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Bonnin FA, Talarico LB, Ferolla FM, Acosta PL, Phung E, Kumar A, Toledano A, Caratozzolo A, Neira P, Mascardi N, Satragno D, Contrini MM, Graham BS, Ruckwardt TJ, López EL. Antibody levels against respiratory syncytial virus fusion protein conformations and lack of association with life-threatening infection in previously healthy infants. Vaccine 2024; 42:126119. [PMID: 39003106 PMCID: PMC11401757 DOI: 10.1016/j.vaccine.2024.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/13/2024] [Accepted: 07/04/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Humoral immune response against the pre-fusion (pre-F) conformation of respiratory syncytial virus (RSV) F protein has been proposed to play a protective role against infection. An RSV pre-F maternal vaccine has been recently approved in several countries to protect young infants against RSV. We aimed to assess serum IgG titers against the pre-F and post-F conformations of RSV F protein and their association with life-threatening RSV disease (LTD) in previously healthy infants. METHODS A prospective cohort study including hospitalized infants <12 months with a first RSV infection was conducted during 2017-2019. Patients with LTD required intensive care and mechanical respiratory assistance. RSV pre-F exclusive and post-F antibody responses were determined by post-F competition and non-competition immunoassays, respectively, and neutralizing activity was measured by plaque reduction neutralization test. RESULTS Fifty-eight patients were included; the median age was 3.5 months and 41 % were females. Fifteen patients developed LTD. RSV F-specific antibody titers positively correlated with neutralizing antibody titers in acute and convalescent phases but, importantly, they did not associate with LTD. Acute RSV pre-F exclusive and post-F IgG titers negatively correlated with patient age (P = 0.0007 and P < 0.0001), while a positive correlation was observed between the fold changes in RSV F-specific antibody titers between convalescent and acute phase and patient age (P = 0.0014 and P < 0.0001). Infants ≤2 months exhibited significantly lower fold-changes in RSV F-specific and neutralizing antibody titers between convalescence and acute phase than older infants. Additionally, acute RSV antibody titers showed no correlation with nasal RSV load and, furthermore, nasal viral load was not associated with the development of LTD. CONCLUSIONS This study highlights that protection against life-threatening RSV disease is not necessarily antibody-dependent. Further characterization of the immune response against RSV and its role in protection against severe disease is important for the development of the safest possible preventive strategies.
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Affiliation(s)
- Florencia A Bonnin
- Laboratory of Infectious Diseases and Molecular Biology, Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina; Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Química Biológica, Buenos Aires 1428, Argentina
| | - Laura B Talarico
- Laboratory of Infectious Diseases and Molecular Biology, Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires 1425, Argentina.
| | - Fausto M Ferolla
- Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires 1425, Argentina
| | - Patricio L Acosta
- Laboratory of Infectious Diseases and Molecular Biology, Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires 1425, Argentina
| | - Emily Phung
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Azad Kumar
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Analía Toledano
- Laboratory of Infectious Diseases and Molecular Biology, Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina
| | - Ana Caratozzolo
- Laboratory of Infectious Diseases and Molecular Biology, Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina
| | - Pablo Neira
- Intensive Care Unit, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina
| | - Normando Mascardi
- Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina
| | - Daniela Satragno
- Department of Medicine, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires 1425, Argentina
| | - María M Contrini
- Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires 1425, Argentina
| | - Barney S Graham
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Tracy J Ruckwardt
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Eduardo L López
- Department of Medicine, Pediatric Infectious Diseases Program, Hospital de Niños Dr. Ricardo Gutiérrez, Universidad de Buenos Aires, Buenos Aires 1425, Argentina.
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Seth D, Kamat D. All That Wheezes Is Not Asthma. Pediatr Ann 2024; 53:e189-e194. [PMID: 38700922 DOI: 10.3928/19382359-20240306-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Wheezing is a high pitched, whistling sound generated when air flows through narrowed airways and is often equated with asthma. However, wheezing may be a presenting symptom of various other conditions including structural lesions of the airways, foreign body aspiration, pulmonary infections as well as cardiac causes. Underlying etiology of wheezing may also vary with age. Detailed history, physical examination, and laboratory investigations are often required to identify the underlying etiology of wheezing. Additional studies may sometimes be needed to accurately identify the underlying etiology such as pulmonary function test or spirometry, chest radiography (chest X-ray), and bronchoscopy. This review article discusses the common causes of wheezing encountered in clinical practice. [Pediatr Ann. 2024;53(5):e189-e194.].
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Fu J, Liu Y, Zhao Y, Chen Y, Chang Z, Xu KF, Fan Z. Increased Risk of Hospital Admission for Asthma from Short-Term Exposure to Low Air Pressure. J Asthma Allergy 2022; 15:1035-1043. [PMID: 35967095 PMCID: PMC9365019 DOI: 10.2147/jaa.s367308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/10/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jia Fu
- Department of Cardiology; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Yanbo Liu
- Department of International Medical Services; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Yakun Zhao
- Department of Cardiology; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Yuxiong Chen
- Department of Cardiology; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Zhenge Chang
- Department of Cardiology; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Kai-Feng Xu
- Department of Respiratory Medicine; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Zhongjie Fan
- Department of Cardiology; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
- Correspondence: Zhongjie Fan, Department of Cardiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, No. 1, Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People’s Republic of China, Tel/Fax +86 010 6915 6114, Email
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Arsène S, Couty C, Faddeenkov I, Go N, Granjeon-Noriot S, Šmít D, Kahoul R, Illigens B, Boissel JP, Chevalier A, Lehr L, Pasquali C, Kulesza A. Modeling the disruption of respiratory disease clinical trials by non-pharmaceutical COVID-19 interventions. Nat Commun 2022; 13:1980. [PMID: 35418135 PMCID: PMC9008035 DOI: 10.1038/s41467-022-29534-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/21/2022] [Indexed: 02/07/2023] Open
Abstract
Respiratory disease trials are profoundly affected by non-pharmaceutical interventions (NPIs) against COVID-19 because they perturb existing regular patterns of all seasonal viral epidemics. To address trial design with such uncertainty, we developed an epidemiological model of respiratory tract infection (RTI) coupled to a mechanistic description of viral RTI episodes. We explored the impact of reduced viral transmission (mimicking NPIs) using a virtual population and in silico trials for the bacterial lysate OM-85 as prophylaxis for RTI. Ratio-based efficacy metrics are only impacted under strict lockdown whereas absolute benefit already is with intermediate NPIs (eg. mask-wearing). Consequently, despite NPI, trials may meet their relative efficacy endpoints (provided recruitment hurdles can be overcome) but are difficult to assess with respect to clinical relevance. These results advocate to report a variety of metrics for benefit assessment, to use adaptive trial design and adapted statistical analyses. They also question eligibility criteria misaligned with the actual disease burden.
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Affiliation(s)
| | | | | | | | | | | | | | - Ben Illigens
- Novadiscovery SA, Lyon, France
- Dresden International University, Dresden, Germany
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Alsulaiman JW, Kheirallah KA, Ajlony MJ, Al-Tamimi TM, Khasawneh RA, Al-Natour L. Paediatric asthma exacerbation admissions and stringency of non-pharmaceutical interventions: Results from a developing country. Int J Clin Pract 2021; 75:e14423. [PMID: 34076942 DOI: 10.1111/ijcp.14423] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPI) mitigation measures implemented to mitigate COVID-19 has brought unprecedented global impact. Changes in daily living routines, reduction in physical activities, and changes in environmental indicators were suggested to positively impact paediatric asthma indicators in western cultures. Little is known about such impact in developing countries. This study investigated the potential impact of COVID-19 NPI measures on paediatric asthma exacerbation admissions in Northern Jordan. METHODS Aggregate data from a paediatric hospital, Princess Rahma Pediatric Teaching Hospital, and King Abdulla University Teaching Hospital were utilised from 2018 to 2020. The number of paediatric asthma exacerbation admissions was calculated by week and compared by year, lockdown status, and weeks for lockdown (weeks 13-19). The stringency index was correlated with the number of weekly paediatric asthma exacerbation admissions for 2020. RESULTS A total of 1,207 paediatric asthma exacerbation admissions were reported; 40.3%, 35.2%, and 24.5% in 2018, 2019 and 2020, respectively. The number of weekly admissions ranged from 1 to 13 paediatric asthma cases (mean (SD) = 7.6 (2.7)). In 2018 and 2019, respectively, mean weekly admissions were 9.2 (1.9) and 8.0 (2.0) paediatric asthma cases, while in 2020 the mean was 5.6 (2.7) cases. Significant differences in mean weekly paediatric asthma exacerbation admissions were detected by year, with mean weekly admissions for 2020 being significantly lower than that for 2018 and 2019. During the lockdown (22 March to 1 May 2020), mean weekly admissions (2.6 (1.4)) was significantly lower than that before the lockdown (8.6 (2.0)) and after the lockdown (5.2 (2.0)). For the lockdown weeks only, the mean admissions for the year 2020 was significantly lower than that for years 2019 and 2018. The stringency index negatively correlated with the number of weekly admissions. CONCLUSION NPI measures in Jordan seem to have positively impacted paediatric asthma exacerbation admissions. Further studies are needed to draw public health policies and fine-tune environmental and community policies.
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Affiliation(s)
- Jomana W Alsulaiman
- Department of Pediatrics, Medical School of Yarmouk University, Irbid, Jordan
| | - Khalid A Kheirallah
- Department of Public Health, Medical School of Jordan University of Science and Technology, Irbid, Jordan
| | | | - Taha M Al-Tamimi
- Department of Pediatrics, Princess Rahma Teaching Hospital, Irbid, Jordan
| | - Rawand A Khasawneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Lara Al-Natour
- Department of Public Health, Medical School of Jordan University of Science and Technology, Irbid, Jordan
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Rodavsky G, Sheiner E, Walfisch A, Gutvirtz G, Hermon N, Landau D, Wainstock T. Meconium stained amniotic fluid exposure and long-term respiratory morbidity in the offspring. Pediatr Pulmonol 2021; 56:2328-2334. [PMID: 33730429 DOI: 10.1002/ppul.25357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/07/2021] [Accepted: 02/16/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Meconium stained amniotic fluid (MSAF) is a well-established risk factor for neonatal short-term respiratory complications. Little is known regarding the long-term morbidity. We investigated the possible association between MSAF and offspring respiratory morbidity. METHODS A population-based, cohort study of singleton deliveries occurring between 1991 and 2014 at a sole regional tertiary medical center was performed. Incidence of offspring respiratory related hospitalizations up to the age of 18 years were evaluated and compared to unexposed offspring. A Kaplan-Meier survival curve was used to compare cumulative respiratory morbidity incidence, and a Cox proportional hazards model was used to control for confounders. RESULTS During the study period 242,342 deliveries met the inclusion criteria. Of them, 14.7% (n = 35,609) were complicated with MSAF. Incidence of respiratory-related hospitalizations was significantly lower in children exposed to MSAF as compared to the unexposed group (4.5% vs. 4.9%, respectively; p < .01). Specifically, hospitalizations involving pneumonitis were significantly less common among the MSAF group (odds ratio, 0.35; 95% confidence interval [95% CI], 0.13-0.96; p = .03). The Kaplan-Meier survival curve demonstrated significantly lower total cumulative respiratory morbidity rates in the MSAF exposed group (log rank p < .01). In the Cox model, controlled for clinically relevant confounders, MSAF exhibited an independent and significant protective effect on long-term childhood respiratory morbidity (aHR, 0.91; 95% CI, 0.86-0.96; p < .01). CONCLUSIONS Fetal exposure to MSAF during labor appears to be associated with lower rates of long-term respiratory related hospitalizations in the offspring. Changes in offspring microbiome, as well as functional and anatomical modulations possibly resulting from MSAF exposure, might offer a plausible explanation of our findings.
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Affiliation(s)
- Gal Rodavsky
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Asnat Walfisch
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gil Gutvirtz
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Narkis Hermon
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Daniella Landau
- Department of Neonatology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tamar Wainstock
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Adams SN, Adgent MA, Gebretsadik T, Hartman TJ, Vereen S, Ortiz C, Tylavsky FA, Carroll KN. Prenatal vitamin D levels and child wheeze and asthma. J Matern Fetal Neonatal Med 2021; 34:323-331. [PMID: 30983439 PMCID: PMC6824925 DOI: 10.1080/14767058.2019.1607286] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/25/2019] [Accepted: 04/10/2019] [Indexed: 01/22/2023]
Abstract
Background: Maternal vitamin D status during pregnancy may influence lung development and risk of childhood wheeze and asthma. We investigated the relationship between prenatal vitamin D and child asthma in a racially diverse cohort with a high burden of vitamin D insufficiency and child asthma.Materials and methods: We included mother-child dyads in the prenatal Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort (2006-2011, Shelby County, Tennessee). Maternal plasma vitamin D [25(OH)D] was measured from second trimester (n = 1091) and delivery specimens (n = 907). At age 4-6 years, we obtained parent report of current child wheeze (symptoms within the past 12 months) and asthma (physician diagnosis and/or medication or symptoms within the past 12 months). We used multivariable logistic regression to assess associations of 25(OH)D and child wheeze/asthma, including an interaction term for maternal race.Results: Median second trimester 25(OH)D levels were 25.1 and 19.1 ng/ml in White (n = 366) and Black women (N = 725), respectively. We detected significant interactions by maternal race for second-trimester plasma 25(OH)D and child current wheeze (p = .014) and asthma (p = .011). Odds of current wheeze and asthma decreased with increasing 25(OH)D in dyads with White mothers and increased in dyads with Black mothers, e.g. adjusted odds ratio (95% confidence interval) for asthma: 0.63 (0.36-1.09) and 1.41 (1.01-1.97) per interquartile range (15-27 ng/ml 25[OH]D) increase, respectively. At delivery, protective associations in White dyads were attenuated.Conclusion: We detected effect modification by maternal race in associations between prenatal 25(OH)D and child wheeze/asthma. Further research in racially diverse populations is needed.
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Affiliation(s)
- Sarah N. Adams
- Division of Allergy and Immunology, Department of Medicine, Vanderbilt University Medical Center
| | - Margaret A. Adgent
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center
| | | | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Shanda Vereen
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center
| | - Christina Ortiz
- Division of Allergy and Immunology, Department of Medicine, Vanderbilt University Medical Center
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center
| | - Kecia N. Carroll
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center
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Hashemi SA, Safamanesh S, Ghasemzadeh-Moghaddam H, Ghafouri M, Mohajerzadeh-Heydari MS, Namdar-Ahmadabad H, Azimian A. Report of death in children with SARS-CoV-2 and human metapneumovirus (hMPV) coinfection: Is hMPV the trigger? J Med Virol 2020; 93:579-581. [PMID: 32767680 PMCID: PMC7436913 DOI: 10.1002/jmv.26401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/27/2020] [Accepted: 08/05/2020] [Indexed: 01/19/2023]
Affiliation(s)
| | - Saghar Safamanesh
- Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hamed Ghasemzadeh-Moghaddam
- Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Majid Ghafouri
- Department of Infectious Diseases, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | | | - Hasan Namdar-Ahmadabad
- Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Amir Azimian
- Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
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The Response of Tissue Mast Cells to TLR3 Ligand Poly(I:C) Treatment. J Immunol Res 2020; 2020:2140694. [PMID: 32185237 PMCID: PMC7060451 DOI: 10.1155/2020/2140694] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/23/2020] [Accepted: 02/01/2020] [Indexed: 12/18/2022] Open
Abstract
Mast cells (MCs) are found mainly at the anatomical sites exposed to the external environment; thus, they are localized close to blood vessels, lymphatic vessels, and a multitude of immune cells. Moreover, those cells can recognize invading pathogens through a range of surface molecules known as pathogen recognition receptors (PRRs), mainly Toll-like receptors (TLRs). MCs are extensively engaged in the control and clearance of bacterial infections, but much less is known about their contribution to antiviral host response as well as pathomechanisms of virus-induced diseases. In the study, we employed in vivo differentiated mature tissue mast cells freshly isolated from rat peritoneal cavity. Here, we demonstrated that rat peritoneal mast cells (rPMCs) express viral dsRNA-specific TLR3 molecule (intracellularly and on the cell surface) as well as other proteins associated with cellular antiviral response: IRF3, type I and II IFN receptors, and MHC I. We found that exposure of rPMCs to viral dsRNA mimic, i.e., poly(I:C), induced transient upregulation of surface TLR3 (while temporarily decreased TLR3 intracellular expression), type II IFN receptor, and MHC I. TLR3 ligand-stimulated rPMCs did not degranulate but generated and/or released type I IFNs (IFN-α and IFNβ) as well as proinflammatory lipid mediators (cysLTs), cytokines (TNF, IL-1β), and chemokines (CCL3, CXCL8). We documented that rPMC priming with poly(I:C) did not affect FcεRI-dependent degranulation. However, their costimulation with TLR3 agonist and anti-IgE led to a significant increase in cysLT and TNF secretion. Our findings confirm that MCs may serve as active participants in the antiviral immune response. Presented data on modulated FcεRI-mediated MC secretion of mediators upon poly(I:C) treatment suggests that dsRNA-type virus infection could influence the severity of allergic reactions.
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Underner M, Perriot J, Peiffer G, Jaafari N. [Asthma and cocaine use]. Rev Mal Respir 2019; 36:610-624. [PMID: 31201016 DOI: 10.1016/j.rmr.2018.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 08/19/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Cocaine use can be responsible for many respiratory complications including asthma. OBJECTIVES Systematic literature review of data on asthma in cocaine users. DOCUMENTARY SOURCES PubMed/Medline search, on the period 1980-2017 with the following keywords: "asthma*" or "bronchospasm" and "cocaine" or "freebase*" or "crack", limits "title/abstract"; the selected languages were English or French. Among 108 articles, 43 abstracts underwent dual reading to select 22 studies. RESULTS In four case reports of asthma associated with cocaine use including 11 patients (mean age: 28.3 years [22-33 years]; sex-ratio: 2.5 [males: 71.5%]), cocaine was sniffed [snorted] (9%), smoked (36.5%) or both sniffed and smoked (54.5%). A medical history of childhood asthma was observed in 45.4% of the cases. Acute respiratory failure, requiring intubation and mechanical ventilation, was observed in 45.4% of the cases. Outcome was rapidly favorable in 82%; 9/11, progressively favorable in one patient, and fatal in another patient. Other studies included 6 cross-sectional studies, 4 case-control studies and 8 longitudinal studies (7 retrospective studies and one prospective study). The mean age was 36.6 years (women: 44.7%). Twenty percent of the subjects used cocaine exclusively, and 80% used cocaine combined with other addictive drugs (cocaine and heroin: 62%). The prevalence of cocaine users was higher in asthmatic subjects and the prevalence of asthma was higher in cocaine users. Cocaine use can be responsible for asthma onset and acute asthma exacerbation. In the case of asthma exacerbation, cocaine users were more likely to be admitted in intensive care units and to require intubation and invasive ventilation. Asthma exacerbations may be fatal in spite of resuscitation measures. Asthma treatment observance was lower in cocaine users. CONCLUSION Cocaine use may be responsible for asthma onset, acute asthma exacerbations (which may require intubation and invasive ventilation) or death related to asthma. Cocaine use must be systematically considered in the case of asthma exacerbation and practitioners must help cocaine users to stop their consumption.
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Affiliation(s)
- M Underner
- Service de pneumologie, unité de tabacologie, centre hospitalier Henri Laborit, CHU La Milétrie, rue de la Milétrie, Pavillon René Beauchant, BP 577, avenue Jacques Cœur, 86021 Poitiers, France; Addictologie, dispensaire Emile Roux, 63100 Clermont-Ferrand, France; Pneumologie, centre hospitalier de Metz, Metz, France; Unité de recherche clinique, centre hospitalier Henri Laborit, 86021 Poitiers, France.
| | - J Perriot
- Service de pneumologie, unité de tabacologie, centre hospitalier Henri Laborit, CHU La Milétrie, rue de la Milétrie, Pavillon René Beauchant, BP 577, avenue Jacques Cœur, 86021 Poitiers, France; Addictologie, dispensaire Emile Roux, 63100 Clermont-Ferrand, France; Pneumologie, centre hospitalier de Metz, Metz, France; Unité de recherche clinique, centre hospitalier Henri Laborit, 86021 Poitiers, France
| | - G Peiffer
- Service de pneumologie, unité de tabacologie, centre hospitalier Henri Laborit, CHU La Milétrie, rue de la Milétrie, Pavillon René Beauchant, BP 577, avenue Jacques Cœur, 86021 Poitiers, France; Addictologie, dispensaire Emile Roux, 63100 Clermont-Ferrand, France; Pneumologie, centre hospitalier de Metz, Metz, France; Unité de recherche clinique, centre hospitalier Henri Laborit, 86021 Poitiers, France
| | - N Jaafari
- Service de pneumologie, unité de tabacologie, centre hospitalier Henri Laborit, CHU La Milétrie, rue de la Milétrie, Pavillon René Beauchant, BP 577, avenue Jacques Cœur, 86021 Poitiers, France; Addictologie, dispensaire Emile Roux, 63100 Clermont-Ferrand, France; Pneumologie, centre hospitalier de Metz, Metz, France; Unité de recherche clinique, centre hospitalier Henri Laborit, 86021 Poitiers, France
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Resiliac J, Grayson MH. Epidemiology of Infections and Development of Asthma. Immunol Allergy Clin North Am 2019; 39:297-307. [PMID: 31284921 DOI: 10.1016/j.iac.2019.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Asthma and allergic diseases have become more prevalent, although the reasons for this increase in disease burden are not known. Understanding why these diseases have become more common requires knowledge of the disease pathogenesis. Multiple studies have identified respiratory viral infections and atypical bacteria as potential etiologic agents underlying the development of asthma (and possibly allergies). This review discusses the epidemiology and potential mechanistic studies that provide links between these infectious agents and the development (and exacerbation) of asthma. These studies provide insight into the increase in disease prevalence and have identified potential targets for future therapeutic intervention.
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Affiliation(s)
- Jenny Resiliac
- Center for Translational and Clinical Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Biomedical Sciences Graduate Program, The Ohio State University College of Medicine, Columbus, OH, USA; Division of Allergy and Immunology, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Mitchell H Grayson
- Center for Translational and Clinical Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Biomedical Sciences Graduate Program, The Ohio State University College of Medicine, Columbus, OH, USA; Division of Allergy and Immunology, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
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Caylan E, Weinblatt E, Welter J, Dozor A, Wang G, Nolan SM. Comparison of the Severity of Respiratory Disease in Children Testing Positive for Enterovirus D68 and Human Rhinovirus. J Pediatr 2018; 197:147-153.e1. [PMID: 29655864 DOI: 10.1016/j.jpeds.2018.02.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 02/05/2018] [Accepted: 02/12/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To compare the characteristics and severity of respiratory disease in children testing positive for enterovirus D68 (EV-D68) and for human rhinovirus (RhV). STUDY DESIGN A retrospective single center study of children presenting with acute respiratory symptoms and positive polymerase chain reaction for RhV/EV from September 1, 2014 through October 31, 2014 was performed. Specimens were subsequently tested specifically for EV-D68 and specimens identified as RhV were subtyped when possible into RhV-A, RhV-B, and RhV-C species. Clinical manifestations in patients with EV-D68 were compared with those with non-EV-D68, RhV, and RhV-C. RESULTS Of the 173 patients included in the analysis, 72 tested positive for EV-D68, 61 for RhV, and 30 for RhV-C. There were significantly fewer infants in the EV-D68 group. Patients with EV-D68 were more likely than those without EV-D68, and specifically with RhV-C, to have fever and wheezing. Patients with EV-D68 received more magnesium sulfate for respiratory distress not responding adequately to repeated doses of inhaled albuterol. Hospitalized patients with EV-D68 received more bronchodilator therapy than patients with RhV. Patients with EV-D68 were more likely to be admitted to the intensive care unit and were older than patients without EV-D68. There was no difference in length of overall hospitalization or time in the pediatric intensive care unit. CONCLUSIONS Children with EV-D68 appeared to have more severe respiratory disease on admission than children with RhV as evidenced by higher rates of fever, wheezing, bronchodilator use and pediatric intensive care unit admission. Despite the initial difference in severity, no significant difference in length of stay was found suggesting that patients with EV-D68 recovered as quickly as other groups.
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Affiliation(s)
- Esra Caylan
- Division of Pediatric Pulmonology, Allergy, Immunology, and Sleep Medicine, New York Medical College, Valhalla, NY
| | | | - John Welter
- Division of Pediatric Pulmonology, Allergy, Immunology, and Sleep Medicine, New York Medical College, Valhalla, NY.
| | - Allen Dozor
- Division of Pediatric Pulmonology, Allergy, Immunology, and Sleep Medicine, New York Medical College, Valhalla, NY
| | - Guiqing Wang
- Pathology and Clinical Laboratories, New York Medical College/ Westchester Medical Center, Valhalla, NY
| | - Sheila M Nolan
- Pediatric Infectious Diseases, New York Medical College, Valhalla, NY
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13
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Mindt BC, Fritz JH, Duerr CU. Group 2 Innate Lymphoid Cells in Pulmonary Immunity and Tissue Homeostasis. Front Immunol 2018; 9:840. [PMID: 29760695 PMCID: PMC5937028 DOI: 10.3389/fimmu.2018.00840] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 04/05/2018] [Indexed: 12/21/2022] Open
Abstract
Group 2 innate lymphoid cells (ILC2) represent an evolutionary rather old but only recently identified member of the family of innate lymphoid cells and have received much attention since their detailed description in 2010. They can orchestrate innate as well as adaptive immune responses as they interact with and influence several immune and non-immune cell populations. Moreover, ILC2 are able to rapidly secrete large amounts of type 2 cytokines that can contribute to protective but also detrimental host immune responses depending on timing, location, and physiological context. Interestingly, ILC2, despite their scarcity, are the dominant innate lymphoid cell population in the lung, indicating a key role as first responders and amplifiers upon immune challenge at this site. In addition, the recently described tissue residency of ILC2 further underlines the importance of their respective microenvironment. In this review, we provide an overview of lung physiology including a description of the most prominent pulmonary resident cells together with a review of known and potential ILC2 interactions within this unique environment. We will further outline recent observations regarding pulmonary ILC2 during immune challenge including respiratory infections and discuss different models and approaches to study ILC2 biology in the lung.
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Affiliation(s)
- Barbara C Mindt
- Department of Microbiology and Immunology, McGill University, Montreal, QC, Canada.,McGill University Research Centre on Complex Traits (MRCCT), McGill University, Montreal, QC, Canada.,FOCiS Centre of Excellence in Translational Immunology (CETI), McGill University, Montreal, QC, Canada
| | - Jörg H Fritz
- Department of Microbiology and Immunology, McGill University, Montreal, QC, Canada.,McGill University Research Centre on Complex Traits (MRCCT), McGill University, Montreal, QC, Canada.,FOCiS Centre of Excellence in Translational Immunology (CETI), McGill University, Montreal, QC, Canada.,Department of Physiology, McGill University, Montreal, QC, Canada
| | - Claudia U Duerr
- Department of Microbiology and Immunology, McGill University, Montreal, QC, Canada.,McGill University Research Centre on Complex Traits (MRCCT), McGill University, Montreal, QC, Canada.,FOCiS Centre of Excellence in Translational Immunology (CETI), McGill University, Montreal, QC, Canada.,Institute of Microbiology and Infection Immunology, Charité - University Medical Centre Berlin, Berlin, Germany
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14
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Hallit S, Leynaert B, Delmas MC, Rocchi S, De Blic J, Marguet C, Scherer E, Dufourg MN, Bois C, Reboux G, Millon L, Charles MA, Raherison C. Wheezing phenotypes and risk factors in early life: The ELFE cohort. PLoS One 2018; 13:e0196711. [PMID: 29702689 PMCID: PMC5922557 DOI: 10.1371/journal.pone.0196711] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 04/18/2018] [Indexed: 11/18/2022] Open
Abstract
Objective Different phenotypes of wheezing have been described to date but not in early life. We aim to describe wheezing phenotypes between the ages of two months and one year, and assess risk factors associated with these wheezing phenotypes in a large birth cohort. Methods We studied 18,041 infants from the ELFE (French Longitudinal Study of Children) birth cohort. Parents reported wheezing and respiratory symptoms at two and 12 months, and answered a complete questionnaire (exposure during pregnancy, parental allergy). Results Children with no symptoms (controls) accounted for 77.2%, 2.1% had had wheezing at two months but no wheezing at one year (intermittent), 2.4% had persistent wheezing, while 18.3% had incident wheezing at one year. Comparing persistent wheezing to controls showed that having one sibling (ORa = 2.19) or 2 siblings (ORa = 2.23) compared to none, nocturnal cough (OR = 5.2), respiratory distress (OR = 4.1) and excess bronchial secretions (OR = 3.47) at two months, reflux in the child at 2 months (OR = 1.55), maternal history of asthma (OR = 1.46) and maternal smoking during pregnancy (OR = 1.57) were significantly associated with persistent wheezing. These same factors, along with cutaneous rash in the child at 2 months (OR = 1.13) and paternal history of asthma (OR = 1.32) were significantly associated with increased odds of incident wheezing. Having one sibling (ORa = 1.9) compared to none, nocturnal cough at 2 months (OR = 1.76) and excess bronchial secretions at 2 months (OR = 1.65) were significantly associated with persistent compared to intermittent wheezing. Conclusion Respiratory symptoms (cough, respiratory distress, and excessive bronchial secretion) were significantly associated with a high risk of persistent wheezing at one year. Smoking exposure during pregnancy was also a risk factor for persistent and incident wheezing.
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Affiliation(s)
- Souheil Hallit
- U1219 INSERM, ISPED, Bordeaux University, Bordeaux, France
- * E-mail:
| | | | | | - Steffi Rocchi
- Parasitology Mycology Department, University Hospital, Besançon, France
- Chrono-environnement UMR CNRS 6249, Bourgogne Franche-Comté University, Besançon, France
| | - Jacques De Blic
- Pediatric Allergy and Pulmonology, CHU Necker Enfants Malades, Paris, France
| | | | - Emeline Scherer
- Parasitology Mycology Department, University Hospital, Besançon, France
- Chrono-environnement UMR CNRS 6249, Bourgogne Franche-Comté University, Besançon, France
| | | | | | - Gabriel Reboux
- Parasitology Mycology Department, University Hospital, Besançon, France
- Chrono-environnement UMR CNRS 6249, Bourgogne Franche-Comté University, Besançon, France
| | - Laurence Millon
- Parasitology Mycology Department, University Hospital, Besançon, France
- Chrono-environnement UMR CNRS 6249, Bourgogne Franche-Comté University, Besançon, France
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15
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Cheung DS, Sigua JA, Simpson PM, Yan K, Hussain SRA, Santoro JL, Buell EJ, Hunter DA, Rohlfing M, Patadia D, Grayson MH. Cysteinyl leukotriene receptor 1 expression identifies a subset of neutrophils during the antiviral response that contributes to postviral atopic airway disease. J Allergy Clin Immunol 2017; 142:1206-1217.e5. [PMID: 29269317 DOI: 10.1016/j.jaci.2017.11.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 10/20/2017] [Accepted: 11/24/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Viral respiratory tract infections increase the risk of development and exacerbation of atopic disease. Previously, we demonstrated the requirement for a neutrophil (PMN) subset expressing CD49d to drive development of postviral atopic airway disease in mice. OBJECTIVE We sought to determine whether human CD49d+ PMNs are present in the nasal mucosa during acute viral respiratory tract infections and further characterize this PMN subset in human subjects and mice. METHODS Sixty subjects (5-50 years old) were enrolled within 4 days of acute onset of upper respiratory symptoms. Nasal lavage for flow cytometry and nasal swabs for viral PCR were performed at enrollment and during convalescence. The Sendai virus mouse model was used to investigate the phenotype and functional relevance of CD49d+ PMNs. RESULTS CD49d+ PMN frequency was significantly higher in nasal lavage fluid during acute respiratory symptoms in all subjects (2.9% vs 1.0%, n = 42, P < .001). In mice CD49d+ PMNs represented a "proatopic" neutrophil subset that expressed cysteinyl leukotriene receptor 1 (CysLTR1) and produced TNF, CCL2, and CCL5. Inhibition of CysLTR1 signaling in the first days of a viral respiratory tract infection was sufficient to reduce accumulation of CD49d+ PMNs in the lungs and development of postviral atopic airway disease. Similar to the mouse, human CD49d+ PMNs isolated from nasal lavage fluid during a viral respiratory tract infection expressed CysLTR1. CONCLUSION CD49d and CysLTR1-coexpressing PMNs are present during symptoms of an acute viral respiratory tract infection in human subjects. Further study is needed to examine selective targeting of proatopic neutrophils as a potential therapeutic strategy to prevent development of postviral atopic airway disease.
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Affiliation(s)
- Dorothy S Cheung
- Division of Allergy and Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wis
| | - Jerome A Sigua
- Division of Allergy and Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wis
| | - Pippa M Simpson
- Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wis
| | - Ke Yan
- Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wis
| | - Syed-Rehan A Hussain
- Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital-The Ohio State University School of Medicine, Columbus, Ohio; Center for Clinical and Translational Research, Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Jennifer L Santoro
- Division of Allergy and Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wis; Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital-The Ohio State University School of Medicine, Columbus, Ohio; Center for Clinical and Translational Research, Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Erika J Buell
- Division of Allergy and Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wis
| | - Desire A Hunter
- Division of Allergy and Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wis
| | - Michelle Rohlfing
- Division of Allergy and Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wis; Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital-The Ohio State University School of Medicine, Columbus, Ohio; Center for Clinical and Translational Research, Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Deepa Patadia
- Division of Allergy and Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wis; Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital-The Ohio State University School of Medicine, Columbus, Ohio
| | - Mitchell H Grayson
- Division of Allergy and Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wis; Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital-The Ohio State University School of Medicine, Columbus, Ohio; Center for Clinical and Translational Research, Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
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16
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Underner M, Perriot J, Peiffer G, Jaafari N. [Asthma and heroin use]. Presse Med 2017; 46:660-675. [PMID: 28734637 PMCID: PMC7126345 DOI: 10.1016/j.lpm.2017.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/11/2017] [Accepted: 06/21/2017] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Heroin use can be responsible for many respiratory complications including asthma. OBJECTIVES Systematic literature review of data on asthma in heroin users. DOCUMENTARY SOURCES Medline®, on the period 1980-2017 with the following keywords: keywords: "asthma" or "bronchospasm" and "heroin" or "opiate" or "opiates", limits "title/abstract"; the selected languages were English or French. Among 97 articles, 67 abstracts have given use to a dual reading to select 23 studies. RESULTS The seven case reports included 21 patients (mean age: 28 years [19-46 years]; sex-ratio: 2.5 [males: 71.5%]). Heroin was inhaled (71.4%), sniffed (19%) or injected by intravenous route (9.5%). Associated addictive substances were tobacco (81%), cannabis (38%), alcohol (4.7%) and cocaine (4.7%). Outcome was fatal in 3 subjects (14.3%). Other studies included one cross-sectional study, 3 case-control studies and 12 longitudinal studies (11 retrospective studies and one prospective study). The proportion of heroin users was higher in asthmatic subjects and the prevalence of asthma and bronchial hyperreactivity was higher in heroin users. Heroin use can be responsible for asthma onset, with a temporal relationship between the onset of heroin use and asthma onset in 28 to 31% of subjects. A positive association between inhaled heroin use and acute asthma exacerbation was observed. Asthma treatment observance was lower in heroin users. In case of asthma exacerbation, heroin users were more likely to seek care in the emergency department, to be admitted in intensive care units and to require intubation and invasive ventilation. Asthma deaths related to heroin use mainly occurred following an intravenous injection (especially in the case of overdose), but also following heroin use by nasal (sniff) or pulmonary route. CONCLUSION Heroin use may be responsible for asthma onset, acute asthma exacerbations (which may require intubation and invasive ventilation) or deaths related to asthma. Heroin use must be sought in case of asthma exacerbation in young persons and practitioners must help heroin users to stop their consumption.
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Affiliation(s)
- Michel Underner
- Université de Poitiers, unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France.
| | - Jean Perriot
- Centre de tabacologie, dispensaire Émile-Roux, 63100 Clermont-Ferrand, France
| | - Gérard Peiffer
- CHR Metz-Thionville, service de pneumologie, 57038 Metz, France
| | - Nematollah Jaafari
- Université de Poitiers, unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France
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17
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McFarlane AJ, McSorley HJ, Davidson DJ, Fitch PM, Errington C, Mackenzie KJ, Gollwitzer ES, Johnston CJC, MacDonald AS, Edwards MR, Harris NL, Marsland BJ, Maizels RM, Schwarze J. Enteric helminth-induced type I interferon signaling protects against pulmonary virus infection through interaction with the microbiota. J Allergy Clin Immunol 2017; 140:1068-1078.e6. [PMID: 28196762 DOI: 10.1016/j.jaci.2017.01.016] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 01/05/2017] [Accepted: 01/18/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Helminth parasites have been reported to have beneficial immunomodulatory effects in patients with allergic and autoimmune conditions and detrimental consequences in patients with tuberculosis and some viral infections. Their role in coinfection with respiratory viruses is not clear. OBJECTIVE Here we investigated the effects of strictly enteric helminth infection with Heligmosomoides polygyrus on respiratory syncytial virus (RSV) infection in a mouse model. METHODS A murine helminth/RSV coinfection model was developed. Mice were infected by means of oral gavage with 200 stage 3 H polygyrus larvae. Ten days later, mice were infected intranasally with either RSV or UV-inactivated RSV. RESULTS H polygyrus-infected mice showed significantly less disease and pulmonary inflammation after RSV infection associated with reduced viral load. Adaptive immune responses, including TH2 responses, were not essential because protection against RSV was maintained in Rag1-/- and Il4rα-/- mice. Importantly, H polygyrus infection upregulated expression of type I interferons and interferon-stimulated genes in both the duodenum and lung, and its protective effects were lost in both Ifnar1-/- and germ-free mice, revealing essential roles for type I interferon signaling and microbiota in H polygyrus-induced protection against RSV. CONCLUSION These data demonstrate that a strictly enteric helminth infection can have remote protective antiviral effects in the lung through induction of a microbiota-dependent type I interferon response.
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Affiliation(s)
- Amanda J McFarlane
- MRC-Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom; Child Life and Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Henry J McSorley
- MRC-Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom; Child Life and Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Donald J Davidson
- MRC-Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Paul M Fitch
- MRC-Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom; Child Life and Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Claire Errington
- National Health Service Lothian, Simpson Centre for Reproductive Health, Edinburgh, United Kingdom
| | - Karen J Mackenzie
- MRC-Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Eva S Gollwitzer
- Faculty of Biology and Medicine, University of Lausanne, Service de Pneumologie, CHUV, Lausanne, Switzerland
| | - Chris J C Johnston
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew S MacDonald
- Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, United Kingdom
| | - Michael R Edwards
- Airway Disease Infection Section, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma and Centre for Respiratory Infection, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Nicola L Harris
- Global Health Institute, École Polytechnique, Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Benjamin J Marsland
- Faculty of Biology and Medicine, University of Lausanne, Service de Pneumologie, CHUV, Lausanne, Switzerland
| | - Rick M Maizels
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Jürgen Schwarze
- MRC-Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom; Child Life and Health, University of Edinburgh, Edinburgh, United Kingdom.
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18
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Baturcam E, Snape N, Yeo TH, Schagen J, Thomas E, Logan J, Galbraith S, Collinson N, Phipps S, Fantino E, Sly PD, Spann KM. Human Metapneumovirus Impairs Apoptosis of Nasal Epithelial Cells in Asthma via HSP70. J Innate Immun 2016; 9:52-64. [PMID: 27723652 DOI: 10.1159/000449101] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 08/13/2016] [Indexed: 12/13/2022] Open
Abstract
Asthmatics are highly susceptible to respiratory viral infections, possibly due to impaired innate immunity. However, the exact mechanisms of susceptibility are likely to differ amongst viruses. Therefore, we infected primary nasal epithelial cells (NECs) from adults with mild-to-moderate asthma, with respiratory syncytial virus (RSV) or human metapneumovirus (hMPV) in vitro and investigated the antiviral response. NECs from these asthmatics supported elevated hMPV but not RSV infection, compared to non-asthmatic controls. This correlated with reduced apoptosis and reduced activation of caspase-9 and caspase-3/7 in response to hMPV, but not RSV. The expression of heat shock protein 70 (HSP70), a known inhibitor of caspase activation and subsequent apoptosis, was amplified in response to hMPV infection. Chemical inhibition of HSP70 function restored caspase activation and reduced hMPV infection in NECs from asthmatic subjects. There was no impairment in the production of IFN by NECs from asthmatics in response to either hMPV or RSV, demonstrating that increased infection of asthmatic airway cells by hMPV is IFN-independent. This study demonstrates, for the first time, a mechanism for elevated hMPV infection in airway epithelial cells from adult asthmatics and identifies HSP70 as a potential target for antiviral and asthma therapies.
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Affiliation(s)
- Engin Baturcam
- School of Medicine, The University of Queensland, Brisbane, Qld., Australia
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Stier MT, Bloodworth MH, Toki S, Newcomb DC, Goleniewska K, Boyd KL, Quitalig M, Hotard AL, Moore ML, Hartert TV, Zhou B, McKenzie AN, Peebles RS. Respiratory syncytial virus infection activates IL-13-producing group 2 innate lymphoid cells through thymic stromal lymphopoietin. J Allergy Clin Immunol 2016; 138:814-824.e11. [PMID: 27156176 PMCID: PMC5014571 DOI: 10.1016/j.jaci.2016.01.050] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 01/12/2016] [Accepted: 01/29/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major health care burden with a particularly high worldwide morbidity and mortality rate among infants. Data suggest that severe RSV-associated illness is in part caused by immunopathology associated with a robust type 2 response. OBJECTIVE We sought to determine the capacity of RSV infection to stimulate group 2 innate lymphoid cells (ILC2s) and the associated mechanism in a murine model. METHODS Wild-type (WT) BALB/c, thymic stromal lymphopoietin receptor (TSLPR) knockout (KO), or WT mice receiving an anti-TSLP neutralizing antibody were infected with the RSV strain 01/2-20. During the first 4 to 6 days of infection, lungs were collected for evaluation of viral load, protein concentration, airway mucus, airway reactivity, or ILC2 numbers. Results were confirmed with 2 additional RSV clinical isolates, 12/11-19 and 12/12-6, with known human pathogenic potential. RESULTS RSV induced a 3-fold increase in the number of IL-13-producing ILC2s at day 4 after infection, with a concurrent increase in total lung IL-13 levels. Both thymic stromal lymphopoietin (TSLP) and IL-33 levels were increased 12 hours after infection. TSLPR KO mice did not mount an IL-13-producing ILC2 response to RSV infection. Additionally, neutralization of TSLP significantly attenuated the RSV-induced IL-13-producing ILC2 response. TSLPR KO mice displayed reduced lung IL-13 protein levels, decreased airway mucus and reactivity, attenuated weight loss, and similar viral loads as WT mice. Both 12/11-19 and 12/12-6 similarly induced IL-13-producing ILC2s through a TSLP-dependent mechanism. CONCLUSION These data demonstrate that multiple pathogenic strains of RSV induce IL-13-producing ILC2 proliferation and activation through a TSLP-dependent mechanism in a murine model and suggest the potential therapeutic targeting of TSLP during severe RSV infection.
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Affiliation(s)
- Matthew T Stier
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tenn
| | - Melissa H Bloodworth
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tenn
| | - Shinji Toki
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn
| | - Dawn C Newcomb
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tenn; Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn
| | - Kasia Goleniewska
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn
| | - Kelli L Boyd
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tenn
| | - Marc Quitalig
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn
| | - Anne L Hotard
- Division of Infectious Disease, Department of Pediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, Ga
| | - Martin L Moore
- Division of Infectious Disease, Department of Pediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, Ga
| | - Tina V Hartert
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn
| | - Baohua Zhou
- Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Ind
| | - Andrew N McKenzie
- MRC Laboratory of Molecular Biology, Cambridge University, Cambridge, United Kingdom
| | - R Stokes Peebles
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tenn; Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn.
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20
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Duenas Meza E, Jaramillo CA, Correa E, Torres-Duque CA, García C, González M, Rojas D, Hernández A, Páez AM, Delgado MDP. Virus and Mycoplasma pneumoniae prevalence in a selected pediatric population with acute asthma exacerbation. J Asthma 2016; 53:253-60. [PMID: 26799194 DOI: 10.3109/02770903.2015.1075548] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the prevalence of viral and atypical bacteria Mycoplasma pneumoniae infection in children experiencing asthma exacerbation and compare positive and negative subjects with regard to exacerbation severity, need for hospitalization, and treatment. METHODS One hundred sixty-nine asthmatic children aged 2-15 years old who were admitted to emergency rooms in Bogota, Colombia for acute asthma exacerbation were interviewed. Nasopharyngeal aspirates were taken for DNA and RNA extraction. M. pneumoniae and virus were detected by PCR using specific primers. RESULTS The prevalence of M. pneumoniae and viral infection in the study population was 12.4% and 83.7%, respectively. All subjects positive for M. pneumoniae were also positive for viral infection. Rhinovirus was the most frequently detected viral agent. No significant differences in severity of asthma exacerbations or in need for hospitalization between the virus or M. pneumoniae positive and negative groups were observed. A significantly lower percentage of M. pneumoniae positive subjects had used inhaled steroids over the six months prior to asthma exacerbation compared to M. pneumoniae negative subjects (38.1% vs. 68.2%), suggesting that inhaled corticosteroids may have a protective effect against M. pneumoniae infections. CONCLUSIONS The M. pneumoniae and virus prevalence found in this study were similar to those described in the literature. The 100% co-infection rate observed suggests that viral infection can predispose patients to M. pneumoniae infection, and that this interaction may trigger asthmatic exacerbation. Further studies should be done to confirm the protective effect of inhaled corticosteroids on M. pneumoniae infection in patients with asthma exacerbations.
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Affiliation(s)
| | - Carlos Alberto Jaramillo
- b Molecular Diagnostics and Bioinformatics Laboratory, Biological Sciences Department , Faculty of Science, Universidad de los Andes , Bogotá , Colombia
| | - Eliana Correa
- a Fundación Neumológica Colombiana , Bogotá , Colombia and
| | | | - Catherine García
- b Molecular Diagnostics and Bioinformatics Laboratory, Biological Sciences Department , Faculty of Science, Universidad de los Andes , Bogotá , Colombia
| | | | - Diana Rojas
- b Molecular Diagnostics and Bioinformatics Laboratory, Biological Sciences Department , Faculty of Science, Universidad de los Andes , Bogotá , Colombia
| | - Alejandra Hernández
- b Molecular Diagnostics and Bioinformatics Laboratory, Biological Sciences Department , Faculty of Science, Universidad de los Andes , Bogotá , Colombia
| | - Ana María Páez
- b Molecular Diagnostics and Bioinformatics Laboratory, Biological Sciences Department , Faculty of Science, Universidad de los Andes , Bogotá , Colombia
| | - María Del Pilar Delgado
- b Molecular Diagnostics and Bioinformatics Laboratory, Biological Sciences Department , Faculty of Science, Universidad de los Andes , Bogotá , Colombia
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Burgess SL, Lu M, Ma JZ, Naylor C, Donowitz JR, Kirkpatrick BD, Haque R, Petri WA. Inflammatory markers predict episodes of wheezing during the first year of life in Bangladesh. Respir Med 2016; 110:53-7. [PMID: 26631486 PMCID: PMC4698242 DOI: 10.1016/j.rmed.2015.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 11/12/2015] [Accepted: 11/15/2015] [Indexed: 01/29/2023]
Abstract
BACKGROUND Environmental factors that influence wheezing in early childhood in the developing world are not well understood and may be useful in predicting respiratory outcomes. Therefore, our objective was to determine the factors that can predict wheezing. METHODS Children from Dhaka, Bangladesh were recruited at birth and episodes of wheezing were measured alongside nutritional, immunological and socioeconomic factors over a one-year period. Poisson Regression with variable selection was utilized to determine what factors were associated with wheezing. RESULTS Elevated serum IL-10 (rate ratio (RR) = 1.51, 95% confidence interval (CI): 1.22-1.87), IL-1β (RR = 1.55, 95% CI: 1.26-1.93) C-reactive protein (CRP) (RR = 1.41, 95% CI: 1.03-1.93) in early life, and male gender (RR = 1.52, 95% CI: 1.27-1.82) predicted increased wheezing episodes. Conversely, increased fecal alpha-1-antitrypsin (RR = 0.87, 95% CI: 0.76-1.00) and family income (RR = 0.98, 95% CI: 0.97-0.99) were associated with a decreased number of episodes of wheezing. CONCLUSIONS Systemic inflammation early in life, poverty, and male sex placed infants at risk of more episodes of wheezing during their first year of life. These results support the hypothesis that there is a link between inflammation in infancy and the development of respiratory illness later in life and provide specific biomarkers that can predict wheezing in a low-income country.
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Affiliation(s)
- Stacey L Burgess
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA
| | - Miao Lu
- Department of Statistics and Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Jennie Z Ma
- Department of Statistics and Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Caitlin Naylor
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA
| | - Jeffrey R Donowitz
- Division of Pediatric Infectious Diseases, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Beth D Kirkpatrick
- Department of Medicine and Vaccine Testing Center, The University of Vermont College of Medicine, Burlington, VT, USA
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Bangladesh, (ICDDR, B), Dhaka, Bangladesh
| | - William A Petri
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
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Fernandes RM, Oleszczuk M, Woods CR, Rowe BH, Cates CJ, Hartling L. The Cochrane Library and safety of systemic corticosteroids for acute respiratory conditions in children: an overview of reviews. ACTA ACUST UNITED AC 2015; 9:733-47. [PMID: 25236311 DOI: 10.1002/ebch.1980] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Acute respiratory conditions are a leading cause of childhood morbidity and mortality. Corticosteroids are effective and established treatments in some acute respiratory infections (e.g. croup) and asthma exacerbations; however, their role is controversial in other conditions owing to inconsistent effectiveness or safety concerns (e.g. bronchiolitis, acute wheeze). OBJECTIVES To examine clinically relevant short-term safety outcomes related to acute single or recurrent systemic short-term (<2 weeks) corticosteroid use based on systematic reviews of acute respiratory conditions. METHODS We searched the Cochrane Database of Systematic Reviews in February 2013 for systematic reviews comparing systemic corticosteroids with placebo for children (aged 0-18 years) with acute asthma, preschool wheezing, bronchiolitis, croup, pharyngitis/tonsillitis or pneumonia. We selected the following outcomes a priori: gastrointestinal (GI) bleeding and abdominal pain; behavioural effects (tremor or hyperactivity, jitteriness, irritability or emotional distress); hypertension; serious adverse events, including death, length of stay in hospital; and relapse leading to hospitalization. One reviewer extracted data and another reviewer independently verified data. Results were combined using Peto odds ratios and risk differences (RD) for dichotomous outcomes and mean differences for continuous outcomes. MAIN RESULTS Seven reviews containing 44 relevant randomized controlled trials were included. Three reviews were on asthma and one each on bronchiolitis, croup, wheeze and pharyngitis/tonsillitis. Six trials (2114 patients) assessed GI bleeding and/or abdominal pain and showed no significant differences between corticosteroids and placebo (1.5% vs. 1.8%, respectively). Various behavioural effects and hypertension/blood pressure were measured in four trials each (838 and 1617 patients, respectively), with no significant differences reported. None of the trials reported deaths in any of the treatment groups. Based on 17 trials (2056 patients), there were significantly fewer admissions at day 1 with corticosteroids (risk differences = -0.11, 95% confidence interval -0.18 to -0.05; Peto odds ratios = 0.63, 95% confidence interval 0.52 to 0.78). Based on 16 trials (1502 patients) corticosteroids resulted in over 8 fewer hours in hospital compared with placebo (mean differences = -8.49 hours, 95% confidence interval -1.76 to -3.23). There were significantly fewer relapses leading to hospitalization (13 trials, 1099 patients) with corticosteroids (Peto odds ratios 0.42, 95% confidence interval 0.23 to 0.76). While differences favouring corticosteroids in hospital-related outcomes were restricted to asthma and/or croup, we did not find any increase in hospital admission at day 1, length of stay or re-hospitalization in the other acute respiratory conditions. AUTHORS' CONCLUSIONS Practitioners may prescribe systemic corticosteroids in otherwise healthy children when indicated for the management of acute respiratory conditions (i.e. infections or asthma exacerbations) with minimal concern about short-term adverse effects.
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Affiliation(s)
- Ricardo M Fernandes
- Department of Pediatrics, Santa Maria Hospital, Lisbon Academic Medical Centre, Lisbon, Portugal; Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
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Ding G, Ji R, Bao Y. Risk and protective factors for the development of childhood asthma. Paediatr Respir Rev 2015; 16:133-9. [PMID: 25155282 DOI: 10.1016/j.prrv.2014.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 05/31/2014] [Accepted: 07/27/2014] [Indexed: 10/25/2022]
Abstract
Childhood asthma prevalence worldwide has been increasing markedly over several decades. Various theories have been proposed to account for this alarming trend. The disease has a broad spectrum of potential determinants ranging from genetics to lifestyle and environmental factors. Epidemiological observations have demonstrated that several important lifestyle and environmental factors including obesity, urban living, dietary patterns such as food low in antioxidants and fast food, non-breastfeeding, gut flora imbalance, cigarette smoking, air pollution, and viral infection are associated with asthma exacerbations in children. However, only environmental tobacco smoke has been associated with the development of asthma. Despite epidemiological studies indicating that many other factors are probably associated with the development of asthma, the relationships are not considered causal due to the inadequate evidence and inconsistent results from recent studies. This may highlight that sufficient data and exact mechanisms of causality are still in need of further study.
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Affiliation(s)
- Guodong Ding
- Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environment Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruoxu Ji
- Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yixiao Bao
- Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Kim J, Lim Y, Kim H. Outdoor temperature changes and emergency department visits for asthma in Seoul, Korea: A time-series study. ENVIRONMENTAL RESEARCH 2014; 135:15-20. [PMID: 25261859 DOI: 10.1016/j.envres.2014.07.032] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 07/02/2014] [Accepted: 07/04/2014] [Indexed: 05/22/2023]
Abstract
BACKGROUND Extreme temperatures and temperature changes are known indicators of climate change, and large temperature variations for several consecutive days may affect human health such as exacerbating respiratory symptoms. The objective of this study was to determine the association between outdoor temperature change and asthma-related emergency department visits. In particular, this study examined seasonality and identified susceptible populations, such as the elderly. METHODS The health data for asthma-related emergency department visits were collected from July 1, 2007, to December 31, 2010 in Seoul, Korea, through the National Emergency Department Information System of the National Emergency Medical Center and we defined temperature change as the absolute difference of mean temperature between the current day and the previous day. We applied generalized linear models with an allowance of over-dispersion for quantifying the estimated effects of temperature change on asthma-related emergency department visits, adjusting for meteorological conditions, air pollution, and time trend. RESULTS In general, temperature change was adversely associated with asthma-related emergency department visits, with a 1-unit increase of temperature change associated with a 3.5% (95% CI 0.7, 6.4%) increase in emergency department visits. In addition, seasonal variation after adjusting for mean temperature and diurnal temperature range had an adverse effect in spring, summer, and fall and a protective effect in winter. Patients aged ≥65 years experienced the most prominent effect during the fall, with a 17.9% (95% CI 4.1, 33.6%) increase in emergency department visits per 1-unit increase of temperature change, whereas the other seasons showed no statistically significant association. CONCLUSIONS Along with diurnal temperature range, temperature change may be an alternative indicator of climate change. Temperature change variables are well-known and easy to communicate with the public relative to the health effects of outdoor temperature fluctuations.
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Affiliation(s)
- Jayeun Kim
- Department of Biostatistics and Epidemiology, School of Public Health, Seoul National University, 1 Gwanak-Ro, Gwanak Gu, Seoul 151-752, Republic of Korea.
| | - Younhee Lim
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.
| | - Ho Kim
- Department of Biostatistics and Epidemiology, School of Public Health, Seoul National University, 1 Gwanak-Ro, Gwanak Gu, Seoul 151-752, Republic of Korea; Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.
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Lange NE, Litonjua A, Hawrylowicz CM, Weiss S. Vitamin D, the immune system and asthma. Expert Rev Clin Immunol 2014; 5:693-702. [PMID: 20161622 DOI: 10.1586/eci.09.53] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The effects of vitamin D on bone metabolism and calcium homeostasis have long been recognized. Emerging evidence has implicated vitamin D as a critical regulator of immunity, playing a role in both the innate and cell-mediated immune systems. Vitamin D deficiency has been found to be associated with several immune-mediated diseases, susceptibility to infection and cancer. Recently, there has been increasing interest in the possible link between vitamin D and asthma. Further elucidation of the role of vitamin D in lung development and immune system function may hold profound implications for the prevention and treatment of asthma.
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Affiliation(s)
- Nancy E Lange
- Channing Laboratory, Division of Pulmonary and Critical Care Medicine, Brigham & Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA Tel.: +1 617 525 0874
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Ripabelli G, Tamburro M, Sammarco ML, de Laurentiis G, Bianco A. Asthma prevalence and risk factors among children and adolescents living around an industrial area: a cross-sectional study. BMC Public Health 2013; 13:1038. [PMID: 24188412 PMCID: PMC4228310 DOI: 10.1186/1471-2458-13-1038] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 10/21/2013] [Indexed: 12/02/2022] Open
Abstract
Background The exposure to air pollution has negative effects on human health, increasing the risk of respiratory diseases, such as asthma. Few data are yet available on the epidemiology of childhood asthma in some areas of Italy. The aim of the study was to estimate asthma prevalence and related risk factors in children and adolescents residents around the industrial area of Termoli, Molise region, Central-South Italy. Methods Prevalence was assessed through the administration of modified ISAAC questionnaires filled out by parents of 89 children and adolescents for the identification of confirmed and probable cases, and by analyzing pediatricians’ databases on drug prescriptions for symptoms control and treatment of assisted population in the study area (n = 1,004), compared to a control area (n = 920) with lower industrialization. The association of asthma with risk factors was evaluated by univariate (Chi-square or Fisher’s Exact test) and regression logistic analysis. Results A total of 22 (24.7%) asthmatics were identified, including both confirmed (n = 7; 7.9%) and probable cases (n = 15; 16.8%), most of them (n = 17; 77.3%) resident of Termoli town. All asthma cases were georeferenced based on the residence, however clusters were not found. Using drug prescriptions analysis, a higher prevalence (n = 138; 13.7%) of diagnosed cases was found. Lifetime history of both atopic dermatitis and bronchitis were significantly relateds to asthma cases, as well as an elevated body mass index, whose association is consistent with prevalence data of overweight/obese children living in the study area. Moreover, being resident of the town of Termoli was associated to the occurrence of cases. Conclusions Although our data indicated a prevalence concordance with previous national studies in pediatric population, a definitive correlation with environmental industrial factors present in the study area was not established. However, asthma outcome was significantly associated to individuals living in the town of Termoli that, despite the industrial/manufacturing activities, is also subjected to a higher environmental pressure due to the presence of toll road, state highway, railroad, and seaport which may cause air pollution from motor vehicle traffic and increase asthma induction. This study provides hitherto unavailable data on asthma in childhood population living in an industrialized area which was never investigated before, could be part of a systematic review or meta-analysis procedure, might suggest significant findings for larger observational studies, and contribute to complete the frame of disease epidemiology in Italy.
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Affiliation(s)
- Giancarlo Ripabelli
- Chair of Hygiene, Department of Medicine and of Health Sciences, University of Molise, Via De Sanctis, Campobasso, 86100, Italy.
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Mendez-Enriquez E, García-Zepeda EA. The multiple faces of CCL13 in immunity and inflammation. Inflammopharmacology 2013; 21:397-406. [PMID: 23846739 DOI: 10.1007/s10787-013-0177-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 06/20/2013] [Indexed: 01/19/2023]
Abstract
CCL13/MCP-4, is a CC family chemokine that is chemoattractant for eosinophils, basophils, monocytes, macrophages, immature dendritic cells, and T cells, and its capable of inducing crucial immuno-modulatory responses through its effects on epithelial, muscular and endothelial cells. Similar to other CC chemokines, CCL13 binds to several chemokine receptors (CCR1, CCR2 and CCR3), allowing it to elicit different effects on its target cells. A number of studies have shown that CCL13 is involved in many chronic inflammatory diseases, in which it functions as a pivotal molecule involved in the selective recruitment of cell lineages to the inflamed tissues and their subsequent activation. Based on these studies, we suggest that blocking the actions of CCL13 can serve as a novel strategy for the generation of agents with anti-inflammatory activity. The main goal of this review is to present the current information about CCL13, its gene and protein structure and the roles of this chemokine during innate/adaptive immune responses in inflammatory diseases.
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Affiliation(s)
- E Mendez-Enriquez
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Escolar S/N, Ciudad Universitaria, 04510, México, DF, México
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Persistent recurring wheezing in the fifth year of life after laboratory-confirmed, medically attended respiratory syncytial virus infection in infancy. BMC Pediatr 2013; 13:97. [PMID: 23782528 PMCID: PMC3703269 DOI: 10.1186/1471-2431-13-97] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 06/13/2013] [Indexed: 11/26/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) infection in infancy is associated with subsequent recurrent wheezing. Methods A retrospective cohort study examined children born at ≥32 weeks gestation between 1996–2004. All children were enrolled in an integrated health care delivery system in Northern California and were followed through the fifth year of life. The primary endpoint was recurrent wheezing in the fifth year of life and its association with laboratory-confirmed, medically-attended RSV infection during the first year, prematurity, and supplemental oxygen during birth hospitalization. Other outcomes measured were recurrent wheezing quantified through outpatient visits, inpatient hospital stays, and asthma prescriptions. Results The study sample included 72,602 children. The rate of recurrent wheezing in the second year was 5.6% and fell to 4.7% by the fifth year. Recurrent wheezing rates varied by risk status: the rate was 12.5% among infants with RSV hospitalization, 8% among infants 32–33 weeks gestation, and 18% in infants with bronchopulmonary dysplasia. In multivariate analyses, increasing severity of respiratory syncytial virus infection was significantly associated with recurrent wheezing in year 5; compared with children without RSV infection in infancy, children who only had an outpatient RSV encounter had an adjusted odds ratio of 1.38 (95% CI,1.03–1.85), while children with a prolonged RSV hospitalization had an adjusted odds ratio of 2.59 (95% CI, 1.49–4.50). Conclusions Laboratory-confirmed, medically attended RSV infection, prematurity, and neonatal exposure to supplemental oxygen have independent associations with development of recurrent wheezing in the fifth year of life.
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Cheung DS, Grayson MH. Role of viruses in the development of atopic disease in pediatric patients. Curr Allergy Asthma Rep 2013; 12:613-20. [PMID: 22911226 DOI: 10.1007/s11882-012-0295-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The prevalence of atopic diseases continues to rise in modernized countries, without a clear explanation for this increase. One potential cause identified from epidemiologic studies of children is respiratory RNA viral infections leading to development of recurrent wheezing, asthma, and allergic sensitization. We review human epidemiologic data that both support and refute the role of viruses in this process. Exploring recent murine models, we document possible immunologic mechanisms that could translate a viral infection into atopic disease. We further discuss evidence for a post-viral "atopic cycle" that could explain the development of multiple allergen sensitization, and we explore available data to suggest a connection between viral infections of the gastrointestinal tract with the development of food allergy. Taken together, this review documents evidence to support the "viral hypothesis", and, in particular, the role of RNA viruses in the development of atopic disease.
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Affiliation(s)
- Dorothy S Cheung
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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Lange NE, Celedón JC, Forno E, Ly NP, Onderdonk A, Bry L, Delaney ML, DuBois AM, Gold DR, Weiss ST, Litonjua AA. Maternal intestinal flora and wheeze in early childhood. Clin Exp Allergy 2013; 42:901-8. [PMID: 22909161 DOI: 10.1111/j.1365-2222.2011.03950.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Increasing evidence links altered intestinal flora in infancy to eczema and asthma. No studies have investigated the influence of maternal intestinal flora on wheezing and eczema in early childhood. OBJECTIVE To investigate the link between maternal intestinal flora during pregnancy and development of wheeze and eczema in infancy. METHODS A total of 60 pregnant women from the Boston area gave stool samples during the third trimester of their pregnancy and answered questions during pregnancy about their own health, and about their children's health when the child was 2 and 6 months of age. Quantitative culture was performed on stool samples and measured in log(10)colony-forming units (CFU)/gram stool. Primary outcomes included infant wheeze and eczema in the first 6 months of life. Atopic wheeze, defined as wheeze and eczema, was analysed as a secondary outcome. RESULTS In multivariate models adjusted for breastfeeding, day care attendance and maternal atopy, higher counts of maternal total aerobes (TA) and enterococci (E) were associated with increased risk of infant wheeze (TA: OR 2.32 for 1 log increase in CFU/g stool [95% CI 1.22, 4.42]; E: OR 1.57 [95% CI 1.06, 2.31]). No organisms were associated with either eczema or atopic wheeze. CONCLUSIONS AND CLINICAL RELEVANCE In our cohort, higher maternal total aerobes and enterococci were related to increased risk of infant wheeze. Maternal intestinal flora may be an important environmental exposure in early immune system development.
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Affiliation(s)
- N E Lange
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
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Gonzalez-Barcala FJ, Pertega S, Perez Castro T, Sampedro M, Sanchez Lastres J, San Jose Gonzalez MA, Bamonde L, Garnelo L, Valdes L, Carreira JM, Moure J, Lopez Silvarrey A. Exposure to paracetamol and asthma symptoms. Eur J Public Health 2012; 23:706-10. [PMID: 22645237 DOI: 10.1093/eurpub/cks061] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Paracetamol is one of the factors that have been associated with the observed increase in asthma prevalence in the last few years. The influence of environmental or genetic factors in this disease may be different in some countries than in others. The purpose of this study was to analyse the relationship between the paracetamol consumption and asthma prevalence in our community. METHODS A cross-sectional study was conducted on more than 20,000 children and adolescents in Galicia, Spain. The International Study of Asthma and Allergies in Childhood methodology was used to collect the information on asthma symptoms in children, paracetamol consumption, body mass index (BMI), pets in the home, education level of the mother and parental asthma and smoking habits. The influence of paracetamol consumption on the prevalence of asthma symptoms was calculated using logistic regression, adjusted for the other parameters included in the study. RESULTS After adjusting for gender, BMI, having a cat or dog, maternal education, parental asthma and smoking, in 6- to 7-year-old children, the consumption of paracetamol during the first year of life is associated with asthma [odds ratio (OR) 2.04 (1.79-2.31) for wheezing at some time]. Paracetamol consumption in the previous year leads to a significant increase in the probability of wheezing at some time [OR 3.32 (2.51-4.41)] in young children and adolescents [OR 2.12 (1.68-2.67)]. CONCLUSIONS Paracetamol consumption is associated with a significant increase in asthma symptoms. The effect is greater the more often the drug is taken.
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Carroll KN, Gebretsadik T, Minton P, Woodward K, Liu Z, Miller EK, Williams JV, Dupont WD, Hartert TV. Influence of maternal asthma on the cause and severity of infant acute respiratory tract infections. J Allergy Clin Immunol 2012; 129:1236-42. [PMID: 22336082 PMCID: PMC3340428 DOI: 10.1016/j.jaci.2012.01.045] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 12/18/2011] [Accepted: 01/17/2012] [Indexed: 12/02/2022]
Abstract
Background Respiratory syncytial virus (RSV) and rhinovirus infections are the most common significant infant respiratory tract illnesses and are associated with increased but differential risks of childhood asthma. Objective We sought to determine whether maternal asthma is associated with higher odds of infant respiratory tract infection with rhinovirus versus RSV and increased infection severity. Methods Mother-infant dyads were enrolled from 2004-2008 during an infant respiratory tract infection (104 with rhinovirus and 279 with RSV). Mothers were classified into mutually exclusive groups (atopic asthma, nonatopic asthma, and no asthma). We determined viral cause using PCR and the severity of the infant’s respiratory tract infection using the bronchiolitis severity score. Adjusted relative odds of maternal asthma with viral cause were calculated by using logistic regression. Proportional odds models assessed the association of maternal asthma and infant infection severity. Results Infants with a mother with atopic asthma compared with infants whose mothers did not have asthma were more likely to have rhinovirus versus RSV infection (adjusted odds ratio, 2.42; 95% CI, 1.19-4.90). Similarly, among infants with rhinovirus, having a mother with atopic asthma was associated with increased infection severity (adjusted odds ratio, 3.10; 95% CI, 1.21-7.98). This relationship was not seen among infants with RSV. Conclusions Clinically significant rhinovirus infection during infancy was more strongly associated with having a mother with atopic asthma than clinically significant RSV infection. Having a mother with atopic asthma was associated with increased severity of infant rhinovirus but not RSV infections. Infants with rhinovirus were more likely to have a familial atopic predisposition, which might partly explain the subsequent increased asthma risk.
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Affiliation(s)
- Kecia N Carroll
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
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Chéron G, Patteau G, Nouyrigat V. Bronchiolite del lattante. EMC - URGENZE 2011. [PMCID: PMC7149004 DOI: 10.1016/s1286-9341(11)70664-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
La bronchiolite è un’infezione virale stagionale delle vie respiratorie basse del lattante. Il suo agente causale principale è il virus respiratorio sinciziale. La comparsa di un distress respiratorio è legata all’intensità della risposta infiammatoria delle vie aeree. Benché si tratti di una malattia frequente, le cause della suscettibilità dei lattanti a questa infezione non sono conosciute. La diagnosi è clinica. Il trattamento è sintomatico in assenza di misure specifiche. I rapporti a medio e a lungo termine di un primo episodio di bronchiolite con le recidive e con l’asma non sono spiegati. Essi potrebbero dipendere dalla natura del virus in causa al momento del primo episodio e da fattori genetici individuali.
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Forno E, Fuhlbrigge A, Soto-Quirós ME, Avila L, Raby BA, Brehm J, Sylvia JM, Weiss ST, Celedón JC. Risk factors and predictive clinical scores for asthma exacerbations in childhood. Chest 2010; 138:1156-65. [PMID: 20472862 PMCID: PMC2972623 DOI: 10.1378/chest.09-2426] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2009] [Accepted: 04/13/2010] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Asthma is a major public health problem that affects millions of children worldwide, and exacerbations account for most of its morbidity and costs. Primary-care providers lack efficient tools to identify children at high risk for exacerbations. We aimed to construct a clinical score to help providers to identify such children. METHODS Our main outcome was severe asthma exacerbation, which was defined as any hospitalization, urgent visit, or systemic steroid course for asthma in the previous year, in children. A clinical score, consisting of a checklist questionnaire made up of 17 yes-no questions regarding asthma symptoms, use of medications and health-care services, and history, was built and validated in a cross-sectional study of Costa Rican children with asthma. It was then evaluated using data from the Childhood Asthma Management Program (CAMP), a longitudinal trial cohort of North American children. RESULTS Compared with children at average risk for an exacerbation in the Costa Rican validation set, the odds of an exacerbation among children in the low-risk (OR, 0.2; 95% CI, 0.1-0.4) and high-risk (OR, 5.4; 95% CI, 1.5-19.2) score categories were significantly reduced and increased, respectively. In CAMP, the hazard ratios for an exacerbation after 1-year follow-up in the low-risk and high-risk groups were 0.6 (95% CI, 0.5-0.7) and 1.9 (95% CI, 1.4-2.4), respectively, with similar results at 2 years. CONCLUSIONS The proposed Asthma Exacerbation Clinical Score is simple to use and effective at identifying children at high and low risk for asthma exacerbations. The tool can easily be used in primary-care settings.
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Affiliation(s)
- Erick Forno
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
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Lim JS, Woo SI, Kwon HI, Baek YH, Choi YK, Hahn YS. Clinical characteristics of acute lower respiratory tract infections due to 13 respiratory viruses detected by multiplex PCR in children. KOREAN JOURNAL OF PEDIATRICS 2010. [DOI: 10.3345/kjp.2010.53.3.373] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jeong-Sook Lim
- Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Sung-Il Woo
- Chuncheong Respiratory Disease Center, Chungbuk National University Hospital, Cheongju, Korea
| | - Hyuk-Il Kwon
- Department of Microbiology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Yun-Hee Baek
- Department of Microbiology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Young-Ki Choi
- Department of Microbiology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Youn-Soo Hahn
- Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea
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