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The International Study of Asthma and Allergies in Childhood (ISAAC) was the largest collaborative epidemiological study of children in the world. ISAAC has measured the symptom prevalence of asthma, rhinitis and eczema in almost 2 million children in 105 countries. The aims of the ISAAC programme were to continue to measure symptom prevalence and severity of asthma, rhinitis and eczema in children, especially in developing countries where it had not been documented before; measure time trends in these conditions; identify major risk factors for asthma, rhinitis and eczema in all regions of the world; and to develop interventions to reduce the prevalence, mortality and burden of disease of asthma, rhinitis and eczema. The ISAAC Programme formally finished in December 2012. A new network to continue ISAAC's work in asthma The Global Asthma Network was founded in 2012 and will extend the work of ISAAC in the asthma field. ==History== The International Study of Asthma and Allergies in Childhood was formed in 1991 to facilitate research into asthma, rhinitis and eczema by promoting a standardised methodology able to be used in diverse locations around the world. * Asthma causes wheezing, and often cough and breathlessness too, due to airway obstruction with smooth muscle contraction and airway inflammation. In children it is most commonly intermittent, but may be persistent. Asthma affects an estimated 300 million people worldwide, causing an estimated 250,000 deaths annually (all ages). Around 15 million disability adjusted life years (DALYs) are lost annually,〔Masoli M, Fabian D, Holt S, et al. Global Burden of Asthma: Global Initiative for Asthma (GINA); 2004.〕 and school absenteeism due to asthma results in reduced educational opportunities, and thus impacts on the economy. Based on studies undertaken in developed countries, asthma has been misinterpreted as a westernized problem based on allergy (atopy). Findings from ISAAC and others have shown that much of it does not have an allergic basis, especially in developing countries〔Pearce N, Pekkanen J, Beasley R. How much asthma is really attributable to atopy? Thorax. 1999;54(3):268-72.〕〔Weinmayr G, Weiland S, Björkstén B, et al. Atopic sensitization and the international variation of asthma symptom prevalence in children. Am J Respir Crit Care Med. 2007;176(6):565 - 74.〕〔Simpson JL, Brooks C, Douwes J. Innate immunity in asthma. Paediatr Respir Rev. 2008;9(4):263-70.〕 where its prevalence is increasing (Africa, Latin America and parts of Asia).〔Asher MI, Montefort S, Bjorksten B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368(9537):733-43.〕 * Rhinitis (also known as rhinoconjunctivitis or hay-fever) gives troublesome nasal symptoms with itchy watery eyes, and is a common reason for medical consultation and use of medicines.〔Stempel DA, Woolf R. The cost of treating allergic rhinitis. Curr Allergy Asthma Rep. 2002;2(3):223-30.〕 ISAAC has shown that in developing countries these symptoms have little association with allergy and important differences may underlie allergic and non-allergic rhinoconjunctivitis.〔Weinmayr G, Forastiere F, Weiland SK, et al. International variation in prevalence of rhinitis and its relationship with sensitisation to perennial and seasonal allergens. Eur Respir J. 2008;32(5):1250-61.〕 * Eczema (also known as atopic eczema, childhood eczema or atopic dermatitis) is the world’s commonest skin disease in children, and is an itchy inflammatory skin condition which commonly settles in the skin creases such as the folds of the elbows or behind the knees. It is commoner in children whose families also have eczema, asthma and hay fever. Many people with eczema have antibodies in their blood to allergens in the environment such as house dust mite; they are then classified as being “atopic”. This does not necessarily mean they are allergic to those substances though. The excessive skin dryness which is commonly seen in eczema may be due to genetic factors that result in defective production of a protein found on the skin surface called filaggrin, which is important for the integrity of the barrier function of the skin. Eczema results in loss of sleep for the child and parents, time off school and work and social exclusion.〔Kemp AS. Atopic eczema: Its social and financial costs. Journal of Paediatrics and Child Health. 1999;35(3):229-31.〕 The costs of eczema may be as high as $3.8 billion per year.〔Mancini AJ, Kaulback K, Chamlin SL. The socioeconomic impact of atopic dermatitis in the United States: a systematic review. Pediatr Dermatol. 2008;25(1):1-6.〕 ISAAC, the first study of eczema in developing countries has shown that eczema is not only common, but also largely non-allergic〔Flohr C, Weiland SK, Weinmayr G, et al. The role of atopic sensitization in flexural eczema: findings from the International Study of Asthma and Allergies in Childhood Phase Two. J Allergy Clin Immunol. 2008;121(1):141-7 e4.〕 and is increasing in prevalence, especially in younger age groups.〔Williams H, Stewart A, von Mutius E, et al. Is eczema really on the increase worldwide? Journal of Allergy & Clinical Immunology. 2008;121(4):947-54.e15.〕 ISAAC developed from a merging of two multinational collaborative projects each investigating variations in childhood asthma at the population level. These were an initiative from Auckland, New Zealand to conduct an international comparative study of asthma severity, and an initiative from Bochum, Germany to conduct an international study to monitor time trends and determinants of the prevalence of asthma and allergies in children. ISAAC was a unique project investigating variations in the prevalence of these conditions at the population level and their potential causes. ISAAC attracted significant worldwide interest and large-scale participation, and became the largest worldwide collaborative research project ever undertaken in children resulting in a Guinness World Record.〔Anonymous. Guinness World Records. London: Guinness World Records, Ltd; 2004.〕 Since 1991, the ISAAC programme has involved 306 research centres in 105 countries with nearly 2 million children. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「International Study of Asthma and Allergies in Childhood」の詳細全文を読む スポンサード リンク
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