1
|
Sarikloglou E, Fouzas S, Paraskakis E. Prediction of Asthma Exacerbations in Children. J Pers Med 2023; 14:20. [PMID: 38248721 PMCID: PMC10820562 DOI: 10.3390/jpm14010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Asthma exacerbations are common in asthmatic children, even among those with good disease control. Asthma attacks result in the children and their parents missing school and work days; limit the patient's social and physical activities; and lead to emergency department visits, hospital admissions, or even fatal events. Thus, the prompt identification of asthmatic children at risk for exacerbation is crucial, as it may allow for proactive measures that could prevent these episodes. Children prone to asthma exacerbation are a heterogeneous group; various demographic factors such as younger age, ethnic group, low family income, clinical parameters (history of an exacerbation in the past 12 months, poor asthma control, poor adherence to treatment, comorbidities), Th2 inflammation, and environmental exposures (pollutants, stress, viral and bacterial pathogens) determine the risk of a future exacerbation and should be carefully considered. This paper aims to review the existing evidence regarding the predictors of asthma exacerbations in children and offer practical monitoring guidance for promptly recognizing patients at risk.
Collapse
Affiliation(s)
| | - Sotirios Fouzas
- Department of Pediatrics, University of Patras Medical School, 26504 Patras, Greece;
| | - Emmanouil Paraskakis
- Paediatric Respiratory Unit, Paediatric Department, University of Crete, 71500 Heraklion, Greece
| |
Collapse
|
2
|
Hoang JA, Celik A, Lupinek C, Valenta R, Duan L, Dai R, Brydges MG, Dubeau A, Lépine C, Wong S, Alexanian‐Farr M, Magder A, Subbarao P, Upton JEM, Schmidthaler K, Szépfalusi Z, Ramani A, Eiwegger T. Modeling the conversion between specific IgE test platforms for nut allergens in children and adolescents. Allergy 2021; 76:831-841. [PMID: 32738829 DOI: 10.1111/all.14529] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/03/2020] [Accepted: 07/14/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Multiplex tests allow for measurement of allergen-specific IgE responses to multiple extracts and molecular allergens and have several advantages for large cohort studies. Due to significant methodological differences, test systems are difficult to integrate in meta-analyses/systematic reviews since there is a lack of datasets with direct comparison. We aimed to create models for statistical integration of allergen-specific IgE to peanut/tree nut allergens from three IgE test platforms. METHODS Plasma from Canadian and Austrian children/adolescents with peanut/tree nut sensitization and a cohort of sensitized, high-risk, pre-school asthmatics (total n = 166) were measured with three R&D multiplex IgE test platforms: Allergy Explorer version 1 (ALEX) (Macro Array Dx), MeDALL-chip (Mechanisms of Development of Allergy) (Thermo Fisher), and EUROLINE (EUROIMMUN). Skin prick test (n = 51) and ImmunoCAP (Thermo Fisher) (n = 62) results for extracts were available in a subset. Regression models (Multivariate Adaptive Regression Splines, local polynomial regression) were applied if >30% of samples were positive to the allergen. Intra-test correlations between PR-10 and nsLTP allergens were assessed. RESULTS Using two regression methods, we demonstrated the ability to model allergen-specific relationships with acceptable measures of fit (r2 = 94%-56%) for peanut and tree nut sIgE testing at the extract and molecular-level, in order from highest to lowest: Ara h 2, Ara h 6, Jug r 1, Ana o 3, Ara h 1, Jug r 2, and Cor a 9. CONCLUSION Our models support the notion that quantitative conversion is possible between sIgE multiplex platforms for extracts and molecular allergens and may provide options to aggregate data for future meta-analysis.
Collapse
Affiliation(s)
- Jennifer A. Hoang
- Translational Medicine Program Research Institute, Hospital for Sick Children Toronto ON Canada
| | - Alper Celik
- Centre for Computational Medicine Hospital for Sick Children Toronto ON Canada
| | - Christian Lupinek
- Division of Immunopathology Department of Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Rudolf Valenta
- Division of Immunopathology Department of Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- NRC Institute of Immunology FMBA of Russia Moscow Russia
- Laboratory for Immunopathology Department of Clinical Immunology and Allergy Sechenov First Moscow State Medical University Moscow Russia
- Karl Landsteiner University of Health Sciences Krems Austria
| | - Lucy Duan
- Division of Immunology and Allergy Food Allergy and Anaphylaxis Program Department of Pediatrics The Hospital for Sick Children Toronto ON Canada
| | - Ruixue Dai
- Translational Medicine Program Research Institute, Hospital for Sick Children Toronto ON Canada
| | - May G. Brydges
- Translational Medicine Program Research Institute, Hospital for Sick Children Toronto ON Canada
| | - Aimée Dubeau
- Translational Medicine Program Research Institute, Hospital for Sick Children Toronto ON Canada
| | - Claire Lépine
- Translational Medicine Program Research Institute, Hospital for Sick Children Toronto ON Canada
| | - Samantha Wong
- Division of Immunology and Allergy Food Allergy and Anaphylaxis Program Department of Pediatrics The Hospital for Sick Children Toronto ON Canada
| | - Mara Alexanian‐Farr
- Division of Immunology and Allergy Food Allergy and Anaphylaxis Program Department of Pediatrics The Hospital for Sick Children Toronto ON Canada
| | - Ahuva Magder
- Division of Immunology and Allergy Food Allergy and Anaphylaxis Program Department of Pediatrics The Hospital for Sick Children Toronto ON Canada
| | - Padmaja Subbarao
- Translational Medicine Program Research Institute, Hospital for Sick Children Toronto ON Canada
- Division of Respiratory Medicine and Translational Medicine Departments of Pediatrics and Physiology Hospital for Sick Children and University of Toronto Toronto ON Canada
| | - Julia E. M. Upton
- Division of Immunology and Allergy Food Allergy and Anaphylaxis Program Department of Pediatrics The Hospital for Sick Children Toronto ON Canada
| | - Klara Schmidthaler
- Division of Pediatric Pulmonology, Allergology and Endocrinology Department of Pediatric and Adolescent Medicine Medical University of Vienna Vienna Austria
| | - Zsolt Szépfalusi
- Division of Pediatric Pulmonology, Allergology and Endocrinology Department of Pediatric and Adolescent Medicine Medical University of Vienna Vienna Austria
| | - Arun Ramani
- Centre for Computational Medicine Hospital for Sick Children Toronto ON Canada
| | - Thomas Eiwegger
- Translational Medicine Program Research Institute, Hospital for Sick Children Toronto ON Canada
- Division of Immunology and Allergy Food Allergy and Anaphylaxis Program Department of Pediatrics The Hospital for Sick Children Toronto ON Canada
- Departments of Pediatrics and Immunology University of Toronto Toronto ON Canada
| |
Collapse
|
3
|
Liu L, Zhang J, Zhang L, Yuan SH, Wu JH, Tang MY, Chen JD, Zhang F, Qi XY, Yin Y. The Relationship of the Test for Respiratory and Asthma Control in Kids Initial Score on the Prognosis of Pre-school Children With Asthma: A Prospective Cohort Study. Front Pediatr 2021; 9:690333. [PMID: 34277524 PMCID: PMC8277926 DOI: 10.3389/fped.2021.690333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/03/2021] [Indexed: 11/21/2022] Open
Abstract
Objective: The test for respiratory and asthma control in kids (TRACK) is currently the only standard follow-up tool for children under 5 years of age with asthma. The purpose of this study was to investigate the relationship between the TRACK initial score (Ti) and their prognosis after 6 months of follow-up in pre-schoolers with asthma. Design: A prospective cohort study. Methods: The study included pre-schoolers diagnosed with asthma at the Shanghai Children's Medical Center between January 2019 and June 2020, and follow-up for 6 months. TRACK scores, frequency of wheezing and respiratory infections, number of Emergency Department (ED) visits and treatment regimen were collected. According to the TRACK initial score, the children were divided into "Ti < 60 group" and "Ti ≥ 60 group," and the two groups were compared in terms of TRACK score related indicators, clinical manifestations and treatment. Results: There are 102 pre-schoolers included in the analysis [78 boys (76.5%) and 24 girls (23.5%); mean (SD) age, 28.05 (11.63) months]. After 6 months of follow-up, the TRACK score was improved in both groups, and the "Ti ≥ 60 group" had a higher score, lower rate of uncontrolled asthma and fewer reassessments were required. There was no difference in the number of wheezing attacks between the two groups in terms of clinical presentation, but the "Ti < 60 group" had more respiratory infections and ED visits. Regarding the use of ICSs, in the "Ti < 60 groups," the dose of ICSs was higher and reduced slowly, and the dose difference between the two groups began to appear after 5 months of follow-up. Conclusion: TRACK is essential for pre-schoolers with asthma at the time they are diagnosed. In addition, if the TRACK initial score is < 60, the probability of poor prognosis is higher.
Collapse
Affiliation(s)
- Lu Liu
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shu-Hua Yuan
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jin-Hong Wu
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ming-Yu Tang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jian-De Chen
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Fen Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xin-Yi Qi
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|