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Al-Haggar M, Osman E, Eid AR, Barakat T, El-Morsi S. Screening for the Most Common Mutations of CFTR Gene among Egyptian Children with Difficult-to-Treat Asthma. J Pediatr Genet 2020; 9:164-170. [PMID: 32714616 DOI: 10.1055/s-0040-1701446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 12/30/2019] [Indexed: 10/25/2022]
Abstract
Cystic fibrosis (CF) is panethnic autosomal recessive disease that affects the exocrine glands of pancreas, lungs, and intestine. It is often misdiagnosed in developing countries as difficult-to-treat asthma. We enrolled 150 Egyptian families with one or more probands who were complaining of difficult-to-treat asthma, and 112 cases were studied extensively through history taking including pedigree construction and clinical examination. In addition, spirometry and computed tomography of the chest were done in selected cases. All cases were subjected to quantitative sweat chloride test and molecular screening for the three most common mutations of cystic fibrosis transconductance regulator ( CFTR ) gene ( ΔF508 , G542X , W1282X ) using amplification refractory mutation system (ARMS) technique. Probands of difficult-to-treat asthma comprised 66 males and 46 females; their age range was 1 to 14 years. Sixty-one probands (54.5%) were carriers of one or more of the studied mutations (36 cases and 25 carriers). Six carriers of single mutations had mild respiratory symptoms and negative sweat test. The most common allele was ΔF508 , 60 alleles in 56 individuals (4 were homozygous ΔF508 / ΔF508 ) followed by W1282X in 25 individuals and G542X in 12 individuals. Allele W1282X had an increased risk of recurrent chest infection and bronchiectasis. Moreover, cases with two mutations had more severe symptoms compared with those with a single mutation. CFTR mutations and CF-related syndromes are not rare as thought in Egypt, especially among the high-risk difficult-to-treat asthma. The readily available ARMS technique is recommended for ΔF508 and/or W1282X screening on priority basis among these children.
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Affiliation(s)
- Mohammad Al-Haggar
- Genetics Unit, Pediatrics Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Engy Osman
- Pulmonology Unit, Pediatrics Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Abdel-Rahman Eid
- Genetics Unit, Pediatrics Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Tarek Barakat
- Genetics Unit, Pediatrics Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samar El-Morsi
- Pediatrics Department, Faculty of Medicine, Mansoura University Children's Hospital, Mansoura, Egypt
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Ferraro V, Carraro S, Bozzetto S, Zanconato S, Baraldi E. Exhaled biomarkers in childhood asthma: old and new approaches. Asthma Res Pract 2018; 4:9. [PMID: 30094051 PMCID: PMC6081883 DOI: 10.1186/s40733-018-0045-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/30/2018] [Indexed: 12/21/2022] Open
Abstract
Background Asthma is a chronic condition usually characterized by underlying inflammation. The study of asthmatic inflammation is of the utmost importance for both diagnostic and monitoring purposes. The gold standard for investigating airway inflammation is bronchoscopy, with bronchoalveolar lavage and bronchial biopsy, but the invasiveness of such procedures limits their use in children. For this reason, in the last decades there has been a growing interest for the development of noninvasive methods. Main body In the present review, we describe the most important non-invasive methods for the study of airway inflammation in children, focusing on the measure of the fractional exhaled nitric oxide (feNO), on the measure of the exhaled breath temperature (EBT) and on the analysis of both exhaled breath condensate (EBC) and exhaled air (Volatile Organic Compounds, VOCs), using targeted and untargeted approaches. We summarize what is currently known on the topic of exhaled biomarkers in childhood asthma, with a special emphasis on emerging approaches, underlining the role of exhaled biomarkers in the diagnosis, management and treatment of asthma, and their potential for the development of personalized treatments. Conclusion Among non-invasive methods to study asthma, exhaled breath analysis remains one of the most interesting approaches, feNO and “-omic” sciences seem promising for the purpose of characterizing biomarkers of this disease.
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Affiliation(s)
- Valentina Ferraro
- Women's and Children's Health Department, University of Padova, Padova, Italy
| | - Silvia Carraro
- Women's and Children's Health Department, University of Padova, Padova, Italy
| | - Sara Bozzetto
- Women's and Children's Health Department, University of Padova, Padova, Italy
| | - Stefania Zanconato
- Women's and Children's Health Department, University of Padova, Padova, Italy
| | - Eugenio Baraldi
- Women's and Children's Health Department, University of Padova, Padova, Italy
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Avilés-Santa ML, Heintzman J, Lindberg NM, Guerrero-Preston R, Ramos K, Abraído-Lanza AL, Bull J, Falcón A, McBurnie MA, Moy E, Papanicolaou G, Piña IL, Popovic J, Suglia SF, Vázquez MA. Personalized medicine and Hispanic health: improving health outcomes and reducing health disparities - a National Heart, Lung, and Blood Institute workshop report. BMC Proc 2017; 11:11. [PMID: 29149222 PMCID: PMC5667592 DOI: 10.1186/s12919-017-0079-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Persons of Hispanic/Latino descent may represent different ancestries, ethnic and cultural groups and countries of birth. In the U.S., the Hispanic/Latino population is projected to constitute 29% of the population by 2060. A personalized approach focusing on individual variability in genetics, environment, lifestyle and socioeconomic determinants of health may advance the understanding of some of the major factors contributing to the health disparities experienced by Hispanics/Latinos and other groups in the U.S., thus leading to new strategies that improve health care outcomes. However, there are major gaps in our current knowledge about how personalized medicine can shape health outcomes among Hispanics/Latinos and address the potential factors that may explain the observed differences within this heterogeneous group, and between this group and other U.S. demographic groups. For that purpose, the National Heart, Lung, and Blood Institute (NHLBI), in collaboration with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and the Food and Drug Administration (FDA), held a workshop in which experts discussed (1) potential approaches to study medical treatments and health outcomes among Hispanics/Latinos and garner the necessary evidence to fill gaps of efficacy, effectiveness and safety of therapies for heart, lung, blood and sleep (HLBS) disorders and conditions--and their risk factors; (2) research opportunities related to personalized medicine to improve knowledge and develop effective interventions to reduce health disparities among Hispanics/Latinos in the U.S.; and (3) the incorporation of expanded sociocultural and socioeconomic data collection and genetic/genomic/epigenetic information of Hispanic/Latino patients into their clinical assessments, to account for individual variability in ancestry; physiology or disease risk; culture; environment; lifestyle; and socioeconomic determinants of health. The experts also provided recommendations on: sources of Hispanic/Latino health data and strategies to enhance its collection; policy; genetics, genomics and epigenetics research; and integrating Hispanic/Latino health research within clinical settings.
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Affiliation(s)
- M Larissa Avilés-Santa
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Room 10188, Bethesda, MD 20892-7936 USA
| | - John Heintzman
- Department of Family Medicine, Oregon Health and Science University, 318 SW Sam Jackson Park Rd, Portland, OR 97239 USA
| | - Nangel M Lindberg
- Kaiser Permanente Northwest Center for Health Research, 3800 N. Interstate Ave, Portland, OR 97227 USA
| | - Rafael Guerrero-Preston
- Johns Hopkins University School of Medicine, 1550 Orleans Street, CRB2 Room 5M, Baltimore, MD 21231 USA
| | - Kenneth Ramos
- University of Arizona Health Sciences, 1295 North Martin Avenue, PO Box 210202, Tucson, AZ 86721 USA
| | - Ana L Abraído-Lanza
- Columbia University, Mailman School of Public Health, 722 West 168th Street, New York, NY 10032 USA
| | - Jonca Bull
- Office of Minority Health, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993 USA
| | - Adolph Falcón
- National Alliance for Hispanic Health, 1600 P St NW, Washington, DC 20009 USA
| | - Mary Ann McBurnie
- Kaiser Permanente Northwest Center for Health Research, 3800 N. Interstate Ave, Portland, OR 97227 USA
| | - Ernest Moy
- National Center for Health Statistics, 3311 Toledo Road, Hyattsville, MD 20782 USA
| | - George Papanicolaou
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Room 10188, Bethesda, MD 20892-7936 USA
| | - Ileana L Piña
- Albert Einstein College of Medicine, Montefiore Heart and Vascular Center, 111 East 210th Street, Bronx, NY 10467-2401 USA
| | - Jennifer Popovic
- Program for Health Data and Standardized Methods, Center for Health Data Analytics
- eHealth, Quality & Analytics Division, RTI International
- 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452 USA
| | - Shakira F Suglia
- Rollins School of Public Health, Emory University, 1518 Clifton Rd Rm 4005, Atlanta, GA 30322 USA
| | - Miguel A Vázquez
- Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8856 USA
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