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Staal SL, Hogendoorn SKL, Voets SA, Tepper RC, Veenstra M, de Vos II, van Son KC, Gool JK, Paramitha AC, Aristyo K, Wildan A, Pratiwi C, van Ree R, Yazdanbakhsh M, Supali T, Djuardi Y, Labuda LA, Tahapary DL, Sartono E. Prevalence of Atopy following Mass Drug Administration with Albendazole: A Study in School Children on Flores Island, Indonesia. Int Arch Allergy Immunol 2018; 177:192-198. [PMID: 30130756 DOI: 10.1159/000490952] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 06/16/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND In many rural areas of tropical countries such as Indonesia, the prevalence of soil-transmitted helminths (STH) infections remains high. At the same time, the burden of allergic disorders in such rural areas is reported to be low and inversely associated with helminth infections. To reduce the morbidity and transmission of helminth infections, the world health organization recommends preventive treatment of school children by providing mass drug administration (MDA) with albendazole. Here, we had an opportunity to evaluate the prevalence of skin reactivity to allergens before and after albendazole treatment to get an indication of the possible impact of MDA on allergic sensitization. METHODS A study was conducted among 150 school children living in an area endemic for STH infections. Before and 1 year after anthelminthic treatment with albendazole, stool samples were examined for the presence of STH eggs, skin prick tests (SPT) for cockroach and house dust mites were performed, blood eosinophilia was assessed, and total immunoglobulin E (IgE) and C-reactive protein (CRP) were measured in plasma. RESULTS Anthelminthic treatment significantly reduced the prevalence of STH from 19.6 before treatment to 6% after treatment (p < 0.001). Levels of total IgE (estimate: 0.30; 95% CI 0.22-0.42, p < 0.0001), CRP (estimate: 0.60; 95% CI 0.42-0.86, p = 0.006), and eosinophil counts (estimate: 0.70; 95% CI 0.61-0.80, p < 0.001) decreased significantly. The prevalence of SPT positivity increased from 18.7 to 32.7%. Multivariate analysis adjusted for confounding factors showed an increased risk of being SPT positive to any allergen (OR 3.04; 95% CI 1.338-6.919, p = 0.008). CONCLUSIONS This study indicates that 1 year of MDA with albendazole was associated with a reduced prevalence of STH infections. This study shows that the prevalence of allergic sensitization increases after 1 year of albendazole treatment. Placebo-controlled and larger studies are needed to further substantiate a role of deworming treatment in an increased risk of allergic sensitization.
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Affiliation(s)
- Steven L Staal
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Sarika K L Hogendoorn
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Sophie A Voets
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rebecca C Tepper
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Mirte Veenstra
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ivo I de Vos
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Koen C van Son
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jari K Gool
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Antonia C Paramitha
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Kevin Aristyo
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ardy Wildan
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Chici Pratiwi
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ronald van Ree
- Departments of Experimental Immunology and Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Taniawati Supali
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Yenny Djuardi
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Lucja A Labuda
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Dicky L Tahapary
- Division of Endocrinology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Erliyani Sartono
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
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Rider CF, Carlsten C. Air pollution and resistance to inhaled glucocorticoids: Evidence, mechanisms and gaps to fill. Pharmacol Ther 2018; 194:1-21. [PMID: 30138638 DOI: 10.1016/j.pharmthera.2018.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Substantial evidence indicates that cigarette smoke exposure induces resistance to glucocorticoids, the primary maintenance medication in asthma treatment. Modest evidence also suggests that air pollution may reduce the effectiveness of these critical medications. Cigarette smoke, which has clear parallels with air pollution, has been shown to induce glucocorticoid resistance in asthma and it has been speculated that air pollution may have similar effects. However, the literature on an association of air pollution with glucocorticoid resistance is modest to date. In this review, we detail the evidence for, and against, the effects of air pollution on glucocorticoid effectiveness, focusing on results from epidemiology and controlled human exposure studies. Epidemiological studies indicate a correlation between increased air pollution exposure and worse asthma symptoms. But these studies also show a mix of beneficial and harmful effects of glucocorticoids on spirometry and asthma symptoms, perhaps due to confounding influences, or the induction of glucocorticoid resistance. We describe mechanisms that may contribute to reductions in glucocorticoid responsiveness following air pollution exposure, including changes to phosphorylation or oxidation of the glucocorticoid receptor, repression by cytokines, or inflammatory pathways, and epigenetic effects. Possible interactions between air pollution and respiratory infections are also briefly discussed. Finally, we detail a number of therapies that may boost glucocorticoid effectiveness or reverse resistance in the presence of air pollution, and comment on the beneficial effects of engineering controls, such as air filtration and asthma action plans. We also call attention to the benefits of improved clean air policy on asthma. This review highlights numerous gaps in our knowledge of the interactions between air pollution and glucocorticoids to encourage further research in this area with a view to reducing the harm caused to those with airways disease.
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Affiliation(s)
- Christopher F Rider
- Respiratory Medicine, Faculty of Medicine, Chan-Yeung Centre for Occupational and Environmental Respiratory Disease (COERD), University of British Columbia, Vancouver, BC, Canada.
| | - Chris Carlsten
- Respiratory Medicine, Faculty of Medicine, Chan-Yeung Centre for Occupational and Environmental Respiratory Disease (COERD), University of British Columbia, Vancouver, BC, Canada; Institute for Heart and Lung Health, University of British Columbia, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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103
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Tesfaye ZT, Gebreselase NT, Horsa BA. Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study. World Allergy Organ J 2018; 11:18. [PMID: 30128064 PMCID: PMC6085626 DOI: 10.1186/s40413-018-0196-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 07/10/2018] [Indexed: 11/10/2022] Open
Abstract
Background Although asthma cannot be cured, appropriate management can ensure adequate control of the disease, prevent disease progression and even reverse the illness, enabling people to enjoy good quality of life. Predisposing factors for inappropriate asthma management, including limited diagnostic options and inadequate supply of medications, are features of health institutions in developing countries like Ethiopia. This study was launched to determine the appropriateness of asthma management in patients visiting ambulatory clinic of the Gondar University Hospital. Methods Cross-sectional study was conducted on asthmatic patients who were on chronic follow-up at Gondar University Hospital. Data were collected by review of patients' medical records and through a semi-structured questionnaire. The Global Initiative for Asthma guideline was used as a reference for determining the appropriateness of asthma management whereas the eight-item Morisky medication adherence scale (MMAS-8) was used to collect data on patients' adherence to asthma medications. Results The study participants' ages ranged from 20 to 80 years with a mean age of 49.3 ± 13.6 years. Mild asthma showed a slight predominance in frequency accounting for 38.7% of cases. Asthma management was found to be inappropriate in 52.0% of the patients. Inappropriateness of therapy is attributed to incorrect dosing of medications, addition of unnecessary medications and omission of necessary medications. Patients who had moderate asthma were more likely to receive appropriate treatment [AOR = 728: 63.2, 8386.06], whereas having a treatment regimen of beclomethasone with salbutamol was found to be predictor of inappropriate treatment [AOR = 0.004: 0.001, 0.07]. More than half (56.7%) of the study subjects reported to have high adherence to their medications. Having no formal education was a predictor of low adherence to asthma medications [AOR = 0.051: 0.003, 0.978] whereas, increased monthly income was found to have a positive association with adherence [AOR = 1.923: 1.037, 3.566]. Discussion High prevalence of inappropriate therapy in this study may be attributed primarily to limited accessibility of asthma medications, as 86% of the patients received medium dose beclomethasone with salbutamol for exacerbations despite being at different severity of asthma and level of control. Conclusion The findings of the study showed more than half of asthmatic patients received inappropriate treatment. Nevertheless, a larger proportion of the patients claimed to be highly adherent to their medications.
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Affiliation(s)
- Zelalem Tilahun Tesfaye
- 1Department of pharmacology and clinical pharmacy, school of pharmacy, college of health sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Boressa Adugna Horsa
- 3Department of clinical pharmacy, school of pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Machelart A, Potemberg G, Van Maele L, Demars A, Lagneaux M, De Trez C, Sabatel C, Bureau F, De Prins S, Percier P, Denis O, Jurion F, Romano M, Vanderwinden JM, Letesson JJ, Muraille E. Allergic Asthma Favors Brucella Growth in the Lungs of Infected Mice. Front Immunol 2018; 9:1856. [PMID: 30147700 PMCID: PMC6095999 DOI: 10.3389/fimmu.2018.01856] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 07/27/2018] [Indexed: 12/12/2022] Open
Abstract
Allergic asthma is a chronic Th2 inflammatory disease of the lower airways affecting a growing number of people worldwide. The impact of infections and microbiota composition on allergic asthma has been investigated frequently. Until now, however, there have been few attempts to investigate the impact of asthma on the control of infectious microorganisms and the underlying mechanisms. In this work, we characterize the consequences of allergic asthma on intranasal (i.n.) infection by Brucella bacteria in mice. We observed that i.n. sensitization with extracts of the house dust mite Dermatophagoides farinae or the mold Alternaria alternata (Alt) significantly increased the number of Brucella melitensis, Brucella suis, and Brucella abortus in the lungs of infected mice. Microscopic analysis showed dense aggregates of infected cells composed mainly of alveolar macrophages (CD11c+ F4/80+ MHCII+) surrounded by neutrophils (Ly-6G+). Asthma-induced Brucella susceptibility appears to be dependent on CD4+ T cells, the IL-4/STAT6 signaling pathway and IL-10, and is maintained in IL-12- and IFN-γR-deficient mice. The effects of the Alt sensitization protocol were also tested on Streptococcus pneumoniae and Mycobacterium tuberculosis pulmonary infections. Surprisingly, we observed that Alt sensitization strongly increases the survival of S. pneumoniae infected mice by a T cell and STAT6 independent signaling pathway. In contrast, the course of M. tuberculosis infection is not affected in the lungs of sensitized mice. Our work demonstrates that the impact of the same allergic sensitization protocol can be neutral, negative, or positive with regard to the resistance of mice to bacterial infection, depending on the bacterial species.
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Affiliation(s)
- Arnaud Machelart
- Unité de Recherche en Biologie des Microorganismes, Laboratoire d’Immunologie et de Microbiologie, NAmur Research Institute for Life Sciences (NARILIS), Université de Namur, Namur, Belgium
| | - Georges Potemberg
- Unité de Recherche en Biologie des Microorganismes, Laboratoire d’Immunologie et de Microbiologie, NAmur Research Institute for Life Sciences (NARILIS), Université de Namur, Namur, Belgium
| | - Laurye Van Maele
- Institute for Medical Immunology, Université Libre de Bruxelles, Brussels, Belgium
| | - Aurore Demars
- Unité de Recherche en Biologie des Microorganismes, Laboratoire d’Immunologie et de Microbiologie, NAmur Research Institute for Life Sciences (NARILIS), Université de Namur, Namur, Belgium
| | - Maxime Lagneaux
- Unité de Recherche en Biologie des Microorganismes, Laboratoire d’Immunologie et de Microbiologie, NAmur Research Institute for Life Sciences (NARILIS), Université de Namur, Namur, Belgium
| | - Carl De Trez
- Department of Molecular and Cellular Interactions, Vlaams Interuniversitair Instituut voor Biotechnologie, Vrije Universiteit Brussel, Brussels, Belgium
| | - Catherine Sabatel
- Laboratory of Cellular and Molecular Immunology, GIGA- Research & WELBIO, University of Liège, Liège, Belgium
| | - Fabrice Bureau
- Laboratory of Cellular and Molecular Immunology, GIGA- Research & WELBIO, University of Liège, Liège, Belgium
| | - Sofie De Prins
- Immunology Unit, Scientific Institute for Public Health (WIV-ISP), Brussels, Belgium
| | - Pauline Percier
- Immunology Unit, Scientific Institute for Public Health (WIV-ISP), Brussels, Belgium
| | - Olivier Denis
- Immunology Unit, Scientific Institute for Public Health (WIV-ISP), Brussels, Belgium
| | - Fabienne Jurion
- Immunology Unit, Scientific Institute for Public Health (WIV-ISP), Brussels, Belgium
| | - Marta Romano
- Immunology Unit, Scientific Institute for Public Health (WIV-ISP), Brussels, Belgium
| | | | - Jean-Jacques Letesson
- Unité de Recherche en Biologie des Microorganismes, Laboratoire d’Immunologie et de Microbiologie, NAmur Research Institute for Life Sciences (NARILIS), Université de Namur, Namur, Belgium
| | - Eric Muraille
- Unité de Recherche en Biologie des Microorganismes, Laboratoire d’Immunologie et de Microbiologie, NAmur Research Institute for Life Sciences (NARILIS), Université de Namur, Namur, Belgium
- Laboratoire de Parasitologie, Faculté de Médecine, Université Libre de Bruxelles, Brussels, Belgium
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105
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Castell N, Schneider P, Grossberndt S, Fredriksen MF, Sousa-Santos G, Vogt M, Bartonova A. Localized real-time information on outdoor air quality at kindergartens in Oslo, Norway using low-cost sensor nodes. ENVIRONMENTAL RESEARCH 2018; 165:410-419. [PMID: 29106951 DOI: 10.1016/j.envres.2017.10.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 09/24/2017] [Accepted: 10/12/2017] [Indexed: 06/07/2023]
Abstract
In Norway, children in kindergartens spend significant time outdoors under all weather conditions, and there is thus a natural concern about the quality of outdoor air. It is well known that air pollution is associated with a wide variety of adverse health impacts for children, with greater impact on children with asthma. Especially during winter and spring, kindergartens in Oslo that are situated close to streets with busy traffic, or in areas where wood burning is used for house heating, can experience many days with bad air quality. During these periods, updated information on air quality levels can help the kindergarten teachers to plan appropriate outdoor activities and thus protect children's health. We have installed 17 low-cost air quality nodes in kindergartens in Oslo. These nodes are smaller, cheaper and less complex to use than traditional equipment. Performance evaluation shows that while they are less accurate and suffer from higher uncertainty than reference equipment, they still can provide reliable coarse information about local pollution. The main challenge when using this technology is that calibration parameters might change with time depending on the atmospheric conditions. Thus, even if the sensors are calibrated a priori, once deployed, and especially if they are deployed for a long time, it is not possible to determine if a node is over- or under-estimating the concentration levels. To enhance the data from the sensors, we employed a data fusion technique that allows generating a detailed air quality map merging the data from the sensors and the data from an urban model, thus being able to offer air quality information to any location within Oslo. We arranged a focus group with the participation of local administration, kindergarten staff and parents to understand their opinion and needs related to the air quality information that was provided to the participant kindergartens. They expressed concern about the data quality but agree that having updated information on the air quality in the surroundings of kindergartens can help them to reduce children's exposure to air pollution.
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Affiliation(s)
- Nuria Castell
- NILU - Norwegian Institute for Air Research, Kjeller, Norway.
| | | | | | | | | | - Mathias Vogt
- NILU - Norwegian Institute for Air Research, Kjeller, Norway
| | - Alena Bartonova
- NILU - Norwegian Institute for Air Research, Kjeller, Norway
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106
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Abo-Zaid G, Sharpe RA, Fleming LE, Depledge M, Osborne NJ. Association of Infant Eczema with Childhood and Adult Asthma: Analysis of Data from the 1958 Birth Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071415. [PMID: 29976870 PMCID: PMC6069479 DOI: 10.3390/ijerph15071415] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 07/02/2018] [Accepted: 07/04/2018] [Indexed: 12/13/2022]
Abstract
The influence of early life exposures on later life disease has for some time provided clues to modifiable risk factors of disease. The “atopic march” is thought to play a role in the progression of allergic diseases and may offer an opportunity to lower asthma’s health and socioeconomic burden, although evidence remains controversial. We aimed to examine the relationship between early life eczema and asthma later in life. Using the National Child Development Study, we examined infant eczema and childhood and adult asthma. Data related to asthma or wheezing bronchitis were available for 13,503 (73%; 95% CI 72–74), 11,503 (61%; 95% CI 60–61), 12,524 (68%; 95% CI 67–69), 11,194 (60%; 95% CI 60–60), 9377 (51%; 95% CI 51–51), and 9760 (53%; 95% CI 52–53) subjects at ages 11, 16, 23, 33, 44, and 50 years, respectively. Logistic regression models were fitted to examine each wave separately before and after adjusting for a range of potential confounders. Generalised estimating equation (GEE) methods were undertaken to examine the associations after pooling all data from questionnaires. The prevalence of self-reported asthma in those that had previously reported infant eczema ranged from 1.0%; 95% CI 0.9–1.4 (age 44 years) to 2.2%; 95% CI 2.1–2.3 (age 33 years). Participants with infant eczema had a 2–3-fold increased risk of reporting asthma in childhood and adulthood; this was 1.6 times at age 44 years when using spirometry measures. Similar effect sizes were observed in the GEE models when considering all participants (OR 2.9; 95% CI 2.6–3.2). Childhood and adult asthma were consistently associated with infant eczema both by using the self-reported data and lung measures.
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Affiliation(s)
- Ghada Abo-Zaid
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UK.
- Department of Mathematics and Statistics, Ain Shams University, Khalifa El-Maamon St, Abbasiya Sq., Cairo 11566, Egypt.
| | - Richard A Sharpe
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UK.
- Public Health, Cornwall Council, New County Hall, Truro, Cornwall, TR1 3AY, UK.
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UK.
| | - Michael Depledge
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UK.
| | - Nicholas J Osborne
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UK.
- School of Public Health and Community Medicine, University of New South Wales, Kensington, Sydney 2052, Australia.
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107
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Damgaard ALDB, Gregersen R, Lange T, Buchvald F, Hansen BM, Greisen G. The increased purchase of asthma medication for individuals born preterm seems to wane with age: A register-based longitudinal national cohort study. PLoS One 2018; 13:e0199884. [PMID: 29975752 PMCID: PMC6033435 DOI: 10.1371/journal.pone.0199884] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 06/17/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction Preterm birth is associated with increased risk of respiratory symptoms in childhood, often treated with asthma medication. We designed a follow-up study to previous research and investigated whether the association of gestational age with purchasing asthma medication diminishes in adulthood. Methods We conducted a register-based study of a national cohort of all infants born in Denmark in 1980–2009 evaluating longitudinal data on individually prescribed asthma medication (both inhaled ß-2 receptor agonist and different controller treatment over 2-year periods) available from 1995–2011. We analyzed the effect of gestational age considering age, birth year, and perinatal variables using logistic regression with a Generalized Estimating Equations model. All data were unambiguously linked through the Civil Registration System. Results We included 1,819,743 individuals in our study population. We found an inverse dose-response relationship between gestational age and asthma medication in earlier age-groups with a gradual decrease in odds ratios with increasing age and loss of statistical significance in early adulthood (18–31 years). For our oldest generations, there was a significant effect of gestational age (p-value = 0.04), which became insignificant when adjusting for confounding and mediating factors (p = 0.44). There were significant interactions between gestational age and age (p<0.0001) and gestational age and birth year, but these were most important during childhood (0–11 years) and for our youngest generations (born after 1995). Conclusion The strong association between gestational age and purchase of prescription asthma medication weakens with age into early adulthood, in consistence with the results from our previous study. The risk for purchasing medication to treat asthma-like symptoms was higher in more recent birth years, but the effect of gestational age was small beyond 11 years of age. Gestational age per se did not seem to be significant for the development of asthma-like symptoms: most of its effect could be explained by other perinatal factors.
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Affiliation(s)
| | - Rasmus Gregersen
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Theis Lange
- Center for Statistical Science, Peking University, Beijing, China
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Frederik Buchvald
- Pulmonary Service, Department of Pediatrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Bo Mølholm Hansen
- Neonatology Service, Department of Pediatrics, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Gorm Greisen
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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Liu Z, Li J, Wang K, Tan Q, Tan W, Guo G. Association Between TGF-β1 Polymorphisms and Asthma Susceptibility Among the Chinese: A Meta-Analysis. Genet Test Mol Biomarkers 2018; 22:433-442. [PMID: 29958018 DOI: 10.1089/gtmb.2017.0238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Asthma is the most common chronic pulmonary disease in China and is characterized by airway inflammation and episodic airflow obstruction. The aim of this meta-analysis was to evaluate the relation of two transforming growth factor-β1 (TGF-β1) polymorphisms with asthma risk in Chinese population. METHODS PubMed, Springer, EMBASE, MEDLINE, CNKI (China National Knowledge Infrastructure), and Wanfang databases were used to search and retrieve relevant eligible case-control studies published through December 2017. The odds ratios (OR) and 95% confidence intervals (CI) were used to evaluate the effect. RESULTS A total of 2040 asthma patients and 1952 controls from 12 studies were analyzed. Two polymorphic sites of TGF-β1 gene were identified: -509C/T and +869T/C. We found that the -509C/T polymorphism was associated with increased asthma risk under the heterozygous model (CT vs. CC: OR = 1.40, 95% CI = 1.03-1.90, p = 0.03) and the dominant model (TT+CT vs. CC: OR = 1.41, 95% CI = 1.05-1.90, p = 0.02). Subgroup analyses by age suggested that -509C/T variant was associated with childhood asthma. Analysis of disease severity indicated that this variant was associated with both mild-to-moderate asthma and severe asthma. However, the +869T/C polymorphism was not associated with asthma susceptibility in subgroup analysis by age or disease severity. CONCLUSIONS This study demonstrated that the -509C/T polymorphism of the TGF-β1 gene might be a risk factor for asthma in the Chinese population, especially in Chinese children. Further large-scale case-control studies are still required.
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Affiliation(s)
- Zhenyu Liu
- 1 School of Basic Medical Sciences, Harbin Medical University , Harbin, Heilongjiang, China
| | - Junjuan Li
- 2 Department of Respiratory Medicine, Weifang People's Hospital , Weifang, Shandong, China
| | - Kun Wang
- 2 Department of Respiratory Medicine, Weifang People's Hospital , Weifang, Shandong, China
| | - Qiang Tan
- 2 Department of Respiratory Medicine, Weifang People's Hospital , Weifang, Shandong, China
| | - Wei Tan
- 2 Department of Respiratory Medicine, Weifang People's Hospital , Weifang, Shandong, China
| | - Guifang Guo
- 2 Department of Respiratory Medicine, Weifang People's Hospital , Weifang, Shandong, China
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Kourlaba G, Bakakos P, Loukides S, Vellopoulou K, Solakidi A, Maniadakis N. The self-reported prevalence and disease burden of asthma in Greece. J Asthma 2018; 56:478-497. [PMID: 29718784 DOI: 10.1080/02770903.2018.1471704] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The primary objective was to estimate the self-reported prevalence of asthma in Greece. The secondary one was to assess the impact of asthma control on patients' health related Quality-of-Life (HRQoL), productivity loss, daily activities and psychological distress. METHODS A population-based, random-digit dialing, telephone nationwide survey was conducted to recruit patients with asthma. Among the responders, 3,946 met the age criterion (≥18 years) and completed the screening questions regarding asthma. Of them, 353 subjects reported that they had been diagnosed with asthma sometime in their life and completed the survey. Data on demographic and lifestyle characteristics, asthma control, comorbidities, limitations in daily activities, psychological distress, productivity loss, as well as HRQoL, were collected through telephone interview. RESULTS The lifetime self-reported prevalence of asthma was found to be 9.10% (95% CI:8.14%-9.94%). Sixty three percent of patients had well-controlled (WC) asthma. Asthma control was associated with gender, age, and specific comorbidities. Moreover, patients with not well-controlled (NWC) asthma were more likely to have missed work and reduced productivity during the past 12 months due to their asthma (p < 0.01). Patients with NWC asthma were more likely to declare psychological distress and limitations in their daily living activities. Patients' HRQoL with NWC asthma was significantly worse (0.65 ± 0.24) compared to those with WC asthma (0.86 ± 0.17, p ≤ 0.001). CONCLUSIONS The results of this survey revealed the link between the asthma control and burden of disease demonstrating the need for the implementation of programs aiming at the management of chronic symptoms related to this condition.
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Affiliation(s)
| | - Petros Bakakos
- b 1st Respiratory Medicine Department , National and Kapodistrian University of Athens , Athens , Greece
| | - Stelios Loukides
- c 2nd Respiratory Medicine Department , National and Kapodistrian University of Athens , Chaidari , Greece
| | | | | | - Nikos Maniadakis
- d Department οf Health Services Organization and Management , National School οf Public Health , Athens , Greece
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Mohamed Hussain S, Ayesha Farhana S, Mohammed Alnasser S. Time Trends and Regional Variation in Prevalence of Asthma and Associated Factors in Saudi Arabia: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8102527. [PMID: 29951546 PMCID: PMC5989288 DOI: 10.1155/2018/8102527] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 03/15/2018] [Accepted: 04/05/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Asthma is the most common reason for emergency visits to hospital and loss of productive hours. In Saudi Arabia, asthma affects more than 2 million people and majority of them have uncontrolled asthma with their quality of life adversely being impacted. It is well known that the prevalence of asthma has been increasing in many places around the world in the last few decades. The present review attempted to identify studies on asthma and associated factors in Saudi Arabian population and assess their time trends and regional variation. METHODS The titles and abstracts of retrieved articles were compared to delete duplication and irrelevant data. A data collection form was designed to extract several key components from selected articles like bibliographic information on the article, study population, and sample size. Extracted information was grouped appropriately for data analysis. Database search retrieved 71 articles. Applying inclusion and exclusion criteria, 40 articles were excluded and 31 qualified full articles were included for the review. RESULTS Among 31 retained studies, Riyadh had the highest publication output followed by Jeddah. Ten studies were based on ISAAC and 5 on non-ISAAC questionnaires while 5 studies were genetic studies conducted to unravel the genetic basis of asthma. Most of the studies were conducted on pediatric subjects of less than 16 years of age. Sample sizes ranged from less than 150 to more than 10000 with study settings being predominantly urban (22 studies). The pooled weighted prevalence rates of asthma, lifetime wheeze, and rhinitis were 14.3% (95% CI: 13.4-15.2), 16.5 (95% CI 15.5-17.4), and 21.4 (95% CI 20.5-22.3), respectively. An increase in asthma prevalence from 1990 to 2000 along with a stabilized or not so significant decline in the prevalence from 2010 to 2016 was observed. CONCLUSION The prevalence of asthma varied in different regions without any disparity in prevalence in the rural and urban areas of Saudi Arabia. The understanding of genetic variability and recognition of risk factors in asthma patients can greatly help in individualizing the therapy for the management and control of asthma.
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Affiliation(s)
- Shalam Mohamed Hussain
- Department of Pharmacology and Toxicology, Unaizah College of Pharmacy, Qassim University, Unaizah, Saudi Arabia
| | - Syeda Ayesha Farhana
- Department of Pharmaceutics, Unaizah College of Pharmacy, Qassim University, Unaizah, Saudi Arabia
| | - Sulaiman Mohammed Alnasser
- Department of Pharmacology and Toxicology, Unaizah College of Pharmacy, Qassim University, Unaizah, Saudi Arabia
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Cui Y, Yang S. Overexpression of Annexin A1 protects against benzo[a]pyrene‑induced bronchial epithelium injury. Mol Med Rep 2018; 18:349-357. [PMID: 29749523 PMCID: PMC6059690 DOI: 10.3892/mmr.2018.8998] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/24/2018] [Indexed: 12/31/2022] Open
Abstract
The incidence of asthma is increasing worldwide. Bronchial epithelium injury is common in asthma. The regulatory role of Annexin A1 (ANXA1) in bronchial epithelium injury is currently not well understood. The aim of the present study was to evaluate the role of ANXA1 on bronchial epithelium injury. The cell viability and levels of apoptosis were respectively tested by Cell Counting Kit-8 and flow cytometry. Reactive oxygen species (ROS) content and the activity of oxidative indicators were assessed by commercial kits. Enzyme linked immunosorbent assay was performed to detect the activity of active caspase-3. Reverse transcription-quantitative polymerase chain reaction and western blot assays were used to determine the expression levels of the target factors. The results demonstrated that ANXA1 improved the viability of benzo[a]pyrene (Bap)-treated bronchial epithelial cells. The Bap-induced oxidative stress was mitigated by the reduction in ROS generation, and the regulation of the activity of superoxide dismutase, glutathione peroxidases, malondialdehyde and lactic dehydrogenase. In addition, apoptosis was decreased by ANXA1 via the reduction of the expression of B-cell lymphoma 2 (Bcl-2), and the increase in the expression of Bcl-2-associated X protein and cyclin D1. Furthermore, the expression of phosphatase and tensin homolog (PTEN) and focal adhesion kinase (FAK) was rescued and the phosphorylation of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) was depressed by ANXA1, when compared with the Bap group. SF1670 treatment reversed the anti-apoptotic effect of ANXA1. In conclusion, the results highlighted the protective effects of ANXA1 on bronchial epithelium injury, which most likely occurred via the PTEN/FAK/PI3K/Akt signaling pathway. Thus, the present study contributes to a potential therapeutic strategy for asthma patients.
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Affiliation(s)
- Yanfei Cui
- Department of Tuberculosis, Hangzhou Red Cross Hospital/Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, Zhejiang 310003, P.R. China
| | - Shengya Yang
- Department of Tuberculosis, Hangzhou Red Cross Hospital/Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, Zhejiang 310003, P.R. China
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Chien LC, Chen YA, Yu HL. Lagged Influence of Fine Particulate Matter and Geographic Disparities on Clinic Visits for Children's Asthma in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040829. [PMID: 29690596 PMCID: PMC5923871 DOI: 10.3390/ijerph15040829] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/19/2018] [Accepted: 04/19/2018] [Indexed: 11/16/2022]
Abstract
Recent studies have revealed the influence of fine particulate matter (PM2.5) on increased medication use, hospital admission, and emergency room visits for asthma attack in children, but the lagged influence of PM2.5 on children’s asthma and geographic disparities of children’s asthma have rarely been discussed simultaneously. This study investigated the documented diagnosis of children’s asthma in clinic visits for children aged less than 15 years old that were associated with PM2.5 in two counties located in west-central Taiwan during 2005–2010. The result shows that PM2.5 had a significant lagged effect on children’s asthma for up to 6 days. A significantly higher relative risk for children’s asthma was more likely to happen at 2-day lag compared to the present day when PM2.5 increased from 36.17 μg/m3 to 81.26 μg/m3. Considering all lagged effects, the highest relative risk for children’s asthma was 1.08 (95% CI = 1.05, 1.11) as PM2.5 increased as high as 64.66 μg/m3. In addition, geographic disparities of children’s asthma were significant, and 47.83% of areas were identified to have children vulnerable to asthma. To sum up, our findings can serve as a valuable reference for the implementation of an early warning to governmental agencies about a susceptible population of children.
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Affiliation(s)
- Lung-Chang Chien
- Epidemiology and Biostatistics, Department of Environmental and Occupational Health, University of Nevada, Las Vegas, NV 89154, USA.
| | - Yu-An Chen
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei 10617, Taiwan.
| | - Hwa-Lung Yu
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei 10617, Taiwan.
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113
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Wong TH, Lee CL, Su HH, Lee CL, Wu CC, Wang CC, Sheu CC, Lai RS, Leung SY, Lin CC, Wei YF, Wang CJ, Lin YC, Chen HL, Huang MS, Yen JH, Huang SK, Suen JL. A prominent air pollutant, Indeno[1,2,3-cd]pyrene, enhances allergic lung inflammation via aryl hydrocarbon receptor. Sci Rep 2018; 8:5198. [PMID: 29581487 PMCID: PMC5979946 DOI: 10.1038/s41598-018-23542-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/14/2018] [Indexed: 12/18/2022] Open
Abstract
Chronic exposure to ambient polycyclic aromatic hydrocarbons (PAHs) is associated with asthma, but its regulatory mechanisms remain incompletely defined. We report herein that elevated levels of urinary 1-hydroxypyrene, a biomarker of PAH exposure, were found in asthmatic subjects (n = 39) as compared to those in healthy subjects (n = 43) living in an industrial city of Taiwan, where indeno[1,2,3-cd]pyrene (IP) was found to be a prominent PAH associated with ambient PM2.5. In a mouse model, intranasal exposure of mice with varying doses of IP significantly enhanced antigen-induced allergic inflammation, including increased airway eosinophilia, Th2 cytokines, including IL-4 and IL-5, as well as antigen-specific IgE level, which was absent in dendritic cell (DC)-specific aryl hydrocarbon receptor (AhR)-null mice. Mechanistically, IP treatment significantly altered DC's function, including increased level of pro-inflammatory IL-6 and decreased generation of anti-inflammatory IL-10. The IP's effect was lost in DCs from mice carrying an AhR-mutant allele. Taken together, these results suggest that chronic exposure to environmental PAHs may pose a significant risk for asthma, in which IP, a prominent ambient PAH in Taiwan, was shown to enhance the severity of allergic lung inflammation in mice through, at least in part, its ability in modulating DC's function in an AhR-dependent manner.
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Affiliation(s)
- Tzu-Hsuan Wong
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chon-Lin Lee
- Department of Marine Environment and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
- Research Center of Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiang-Han Su
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chin-Lai Lee
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Chien Wu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| | - Chin-Chou Wang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Kaohsiung, Taiwan
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chau-Chyun Sheu
- Research Center of Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Divison of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ruay-Sheng Lai
- Division of Chest Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Sum-Yee Leung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| | - Chi-Cheng Lin
- Chest Division, Department of Internal Medicine, Antai Medical Care Cooperation Antai Tian-Sheng Memorial Hospital, Ping-Tung, Taiwan
| | - Yu-Feng Wei
- Division of Chest Medicine, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chien-Jen Wang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Yu-Chun Lin
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Hua-Ling Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Ming-Shyan Huang
- Divison of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jeng-Hsien Yen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Rheumatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shau-Ku Huang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center of Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Lou-Hu Hospital, Shen-Zhen University, Shen-Zhen, China
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jau-Ling Suen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Research Center of Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Ng HS, Koczwara B, Roder D, Vitry A. Changes in the prevalence of comorbidity in the Australian population with cancer, 2007-2014. Cancer Epidemiol 2018; 54:56-62. [PMID: 29597133 DOI: 10.1016/j.canep.2018.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/14/2018] [Accepted: 03/16/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Coexistence of multiple chronic diseases is highly prevalent among the cancer population. This study aims to assess changes in the prevalence of chronic conditions among the population with cancer compared to the Australian general population between 2007 and 2014. METHODS Data from three successive National Health Surveys conducted by the Australian Bureau of Statistics between 2007 and 2014 were utilized. Comparisons were made between the samples of the Australian population aged 25 years and above with a history of cancer and those respondents who did not report having had a cancer using logistics regression models. RESULTS People with a history of cancer had significantly higher odds of reporting non-infectious comorbidity compared to the non-cancer groups across the three surveys. There were no significant changes in the prevalence of diseases affecting circulatory, musculoskeletal, digestive, nervous system, blood and blood forming organs, eye, skin and infectious and parasitic diseases over time among the population with cancer. The prevalence of mental and behavioural problems, endocrine, nutritional and metabolic diseases, and diseases of respiratory and genitourinary system has increased over time among the cancer survivors. CONCLUSION Comorbidity is more prevalent among the cancer population than the general population without cancer. The prevalence of comorbidity was fairly stable for most but not all comorbidities in the population with cancer over the eight-year study period. Further studies on the impacts of coordinated care models for the management of multi-morbidity experienced by cancer survivors that align with the 'National Strategic Framework for Chronic Conditions' are needed.
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Affiliation(s)
- Huah Shin Ng
- School of Pharmacy and Medical Sciences, University of South Australia, Australia.
| | - Bogda Koczwara
- Flinders Centre for Innovation in Cancer, Flinders University, Australia
| | - David Roder
- Cancer Epidemiology and Population Health, Centre of Population Health Research, School of Health Sciences, University of South Australia, Australia
| | - Agnes Vitry
- School of Pharmacy and Medical Sciences, University of South Australia, Australia
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115
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Walsh GM. Reslizumab in the treatment of severe eosinophilic asthma: an update. Immunotherapy 2018; 10:695-698. [PMID: 29554826 DOI: 10.2217/imt-2017-0176] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
A marked heterogeneity is exhibited by asthma both clinically and at the molecular level with different phenotypes driven by diverse mechanistic pathways that require specifically targeted treatments. Biologics aimed at IL-4/13, IL-5 or IgE are proven or potentially effective treatments for patients with difficult to treat eosinophilic asthma. Importantly, it is now widely accepted that biologic-based therapies give significant clinical improvements in those patient populations where asthma phenotypes are taken into account. Such asthma phenotypes have been identified by reproducible and straightforward discriminatory biomarkers. This short review discusses recent studies of the effectiveness of the anti-IL-5 reslizumab in relation to the use of simple reproducible biomarkers in eosinophilic asthma.
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Affiliation(s)
- Garry M Walsh
- School of Medicine, Medical Sciences & Nutrition, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK
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116
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Wang JY, Yao TC, Tsai YT, Wu AC, Tsai HJ. Increased Dose and Duration of Statin Use Is Associated with Decreased Asthma-Related Emergency Department Visits and Hospitalizations. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1588-1595.e1. [PMID: 29426752 DOI: 10.1016/j.jaip.2017.12.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 12/12/2017] [Accepted: 12/13/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Statins have pleiotropic anti-inflammatory and immunomodulatory effects, yet the effect of statin use on asthma-related emergency department (ED) visits and hospitalizations has remained unclear, especially in Asian populations. OBJECTIVE We sought to examine the effect of statin therapy on asthma-related ED visits and/or hospitalizations. METHODS A cohort study was conducted using data from Taiwan's National Health Insurance Research Database from 2001 to 2013. A total of 117,595 adult patients with asthma were included. The outcomes were defined as asthma-related ED visits and/or hospitalizations. Multiple Cox proportional hazards models were applied to determine the effect of statin use on asthma-related ED visits and/or hospitalizations. RESULTS There were 3,417 asthma-related ED visits and/or hospitalizations among 117,595 subjects with asthma. Statin users were significantly less likely to experience asthma-related ED visits and/or hospitalizations (adjusted hazard ratio: 0.81; 95% confidence interval: 0.74-0.89) compared with nonstatin users. The risks of asthma-related ED visits and/or hospitalizations were decreased among those with a higher cumulative defined daily dose (DDD), greater average DDD, and longer cumulative-day users than the counterparts. CONCLUSIONS Our study suggests that statin use is associated with the decreased risk of asthma-related ED visits and/or hospitalizations in patients with asthma. A dose-response effect of statin use is also observed in this study. Therefore, future randomized clinical trials would be warranted to further evaluate the association.
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Affiliation(s)
- Jiu-Yao Wang
- Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Allergy and Clinical Immunology Research (ACIR) Centre, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Chieh Yao
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan; Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Yu-Ting Tsai
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Ann Chen Wu
- PrecisiOn Medicine and Translational Research (PROMoTeR) Center, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Mass; Department of Pediatrics, Children's Hospital, Boston, Mass.
| | - Hui-Ju Tsai
- Allergy and Clinical Immunology Research (ACIR) Centre, National Cheng Kung University, Tainan, Taiwan; Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
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117
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Kang SY, Song WJ, Cho SH, Chang YS. Time trends of the prevalence of allergic diseases in Korea: A systematic literature review. Asia Pac Allergy 2018; 8:e8. [PMID: 29423375 PMCID: PMC5796968 DOI: 10.5415/apallergy.2018.8.e8] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 01/27/2018] [Indexed: 11/30/2022] Open
Abstract
The prevalence of allergic diseases has increased dramatically in recent decades, and are now considered major chronic diseases at the global level. The increasing burden of allergic diseases has led to numerous worldwide and local researchers to investigate the time trends in its prevalence and identify its driving factors. Environmental changes such as urbanization and industrialization have been suggested to explain the increasing prevalence, but recent reports from Western countries suggest that this prevalence has reached a plateau or even possibly, started to decrease. However, such environmental changes are still occurring in many Asia-Pacific countries, including Korea, and it is speculated that the peak in allergy epidemics has yet to come. The present systematic literature review aimed to explore the time trends in the prevalence of allergic diseases in Korea and to identify the unmet needs for facilitating further studies.
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Affiliation(s)
- Sung-Yoon Kang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea
| | - Woo-Jung Song
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea
| | - Sang-Heon Cho
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
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Abstract
PURPOSE OF REVIEW The development of monoclonal antibody-based biologics targeted at inhibition of the Th2 cytokines interleukin-4, interleukin-5 and interleukin-13 represent potentially effective treatments for asthma and allergic diseases. This short review is based on English-language original articles in PubMed or MedLine that reported significant clinical findings on the evidence demonstrating the effectiveness or otherwise of the targeting of interleukin-4, interleukin-5 or interleukin-13 in asthma or allergic disease. RECENT FINDINGS Asthma exhibits marked heterogeneity both clinically and at the molecular phenotypic level requiring specifically targeted treatments to block the key pathways of the disease. It is becoming apparent that significant clinical effects with anticytokine-based biologic therapies are more likely in carefully selected patient populations that take asthma phenotypes into account. Biologics aimed at interleukin-4/13, interleukin-5 or immunoglobulin E are potentially effective treatments for patients with difficult to treat allergic disease. The development of reproducible and straightforward discriminatory biomarkers may aid identification of those patients most likely to benefit from treatment with these expensive interventions. SUMMARY Overall these biologics-based therapies are effective treatments for difficult to treat asthma and allergic disease with a safety profile comparable with placebo in the majority of published studies.
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An J, Lee KS, Kim JT, Yang HJ, Cho YS, Jang KC, Song WJ, Kwon HS, Yoon JS, Han MY. A Delphi approach to the development of standard questionnaire to investigate asthma in Koreans. ALLERGY ASTHMA & RESPIRATORY DISEASE 2018. [DOI: 10.4168/aard.2018.6.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jaewoo An
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Kyung Suk Lee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jin Tack Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - You Sook Cho
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kwang Cheon Jang
- Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Woo-Jung Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyouk-Soo Kwon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Seo Yoon
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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Ghozikali MG, Ansarin K, Naddafi K, Nodehi RN, Yaghmaeian K, Hassanvand MS, Yunesian M. Prevalence of asthma and associated factors among male late adolescents in Tabriz, Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:2184-2193. [PMID: 29116535 DOI: 10.1007/s11356-017-0553-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/23/2017] [Indexed: 06/07/2023]
Abstract
Asthma is an important chronic disease all over the world. The aim of this study was to determine the prevalence of asthma in a population of male late adolescents and its association with some contributing risk factors in northwest of Iran. This cross-sectional study was carried out in selected high schools of Tabriz, Iran, in 2016. The asthma prevalence and patient background information were examined using a questionnaire that prepared by the ISAAC. One hundred forty-two out of 1134 subjects (12.4%) identified to have asthma, 23.3% had history of current wheeze, and 16.3% had wheezing in the previous year. Family history of asthma was present in 17.1% of the participants; prevalence of active smoking in the study subjects was 3.1%; 25.1% of all subjects had exposure to secondhand tobacco smoke and keeping pets at home was present in 9.1%. Excess weight (overweight and obesity) was positively associated with prevalence of asthma (p < 0.001). No statistically significant associations were observed between asthma and father's education level (p = 0.570), mother's education level (p = 0.584), type of birth subjects (p = 0.571), and time spent outdoors during a full day (p = 0.863). Our results suggest that family history of asthma and atopy, exposure to secondhand tobacco smoke, active smoking, amount of automobile traffic around subjects' home, and keeping pets at homes are important risk factors for asthma, while time spent outdoors, educations of parents, and delivery type (normal vaginal delivery vs. C-section) subjects are not. Therefore, decreased of exposure to some environmental risk factors could be effective to reduce rate of the prevalence of asthma and wheeze.
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Affiliation(s)
- Mohammad Ghanbari Ghozikali
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Khalil Ansarin
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh Nodehi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamyar Yaghmaeian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Research Methodology and Data Analysis Department, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
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Licari A, Castagnoli R, Panfili E, Marseglia A, Brambilla I, Marseglia GL. An Update on Anti-IgE Therapy in Pediatric Respiratory Diseases. CURRENT RESPIRATORY MEDICINE REVIEWS 2017; 13:22-29. [PMID: 29290750 PMCID: PMC5735517 DOI: 10.2174/1573398x13666170616110738] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/24/2017] [Accepted: 05/23/2017] [Indexed: 11/22/2022]
Abstract
Anti-IgE treatment represents a major breakthrough in the therapeutic management of severe allergic asthma. Omalizumab is the unique biologic treatment registered for asthma therapy in children. The clinical efficacy and safety of omalizumab treatment in the pediatric population has been extensively documented in specific trials and consistently expanded from real-life studies. In addition, new experimental evidence suggests that omalizumab may also interfere with the cellular and molecular mechanisms underlying airway remodeling. Novel investigational anti-IgE monoclonal antibodies with improved pharmacodynamic properties are in the pipeline, potentially offering alternative mechanisms of modulating IgE pathway. The aim of this review is to update current knowledge on anti-IgE therapy in pediatric respiratory diseases.
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Affiliation(s)
- Amelia Licari
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Riccardo Castagnoli
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Elisa Panfili
- Institute of Paediatrics, Department of Biomedical and Surgical Specialties, University of Perugia, Perugia, Italy
| | - Alessia Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Ilaria Brambilla
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Gian Luigi Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
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122
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Manti S, Cuppari C, Marseglia L, D'Angelo G, Arrigo T, Gitto E, Leonardi S, Salpietro C. Association between Allergies and Hypercholesterolemia: A Systematic Review. Int Arch Allergy Immunol 2017; 174:67-76. [PMID: 29035883 DOI: 10.1159/000480081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is controversy in the literature regarding the potential relationship between atopic predisposition (AP) and serum cholesterol levels. To this purpose, we reviewed human studies that investigated this possible link. METHODS Following PRISMA guidelines, a literature search of PubMed and Science Direct for peer-reviewed journal articles in English from January 2003, with updates through to August 2016, was conducted. Relevant publications were reviewed that included pediatric and adult populations. Information on the study design, sample, intervention, comparators, outcome, time frame, and risk of bias were abstracted for each article. RESULTS Of 601 reviewed reports, 18 were included in this systematic review. Fifteen studies assessed the relationship between AP and serum cholesterol levels. Due to the lack both of observational and cross-sectional studies from the literature search at this time (only 8 studies also analyzed confounding factors) there is a high possibility of confounding variables (familial and genetic predisposition, age, gender, BMI, comorbidity, and medication status) that could not be ruled out. CONCLUSION Existing studies are heterogeneous, making it difficult to draw broad conclusions. Future studies and more detailed analyses, considering confounding variables and including a larger and homogeneous population, are needed to strengthen the argument for a link between lipid metabolism and atopy.
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Affiliation(s)
- Sara Manti
- Units of Pediatric Genetics and Immunology, University of Messina, Messina, Italy
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123
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Kim J, Guenthart B, O'Neill JD, Dorrello NV, Bacchetta M, Vunjak-Novakovic G. Controlled delivery and minimally invasive imaging of stem cells in the lung. Sci Rep 2017; 7:13082. [PMID: 29026127 PMCID: PMC5638808 DOI: 10.1038/s41598-017-13280-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 09/19/2017] [Indexed: 12/11/2022] Open
Abstract
Intratracheal delivery of stem cells into injured or diseased lungs can provide a variety of therapeutic and immunomodulatory effects for the treatment of acute lung injury and chronic lung disease. While the efficacy of this approach depends on delivering the proper cell dosage into the target region of the airway, tracking and analysis of the cells have been challenging, largely due to the limited understanding of cell transport and lack of suitable cell monitoring techniques. We report on the transport and deposition of intratracheally delivered stem cells as well as strategies to modulate the number of cells (e.g., dose), topographic distribution, and region-specific delivery in small (rodent) and large (porcine and human) lungs. We also developed minimally invasive imaging techniques for real-time monitoring of intratracheally delivered cells. We propose that this approach can facilitate the implementation of patient-specific cells and lead to enhanced clinical outcomes in the treatment of lung disease with cell-based therapies.
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Affiliation(s)
- Jinho Kim
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | | | - John D O'Neill
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - N Valerio Dorrello
- Department of Biomedical Engineering, Columbia University, New York, NY, USA.,Department of Pediatrics, Columbia University, New York, NY, USA
| | | | - Gordana Vunjak-Novakovic
- Department of Biomedical Engineering, Columbia University, New York, NY, USA. .,Department of Medicine, Columbia University, New York, NY, USA.
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124
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Ade S, Awanou B, Wachinou A, Kouchadé V, Adjobimey M, Adjibode O, Dovonou A, Agodokpessi G. Prise en charge de l’asthme « sévère » au Bénin, un pays aux ressources limitées. REVUE FRANCAISE D ALLERGOLOGIE 2017. [DOI: 10.1016/j.reval.2017.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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125
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Koopmans T, Gosens R. Revisiting asthma therapeutics: focus on WNT signal transduction. Drug Discov Today 2017; 23:49-62. [PMID: 28890197 DOI: 10.1016/j.drudis.2017.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 07/20/2017] [Accepted: 09/01/2017] [Indexed: 12/16/2022]
Abstract
Asthma is a complex disease of the airways that develops as a consequence of both genetic and environmental factors. This interaction has highlighted genes important in early life, particularly those that control lung development, such as the Wingless/Integrase-1 (WNT) signalling pathway. Although aberrant WNT signalling is involved with an array of human conditions, it has received little attention within the context of asthma. Yet it is highly relevant, driving events involved with inflammation, airway remodelling, and airway hyper-responsiveness (AHR). In this review, we revisit asthma therapeutics by examining whether WNT signalling is a valid therapeutic target for asthma.
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Affiliation(s)
- Tim Koopmans
- Department of Molecular Pharmacology, University of Groningen, The Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, The Netherlands
| | - Reinoud Gosens
- Department of Molecular Pharmacology, University of Groningen, The Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, The Netherlands.
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126
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Identification of some novel xanthine-based derivatives with bronchodilator activity. Future Med Chem 2017; 9:1731-1747. [PMID: 28871831 DOI: 10.4155/fmc-2017-0092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIM The discovery of new bronchodilators with higher efficacy than theophylline is an important issue for asthmatic patients. MATERIALS & METHODS Theophylline 2, 8-bromotheophylline 4 and theobromine 6 were reacted with different 2/3-chloro-N-phenylacetamides 1a-d or their propanamide analogs 1e-g to obtain 3a-g, 5a-g and 7a-g, respectively. The target compounds were screened for their in vitro bronchodilator activity using isolated guinea pig tracheal rings precontracted with histamine and compared with their precursors. RESULTS Many compounds exhibited promising activity especially 3d, 3f, 5d, 7d and 7e. 2D-QSAR study resulted in a significant model (N = 24, n = 5, R 2 = 0.848, R 2cvOO = 0.748, R 2cvMO = 0.745, F = 21.215, s 2 = 0.0002) using CODESSA-Pro software. CONCLUSION These compounds can be considered as promising hits for potent bronchodilators that may be useful for further investigations. [Formula: see text].
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127
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Choi JY, Yoon HK, Lee JH, Yoo KH, Kim BY, Bae HW, Kim YK, Rhee CK. Current status of asthma care in South Korea: nationwide the Health Insurance Review and Assessment Service database. J Thorac Dis 2017; 9:3208-3214. [PMID: 29221297 PMCID: PMC5708454 DOI: 10.21037/jtd.2017.08.109] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Quality control is important for patients with asthma because of its prevalence and because the social burden is substantial. This study analyzed the Health Insurance Review and Assessment Service (HIRA) database to assess asthma quality control in South Korea. METHODS We investigated the HIRA nationwide database for reimbursed insurance claims from all medical institutions in South Korea from July 2013 to June 2014. The number of patients with asthma were evaluated and the medical institutions were categorized by type of medical institution. Asthma care quality was assessed by measuring the performance rate on pulmonary function test (PFT) and investigating prescriptions for asthma medications. RESULTS A total of 16,804 medical institutions and 831,613 patients were included in this study. Among them, primary health clinics accounted for 87.75% of all medical institutions and 82.50% of patients were treated in a primary health clinic. The overall PFT performance rate was 23.47%, which was highest in tertiary hospitals (80.59%) and relatively lower in primary health clinics (17.06%). Oral agents were prescribed to 93.96% of patients, whereas inhaled agents were prescribed to only 30.34%. Oral corticosteroids were prescribed to 40.61% of patients, leukotriene antagonists to 48.78%, and inhaled corticosteroids (ICS) to 25.37% of patients by drug category. CONCLUSIONS Most patients with asthma were treated in primary health clinics rather than higher class medical institutions. Asthma quality control was poor regarding usage of diagnostic measures and prescribed medications.
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Affiliation(s)
- Joon Young Choi
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Ha Lee
- Division of Pulmonology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, South Korea
| | - Kwang Ha Yoo
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, South Korea
| | - Bo Yeon Kim
- Health Insurance Review & Assessment Service, Wonju, South Korea
| | - Hye Won Bae
- Health Insurance Review & Assessment Service, Wonju, South Korea
| | - Young Kyoon Kim
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Chin Kook Rhee
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea
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128
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Prevention of allergies in childhood - where are we now? Allergol Select 2017; 1:200-213. [PMID: 30402617 PMCID: PMC6040005 DOI: 10.5414/alx01807e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 07/27/2015] [Indexed: 11/18/2022] Open
Abstract
Allergic diseases represent an increasing health problem for children worldwide. Along with allergic airway diseases, food allergy comes to the fore and herewith closely intertwined the hypothesis that an early allergic sensitization might occur via skin barrier defect(s). The importance of the skin barrier has been documented by several studies meanwhile. Not only genetic studies screen the associations between Filaggrin loss-of-function mutations, atopic dermatitis, allergic sensitization, food allergy and even airway diseases, but also epidemiological studies cast new light on the hypothesis of the atopic march. As another focus in context of the development of an allergic phenotype, the specific microbial exposure with all its diversities has been crystallized as it shapes the immune system in (early) infancy. Studies explored both, the role of human intestinal microbiota as well as the external microbial diversity. Unfortunately suitable markers for atopic predictors are still rare. New studies point out that specific IgE antibodies (e.g., IgE to Phl p 1) in children without allergic symptoms so far, might function as a pre-clinical biomarker, which may help to identify candidates for primary (allergen non-specific) or secondary (allergen-specific) prevention in terms of specific immunoprophylaxis. These manifold research activities document a complex increase in knowledge. Nevertheless new assumptions need to be substantively confirmed in order to finally generate the urgently needed preventive strategies for allergic diseases in childhood.
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129
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Paw M, Borek I, Wnuk D, Ryszawy D, Piwowarczyk K, Kmiotek K, Wójcik-Pszczoła KA, Pierzchalska M, Madeja Z, Sanak M, Błyszczuk P, Michalik M, Czyż J. Connexin43 Controls the Myofibroblastic Differentiation of Bronchial Fibroblasts from Patients with Asthma. Am J Respir Cell Mol Biol 2017; 57:100-110. [PMID: 28245135 DOI: 10.1165/rcmb.2015-0255oc] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Pathologic accumulation of myofibroblasts in asthmatic bronchi is regulated by extrinsic stimuli and by the intrinsic susceptibility of bronchial fibroblasts to transforming growth factor-β (TGF-β). The specific function of gap junctions and connexins in this process has remained unknown. Here, we investigated the role of connexin43 (Cx43) in TGF-β-induced myofibroblastic differentiation of fibroblasts derived from bronchoscopic biopsy specimens of patients with asthma and donors without asthma. Asthmatic fibroblasts expressed considerably higher levels of Cx43 and were more susceptible to TGF-β1-induced myofibroblastic differentiation than were their nonasthmatic counterparts. TGF-β1 efficiently up-regulated Cx43 levels and activated the canonical Smad pathway in asthmatic cells. Ectopic Cx43 expression in nonasthmatic (Cx43low) fibroblasts increased their predilection to TGF-β1-induced Smad2 activation and fibroblast-myofibroblast transition. Transient Cx43 silencing in asthmatic (Cx43high) fibroblasts by Cx43 small interfering RNA attenuated the TGF-β1-triggered Smad2 activation and myofibroblast formation. Direct interactions of Smad2 and Cx43 with β-tubulin were demonstrated by co-immunoprecipitation assay, whereas the sensitivity of these interactions to TGF-β1 signaling was confirmed by Förster Resonance Energy Transfer analyses. Furthermore, inhibition of the TGF-β1/Smad pathway attenuated TGF-β1-triggered Cx43 up-regulation and myofibroblast differentiation of asthmatic fibroblasts. Chemical inhibition of gap junctional intercellular communication with 18 α-glycyrrhetinic acid did not affect the initiation of fibroblast-myofibroblast transition in asthmatic fibroblasts but interfered with the maintenance of their myofibroblastic phenotype. Collectively, our data identified Cx43 as a new player in the feedback mechanism regulating TGF-β1/Smad-dependent differentiation of bronchial fibroblasts. Thus, our observations point to Cx43 as a novel profibrotic factor in asthma progression.
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Affiliation(s)
- Milena Paw
- 1 Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Izabela Borek
- 1 Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Dawid Wnuk
- 1 Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Damian Ryszawy
- 1 Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Katarzyna Piwowarczyk
- 1 Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Katarzyna Kmiotek
- 1 Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Katarzyna A Wójcik-Pszczoła
- 1 Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland.,2 Department of Medicine, Jagiellonian University Medical School, Kraków, Poland
| | | | - Zbigniew Madeja
- 1 Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Marek Sanak
- 2 Department of Medicine, Jagiellonian University Medical School, Kraków, Poland
| | - Przemysław Błyszczuk
- 3 Department of Food Biotechnology, Faculty of Food Technology, University of Agriculture, Kraków, Poland.,5 Department of Clinical Immunology, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Marta Michalik
- 1 Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Jarosław Czyż
- 1 Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
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130
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Basheti IA, Abu-Gharbieh E. Revealing treatment-related problems for outpatients with alarming health status in the United Arab Emirates. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2017. [DOI: 10.1111/jphs.12186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Iman A. Basheti
- Department of Clinical Pharmacy & Therapeutics; Faculty of Pharmacy; Applied Science Private University; Amman Jordan
| | - Eman Abu-Gharbieh
- Department of Clinical Sciences; Faculty of Medicine; University of Sharjah; Sharjah UAE
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131
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Ahmed R, Robinson R, Mortimer K. The epidemiology of noncommunicable respiratory disease in sub-Saharan Africa, the Middle East, and North Africa. Malawi Med J 2017; 29:203-211. [PMID: 28955434 PMCID: PMC5610297 DOI: 10.4314/mmj.v29i2.24] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Noncommunicable diseases (NCDs) are a major and increasing global health issue. The World Health Organization (WHO) estimates that NCDs represent 63% of all global deaths of which 3.9 million are due to chronic respiratory diseases (CRDs) and Chronic Obstructive Pulmonary Disease (COPD) in particular. COPD is now the third most common cause of death globally; 90% of these deaths occur in Low and Middle Income Countries (LMICs). COPD affects 329 million people, almost 5% of the world's population. In addition, asthma affects 334 million people, again representing almost 5% of the world's population. There is limited literature published on the epidemiology of COPD and Asthma from Sub-Saharan Africa (SSA) and Middle East and North Africa (MENA). Both diseases are under-diagnosed and underestimated in both SSA and MENA regions. The burden of COPD in sub-Saharan Africa is disputed and reports offer variable prevalence estimates, ranging from 4.1% to almost 22.2%. SSA and MENA countries report similar mortality rates from COPD of 18 per 100,000 population (2001 data). Asthma is a less common cause of death than COPD but is a major cause of morbidity; WHO estimates that there are 250,000 deaths per year from asthma, mainly in LMICs and it remains in the top twenty causes of disability in children globally. Risk factors for CRD are genetic and environmental; the latter dominated by air pollution exposures including tobacco smoke, household air pollution, outdoor air pollution and occupational exposures.
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Affiliation(s)
- Rana Ahmed
- The Epidemiological Laboratory, Khartoum, Sudan
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Ryan Robinson
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Kevin Mortimer
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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132
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Bhuia MR, Nwaru BI, Weir CJ, Sheikh A. Models for estimating and projecting global, regional and national prevalence and disease burden of asthma: protocol for a systematic review. BMJ Open 2017; 7:e015441. [PMID: 28515197 PMCID: PMC5791547 DOI: 10.1136/bmjopen-2016-015441] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Models that have so far been used to estimate and project the prevalence and disease burden of asthma are in most cases inadequately described and irreproducible. We aim systematically to describe and critique the existing models in relation to their strengths, limitations and reproducibility, and to determine the appropriate models for estimating and projecting the prevalence and disease burden of asthma. METHODS We will search the following electronic databases to identify relevant literature published from 1980 to 2017: Medline, Embase, WHO Library and Information Services and Web of Science Core Collection. We will identify additional studies by searching the reference list of all the retrieved papers and contacting experts. We will include observational studies that used models for estimating and/or projecting prevalence and disease burden of asthma regarding human population of any age and sex. Two independent reviewers will assess the studies for inclusion and extract data from included papers. Data items will include authors' names, publication year, study aims, data source and time period, study population, asthma outcomes, study methodology, model type, model settings, study variables, methods of model derivation, methods of parameter estimation and/or projection, model fit information, key findings and identified research gaps. A detailed critical narrative synthesis of the models will be undertaken in relation to their strengths, limitations and reproducibility. A quality assessment checklist and scoring framework will be used to determine the appropriate models for estimating and projecting the prevalence anddiseaseburden of asthma. ETHICS AND DISSEMINATION We will not collect any primary data for this review, and hence there is no need for formal National Health Services Research Ethics Committee approval. We will present our findings at scientific conferences and publish the findings in the peer-reviewed scientific journal.
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Affiliation(s)
- Mohammad Romel Bhuia
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Bright I Nwaru
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Christopher J Weir
- Edinburgh Clinical Trials Unit, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
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133
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Obel KB, Ntumba KJM, Kalambayi KP, Zalagile AP, Kinkodi KD, Munogolo KZ. Prevalence and determinants of asthma in adults in Kinshasa. PLoS One 2017; 12:e0176875. [PMID: 28464036 PMCID: PMC5413054 DOI: 10.1371/journal.pone.0176875] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 04/18/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Epidemiological data on asthma among adults in sub-Saharan Africa are sparse. OBJECTIVE To determine the prevalence of and factors associated with asthma among adults in Kinshasa. METHODS A previously validated asthma questionnaire was administered to an adult population aged ≥18 years in urban and peri-urban suburbs of Kinshasa. A random stratified multi-stage sampling plan was used to select the study participants. Logistic regression was used to identify factors associated with asthma. RESULTS The mean age of respondents was 36.7 (SD 15.36) years, 75% lived in an urban environment, and 57% were women. The prevalence of asthma-ever was 6.9% (95% CI: 5.4-8.4). Among asthmatic patients, intermittent asthma was estimated at 75.7% and severe asthma at 9.3%. Family atopy (OR: 3.97; 95% CI: 2.42-6.50; p<0.001), and the presence of a cat in the house (OR: 1.82; 95% CI: 1.01-3.28; p = 0.045) were associated with self-reported asthma. CONCLUSION Asthma is relatively frequent in adults in Kinshasa, a prevalence similar to those reported elsewhere in Africa. Family atopy and the presence of a cat in the house could be the most common determinants to be confirmed with national survey in order to design guidelines for the control of asthma.
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Affiliation(s)
- Kabengele Benoit Obel
- Department of Internal Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | | | | | | | - Kaba Didine Kinkodi
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
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134
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Verkleij M, Beelen A, van Ewijk BE, Geenen R. Multidisciplinary treatment in children with problematic severe asthma: A prospective evaluation. Pediatr Pulmonol 2017; 52:588-597. [PMID: 27736038 DOI: 10.1002/ppul.23623] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 09/16/2016] [Accepted: 09/27/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE For children with problematic severe asthma, achieving adequate control of asthma is difficult. The aim of this prospective observational study was to evaluate the effects of intensive multidisciplinary inpatient treatment on multiple outcome variables in children with problematic severe asthma. METHODS Participants were 89 children with problematic severe asthma (mean age 13.6 ± 2.5 years) treated in tertiary care clinics at high altitude (Switzerland) or sea level (Netherlands) and their parents (85 mothers, 55 fathers). The primary outcome variable was the Childhood Asthma Control Test (C-ACT). Other outcome variables were forced expiratory volume in 1 sec (FEV1 ), fractional concentration of exhaled nitric oxide (FeNO), quality of life [PAQLQ(S)], children's coping (UCL-A), parents' report of behavioral problems (CBCL), and parenting stress (PSI/NOSI). Evaluations were taken pre-treatment, post-treatment, and 3-6 months follow-up. Median [P25;P75] treatment duration 74 [56;80] days; Median follow-up interval 131 [103;177] days. RESULTS The percentages of children showing controlled asthma (C-ACT) were 18% (pre-treatment), 69% (post-treatment), and 44% (follow-up). The vast majority of the children (80%) showed an improvement on C-ACT with 4% showing a deterioration. On C-ACT, FeNO, quality of life, and behavioral problems, improvements at post-treatment were highly significant. Improvements generally remained at a functional level at follow-up. Children's coping and parenting stress in parents did not change. CONCLUSIONS The improvement in asthma control and other outcome variables suggests that multidisciplinary inpatient treatment is an effective approach for a heterogeneous group of children with asthma that remained uncontrolled in secondary care. Pediatr Pulmonol. 2017;52:588-597. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Marieke Verkleij
- Merem Netherlands Asthma Center, Davos, Switzerland.,Merem Asthma Center Heideheuvel, Hilversum, The Netherlands.,Department of Pediatric Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Anita Beelen
- Merem Asthma Center Heideheuvel, Hilversum, The Netherlands.,Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Rinie Geenen
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
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135
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Khreis H, Kelly C, Tate J, Parslow R, Lucas K, Nieuwenhuijsen M. Exposure to traffic-related air pollution and risk of development of childhood asthma: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2017; 100:1-31. [PMID: 27881237 DOI: 10.1016/j.envint.2016.11.012] [Citation(s) in RCA: 405] [Impact Index Per Article: 57.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 11/04/2016] [Accepted: 11/10/2016] [Indexed: 05/19/2023]
Abstract
BACKGROUND AND OBJECTIVE The question of whether children's exposure to traffic-related air pollution (TRAP) contributes to their development of asthma is unresolved. We conducted a systematic review and performed meta-analyses to analyze the association between TRAP and asthma development in childhood. DATA SOURCES We systematically reviewed epidemiological studies published until 8 September 2016 and available in the Embase, Ovid MEDLINE (R), and Transport databases. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS We included studies that examined the association between children's exposure to TRAP metrics and their risk of 'asthma' incidence or lifetime prevalence, from birth to age 18years old. STUDY APPRAISAL AND SYNTHESIS METHODS We extracted key characteristics of each included study using a predefined data items template and these were tabulated. We used the Critical Appraisal Skills Programme checklists to assess the validity of each included study. Where four or more independent risk estimates were available for a continuous pollutant exposure, we conducted overall and age-specific meta-analyses, and four sensitivity analyses for each summary meta-analytic exposure-outcome association. RESULTS Forty-one studies met our eligibility criteria. There was notable variability in asthma definitions, TRAP exposure assessment methods and confounder adjustment. The overall random-effects risk estimates (95% CI) were 1.08 (1.03, 1.14) per 0.5×10-5m-1 black carbon (BC), 1.05 (1.02, 1.07) per 4μg/m3 nitrogen dioxide (NO2), 1.48 (0.89, 2.45) per 30μg/m3 nitrogen oxides (NOx), 1.03 (1.01, 1.05) per 1μg/m3 Particulate Matter <2.5μm in diameter (PM2.5), and 1.05 (1.02, 1.08) per 2μg/m3 Particulate Matter <10μm in diameter (PM10). Sensitivity analyses supported these findings. Across the main analysis and age-specific analysis, the least heterogeneity was seen for the BC estimates, some heterogeneity for the PM2.5 and PM10 estimates and the most heterogeneity for the NO2 and NOx estimates. LIMITATIONS, CONCLUSIONS AND IMPLICATION OF KEY FINDINGS The overall risk estimates from the meta-analyses showed statistically significant associations for BC, NO2, PM2.5, PM10 exposures and risk of asthma development. Our findings support the hypothesis that childhood exposure to TRAP contributes to their development of asthma. Future meta-analyses would benefit from greater standardization of study methods including exposure assessment harmonization, outcome harmonization, confounders' harmonization and the inclusion of all important confounders in individual studies. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO 2014: CRD42014015448.
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Affiliation(s)
- Haneen Khreis
- Institute for Transport Studies, University of Leeds, Leeds, United Kingdom.
| | - Charlotte Kelly
- Institute for Transport Studies, University of Leeds, Leeds, United Kingdom; Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - James Tate
- Institute for Transport Studies, University of Leeds, Leeds, United Kingdom
| | - Roger Parslow
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Karen Lucas
- Institute for Transport Studies, University of Leeds, Leeds, United Kingdom
| | - Mark Nieuwenhuijsen
- ISGlobal CREAL, C/Dr. Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), C/Dr. Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), C/Monforte de Lemos 3-5, 28029 Madrid, Spain
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136
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Barnish MS, Tagiyeva N, Devereux G, Aucott L, Turner S. Changes in the relationship between asthma and associated risk factors over fifty years. Pediatr Allergy Immunol 2017; 28:162-169. [PMID: 27779796 DOI: 10.1111/pai.12674] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/22/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Childhood asthma is a common condition whose prevalence is changing. We hypothesized that the relationship between asthma and associated risk factors has changed over a 50-year period. METHODS An ecological study design was used. Children aged 8-13 attending schools in Aberdeen city were surveyed on seven occasions between 1964 and 2014. The following were determined: history of asthma, history of eczema, parental smoking, parental asthma, sex and socio-economic status. Analysis was by a structural change model with two knots. The outcome reported was the change in odds ratio between asthma and a given risk factor during a given period. RESULTS There were 23,241 questionnaires distributed and 17,439 returned (75%). The odds ratio (OR) for a child with asthma to have eczema increased between 1989 and 1999 by 1.031 [95% CI 1.028, 1.035] and by 1.042 between 2004 and 2014 [1.038, 1.047]. The OR for a child with asthma to have a parent who smoked rose by 1.032 [1.028, 1.036] between 1989 and 1999 and by 1.043 [1.038, 1.047] between 2004 and 2014), and to have a parent with asthma (1.027 [1.022, 1.031] for 1994-99 and 1.042 [1.037, 1.048] for 2004-2014). The OR for a child with asthma being male, but not and being from the most deprived communities, rose between 1989-1999 and 2004-2014. CONCLUSIONS The relationship between asthma prevalence and particular risk factors changed over the 50-year period of study, and this might reflect changes in children's environment and/or susceptibility.
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Affiliation(s)
- Maxwell S Barnish
- Child Health, University of Aberdeen, Aberdeen, UK.,Epidemiology Group, University of Aberdeen, Aberdeen, UK
| | | | - Graham Devereux
- Child Health, University of Aberdeen, Aberdeen, UK.,Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Lorna Aucott
- Medical Statistics, University of Aberdeen, Aberdeen, UK
| | - Steve Turner
- Child Health, University of Aberdeen, Aberdeen, UK
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137
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Huang ZA, Chen X, Zhu Z, Liu H, Yan GY, You ZH, Wen Z. PBHMDA: Path-Based Human Microbe-Disease Association Prediction. Front Microbiol 2017; 8:233. [PMID: 28275370 PMCID: PMC5319991 DOI: 10.3389/fmicb.2017.00233] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 02/02/2017] [Indexed: 12/12/2022] Open
Abstract
With the advance of sequencing technology and microbiology, the microorganisms have been found to be closely related to various important human diseases. The increasing identification of human microbe-disease associations offers important insights into the underlying disease mechanism understanding from the perspective of human microbes, which are greatly helpful for investigating pathogenesis, promoting early diagnosis and improving precision medicine. However, the current knowledge in this domain is still limited and far from complete. Here, we present the computational model of Path-Based Human Microbe-Disease Association prediction (PBHMDA) based on the integration of known microbe-disease associations and the Gaussian interaction profile kernel similarity for microbes and diseases. A special depth-first search algorithm was implemented to traverse all possible paths between microbes and diseases for inferring the most possible disease-related microbes. As a result, PBHMDA obtained a reliable prediction performance with AUCs (The area under ROC curve) of 0.9169 and 0.8767 in the frameworks of both global and local leave-one-out cross validations, respectively. Based on 5-fold cross validation, average AUCs of 0.9082 ± 0.0061 further demonstrated the efficiency of the proposed model. For the case studies of liver cirrhosis, type 1 diabetes, and asthma, 9, 7, and 9 out of predicted microbes in the top 10 have been confirmed by previously published experimental literatures, respectively. We have publicly released the prioritized microbe-disease associations, which may help to select the most potential pairs for further guiding the experimental confirmation. In conclusion, PBHMDA may have potential to boost the discovery of novel microbe-disease associations and aid future research efforts toward microbe involvement in human disease mechanism. The code and data of PBHMDA is freely available at http://www.escience.cn/system/file?fileId=85214.
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Affiliation(s)
- Zhi-An Huang
- College of Computer Science and Software Engineering, Shenzhen University Shenzhen, China
| | - Xing Chen
- School of Information and Control Engineering, China University of Mining and Technology Xuzhou, China
| | - Zexuan Zhu
- College of Computer Science and Software Engineering, Shenzhen University Shenzhen, China
| | - Hongsheng Liu
- School of Life Science, Liaoning UniversityShenyang, China; Research Center for Computer Simulating and Information Processing of Bio-Macromolecules of Liaoning ProvinceShenyang, China
| | - Gui-Ying Yan
- Academy of Mathematics and Systems Science, Chinese Academy of Sciences Beijing, China
| | - Zhu-Hong You
- Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Science ürümqi, China
| | - Zhenkun Wen
- College of Computer Science and Software Engineering, Shenzhen University Shenzhen, China
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138
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Stiemsma LT, Turvey SE. Asthma and the microbiome: defining the critical window in early life. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2017; 13:3. [PMID: 28077947 PMCID: PMC5217603 DOI: 10.1186/s13223-016-0173-6] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 12/11/2016] [Indexed: 12/23/2022]
Abstract
Asthma is a chronic inflammatory immune disorder of the airways affecting one in ten children in westernized countries. The geographical disparity combined with a generational rise in prevalence, emphasizes that changing environmental exposures play a significant role in the etiology of this disease. The microflora hypothesis suggests that early life exposures are disrupting the composition of the microbiota and consequently, promoting immune dysregulation in the form of hypersensitivity disorders. Animal model research supports a role of the microbiota in asthma and atopic disease development. Further, these model systems have identified an early life critical window, during which gut microbial dysbiosis is most influential in promoting hypersensitivity disorders. Until recently this critical window had not been characterized in humans, but now studies suggest that the ideal time to use microbes as preventative treatments or diagnostics for asthma in humans is within the first 100 days of life. This review outlines the major mouse-model and human studies leading to characterization of the early life critical window, emphasizing studies analyzing the intestinal and airway microbiotas in asthma and atopic disease. This research has promising future implications regarding childhood immune health, as ultimately it may be possible to therapeutically administer specific microbes in early life to prevent the development of asthma in children.
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Affiliation(s)
- Leah T. Stiemsma
- Department of Microbiology & Immunology, University of British Columbia, Vancouver, BC Canada
- BC Children’s Hospital, Vancouver, BC Canada
| | - Stuart E. Turvey
- BC Children’s Hospital, Vancouver, BC Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC Canada
- Department of Pediatrics, BC Children’s Hospital, 950 West 28th Avenue, Vancouver, BC V5Z 4H4 Canada
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139
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Comberiati P, Di Cicco ME, D'Elios S, Peroni DG. How Much Asthma Is Atopic in Children? Front Pediatr 2017; 5:122. [PMID: 28603709 PMCID: PMC5445121 DOI: 10.3389/fped.2017.00122] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 05/08/2017] [Indexed: 12/17/2022] Open
Affiliation(s)
- Pasquale Comberiati
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, Verona, Italy
| | - Maria Elisa Di Cicco
- Department of Clinical and Experimental Medicine, Section of Pediatric, University of Pisa, Pisa, Italy
| | - Sofia D'Elios
- Department of Clinical and Experimental Medicine, Section of Pediatric, University of Pisa, Pisa, Italy
| | - Diego G Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatric, University of Pisa, Pisa, Italy
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140
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Jesenak M, Zelieskova M, Babusikova E. Oxidative Stress and Bronchial Asthma in Children-Causes or Consequences? Front Pediatr 2017; 5:162. [PMID: 28791280 PMCID: PMC5523023 DOI: 10.3389/fped.2017.00162] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 07/06/2017] [Indexed: 12/13/2022] Open
Abstract
Bronchial asthma is one of the most common chronic inflammatory diseases of the airways. In the pathogenesis of this disease, the interplay among the genes, intrinsic, and extrinsic factors are crucial. Various combinations of the involved factors determine and modify the final clinical phenotype/endotype of asthma. Oxidative stress results from an imbalance between the production of reactive oxygen species and reactive nitrogen species and the capacity of antioxidant defense mechanisms. It was shown that oxidative damage of biomolecules is strongly involved in the asthmatic inflammation. It is evident that asthma is accompanied by oxidative stress in the airways and in the systemic circulation. The oxidative stress is more pronounced during the acute exacerbation or allergen challenge. On the other hand, the genetic variations in the genes for anti-oxidative and pro-oxidative enzymes are variably associated with various asthmatic subtypes. Whether oxidative stress is the consequence of, or the cause for, chronic changes in asthmatic airways is still being discussed. Contribution of oxidative stress to asthma pathology remains at least partially controversial, since antioxidant interventions have proven rather unsuccessful. According to current knowledge, the relationship between oxidative stress and asthmatic inflammation is bidirectional, and genetic predisposition could modify the balance between these two positions-oxidative stress as a cause for or consequence of asthmatic inflammation.
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Affiliation(s)
- Milos Jesenak
- Jessenius Faculty of Medicine, Department of Pediatrics, Comenius University in Bratislava, University Hospital, Martin, Slovakia
| | - Maria Zelieskova
- Jessenius Faculty of Medicine, Department of Pediatrics, Comenius University in Bratislava, University Hospital, Martin, Slovakia
| | - Eva Babusikova
- Jessenius Faculty of Medicine, Department of Medical Biochemistry, Comenius University in Bratislava, Martin, Slovakia
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141
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Hoskins G, Williams B, Abhyankar P, Donnan P, Duncan E, Pinnock H, van der Pol M, Rauchhaus P, Taylor A, Sheikh A. Achieving Good Outcomes for Asthma Living (GOAL): mixed methods feasibility and pilot cluster randomised controlled trial of a practical intervention for eliciting, setting and achieving goals for adults with asthma. Trials 2016; 17:584. [PMID: 27931242 PMCID: PMC5146838 DOI: 10.1186/s13063-016-1684-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 11/05/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite being a core component of self-management, goal setting is rarely used in routine care. We piloted a primary care, nurse-led intervention called Achieving Good Outcomes for Asthma Living (GOAL) for adults with asthma. Patients were invited to identify and prioritise their goals in preparation for discussing and negotiating an action/coping plan with the nurse at a routine asthma review. METHODS The 18-month mixed methods feasibility cluster pilot trial stratified and then randomised practices to deliver usual care (UC) or a goal-setting intervention (GOAL). Practice asthma nurses and adult patients with active asthma were invited to participate. The primary outcome was asthma-specific quality of life. Semi-structured interviews with a purposive patient sample (n = 14) and 10 participating nurses explored GOAL perception. The constructs of normalisation process theory (NPT) were used to analyse and interpret data. RESULTS Ten practices participated (five in each arm), exceeding our target of eight. However, only 48 patients (target 80) were recruited (18 in GOAL practices). At 6 months post-intervention, the difference in mean asthma-related quality of life (mAQLQ) between intervention and control was 0.1 (GOAL 6.20: SD 0.76 (CI 5.76-6.65) versus UC 6.1: SD 0.81 (CI 5.63-6.57)), less than the minimal clinically important difference (MCID) of 0.5. However, change from baseline was stronger in the intervention group: at 6 months the change in the emotions sub-score was 0.8 for intervention versus 0.2 for control. Costs were higher in the intervention group by £22.17. Routine review with goal setting was considered more holistic, enhancing rapport and enabling patients to become active rather than passive participants in healthcare. However, time was a major barrier for nurses, who admitted to screening out patient goals they believed were unrelated to asthma. CONCLUSIONS The difference in AQLQ score from baseline is larger in the intervention arm than the control, indicating the intervention may have impact if appropriately strengthened. The GOAL intervention changed the review dynamic and was well received by patients, but necessitated additional time, which was problematic in the confines of the traditional nurse appointment. Modification to recruitment methods and further development of the intervention are needed before proceeding to a definitive cluster randomised controlled trial. TRIAL REGISTRATION ISRCTN18912042 . Registered on 26 June 2012.
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Affiliation(s)
- Gaylor Hoskins
- Nursing, Midwifery and Allied Health Professions Research Unit, School of Health Sciences, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF Scotland, UK
| | - Brian Williams
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh, EH11 4BN Scotland
| | - Purva Abhyankar
- Faculty of Health Sciences and Sport, University of Stirling, Pathfoot Building, Stirling, FK9 4LA Scotland, UK
| | - Peter Donnan
- Tayside Clinical Trials Unit, Level 10 Ninewells Hospital and Medical School, Dundee, DD1 9SY Scotland, UK
| | - Edward Duncan
- Nursing, Midwifery and Allied Health Professions Research Unit, School of Health Sciences, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF Scotland, UK
| | - Hilary Pinnock
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Medical School Doorway 3, Teviot Place, Edinburgh, EH8 9AG Scotland, UK
| | - Marjon van der Pol
- Health Economics Research Unit, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD Scotland, UK
| | - Petra Rauchhaus
- Tayside Clinical Trials Unit, Level 10 Ninewells Hospital and Medical School, Dundee, DD1 9SY Scotland, UK
| | - Anne Taylor
- Faculty of Health Sciences and Sport, University of Stirling, Pathfoot Building, Stirling, FK9 4LA Scotland, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Medical School Doorway 3, Teviot Place, Edinburgh, EH8 9AG Scotland, UK
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142
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Adeyeye OO, Adewumi TA, Adewuya AO. Effect of psychological and other factors on quality of life amongst asthma outpatients in Lagos, Nigeria. Respir Med 2016; 122:67-70. [PMID: 27993293 DOI: 10.1016/j.rmed.2016.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 12/01/2016] [Accepted: 12/02/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study aimed to assess the effect of psychological and other possible factors associated with poor health related quality of life (HRQOL) in outpatient with asthma in Lagos, Nigeria. METHODS Patients (n = 201) recruited from the adult asthma outpatient clinic were assessed for sociodemographic and asthma related variables. Levels of social support (with Oslo 3-Item Social Support Scale), disability (with WHO Disability Assessment Scale) were assessed. The presence of anxiety and depression was assessed using the Mini International Neuropsychiatric Interview (M.I.N.I) and asthma related quality of life was assessed with the Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ). RESULTS Of the 4 domains of Mini-AQLQ, the "environmental" domain has the lowest weighted mean score of 2.43 (SD = 1.64) while the "activity limitation" domain has the highest mean score of 4.74 (SD = 1.57). Poor asthma related QOL was independently associated with being unemployed (p = 0.028), poor social support (p = 0.002), nocturnal asthma (p = 0.046), clinically rated "severe asthma" (p = 0.002), patients rated "severe asthma" (p < 0.001), high level of disability (p < 0.001) and presence of Anxiety/Depression (p < 0.001). CONCLUSION Our study has shown that psychological variables, disability, patients' subjective severity rating and social support are the most important factors independently associated with asthma related QOL. These factors should be considered in planning health care services or formulating a predictive intervention model.
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Affiliation(s)
- Olufunke O Adeyeye
- Lagos State University College of Medicine (LASUCOM), 1-5, Oba Akinjobi Way, Ikeja, Lagos, Nigeria
| | - Tomilola A Adewumi
- Centre for Mental Health Research and Initiative (CEMHRI), Ikeja, Lagos, Nigeria
| | - Abiodun O Adewuya
- Lagos State University College of Medicine (LASUCOM), 1-5, Oba Akinjobi Way, Ikeja, Lagos, Nigeria; Centre for Mental Health Research and Initiative (CEMHRI), Ikeja, Lagos, Nigeria.
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143
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Delmas MC, Guignon N, Leynaert B, Moisy M, Marguet C, Fuhrman C. [Increase in asthma prevalence among young children in France]. Rev Mal Respir 2016; 34:525-534. [PMID: 27919604 DOI: 10.1016/j.rmr.2016.09.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 09/02/2016] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Few data on change over time of asthma prevalence in French children are available. METHODS Data from the 2012-2013 national health survey of schoolchildren conducted in a random sample of almost 20,000 children in the last year of nursery school were compared to those which had been collected in 2005-2006 in the same grade level using the same methodology. RESULTS In the 2012-2013 survey, children had a lifetime prevalence of asthma of 11.0% with 11.8% reporting wheezing in the preceding year. Asthma was more frequent and more often uncontrolled in children from families with low socioeconomic status. Compared to the survey conducted in the same grade level in 2005-2006, the prevalence ratios adjusted for children's gender and obesity, family structure, parental unemployment and region were 1.13 [1.05-1.21] for lifetime asthma and 1.12 [1.05-1.17] for past-year wheezing. CONCLUSION In France, the prevalence of asthma in young children increased between 2005 and 2012. The socioeconomic status of children's parents affects both asthma prevalence and control.
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Affiliation(s)
- M-C Delmas
- Direction des maladies non transmissibles et traumatismes, Santé publique France, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France.
| | - N Guignon
- Direction de la recherche, des études, de l'évaluation et des statistiques (DREES), ministère de la Santé, 75007 Paris, France
| | - B Leynaert
- UMR 1152, Inserm, 75890 Paris cedex 18, France; UMR 1152, université Paris-Diderot Paris-7, 75018 Paris, France
| | - M Moisy
- Direction de la recherche, des études, de l'évaluation et des statistiques (DREES), ministère de la Santé, 75007 Paris, France
| | - C Marguet
- Hôpital Charles-Nicolle, CHU de Rouen, 76000 Rouen, France
| | - C Fuhrman
- Direction des maladies non transmissibles et traumatismes, Santé publique France, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France
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144
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Zellweger F, Eggel A. IgE-associated allergic disorders: recent advances in etiology, diagnosis, and treatment. Allergy 2016; 71:1652-1661. [PMID: 27709638 DOI: 10.1111/all.13059] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2016] [Indexed: 12/11/2022]
Abstract
IgE-associated allergic diseases belong to the most common inflammatory conditions. Their clinical manifestation ranges from mild symptoms to life-threatening episodes. Often patients experience a reduction in physical and psychologic well-being and suffer from a decreased quality of life due to disease activity. The continuously rising number of people that are affected by an allergic condition indicates an urgent need for better diagnostics and more efficient treatment options. Recent progress in the understanding of pathophysiologic mechanisms underlying IgE-associated allergic disorders has led to the identification of novel therapeutic targets and the development of drug candidates that are currently under evaluation. In this review, we highlight studies and clinical trials, which have helped to gain further insight in the etiology of IgE-associated allergic conditions as well as advances in the development of diagnostic tools and therapeutic approaches recently published in Allergy (European Journal of Allergy and Clinical Immunology).
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Affiliation(s)
- F. Zellweger
- Department of Rheumatology, Immunology and Allergology; University Hospital Bern; Bern Switzerland
- Department of Clinical Research; University of Bern; Bern Switzerland
| | - A. Eggel
- Department of Rheumatology, Immunology and Allergology; University Hospital Bern; Bern Switzerland
- Department of Clinical Research; University of Bern; Bern Switzerland
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145
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Wang Y, Chen P, Dai A, Shang S, Kong L. Intervention Studies of Inhaled Corticosteroids Combined with Long-acting Theophylline or Long-acting β 2-agonists in Patients with Moderate to Severe Asthma: A Randomized, Controlled Study. Clin Ther 2016; 38:2622-2627.e1. [PMID: 27913032 DOI: 10.1016/j.clinthera.2016.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/19/2016] [Accepted: 10/31/2016] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate and contrast the therapeutic effect and safety of fluticasone aerosol combined with theophylline tablets in patients with moderate to severe asthma, compared with salmeterol/fluticasone propionate aerosol. METHODS After a screening period, patients meeting the inclusion criteria were randomly assigned to the experiment group (fluticasone aerosol combined with theophylline tablets) or the control group (salmeterol/fluticasone aerosol combined with placebo tablets) for 12 weeks of treatment. The main outcome measurements were forced expiratory volume in 1 second and fractional concentration of exhaled nitric oxide value, whereas the secondary measures were forced vital capacity, peak expiratory flow value, and Asthma Control Test/Asthma Quality of Life Questionnaire score. FINDINGS Forty-four cases completed the course, with 23 cases in the experiment group and 21 cases in the control group. The forced expiratory volume in 1 second values of both groups were significantly improved from before (P < 0.05). The fractional concentration of exhaled nitric oxide values of both groups were significantly decreased from before (P < 0.05). The secondary outcome measurements after treatment achieved obvious improvement from baseline (P < 0.05) in both. There was no significant difference between the 2 groups in all measurements. In addition, the blood biochemistry results, ECG results, and vital signs of both groups had no significant abnormality. IMPLICATIONS There was no significant difference in therapeutic effect and safety between the 2 groups in treating patients with moderate to severe persistent asthma, which suggests that fluticasone aerosol combined with theophylline tablets is worth considering for use in primary hospitals or for low-income populations.
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Affiliation(s)
- Yan Wang
- The Institute Respiratory Disease, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ping Chen
- Respiratory Medicine, General Hospital of Shenyang Military Region, Shenyang, Liaoning, China
| | - Anna Dai
- The Institute Respiratory Disease, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shengyun Shang
- The Institute Respiratory Disease, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Lingfei Kong
- The Institute Respiratory Disease, The First Hospital of China Medical University, Shenyang, Liaoning, China.
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146
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Sanfu acupoint herbal patching for stable asthma: A systematic review and meta-analysis of randomised controlled trials. Complement Ther Med 2016; 30:40-53. [PMID: 28137526 DOI: 10.1016/j.ctim.2016.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 10/06/2016] [Accepted: 11/18/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Sanfu acupoint herbal patching (SAHP) is extensively used in people with stable asthma in China. However, the evidence available is scarce. This systematic review aims to evaluate the preventive and therapeutic effect and safety of SAHP in people with stable asthma. METHODS We searched seven electronic databases for randomised controlled trials (RCTs). The Cochrane risk of bias tool was utilised to evaluate the methodological quality of the included studies and RevMan 5.3 and GRADEpro 3.6.1 were applied to perform data analyses. RESULTS A total of 34 RCTs involving 3313 participants were included. The overall methodological quality of the trials was of high risk of bias. SAHP plus conventional therapy (CT) decreased the mean frequency (times per year) of asthma exacerbations compared with CT alone (MD: -1.42; 95% CI: -2.19 to -0.65; 7 RCTs), and similar effect was found for SAHP versus sham SAHP (MD: 0.42; 95%CI: 0.26-0.69; 1 RCT). For lung function (including PEF%, FEV1% and FEV1/FVC), SAHP plus CT showed better effect than CT alone, and so did SAHP versus sham SAHP on PEF and PEF%. Adverse effects in the SAHP groups were reported to be mild and well tolerated. CONCLUSIONS SAHP alone or combined with CT appears to be more effective than sham SAHP or CT on reduction of asthma exacerbations, improving lung function, and SAHP seems to be safe. However, the findings should be interpreted with caution due to limitations in trial quality. Further, rigorously designed, large-scale trials are warranted for robust evidence.
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147
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Smoke-free legislation and child health. NPJ Prim Care Respir Med 2016; 26:16067. [PMID: 27853176 PMCID: PMC5113157 DOI: 10.1038/npjpcrm.2016.67] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/25/2016] [Accepted: 08/02/2016] [Indexed: 11/08/2022] Open
Abstract
In this paper, we aim to present an overview of the scientific literature on the link between smoke-free legislation and early-life health outcomes. Exposure to second-hand smoke is responsible for an estimated 166 ,000 child deaths each year worldwide. To protect people from tobacco smoke, the World Health Organization recommends the implementation of comprehensive smoke-free legislation that prohibits smoking in all public indoor spaces, including workplaces, bars and restaurants. The implementation of such legislation has been found to reduce tobacco smoke exposure, encourage people to quit smoking and improve adult health outcomes. There is an increasing body of evidence that shows that children also experience health benefits after implementation of smoke-free legislation. In addition to protecting children from tobacco smoke in public, the link between smoke-free legislation and improved child health is likely to be mediated via a decline in smoking during pregnancy and reduced exposure in the home environment. Recent studies have found that the implementation of smoke-free legislation is associated with a substantial decrease in the number of perinatal deaths, preterm births and hospital attendance for respiratory tract infections and asthma in children, although such benefits are not found in each study. With over 80% of the world’s population currently unprotected by comprehensive smoke-free laws, protecting (unborn) children from the adverse impact of tobacco smoking and SHS exposure holds great potential to benefit public health and should therefore be a key priority for policymakers and health workers alike.
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148
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Carlier FM, Sibille Y, Pilette C. The epithelial barrier and immunoglobulin A system in allergy. Clin Exp Allergy 2016; 46:1372-1388. [PMID: 27684559 DOI: 10.1111/cea.12830] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Airway and intestinal epithelial layers represent first-line physical barriers, playing a key role in mucosal immunity. Barrier dysfunction, characterized by alterations such as disruption of cell-cell apical junctions and aberrant epithelial responses, probably constitutes early and key events for chronic immune responses to environmental antigens in the skin and in the gut. For instance, barrier dysfunction drives Th2 responses in atopic disorders or eosinophilic esophagitis. Such epithelial impairment is also a salient feature of allergic asthma and growing evidence indicates that barrier alterations probably play a driving role in this disease. IgA has been identified as the most abundant immunoglobulin in mucosa, where it acts as an active barrier through immune exclusion of inhaled or ingested antigens or pathogens. Historically, it has been thought to represent the serum factor underlying reaginic activity before IgE was discovered. Despite several studies about regulation and major functions of IgA at mucosal surfaces, its role in allergy remains largely unclear. This review aims at summarizing findings about epithelial functions and IgA biology that are relevant to allergy, and to integrate the emerging concepts and the recent developments in mucosal immunology, and how these could translate to clinical observations in allergy.
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Affiliation(s)
- F M Carlier
- Institut de Recherche Expérimentale et Clinique, Pôle Pneumologie, ORL et dermatologie, Brussels, Belgium. .,Department of Internal Medicine, Division of Pneumology, Cliniques Universitaires Saint-Luc, Brussels, Belgium. .,Department of Internal Medicine, Division of Pneumology, Centre Hospitalier Universitaire Dinant-Godinne UCL Namur, Yvoir, Belgium.
| | - Y Sibille
- Institut de Recherche Expérimentale et Clinique, Pôle Pneumologie, ORL et dermatologie, Brussels, Belgium.,Department of Internal Medicine, Division of Pneumology, Centre Hospitalier Universitaire Dinant-Godinne UCL Namur, Yvoir, Belgium
| | - C Pilette
- Institut de Recherche Expérimentale et Clinique, Pôle Pneumologie, ORL et dermatologie, Brussels, Belgium.,Department of Internal Medicine, Division of Pneumology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.,Walloon Excellence in Lifesciences and Biotechnology, Wavre, Belgium
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149
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Tegethoff M, Stalujanis E, Belardi A, Meinlschmidt G. Chronology of Onset of Mental Disorders and Physical Diseases in Mental-Physical Comorbidity - A National Representative Survey of Adolescents. PLoS One 2016; 11:e0165196. [PMID: 27768751 PMCID: PMC5074457 DOI: 10.1371/journal.pone.0165196] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 10/08/2016] [Indexed: 01/10/2023] Open
Abstract
Background The objective was to estimate temporal associations between mental disorders and physical diseases in adolescents with mental-physical comorbidities. Methods This article bases upon weighted data (N = 6483) from the National Comorbidity Survey Adolescent Supplement (participant age: 13–18 years), a nationally representative United States cohort. Onset of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition lifetime mental disorders was assessed with the fully structured World Health Organization Composite International Diagnostic Interview, complemented by parent report. Onset of lifetime medical conditions and doctor-diagnosed diseases was assessed by self-report. Results The most substantial temporal associations with onset of mental disorders preceding onset of physical diseases included those between affective disorders and arthritis (hazard ratio (HR) = 3.36, 95%-confidence interval (CI) = 1.95 to 5.77) and diseases of the digestive system (HR = 3.39, CI = 2.30 to 5.00), between anxiety disorders and skin diseases (HR = 1.53, CI = 1.21 to 1.94), and between substance use disorders and seasonal allergies (HR = 0.33, CI = 0.17 to 0.63). The most substantial temporal associations with physical diseases preceding mental disorders included those between heart diseases and anxiety disorders (HR = 1.89, CI = 1.41 to 2.52), epilepsy and eating disorders (HR = 6.27, CI = 1.58 to 24.96), and heart diseases and any mental disorder (HR = 1.39, CI = 1.11 to 1.74). Conclusions Findings suggest that mental disorders are antecedent risk factors of certain physical diseases in early life, but also vice versa. Our results expand the relevance of mental disorders beyond mental to physical health care, and vice versa, supporting the concept of a more integrated mental-physical health care approach, and open new starting points for early disease prevention and better treatments, with relevance for various medical disciplines.
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Affiliation(s)
- Marion Tegethoff
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
- * E-mail:
| | - Esther Stalujanis
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Angelo Belardi
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Gunther Meinlschmidt
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
- Faculty of Medicine, Ruhr-University Bochum, Bochum, Germany
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150
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Del Giacco SR, Cappai A, Gambula L, Cabras S, Perra S, Manconi PE, Carpiniello B, Pinna F. The asthma-anxiety connection. Respir Med 2016; 120:44-53. [PMID: 27817815 DOI: 10.1016/j.rmed.2016.09.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 09/16/2016] [Accepted: 09/20/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND The literature reports a significant association between various mental disorders and asthma, in particular depression and/or anxiety, with some more robust data regarding anxiety disorders. However, the nature of this association remains largely unclear. OBJECTIVES (1) To test the hypothesis of a specific association of anxiety and depressive disorder (according to the DSM-IV) with asthma and (2) to test the bidirectional hypothesis of causality between asthma and psychiatric disorders. METHODS Ninety-six adults were compared with 96 control subjects matched according to main socio-demographic variables (i.e., gender, age, marital status, cohabiting/non-cohabiting, and BMI). Subjects with asthma were divided according to GINA and ACT classifications. All subjects underwent Structured Clinical Interviews for DSM-IV Axis I (SCID-I) diagnosis. RESULTS Significant association between asthma and lifetime anxiety disorders emerged (OR 3.03; p = 0.003); no significant association with other psychiatric diagnosis emerged. Moreover, lifetime and current anxiety were associated with asthma severity levels (p < 0.01 and p = 0.001 based on age). Asthma preceded anxiety in 48% of cases; in 52% of cases, anxiety preceded asthma, without significant group differences. The risk of asthma, particularly of severe, uncontrolled forms (p < 0.01), resulted higher in lifetime anxiety disorder patients (p = 0.003 and p = 0.001 based on age at onset). Current anxiety increased the risk of asthma, and that of an uncontrolled form (p < 0.05). Asthma increased the risk of lifetime anxiety disorders (p = 0.002 and p = 0.018 using ages). Intermittent asthma increased the risk of lifetime and current anxiety disorders (p < 0.01). CONCLUSIONS Anxiety disorders, in particular Lifetime Anxiety Disorders, represent the only psychiatric disorder significantly associated with asthma, with a possible bidirectional, anxiety-asthma relationship, each of which can be caused or result from the other.
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Affiliation(s)
- Stefano R Del Giacco
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy.
| | - Alessandra Cappai
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Luisanna Gambula
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy
| | - Stefano Cabras
- Department of Mathematics and Informatics, University of Cagliari, Cagliari, Italy; Department of Statistics, Carlos III University of Madrid, Madrid, Spain
| | - Silvia Perra
- Department of Mathematics and Informatics, University of Cagliari, Cagliari, Italy
| | - Paolo Emilio Manconi
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Department of Public Health, Psychiatry Unit, University of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Department of Public Health, Psychiatry Unit, University of Cagliari, Cagliari, Italy
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