the proposed biomarkers for asthma, and its clinical implications. We also indicate the limitations of the method and potential strategies to standardize the procedure of EBC collection and analytical methods.

Peanut allergy is a widespread and potentially life-threatening condition that affects both children and adults, with a growing incidence worldwide. It is estimated to affect around 1–2% of the population in several developed countries. Component-resolved diagnostics is a modern approach to allergy diagnosis that focuses on identifying specific allergenic proteins to provide precise diagnoses and personalized treatment plans. It is a technique that enables the analysis of specific IgE antibodies against tightly defined molecules (components) that constitute the allergen. Component-resolved diagnostics is particularly valuable in peanut allergy diagnosis, helping to determine allergen components associated with severe reactions. It also aids in predicting the course of the allergy and enables the development of personalized immunotherapy plans; however, the full application of it for these purposes still requires more precise studies. In this paper, we present the current knowledge about peanut allergy and component-resolved diagnostics possibilities. We discuss the possibilities of using molecular diagnostics in the diagnosis of peanut allergy. We focus on examining and predicting the development of peanut allergy, including the risk of anaphylaxis, and describe the latest data related to desensitization to peanuts.

The prevalence of both asthma and obesity in the pediatric population is steadily increasing, and even the obese–asthma phenotypes are postulated. Obese children with asthma experience more asthma symptoms, more frequent exacerbations, and worse response to treatment; they also report a lower quality of life compared with lean asthmatics. Some of the etiological factors for asthma and obesity may overlap. Perhaps asthma and obesity share a common genetic and immunologic origin. Diet is a compelling modifiable factor in obesity and asthma prevention and control, although the relationship between these two diseases is certainly multifactorial. In this article, we analyze the impact of dietary intervention and weight loss in obese children on asthma prevention and control.

As the burden of mild asthma is not well understood, the significance of expanding research in the group of patients with mild asthma is emphasized. Thymic stromal lymphopoietin (TSLP) and interleukin 33 (IL-33) are involved in the pathogenesis of atopy and the immune response to inhaled environmental insults, such as allergens, in asthmatic patients. Objectives: The objective of this study was to explore the correlation between specific polymorphisms within the genes encoding TSLP and IL-33, as well as the concentrations of TSLP and IL-33 in the serum, and the occurrence of pediatric mild asthma. Methods: The analysis encompassed 52 pediatric patients diagnosed with mild bronchial asthma, including both atopic and non-atopic cases, and a control group of 26 non-asthmatic children. Recruitment was conducted through a comprehensive questionnaire. Parameters such as allergic sensitization, serum levels of circulating TSLP and IL-33, and the identification of single-nucleotide polymorphisms in TSLP (rs11466750 and rs2289277) and IL-33 (rs992969 and rs1888909) were assessed for all participants. Results: Significantly lower mean serum TSLP concentrations were observed in asthmatic subjects compared to the control group, with atopic asthma patients showing even lower TSLP levels than non-atopic counterparts. No significant differences were found in mean serum IL-33 concentrations between the two groups. Considering the allele model, for both tested SNPs of IL-33, we observed that patients with asthma, atopic asthma, and atopy statistically less frequently possess the risk allele. Conclusions: Our study findings suggest that IL-33 and TSLP do not serve as ideal biomarkers for mild asthma in children. Their effectiveness as biomarkers might be more relevant for assessing disease severity rather than identifying asthma in pediatric patients. Further research focusing on the association between TSLP and IL-33 gene polymorphisms and asthma is expected to significantly advance disease management.

Allergic diseases commonly coexist, manifesting in a sequence described as the “allergic march”. Background/Objectives: This study aimed to evaluate TSLP’s and IL-1β’s potential as biomarkers in both single and multi-pediatric atopic diseases like atopic eczema, food allergy, and anaphylaxis and analyze specific SNPs in the TSLP and IL-1β genes to determine their associations with their occurrence and severity. Methods: This analysis included 109 atopic children diagnosed with atopic dermatitis, food allergy, or anaphylaxis alongside a control group of 57 non-atopic children. Recruitment was facilitated through the use of a comprehensive questionnaire. For the study population, the allergen profile was characterized at the molecular level by measuring specific IgE to purified natural or recombinant allergens, assessing serum levels of circulating TSLP and IL-1β, and identifying single-nucleotide polymorphisms in TSLP (rs2289277) and IL-1β (rs16944 C-511T). Results: The serum levels of TSLP and IL-1β were elevated in the study groups compared to the control group, highlighting their significance in the pathogenesis of the studied diseases. Carrying a higher number of the risk allele [C] in the TSLP SNP rs2289277 is associated with the greatest likelihood of having multiple concurrent allergic conditions, with the highest risk observed in individuals with all three conditions—atopic dermatitis, food allergy, and anaphylaxis, simultaneously. Moreover, children carrying the risk allele had a twofold increased risk of polysensitization, which rose to sixfold in those with two copies of the risk allele. Although no significant variations in genotype frequencies were detected for IL-1β rs16944, significant associations were observed for TSLP rs2289277, particularly with conditions such as atopic dermatitis, food allergy, anaphylaxis, and combinations of these diseases. Conclusions: Further research is required to elucidate these pathways and their role in the development of allergic diseases.

Asthma management in children aims to prevent ongoing symptoms, preserve lung function and support normal daily activities. Impulse oscillometry (IOS) represents a modern approach to evaluating lung function that is also suitable for performing in the pediatric asthma population. Further research is warranted to clarify the role of IOS in the early identification of small airway disease (SAD) as a potential treatable asthma trait and to understand its implications for personalized treatment strategies. Before the integration of IOS into routine clinical protocols, it is necessary to establish population-specific reference values. Further studies in the pediatric population are needed to evaluate the added value of IOS in combination with conventional spirometry and fractional exhaled nitric oxide (FeNO). Future pediatric asthma management guidelines may consider incorporating the assessment of SAD with IOS as a possible tool for its evaluation.