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Muacevic A, Adler JR, Sharahili A, Bin Dayel MA, Al Eissa AI, Alilaj MO. Bronchial Asthma Exacerbation in the Emergency Department in a Saudi Pediatric Population: An Insight From a Tertiary Hospital in Riyadh, Saudi Arabia. Cureus 2023; 15:e33391. [PMID: 36751261 PMCID: PMC9899039 DOI: 10.7759/cureus.33391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 01/07/2023] Open
Abstract
Background Severe uncontrolled asthma in the pediatric population is a complicated disease and is considered a major challenge for pediatricians. Severe bronchial asthma in the pediatric population is related to significant morbidity and mortality. Children with complicated asthma are at a higher risk for unfavorable outcomes, including medication-associated adverse effects, severe life-threatening exacerbations, and poor quality of life. Methodology A cohort study was conducted at National Guard Health Affairs Hospital in Riyadh, Saudi Arabia. Data were collected using the chart review method utilizing a data collection sheet. A total of 363 charts of children aged one month to 14 years who visited the emergency room (ER) due to asthma exacerbation at NGHA were reviewed, from January 2016 to May 2022, to extract the variables. Variables included demographic data, comorbidities, and asthma-related variables which included the number of asthma exacerbations, hospital admission, ER visit, medication use (non-steroidal anti-inflammatory drugs and steroids), and the presence of allergic rhinitis and eczema. Results A total of 363 patients were analyzed, with 229 (63.1%) males and 134 (36.9%) females. The mean age was 4.9 years (SD = 3.5 years). Overall, 8.5% of patients had congenital heart disease, 4.1% had gastroesophageal reflux disease, 2.2% had diabetes mellitus, 1.9% had obstructive sleep apnea, and 0.6% had hypertension. Most patients presented with a cough at 88.2% (n = 320), followed by shortness of breath at 59% (n = 214) and fever at 46% (n = 167). Male asthmatics visited ER more than females. Forty-four patients were admitted to the hospital. Inhaled steroids were associated with fewer emergency department visits and night symptoms. Most asthmatic patients presented in the winter and fall seasons. Conclusions Asthma is a common pediatric respiratory disease that could be a burden if not controlled well. Unfortunately, the frequency of hospital admissions and pediatric ER visits due to asthma exacerbation is increasing. Comorbidities such as obesity and gastroesophageal reflux disease play a significant role in asthma control.
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Kopp MV, Muche-Borowski C, Abou-Dakn M, Ahrens B, Beyer K, Blümchen K, Bubel P, Chaker A, Cremer M, Ensenauer R, Gerstlauer M, Gieler U, Hübner IM, Horak F, Klimek L, Koletzko BV, Koletzko S, Lau S, Lob-Corzilius T, Nemat K, Peters EM, Pizzulli A, Reese I, Rolinck-Werninghaus C, Rouw E, Schaub B, Schmidt S, Steiß JO, Striegel AK, Szépfalusi Z, Schlembach D, Spindler T, Taube C, Trendelenburg V, Treudler R, Umpfenbach U, Vogelberg C, Wagenmann M, Weißenborn A, Werfel T, Worm M, Sitter H, Hamelmann E. S3 guideline Allergy Prevention. Allergol Select 2022; 6:61-97. [PMID: 35274076 PMCID: PMC8905073 DOI: 10.5414/alx02303e] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/14/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The persistently high prevalence of allergic diseases in Western industrial nations and the limited possibilities of causal therapy make evidence-based recommendations for primary prevention necessary. METHODS The recommendations of the S3 guideline Allergy Prevention, published in its last version in 2014, were revised and consulted on the basis of a current systematic literature search. The evidence search was conducted for the period 06/2013 - 11/2020 in the electronic databases Cochrane and MEDLINE, as well as in the reference lists of current reviews and through references from experts. The literature found was screened in two filtering processes, first by title and abstract, and the remaining papers were screened in the full text for relevance. The studies included after this were sorted by level of evidence, and the study quality was indicated in terms of potential bias (low/high). The revised recommendations were formally agreed and consented upon with the participation of representatives of the relevant professional societies and (self-help) organizations (nominal group process). Of 5,681 hits, 286 studies were included and assessed. RESULTS Recommendations on maternal nutrition during pregnancy and breastfeeding as well as on infant nutrition in the first months of life again play an important role in the updated guideline: Many of the previous recommendations were confirmed by the current data. It was specified that breastfeeding should be exclusive for the first 4 - 6 months after birth, if possible, and that breastfeeding should continue with the introduction of complementary foods. A new recommendation is that supplementary feeding of cow's milk-based formula should be avoided in the first days of life if the mother wishes to breastfeed. Furthermore, it was determined that the evidence for a clear recommendation for hydrolyzed infant formula in non-breastfed infants at risk is currently no longer sufficient. It is therefore currently recommended to check whether an infant formula with proven efficacy in allergy prevention studies is available until the introduction of complementary feeding. Finally, based on the EAACI guideline, recommendations were made for the prevention of chicken egg allergy by introducing and regularly giving thoroughly heated (e.g., baked or hard-boiled) but not "raw" chicken egg (also no scrambled egg) with the complementary food. The recommendation to introduce peanut in complementary feeding was formulated cautiously for the German-speaking countries: In families who usually consume peanut, the regular administration of peanut-containing foods in age-appropriate form (e.g., peanut butter) with the complementary diet can be considered for the primary prevention of peanut allergy in infants with atopic dermatitis (AD). Before introduction, a clinically relevant peanut allergy must be ruled out, especially in infants with moderate to severe AD. There is still insufficient evidence for an allergy-preventive efficacy of prebiotics or probiotics, vitamin D, or other vitamins in the form of supplements so that recommendations against their supplementation were adopted for the first time in the current guideline. Biodiversity plays an important role in the development of immunological tolerance to environmental and food allergens: there is clear evidence that growing up on a farm is associated with a lower risk of developing asthma and allergic diseases. This is associated with early non-specific immune stimulation due to, among other things, the greater microbial biodiversity of house dust in this habitat. This aspect is also reflected in the recommendations on animal husbandry, on which a differentiated statement was made: In families without a recognizable increased allergy risk, pet keeping with cats or dogs should not generally be restricted. Families with an increased allergy risk or with children with already existing AD should not acquire a new cat - in contrast, however, dog ownership should not be discouraged. Interventions to reduce exposure to dust mite allergens in the home, such as the use of mite allergen-proof mattress covers ("encasings"), should be restricted to patients with already proven specific sensitization against house dust mite allergen. Children born by caesarean section have a slightly increased risk of asthma - this should be taken into account when advising on mode of delivery outside of emergency situations. Recent work also supports the recommendations on air pollutants: Active and passive exposure to tobacco smoke increase the risk of allergies, especially asthma, and should therefore be avoided. Exposure to nitrogen oxides, ozone, and small particles (PM 2.5) is associated with an increased risk, especially for asthma. Therefore, exposure to emissions of nitrogen oxides, ozone, and small particles (PM 2.5) should be kept low. The authors of this guideline are unanimously in favor of enacting appropriate regulations to minimize these air pollutants. There is no evidence that vaccinations increase the risk of allergies, but conversely there is evidence that vaccinations can reduce the risk of allergies. All children, including children at risk, should be vaccinated according to the current recommendations of the national public health institutes, also for reasons of allergy prevention. CONCLUSION The consensus of recommendations in this guideline is based on an extensive evidence base. The update of the guideline enables evidence-based and up-to-date recommendations for the prevention of allergic diseases including asthma and atopic dermatitis.
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Affiliation(s)
- Matthias V. Kopp
- Airway Research Center North, University of Lübeck, Member of Deutsches Zentrum für Lungenforschung, Universitätsklinik für Kinderheilkunde, Inselspital, Bern, Switzerland
| | - Cathleen Muche-Borowski
- Institut für Allgemeinmedizin, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Abou-Dakn
- Clinic for Gynecology and Obstetrics, St. Joseph-Krankenhaus Berlin-Tempelhof, Germany
| | - Birgit Ahrens
- Children’s Hospital, University Hospital Frankfurt, Germany
| | - Kirsten Beyer
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Germany
| | | | | | - Adam Chaker
- HNO-Klinik, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Monika Cremer
- Ökotrophologin, Journalistin, Idstein/Taunus, Germany
| | - Regina Ensenauer
- Institut für Kinderernährung, Max Rubner-Institut, Karlsruhe, Germany
| | | | - Uwe Gieler
- Klinik für Psychosomatik und Psychotherapie des UKGM, Universitätsklinik, Giessen, Germany
| | - Inga-Marie Hübner
- Arbeitsgemeinschaft Dermatologiche Prävention e.V., Hamburg, Germany
| | | | - Ludger Klimek
- Zentrum für Rhinologie und Allergologie, Wiesbaden, Germany
| | - Berthold V. Koletzko
- Integriertes Sozialpädiatrisches Zentrum, Dr. von Haunerschen Kinderspital, LMU Klinikum der Universität München, Munich, Germany
| | - Sybille Koletzko
- Abteilung für Stoffwechsel und Ernährung, Dr. von Haunersches Kinderspital, LMU Klinikum der Universität München, Munich, Germany
| | - Susanne Lau
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Germany
| | | | - Katja Nemat
- Kinderzentrum Dresden-Friedrichstadt, Dresden, Germany
| | - Eva M.J. Peters
- Klinik für Psychosomatik und Psychotherapie des UKGM, Universitätsklinik, Giessen, Germany
| | - Antonio Pizzulli
- Schwerpunktpraxis für Allergologie und Lungenheilkunde im Kinder- und Jugendalter, Berlin, Germany
| | - Imke Reese
- Ernährungsberatung und -therapie mit Schwerpunkt Allergologie, Munich, Germany
| | | | | | - Bianca Schaub
- Asthma- und Allergieambulanz, Dr. von Haunersches Kinderspital, LMU Klinikum der Universität, Munich, Germany
| | - Sebastian Schmidt
- Allgemeine Pädiatrie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | | | | | - Zsolt Szépfalusi
- Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Vienna, Austria
| | | | | | - Christian Taube
- Klinik für Pneumologie, Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum, Essen, Germany
| | - Valérie Trendelenburg
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Germany
| | - Regina Treudler
- Klinik für Dermatologie, Venerologie und Allergologie, Leipziger Allergie-Centrum LICA – CAC, Universitätsmedizin, Leipzig, Germany
| | | | - Christian Vogelberg
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus an der Technischen Universität, Dresden, Germany
| | - Martin Wagenmann
- HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Anke Weißenborn
- German Federal Institute for Risk Assessment, Berlin, Germany
| | - Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Margitta Worm
- Klinik für Dermatologie, Allergologie und Venerologie, Campus Charité Mitte, Universitätsmedizin Berlin, Berlin, Germany
| | - Helmut Sitter
- Institut für Chirurgische Forschung, Philipps-Universität, Marburg, Germany, and
| | - Eckard Hamelmann
- Kinder-Zentrum Bethel, Evangelisches Klinikum Bethel, Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum OWL, Universität Bielefeld, Bielefeld, Germany
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Sio YY, Chew FT. Risk factors of asthma in the Asian population: a systematic review and meta-analysis. J Physiol Anthropol 2021; 40:22. [PMID: 34886907 PMCID: PMC8662898 DOI: 10.1186/s40101-021-00273-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Background and objective An increasing trend of asthma prevalence was observed in Asia; however, contributions of environmental and host-related risk factors to the development of this disease remain uncertain. This study aimed to perform a systematic review and meta-analysis for asthma-associated risk factors reported in Asia. Methods We systematically searched three public databases (Web of Science, PubMed, and Scopus) in Feb 2021. We only included articles that reported environmental and host-related risk factors associated with asthma in the Asian population. Random-effect meta-analyses were conducted for frequently reported asthma-associated risk factors to provide an overall risk estimate of asthma development. Results Of 4030 records obtained from public databases, 289 articles were selected for review. The most frequently reported asthma-associated risk factor was the family history of allergy-related conditions. The random-effect asthma risk estimates (pooled odds ratio, OR) were 4.66 (95% confidence interval (CI): 3.73–5.82) for the family history of asthma, 3.50 (95% CI: 2.62–4.67) for the family history of atopy, 3.57 (95% CI: 3.03–4.22) for the family history of any allergic diseases, 1.96 (95% CI: 1.47–2.61) for the family history of allergic rhinitis, and 2.75 (95% CI: 1.12–6.76) for the family history of atopic dermatitis. For housing-related factors, including the presence of mold, mold spots, mold odor, cockroach, water damage, and incense burning, the random-effect pooled OR ranged from 1.43 to 1.73. Other risk factors with significant pooled OR for asthma development included male gender (1.30, 95% CI: 1.23–1.38), cigarette smoke exposure (1.44, 95% CI: 1.30–1.60), cigarette smoking (1.66, 95% CI: 1.44–1.90), body mass index (BMI)–related parameters (pooled OR ranged from 1.06 to 2.02), various types of air pollution (NO2, PM10, and O3; pooled OR ranged from 1.03 to 1.22), and pre- and perinatal factors (low birth weight, preterm birth, and cesarean section; pooled OR ranged from 1.14 to 1.32). Conclusions The family history of asthma was the most frequently reported risk factor for asthma development in Asia with the highest risk estimate for asthma development. This suggests a major role of the genetic component in asthma pathogenesis. Further study on asthma genetics is required to improve the current understanding of asthma etiology. Supplementary Information The online version contains supplementary material available at 10.1186/s40101-021-00273-x.
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Affiliation(s)
- Yang Yie Sio
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore
| | - Fook Tim Chew
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore.
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Musharrafieh U, Tamim H, Houry R, AlBuhairan F. A nationwide study of asthma correlates among adolescents in Saudi Arabia. Asthma Res Pract 2020; 6:3. [PMID: 32514367 PMCID: PMC7262750 DOI: 10.1186/s40733-020-00056-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 04/27/2020] [Indexed: 11/15/2022] Open
Abstract
Background Asthma is a chronic airway inflammation disease that is frequently found in children and adolescents with an increasing prevalence. Several studies are linking its presence to many lifestyle and health correlates. The objective of this study was to explore these correlates and find characteristics of self-reported asthmatics among adolescents in Saudi Arabia. Methods This is a cross-sectional, school-based study carried out in all 13 regions of Saudi Arabia. Sampling was randomly done from intermediate and secondary school students. Data in our study consisted of demographic characteristics, health conditions and lifestyle patterns and were compared between the two groups: asthmatics versus non-asthmatics. Comparison between the two groups was done by analyzing our data using Statistical Analysis Software SURVEYFREQ procedure (SAS Version 9; SAS Institute, Cary, NC). Results Among a sample of 11,348 participants, the prevalence of self-reported asthma was found to be 8.2%. Various characteristics were found significantly different between the 2 groups including the gender, the weight, the family’s education, and dietary patterns. Self –reported asthmatic were more likely to be males, overweight or obese, with a lower father’s level of education and a higher consumption of milk and power drinks. Conclusion Asthma disease remains prevalent among adolescents in Saudi Arabia and requires higher awareness and better guidance for its prevention and treatment. Further efforts should focus on health promotion and lifestyle wellness to support preventive efforts of this chronic disease condition.
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Affiliation(s)
- Umayya Musharrafieh
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rana Houry
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadia AlBuhairan
- Department of Pediatrics and Adolescent Medicine, AlDara Hospital and Medical Center; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Saheb Sharif-Askari N, Sharif HA, Saheb Sharif-Askari F, Hamid Q, Abusnana S, Hamoudi R. Association between body mass index and asthma severity in Arab pediatric population: A retrospective study. PLoS One 2019; 14:e0226957. [PMID: 31881055 PMCID: PMC6934300 DOI: 10.1371/journal.pone.0226957] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 12/09/2019] [Indexed: 01/22/2023] Open
Abstract
Increased body mass index (BMI) has been associated with an increased prevalence of asthma in children, however the association between BMI status and asthma severity has been less well defined. The aim of this study was to describe the association between childhood obesity and asthma severity, frequency of hospital and emergency department visits as well as pattern of aeroallergen sensitization. A retrospective study was conducted at pediatric outpatient clinics in University Hospital Sharjah. All consecutive patients aged 6 years and above, with confirmed diagnosis of asthma visiting the outpatient pediatric clinics during 2018 were included in this study. Sources of information were the patient’s medical file, laboratory data, pharmacy data, as well as reports from the pediatric in charge. This study included 164 children with asthma. 63% of asthma patients were male. The vast majority of patients were from Arab ethnicities (n = 154, 94%), majority had mild asthmatic conditions (n = 133, 81%), and one-third were either overweight or obese (n = 52, 32%). Overweight or obese asthmatic children with BMI percentile of equal or more than 85% was associated with more asthma severity (odds ratio [OR]: 3.27, 95% confidence interval [CI]: 1.42–7.54; P = 0.005), as well as more frequent asthma related hospital visits (OR: 2.53, 95% CI: 1.22–5.26; P = 0.013). Overweight asthmatic children with BMI between the 85th and 94th percentiles and obese asthmatic children with BMI equal to or greater than 95th percentile are associated with more severe asthma phenotype and more frequent hospital and emergency department visits.
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Affiliation(s)
- Narjes Saheb Sharif-Askari
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Fatemeh Saheb Sharif-Askari
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Qutayba Hamid
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Salah Abusnana
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Rifat Hamoudi
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- * E-mail:
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Al-Ayed M, Alshaybari K, Alshehri D, Jamaan A, Nasser I, Alaamri H, Alaseeri W, Mahfouz AA, Ali Alsareli S, Asaad AM, Ali Magzoub A, Qureshi MA, Shalayel MH. Obesity and childhood asthma in male schoolchildren in Saudi Arabia: Is there a role for leptin, interleukin-4, interleukin-5, and interleukin-21? Ann Saudi Med 2019; 39:295-301. [PMID: 31580718 PMCID: PMC6832322 DOI: 10.5144/0256-4947.2019.295] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Adiposity is associated with high serum levels of adipokines and chemokines which are possibly implicated in a co-existence of obesity and asthma. OBJECTIVES Elucidate the possible roles of leptin, interleukin (IL)-4, IL-5 and IL-21 in linking obesity with childhood asthma. DESIGN Cross-sectional, analytical. SETTING Population of schoolchildren in a small Saudi city. SUBJECTS AND METHODS The study included a representative sample of Saudi schoolchildren grouped as obese asthmatics, non-obese asthmatics, or obese nonasthmatics, with nonobese nonasthmatics as a control group. An asthma control test was done for the asthmatic groups. MAIN OUTCOME MEASURES Serum levels of leptin, IL-4, IL-5, and IL-21. SAMPLE SIZE 345 male schoolchildren with a mean (SD) age of 13.0 (2.3) years. RESULTS Median serum leptin concentrations in obese asthmatics were significantly higher than in nonobese asthmatics ( P<.001). Uncontrolled asthmatics also had significantly higher leptin levels than controlled asthmatic children ( P<.002). Leptin levels were weakly but significantly correlated with the cytokines IL-4, IL-5, and IL-21. CONCLUSIONS Leptin may contribute to a link between obesity and childhood asthma. Differences in IL-21 levels between nonobese and obese asthmatics suggest that the co-existence of asthma and obesity increased IL-21 levels. Leptin plus some proinflammatory cytokines especially IL-21 may be potential predictors for asthma control in children. LIMITATIONS Blood sampling at different stages of asthma might influence cytokine expression. CONFLICT OF INTEREST None.
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Affiliation(s)
- Mohammed Al-Ayed
- From the Department of Pediatrics, College of Medicine, Najran University, Najran, Saudi Arabia
| | - Khalid Alshaybari
- From the Department of Pediatrics, College of Medicine, Najran University, Najran, Saudi Arabia
| | - Dhafer Alshehri
- From the Department of Pediatrics, College of Medicine, Najran University, Najran, Saudi Arabia
| | - Alzahrani Jamaan
- From the Department of Pediatrics, College of Medicine, Najran University, Najran, Saudi Arabia
| | - Iman Nasser
- From the Department of Pediatrics, College of Medicine, Najran University, Najran, Saudi Arabia
| | - Hamdan Alaamri
- From the Department of Pediatrics, Armed Forces Medical Services, Ministry of Defense, Najran, Saudi Arabia
| | - Wed Alaseeri
- From the Department of Pediatrics, Ministry of Health, Saudi Arabia
| | - Ahmed A Mahfouz
- From the Department of Family Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Ahmed Morad Asaad
- From the Department of Microbiology, College of Medicine, Najran University, Najran, Saudi Arabia
| | - Aamir Ali Magzoub
- From the Department Physiology, College of Medicine, Najran University, Najran, Saudi Arabia
| | - Mohamed Ansar Qureshi
- From the Department of Microbiology, College of Medicine, Najran University, Najran, Saudi Arabia
| | - Mohammed Helmy Shalayel
- From the Department of Biochemistry, College of Medicine, Najran University, Najran, Saudi Arabia
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Hammoudeh S, Gadelhak W, Janahi IA. Asthma and obesity in the Middle East region: An overview. Ann Thorac Med 2019; 14:116-121. [PMID: 31007762 PMCID: PMC6467016 DOI: 10.4103/atm.atm_115_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 08/07/2018] [Indexed: 01/03/2023] Open
Abstract
This paper aims to cover the current status of asthma and obesity in the Middle East, as well as to introduce the various studies tying the two diseases; further expanding on the proposed mechanisms. Finally, the paper covers recent literature related to sphingolipids and its role in asthma, followed by recommendations and future directions. In preparation of this paper, we searched PubMed and Google Scholar, with no restrictions, using the following terms; asthma, obesity, Middle East, sphingolipids. We also used the reference list of retrieved articles to further expand on the pool of articles that were used for this review.
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Affiliation(s)
- Samer Hammoudeh
- Medical Research Center, Research Affairs, Hamad Medical Corporation, Doha, Qatar
| | - Wessam Gadelhak
- Medical Research Center, Research Affairs, Hamad Medical Corporation, Doha, Qatar
| | - Ibrahim A. Janahi
- Medical Research Center, Research Affairs, Hamad Medical Corporation, Doha, Qatar
- Pediatric Pulmonology, Hamad Medical Corporation, Doha, Qatar
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8
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Azizpour Y, Delpisheh A, Montazeri Z, Sayehmiri K, Darabi B. Effect of childhood BMI on asthma: a systematic review and meta-analysis of case-control studies. BMC Pediatr 2018; 18:143. [PMID: 29699517 PMCID: PMC5922016 DOI: 10.1186/s12887-018-1093-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 03/15/2018] [Indexed: 01/07/2023] Open
Abstract
Background Asthma is a multifactorial syndrome that threatens the health of children. Body mass index (BMI) might be one of the potential factors but the evidence is controversial. The aim of this study is to perform a comprehensive meta-analysis to investigate the association between asthma and BMI. Methods Electronic databases including, Web of Science, Pubmed, Scopus, Science Direct, ProQuest, up to April 2017, were searched by two researchers independently. The keywords “asthma, body mass index, obesity, overweight, childhood and adolescence” were used. Random and fixed effects models were applied to obtain the overall odds ratios (ORs) and standardized mean difference (SMD). Heterogeneity between the studies was examined using I2 and Cochrane Q statistics. Results After reviewing 2511 articles, 16 studies were eligible for meta-analysis according to inclusion/exclusion criteria. A meta-analysis from 11 case-control studies revealed OR of asthma and overweight as OR = 1.64; (95% Confidence Interval (CI): 1.13–2.38) and from 14 case-control studies, OR for asthma and obesity was OR = 1.92 (95% CI: 1.39–2.65), which indicated that risk of asthma in overweight and obese children and adolescence was significantly higher (1.64 and 1.92 times) than that of individuals with (p-value < 0.01 for underweight/normal weight in both cases). Furthermore, there was a significant relationship between asthma and BMI > 85 percentile according to SMD SMD = 0.21; (95%CI: 0.03–0.38; p-value = 0.021). Conclusions The results showed a significant relationship between BMI (obesity/overweight) and asthma among children and adolescents. It is important to study the confounding factors that affect the relationship between asthma and BMI in future epidemiological researches. Electronic supplementary material The online version of this article (10.1186/s12887-018-1093-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yosra Azizpour
- Department of Clinical Epidemiology, Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Delpisheh
- Department of Clinical Epidemiology, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Zahra Montazeri
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Kourosh Sayehmiri
- Department of Biostatistics, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran.
| | - Behzad Darabi
- Department of Pediatrics, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
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Abstract
OBJECTIVE This literature review aims to compare obese-asthmatic adults and children, and to characterize differences and similarities between the two subgroups from epidemiological, demographical, phenotypical, and physiological perspectives. METHODS Literature search was conducted using Pubmed database with "obesity," "asthma," "epidemiology," "cluster analysis," "demography," "mechanics," and ''FeNO'' as search terms. METHODS Articles investigating epidemiological, demographic, phenotypical variation, and mechanical aspects of breathing specifically in obese asthmatics were identified. The studies were then divided according to age: children (<18 years of age) and adults (>18 years of age). RESULTS Increase in asthma incidence and prevalence is observed in both obese-asthmatic children and adults. Asthma prevalence is greater in adult females regardless of ethnic background, and in men of African American and Hispanic ethnicities. Degree of weight gain and early onset of menarche appears to directly affect asthma severity in adolescent girls and females. Airway hyperresponsiveness and fractional exhaled nitric oxide do not have any positive correlation with high BMI in obese-asthmatic children and adults. Obesity also alters lung mechanics in asthmatics, but the impact is different for children and adults likely due to differential effect of obesity on central and peripheral airway. CONCLUSION Existing literature suggests both similarities and differences in obese-asthmatic children and adults. The most pertinent differences are related to gender, ethnicity, and lung functions.
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Affiliation(s)
- Faiza Khalid
- a Department of Internal Medicine , University Hospitals Cleveland Medical Center/ Case Western Reserve University , Cleveland , OH , USA
| | - Fernando Holguin
- b Division of Pulmonary and Critical Care , University of Colorado , Denver , CO , USA
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10
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Alhekail GA, Althubaiti A, AlQueflie S. The association between body mass index and frequency of emergency department visits and hospitalization for asthma exacerbation in a pediatric population. Ann Saudi Med 2017; 37:415-419. [PMID: 29229888 PMCID: PMC6074121 DOI: 10.5144/0256-4947.2017.415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The prevalence of both asthma and obesity are increasing. Although some studies suggest an association between body mass index (BMI) and frequency of emergency department (ED) visits and hospitalization for asthma exacerbation, any association remains unproven. OBJECTIVE Estimate the frequency of asthma exacerbation in obese children, and identify any relationship between BMI and frequency of ED visits and hospitalization for asthma exacerbation. DESIGN Retrospective review of medical records. SETTINGS Tertiary children's hospital, Riyadh. SUBJECTS AND METHODS All children aged 2-15 years who attended the ED for asthma exacerbation between January 2015 and January 2016 were included. Children with comorbidities or undocumented asthma were excluded. The Centers for Disease Control and Prevention BMI-for-age growth charts for boys and girls aged 2 to 20 years were used to classify underweight, normal, overweight, and obese. MAIN OUTCOME MEASURES The frequency of ED visits and the rate, frequency, and duration of hospitalization. RESULTS Of the 1000 cases reviewed, 64.6% were boys and the mean age (standard deviation) of all sub.jects was 5.6 (3.3) years. The proportions of overweight and obese children was 11.8% and 12.1%, respectively. There was no association between increased BMI and frequency of ED visits for asthma exacerbation (P=.84), duration of hospitalization (P=.41) or frequency of hospitalization (P=.89). CONCLUSION There was no evidence of an association between BMI and frequency of ED visits and hospitalization for asthma exacerbation among children. LIMITATIONS This study included patients as young as 2 years, while asthma is only well-defined in children > 5 years. Asthma triggers that can cause exacerbation despite body weight were not included. We included only frequency of ED visits and hospitalization, which may be inadequate to measure asthma severity.
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Affiliation(s)
- Ghadah Abdulrahman Alhekail
- Dr. Ghadah Abdulrahman Alhekail, College of Medicine, King Saud bin Abdulaziz University for Health Sciences,, PO Box 3660, Riyadh 11426, Saudi Arabia, T: +966502451666, , ORCID: http://orcid.org/0000-0003-0571-6457
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11
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Stephenson P, Sheikh A. Working in harmony with Nature: highlights from 2014, and a look to the future. NPJ Prim Care Respir Med 2015; 25:15031. [PMID: 25905859 PMCID: PMC4532159 DOI: 10.1038/npjpcrm.2015.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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The S6K protein family in health and disease. Life Sci 2015; 131:1-10. [PMID: 25818187 DOI: 10.1016/j.lfs.2015.03.001] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 03/02/2015] [Accepted: 03/05/2015] [Indexed: 02/06/2023]
Abstract
The S6K proteins are mTOR pathway effectors and accumulative evidence suggest that mTOR/S6K signaling contributes to several pathological conditions, such as diabetes, cancer and obesity. The activation of the mTOR/S6K axis stimulates protein synthesis and cell growth. S6K1 has two well-known isoforms, p70-S6K1 and p85-S6K1, generated by alternative translation initiation sites. A third isoform, named p31-S6K1, has been characterized as a truncated type of the protein due to alternative splicing, and reports have shown its important role in cancer. Studies involving S6K2 are scarce. This article aims to review what is new in the literature about these kinases and establish differences regarding their interacting proteins, activation and function, connecting their roles in the homeostasis of the cell and in pathological conditions.
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13
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Saadeh D, Salameh P, Caillaud D, Charpin D, de Blay F, Kopferschmitt C, Lavaud F, Annesi-Maesano I, Baldi I, Raherison C. High body mass index and allergies in schoolchildren: the French six cities study. BMJ Open Respir Res 2014; 1:e000054. [PMID: 26034606 PMCID: PMC4448005 DOI: 10.1136/bmjresp-2014-000054] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 10/03/2014] [Indexed: 12/24/2022] Open
Abstract
Background The prevalence of allergic diseases such as asthma, allergic rhinitis and atopic dermatitis is increasing rapidly worldwide, especially among children and in western countries. This coincides with an increase in body mass index (BMI), which might be a major risk factor for atopic diseases. Objectives To study the relationship between high BMI and allergic diseases, as well as skin-prick test (SPT) positivity and exercise-induced asthma (EIA) in 6733 randomly selected schoolchildren aged 9–11 years in the French Six Cities Study. Methods A cross-sectional study was carried out in Bordeaux, Clermont-Ferrand, Créteil, Marseille, Reims and Strasbourg. Parental questionnaires based on the International Study on Asthma and Allergies in Childhood (ISAAC) were used to collect information on allergic diseases and potential risk factors. Skin-prick testing to common allergens was performed to identify the existence of an allergic hypersensitivity and an exercise test was also performed to assess EIA. Height and weight were collected by trained investigators. After computing the BMI (weight/height squared), the International Obesity Task Force (IOTF) cut-offs were used to define overweight and obesity. The children were also classified as wheezing or non-wheezing. Results After adjustment for confounding factors, lifetime asthma was associated with high BMI among non-wheezing children (adjusted OR, aOR=1.98, 95% CI (1.06 to 3.70)). In addition, lifetime and past-year allergic rhinitis was associated with high BMI in wheezing children (aOR=1.63, (1.09 to 2.45) and aOR=2.20, (1.13 to 4.27)). However, high BMI was not significantly associated with eczema, SPT positivity or EIA. Conclusions This study shows a positive association between high BMI and lifetime asthma in non-wheezing children. High BMI was also associated with lifetime and past-year allergic rhinitis. Further studies are needed to provide causal evidence.
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Affiliation(s)
- Danielle Saadeh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy , Lebanese University , Hadath , Lebanon ; INSERM U897, Institut de Santé Publique d'Epidémiologie et de Développement, Université de Bordeaux , Bordeaux , France
| | - Pascale Salameh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy , Lebanese University , Hadath , Lebanon
| | | | | | | | | | | | - Isabella Annesi-Maesano
- EPAR, UMR-S 1136, Institute Pierre Louis of Epidemiology and Public Health, INSERM and UPMC Sorbonne Universites , Paris , France
| | - Isabelle Baldi
- INSERM U897, Institut de Santé Publique d'Epidémiologie et de Développement, Université de Bordeaux , Bordeaux , France
| | - Chantal Raherison
- INSERM U897, Institut de Santé Publique d'Epidémiologie et de Développement, Université de Bordeaux , Bordeaux , France ; Service des maladies respiratoires , Hôpital du Haut-Lévèque, Avenue de Magellan , Pessac , France
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