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Nahum U, Gorlanova O, Decrue F, Oller H, Delgado-Eckert E, Böck A, Schulzke S, Latzin P, Schaub B, Karvonen AM, Lauener R, Divaret-Chauveau A, Illi S, Roduit C, von Mutius E, Frey U. Symptom trajectories in infancy for the prediction of subsequent wheeze and asthma in the BILD and PASTURE cohorts: a dynamic network analysis. Lancet Digit Health 2024; 6:e718-e728. [PMID: 39332855 DOI: 10.1016/s2589-7500(24)00147-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 06/28/2024] [Indexed: 09/29/2024]
Abstract
BACKGROUND Host and environment early-life risk factors are associated with progression of wheezing symptoms over time; however, their individual contribution is relatively small. We hypothesised that the dynamic interactions of these factors with an infant's developing respiratory system are the dominant factor for subsequent wheeze and asthma. METHODS In this dynamic network analysis we used data from term healthy infants from the Basel-Bern Infant Lung Development (BILD) cohort (435 neonates aged 0-4 weeks recruited in Switzerland between Jan 1, 1999, and Dec 31, 2012) and replicated the findings in the Protection Against Allergy Study in Rural Environments (PASTURE) cohort (498 infants aged 0-12 months recruited in Germany, Switzerland, Austria, France, and Finland between Jan 1, 2002, and Oct 31, 2006). BILD exclusion criteria for the current study were prematurity (<37 weeks), major birth defects, perinatal disease of the neonate, and incomplete follow-up period. PASTURE exclusion criteria were women younger than 18 years, a multiple pregnancy, the sibling of a child was already included in the study, the family intended to move away from the area where the study was conducted, and the family had no telephone connection. Outcome groups were subsequent wheeze, asthma, and healthy. The first outcome was defined as ever wheezed between the age of 2 years and 6 years. Week-by-week correlations of the determining factors with cumulative symptom scores (CSS) were calculated from weeks 2 to 52 (BILD) and weeks 8 to 52 (PASTURE). The complex dynamic interaction between the determining factors and the CSS was assessed via dynamic host-environment correlation network, quantified by a simple descriptor: trajectory function G(t). Wheeze outcomes at age 2-6 years were compared in 335 infants from BILD and 437 infants from PASTURE, and asthma outcomes were analysed at age 6 years in a merged cohort of 783 infants. FINDINGS CSS was significantly different for wheeze and asthma outcomes and became increasingly important during infancy in direct comparison with all determining factors. Weekly symptoms were tracked for groups of infants, showing a non-linear increase with time. Using logistic regression classification, G(t) distinguished between the healthy group and wheeze or asthma groups (area under the curve>0·97, p<0·0001; sensitivity analysis confirmed significant CSS association with wheeze [BILD p=0·0002 and PASTURE p=0·068]) and G(t) was also able to distinguish between the farming and non-farming exposure groups (p<0·0001). INTERPRETATION Similarly to other risk factors, CSS had weak sensitivity and specificity to identify risks at the individual level. At group level however, the dynamic host-environment correlation network properties (G(t)) showed excellent discriminative ability for identifying groups of infants with subsequent wheeze and asthma. Results from this study are consistent with the 2018 Lancet Commission on asthma, which emphasised the importance of dynamic interactions between risk factors during development and not the risk factors per se. FUNDING The Swiss National Science Foundation, the Kühne Foundation, the EFRAIM study EU research grant, the FORALLVENT study EU research grant, and the Leibniz Prize.
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Affiliation(s)
- Uri Nahum
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fabienne Decrue
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Centre for Cardiovascular Science, Queens Medical Research Institute, Edinburgh, UK
| | - Heide Oller
- University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Andreas Böck
- Pediatric Allergology, Department of Pediatrics, Dr von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität Munich Haunerschen Kinderklinik, Munich, Germany; Member of German Center for Lung Research-DZL, Ludwig-Maximilians-Universität Munich, Germany
| | - Sven Schulzke
- University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | - Philipp Latzin
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Bianca Schaub
- Pediatric Allergology, Department of Pediatrics, Dr von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität Munich Haunerschen Kinderklinik, Munich, Germany; Member of German Center for Lung Research-DZL, Ludwig-Maximilians-Universität Munich, Germany
| | - Anne M Karvonen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Roger Lauener
- Christine Kühne Center for Allergy Research and Education, Davos, Switzerland; Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
| | - Amandine Divaret-Chauveau
- Pediatric Allergy Department, University Hospital of Nancy, Nancy, France; UR3450 Développement Adaptation et Handicap, University of Lorraine, Nancy, France; UMR 6249 Chrono-environment, CNRS and University of Franche-Comté, Respiratory Disease Department, University Hospital of Besançon, Besançon, France
| | - Sabina Illi
- Member of German Center for Lung Research-DZL, Ludwig-Maximilians-Universität Munich, Germany; Institute for Asthma and Allergy Prevention, Helmholtz Zentrum Munich, German Research Center for Environmental Health, Munich, Germany; Comprehensive Pneumology Center Munich, Munich, Germany
| | - Caroline Roduit
- Christine Kühne Center for Allergy Research and Education, Davos, Switzerland; Division of Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Erika von Mutius
- Pediatric Allergology, Department of Pediatrics, Dr von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität Munich Haunerschen Kinderklinik, Munich, Germany; Member of German Center for Lung Research-DZL, Ludwig-Maximilians-Universität Munich, Germany
| | - Urs Frey
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; University of Basel, Basel, Switzerland.
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Frauchiger BS, Willers C, Cotting J, Kieninger E, Korten I, Casaulta C, Salem Y, Stranzinger E, Brabandt B, Usemann J, Regamey N, Kuhn A, Blanchon S, Rochat I, Bauman G, Müller-Suter D, Moeller A, Latzin P, Ramsey KA. Lung structural and functional impairments in young children with cystic fibrosis diagnosed following newborn screening - A nationwide observational study. J Cyst Fibros 2024; 23:910-917. [PMID: 38926017 DOI: 10.1016/j.jcf.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/04/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Non-invasive and sensitive clinical endpoints are needed to monitor onset and progression of early lung disease in children with cystic fibrosis (CF). We compared lung clearance index (LCI), FEV1, functional and structural lung magnetic resonance imaging (MRI) outcomes in Swiss children with CF diagnosed following newborn screening. METHODS Lung function (LCI, FEV1) and unsedated functional and structural lung MRI was performed in 79 clinically stable children with CF (3 - 8 years) and 75 age-matched healthy controls. Clinical information was collected throughout childhood. RESULTS LCI, ventilation and perfusion defects, and structural MRI scores were significantly higher in children with CF compared with controls, but FEV1 was not different between groups. Lung MRI outcomes correlated significantly with LCI (morphology score (r = 0.56, p < 0.001); ventilation defects (r = 0.43, p = 0.001); perfusion defects (r = 0.64, p < 0.001), but not with FEV1. Lung MRI outcomes were more sensitive to detect impairments in children with CF (abnormal ventilation and perfusion outcomes in 47 %, morphology score in 30 %) compared with lung function (abnormal LCI in 21 % and FEV1 in 4.8 %). Pulmonary exacerbations, respiratory hospitalizations, and increase in patient-reported cough was associated with higher LCI and higher structural and functional MRI outcomes. CONCLUSIONS The LCI and lung MRI outcomes non-invasively detect even mild early lung disease in young children with CF diagnosed following newborn screening. Pulmonary exacerbations and early respiratory symptoms were risk factors for structural and functional impairment in childhood.
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Affiliation(s)
- Bettina S Frauchiger
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Corin Willers
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Paediatrics, Kantonsspital Aarau, Aarau, Switzerland
| | - Jasna Cotting
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Elisabeth Kieninger
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Insa Korten
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carmen Casaulta
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yasmin Salem
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Enno Stranzinger
- Diagnostic, interventional and pediatric radiology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ben Brabandt
- Diagnostic, interventional and pediatric radiology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jakob Usemann
- Division of Respiratory Medicine and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland; University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Nicolas Regamey
- Department of Respiratory Medicine, Children's Hospital Luzern, Luzern, Switzerland
| | - Alena Kuhn
- Department of Paediatrics, Kantonsspital Aarau, Aarau, Switzerland
| | | | | | - Grzegorz Bauman
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | | | - Alexander Moeller
- Division of Respiratory Medicine and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Philipp Latzin
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kathryn A Ramsey
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth WA Australia.
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Gorlanova O, Rüttimann C, Soti A, de Hoogh K, Vienneau D, Künstle N, Da Silva Sena CR, Steinberg R, Bovermann X, Schulzke S, Latzin P, Röösli M, Frey U, Müller L. TOLLIP and MUC5B modulate the effect of ambient NO 2 on respiratory symptoms in infancy. CHEMOSPHERE 2024; 363:142837. [PMID: 39009092 DOI: 10.1016/j.chemosphere.2024.142837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 06/25/2024] [Accepted: 07/11/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Current knowledge suggests that the gene region containing MUC5B and TOLLIP plays a role in airway defence and airway inflammation, and hence respiratory disease. It is also known that exposure to air pollution increases susceptibility to respiratory disease. We aimed to study whether the effect of air pollutants on the immune response and respiratory symptoms in infants may be modified by polymorphisms in MUC5B and TOLLIP genes. METHODS 359 healthy term infants from the prospective Basel-Bern Infant Lung Development (BILD) birth cohort were included in the study. The main outcome was the score of weekly assessed respiratory symptoms in the first year of life. Using the candidate gene approach, we selected 10 single nucleotide polymorphisms (SNPs) from the MUC5B and TOLLIP regions. Nitrogen dioxide (NO2) and particulate matter ≤10 μm in aerodynamic diameter (PM10) exposure was estimated on a weekly basis. We used generalised additive mixed models adjusted for known covariates. To validate our results in vitro, cells from a lung epithelial cell line were downregulated in TOLLIP expression and exposed to diesel particulate matter (DPM) and polyinosinic-polycytidylic acid. RESULTS Significant interaction was observed between modelled air pollution (weekly NO2 exposure) and 5 SNPs within MUC5B and TOLLIP genes regarding respiratory symptoms as outcome: E.g., infants carrying minor alleles of rs5744034, rs3793965 and rs3750920 (all TOLLIP) had an increased risk of respiratory symptoms with increasing NO2 exposure. In vitro experiments showed that cells downregulated for TOLLIP react differently to environmental pollutant exposure with DPM and viral stimulation. CONCLUSION Our findings suggest that the effect of air pollution on respiratory symptoms in infancy may be influenced by the genotype of specific SNPs from the MUC5B and TOLLIP regions. For validation of the findings, we provided in vitro evidence for the interaction of TOLLIP with air pollution.
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Affiliation(s)
- Olga Gorlanova
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Céline Rüttimann
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andras Soti
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Paediatrics and Youth Medicine, Clinic Donaustadt, Vienna, Austria
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute Basel, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute Basel, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Noëmi Künstle
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carla Rebeca Da Silva Sena
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Priority Research Centre GrowUpWell® and Hunter Medical Research Institute, University of Newcastle, NSW, Australia
| | - Ruth Steinberg
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Xenia Bovermann
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sven Schulzke
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute Basel, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Urs Frey
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.
| | - Loretta Müller
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Lung Precision Medicine, Department for BioMedical Research (DBMR), University of Bern, Switzerland
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4
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Wyler F, Manogaran T, Monney N, Salem Y, Steinberg R, Kentgens AC, Jacobs C, Chaya S, Sena CRDS, Künstle N, Gorlanova O, Yammine S, Gray DM, Frey U, Oestreich MA, Latzin P. Optimized algorithm for speed-of-sound-based infant sulfur hexafluoride multiple-breath washout measurements. Pediatr Pulmonol 2024. [PMID: 39023392 DOI: 10.1002/ppul.27180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/29/2024] [Accepted: 07/10/2024] [Indexed: 07/20/2024]
Abstract
INTRODUCTION Major methodological issues with the existing algorithm (WBreath) used for the analysis of speed-of-sound-based infant sulfur hexafluoride (SF6) multiple-breath washout (MBW) measurements lead to implausible results and complicate the comparison between different age groups and centers. METHODS We developed OASIS-a novel algorithm to analyze speed-of-sound-based infant SF6 MBW measurements. This algorithm uses known context of the measurements to replace the dependence of WBreath on model input parameters. We validated the functional residual capacity (FRC) measurement accuracy of this new algorithm in vitro, and investigated its use in existing infant MBW data sets from different infant cohorts from Switzerland and South Africa. RESULTS In vitro, OASIS managed to outperform WBreath at FRC measurement accuracy, lowering mean (SD) absolute error from 5.1 (3.2) % to 2.1 (1.6) % across volumes relevant for the infant age range, in variable temperature, respiratory rate, tidal volume and ventilation inhomogeneity conditions. We showed that changes in the input parameters to WBreath had a major impact on MBW results, a methodological drawback which does not exist in the new algorithm. OASIS produced more plausible results than WBreath in longitudinal tracking of lung clearance index (LCI), provided improved measurement stability in LCI over time, and improved comparability between centers. DISCUSSION This new algorithm represents a meaningful advance in obtaining results from a legacy system of lung function measurement by allowing a single method to analyze measurements from different age groups and centers.
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Affiliation(s)
- Florian Wyler
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thuvarakha Manogaran
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nathalie Monney
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yasmin Salem
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ruth Steinberg
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Anne-Christianne Kentgens
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Carvern Jacobs
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Shaakira Chaya
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | | | - Noëmi Künstle
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Sophie Yammine
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Diane M Gray
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Urs Frey
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Marc-Alexander Oestreich
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Oestreich MA, Doswald I, Salem Y, Künstle N, Wyler F, Frauchiger BS, Kentgens AC, Latzin P, Yammine S. A computerized tool for the systematic visual quality assessment of infant multiple-breath washout measurements. Front Pediatr 2024; 12:1393291. [PMID: 38910962 PMCID: PMC11191423 DOI: 10.3389/fped.2024.1393291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/28/2024] [Indexed: 06/25/2024] Open
Abstract
Background Multiple-breath washout (MBW) is a sensitive method for assessing lung volumes and ventilation inhomogeneity in infants, but remains prone to artefacts (e.g., sighs). There is a lack of tools for systematic retrospective analysis of existing datasets, and unlike N2-MBW in older children, there are few specific quality control (QC) criteria for artefacts in infant SF6-MBW. Aim We aimed to develop a computer-based tool for systematic evaluation of visual QC criteria of SF6-MBW measurements and to investigate interrater agreement and effects on MBW outcomes among three independent examiners. Methods We developed a software package for visualization of raw Spiroware (Eco Medics AG, Switzerland) and signal processed WBreath (ndd Medizintechnik AG, Switzerland) SF6-MBW signal traces. Interrater agreement among three independent examiners (two experienced, one novice) who systematically reviewed 400 MBW trials for visual artefacts and the decision to accept/reject the washin and washout were assessed. Results Our tool visualizes MBW signals and provides the user with (i) display options (e.g., zoom), (ii) options for a systematic QC assessment [e.g., decision to accept or reject, identification of artefacts (leak, sigh, irregular breathing pattern, breath hold), and comments], and (iii) additional information (e.g., automatic identification of sighs). Reviewer agreement was good using pre-defined QC criteria (κ 0.637-0.725). Differences in the decision to accept/reject had no substantial effect on MBW outcomes. Conclusion Our visual quality control tool supports a systematic retrospective analysis of existing data sets. Based on predefined QC criteria, even inexperienced users can achieve comparable MBW results.
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Affiliation(s)
- Marc-Alexander Oestreich
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Isabelle Doswald
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yasmin Salem
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Noëmi Künstle
- University Children’s Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| | - Florian Wyler
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Bettina S. Frauchiger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anne-Christianne Kentgens
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Künstle N, Gorlanova O, Marten A, Müller L, Sharma P, Röösli M, Sinues P, Schär P, Schürmann D, Rüttimann C, Da Silva Sena CR, Nahum U, Usemann J, Steinberg R, Yammine S, Schulzke S, Latzin P, Frey U. Differences in autophagy marker levels at birth in preterm vs. term infants. Pediatr Res 2024:10.1038/s41390-024-03273-6. [PMID: 38811718 DOI: 10.1038/s41390-024-03273-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/04/2024] [Accepted: 04/22/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Preterm infants are susceptible to oxidative stress and prone to respiratory diseases. Autophagy is an important defense mechanism against oxidative-stress-induced cell damage and involved in lung development and respiratory morbidity. We hypothesized that autophagy marker levels differ between preterm and term infants. METHODS In the prospective Basel-Bern Infant Lung Development (BILD) birth cohort we compared cord blood levels of macroautophagy (Beclin-1, LC3B), selective autophagy (p62) and regulation of autophagy (SIRT1) in 64 preterm and 453 term infants. RESULTS Beclin-1 and LC3B did not differ between preterm and term infants. However, p62 was higher (0.37, 95% confidence interval (CI) 0.05;0.69 in log2-transformed level, p = 0.025, padj = 0.050) and SIRT1 lower in preterm infants (-0.55, 95% CI -0.78;-0.31 in log2-transformed level, padj < 0.001). Furthermore, p62 decreased (padj-value for smoothing function was 0.018) and SIRT1 increased (0.10, 95% CI 0.07;0.13 in log2-transformed level, padj < 0.001) with increasing gestational age. CONCLUSION Our findings suggest differential levels of key autophagy markers between preterm and term infants. This adds to the knowledge of the sparsely studied field of autophagy mechanisms in preterm infants and might be linked to impaired oxidative stress response, preterm birth, impaired lung development and higher susceptibility to respiratory morbidity in preterm infants. IMPACT To the best of our knowledge, this is the first study to investigate autophagy marker levels between human preterm and term infants in a large population-based sample in cord blood plasma This study demonstrates differential levels of key autophagy markers in preterm compared to term infants and an association with gestational age This may be linked to impaired oxidative stress response or developmental aspects and provide bases for future studies investigating the association with respiratory morbidity.
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Affiliation(s)
- Noëmi Künstle
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Andrea Marten
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Loretta Müller
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Pawan Sharma
- Center for Translational Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Jane & Leonard Korman Respiratory Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland and University of Basel, Basel, Switzerland
| | - Pablo Sinues
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Primo Schär
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - David Schürmann
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Céline Rüttimann
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carla Rebeca Da Silva Sena
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Priority Research Centre GrowUpWell® and Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Uri Nahum
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ruth Steinberg
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sven Schulzke
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Philipp Latzin
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Urs Frey
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.
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7
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Salem Y, Jakob J, Steinberg R, Gorlanova O, Fuchs O, Müller L, Usemann J, Frey U, Latzin P, Yammine S. Cohort Profile Update: The Bern Basel Infant Lung Development Cohort. Int J Epidemiol 2024; 53:dyad164. [PMID: 38061036 DOI: 10.1093/ije/dyad164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/05/2023] [Indexed: 02/12/2024] Open
Affiliation(s)
- Yasmin Salem
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Julian Jakob
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Ruth Steinberg
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Biomedical Science, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Oliver Fuchs
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Allergology, Department of Medicine, Lucerne Cantonal Hospital and University of Lucerne, Lucerne, Switzerland
| | - Loretta Müller
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Urs Frey
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Philipp Latzin
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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8
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Percival E, Collison AM, da Silva Sena CR, De Queiroz Andrade E, De Gouveia Belinelo P, Gomes GMC, Oldmeadow C, Murphy VE, Gibson PG, Karmaus W, Mattes J. The association of exhaled nitric oxide with air pollutants in young infants of asthmatic mothers. Environ Health 2023; 22:84. [PMID: 38049853 PMCID: PMC10696885 DOI: 10.1186/s12940-023-01030-6] [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: 05/03/2023] [Accepted: 11/08/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Exhaled nitric oxide is a marker of airway inflammation. Air pollution induces airway inflammation and oxidative stress. Little is known about the impact of air pollution on exhaled nitric oxide in young infants. METHODS The Breathing for Life Trial recruited pregnant women with asthma into a randomised controlled trial comparing usual clinical care versus inflammometry-guided asthma management in pregnancy. Four hundred fifty-seven infants from the Breathing for Life Trial birth cohort were assessed at six weeks of age. Exhaled nitric oxide was measured in unsedated, sleeping infants. Its association with local mean 24-h and mean seven-day concentrations of ozone, nitric oxide, nitrogen dioxide, carbon monoxide, sulfur dioxide, ammonia, particulate matter less than 10 μm (PM10) and less than 2.5 μm (PM2.5) in diameter was investigated. The air pollutant data were sourced from local monitoring sites of the New South Wales Air Quality Monitoring Network. The association was assessed using a 'least absolute shrinkage and selection operator' (LASSO) approach, multivariable regression and Spearman's rank correlation. RESULTS A seasonal variation was evident with higher median exhaled nitric oxide levels (13.6 ppb) in warmer months and lower median exhaled nitric oxide levels (11.0 ppb) in cooler months, P = 0.008. LASSO identified positive associations for exhaled nitric oxide with 24-h mean ammonia, seven-day mean ammonia, seven-day mean PM10, seven-day mean PM2.5, and seven-day mean ozone; and negative associations for eNO with seven-day mean carbon monoxide, 24-h mean nitric oxide and 24-h mean sulfur dioxide, with an R-square of 0.25 for the penalized coefficients. These coefficients selected by LASSO (and confounders) were entered in multivariable regression. The achieved R-square was 0.27. CONCLUSION In this cohort of young infants of asthmatic mothers, exhaled nitric oxide showed seasonal variation and an association with local air pollution concentrations.
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Affiliation(s)
- Elizabeth Percival
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Adam M Collison
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Carla Rebeca da Silva Sena
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Ediane De Queiroz Andrade
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Patricia De Gouveia Belinelo
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Gabriela Martins Costa Gomes
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | | | - Vanessa E Murphy
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Peter G Gibson
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Wilfried Karmaus
- Division of Epidemiology, School of Public Health, and Environmental Health Science, University of Memphis, BiostatisticsMemphis, TN, 38152, USA
| | - Joerg Mattes
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.
- Department of Paediatric Respiratory & Sleep Medicine, John Hunter Children's Hospital, Newcastle, NSW, Australia.
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9
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Rüttimann C, Nissen-Kratzert A, Mostacci N, Künstle N, Marten A, Gisler A, Bacher K, Yammine S, Steinberg R, Schulzke S, Röösli M, Latzin P, Hilty M, Frey U, Gorlanova O. Antibiotics in pregnancy influence nasal microbiome and respiratory morbidity in infancy. ERJ Open Res 2023; 9:00225-2023. [PMID: 37650088 PMCID: PMC10463034 DOI: 10.1183/23120541.00225-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/06/2023] [Indexed: 09/01/2023] Open
Abstract
Background The effects of prenatal antibiotic exposure on respiratory morbidity in infancy and the involved mechanisms are still poorly understood. We aimed to examine whether prenatal antibiotic exposure in the third trimester is associated with nasal microbiome and respiratory morbidity in infancy and at school age, and whether this association with respiratory morbidity is mediated by the nasal microbiome. Methods We performed 16S ribosomal RNA gene sequencing (regions V3-V4) on nasal swabs obtained from 296 healthy term infants from the prospective Basel-Bern birth cohort (BILD) at age 4-6 weeks. Information about antibiotic exposure was derived from birth records and standardised interviews. Respiratory symptoms were assessed by weekly telephone interviews in the first year of life and a clinical visit at age 6 years. Structural equation modelling was used to test direct and indirect associations accounting for known risk factors. Results α-Diversity indices were lower in infants with antibiotic exposure compared to nonexposed infants (e.g. Shannon index p-value 0.006). Prenatal antibiotic exposure was also associated with a higher risk of any, as well as severe, respiratory symptoms in the first year of life (risk ratio 1.38, 95% CI 1.03-1.84; adjusted p-value (padj)=0.032 and risk ratio 1.75, 95% CI 1.02-2.97; padj=0.041, respectively), but not with wheeze or atopy in childhood. However, we found no indirect mediating effect of nasal microbiome explaining these clinical symptoms. Conclusion Prenatal antibiotic exposure was associated with lower diversity of nasal microbiome in infancy and, independently of microbiome, with respiratory morbidity in infancy, but not with symptoms later in life.
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Affiliation(s)
- Céline Rüttimann
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Annika Nissen-Kratzert
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nadja Mostacci
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Noëmi Künstle
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrea Marten
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Amanda Gisler
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Katharina Bacher
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ruth Steinberg
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Sven Schulzke
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland and University of Basel, Basel, Switzerland
| | - Philipp Latzin
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Urs Frey
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Shared senior authorship
| | - Olga Gorlanova
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Shared senior authorship
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10
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Gorlanova O, Oller H, Marten A, Müller L, Laine-Carmelli J, Decrue F, Salem Y, Vienneau D, Hoogh KD, Gisler A, Usemann J, Korten I, Yammine S, Nahum U, Künstle N, Sinues P, Schulzke S, Latzin P, Fuchs O, Röösli M, Schaub B, Frey U. Ambient prenatal air pollution exposure is associated with low cord blood IL-17a in infants. Pediatr Allergy Immunol 2023; 34:e13902. [PMID: 36705042 DOI: 10.1111/pai.13902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 11/24/2022] [Accepted: 12/05/2022] [Indexed: 01/03/2023]
Affiliation(s)
- Olga Gorlanova
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Heide Oller
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Andrea Marten
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Loretta Müller
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Fabienne Decrue
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Yasmin Salem
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Amanda Gisler
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Insa Korten
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Uri Nahum
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Noemi Künstle
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Pablo Sinues
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Sven Schulzke
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Philipp Latzin
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Oliver Fuchs
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Bianca Schaub
- Department of Pulmonary and Allergy, Dr. von Hauner Children's Hospital, LMU, University of Munich, Munich, Germany
| | - Urs Frey
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | -
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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11
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Gisler A, Eeftens M, de Hoogh K, Vienneau D, Salem Y, Yammine S, Jakob J, Gorlanova O, Decrue F, Gehrig R, Frey U, Latzin P, Fuchs O, Usemann J, Decrue F, Frey U, Fuchs O, Gisler A, Gorlanova O, Kentgens A, Korten I, Kurz J, Latzin P, Nissen A, Oestreich M, Röösli M, Salem Y, Usemann J, Vienneau D. Pollen exposure is associated with risk of respiratory symptoms during the first year of life. Allergy 2022; 77:3606-3616. [PMID: 35302662 PMCID: PMC10078730 DOI: 10.1111/all.15284] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/12/2022] [Accepted: 02/14/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Pollen exposure is associated with respiratory symptoms in children and adults. However, the association of pollen exposure with respiratory symptoms during infancy, a particularly vulnerable period, remains unclear. We examined whether pollen exposure is associated with respiratory symptoms in infants and whether maternal atopy, infant's sex or air pollution modifies this association. METHODS We investigated 14,874 observations from 401 healthy infants of a prospective birth cohort. The association between pollen exposure and respiratory symptoms, assessed in weekly telephone interviews, was evaluated using generalized additive mixed models (GAMMs). Effect modification by maternal atopy, infant's sex, and air pollution (NO2 , PM2.5 ) was assessed with interaction terms. RESULTS Per infant, 37 ± 2 (mean ± SD) respiratory symptom scores were assessed during the analysis period (January through September). Pollen exposure was associated with increased respiratory symptoms during the daytime (RR [95% CI] per 10% pollen/m3 : combined 1.006 [1.002, 1.009]; tree 1.005 [1.002, 1.008]; grass 1.009 [1.000, 1.23]) and nighttime (combined 1.003 [0.999, 1.007]; tree 1.003 [0.999, 1.007]; grass 1.014 [1.004, 1.024]). While there was no effect modification by maternal atopy and infant's sex, a complex crossover interaction between combined pollen and PM2.5 was found (p-value 0.003). CONCLUSION Even as early as during the first year of life, pollen exposure was associated with an increased risk of respiratory symptoms, independent of maternal atopy and infant's sex. Because infancy is a particularly vulnerable period for lung development, the identified adverse effect of pollen exposure may be relevant for the evolvement of chronic childhood asthma.
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Affiliation(s)
- Amanda Gisler
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marloes Eeftens
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Yasmin Salem
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Julian Jakob
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Primary Health Care (BIHAM), Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fabienne Decrue
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Regula Gehrig
- Federal Office of Meteorology and Climatology MeteoSwiss, Zurich, Switzerland
| | - Urs Frey
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Oliver Fuchs
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Respiratory Medicine, University Children's Hospital of Zurich, Zurich, Switzerland
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12
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Yue H, Yang X, Wu X, Geng X, Ji X, Li G, Sang N. Maternal NO 2 exposure disturbs the long noncoding RNA expression profile in the lungs of offspring in time-series patterns. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 246:114140. [PMID: 36209526 DOI: 10.1016/j.ecoenv.2022.114140] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/07/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
Gestation is a sensitive window to nitrogen dioxide (NO2) exposure, which may disturb fetal lung development and lung function later in life. Animal and epidemiological studies indicated that long noncoding RNAs (lncRNAs) participate in abnormal lung development induced by environmental pollutant exposure. In the present study, pregnant C57BL/6J mice were exposed to 2.5 ppm NO2 (mimicking indoor occupational exposure) or clean air, and lncRNAs expression profiles in the lungs of offspring mice were determined by lncRNA-seq on embryonic day 13.5 (E13.5), E18.5, postnatal day 1 (P1), and P14. The lung histopathology examination of offspring was performed, followed by weighted gene coexpression network analysis (WGCNA), prediction of lncRNAs-target genes, and the biological processes enrichment analysis of lncRNAs. Our results indicated that maternal NO2 exposure induced hypoalveolarization on P14 and differentially expressed lncRNAs showed a time-series pattern. Following WGCNA and enrichment analysis, 2 modules participated in development-related pathways. Importantly, the expressions of related genes were altered, some of which were confirmed to be related to abnormal vascular development and even lung diseases. The research points out that the maternal NO2 exposure leads to abnormal lung development in offspring that might be related to altered lncRNAs expression profiles with time-series-pattern.
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Affiliation(s)
- Huifeng Yue
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China.
| | - Xiaowen Yang
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China.
| | - Xiaoyun Wu
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China.
| | - Xilin Geng
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China.
| | - Xiaotong Ji
- Department of Environmental Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, PR China.
| | - Guangke Li
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China.
| | - Nan Sang
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China.
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13
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Oestreich MA, Wyler F, Frauchiger BS, Latzin P, Ramsey KA. Breath detection algorithms affect multiple-breath washout outcomes in pre-school and school age children. PLoS One 2022; 17:e0275866. [PMID: 36240198 PMCID: PMC9565421 DOI: 10.1371/journal.pone.0275866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Background Accurate breath detection is essential for the computation of outcomes in the multiple-breath washout (MBW) technique. This is particularly important in young children, where irregular breathing is common, and the designation of inspirations and expirations can be challenging. Aim To investigate differences between a commercial and a novel breath-detection algorithm and to characterize effects on MBW outcomes in children. Methods We replicated the signal processing and algorithms used in Spiroware software (v3.3.1, Eco Medics AG). We developed a novel breath detection algorithm (custom) and compared it to Spiroware using 2,455 nitrogen (N2) and 325 sulfur hexafluoride (SF6) trials collected in infants, children, and adolescents. Results In 83% of N2 and 32% of SF6 trials, the Spiroware breath detection algorithm rejected breaths and did not use them for the calculation of MBW outcomes. Our custom breath detection algorithm determines inspirations and expirations based on flow reversal and corresponding CO2 elevations, and uses all breaths for data analysis. In trials with regular tidal breathing, there were no differences in outcomes between algorithms. However, in 10% of pre-school children tests the number of breaths detected differed by more than 10% and the commercial algorithm underestimated the lung clearance index by up to 21%. Conclusion Accurate breath detection is challenging in young children. As the MBW technique relies on the cumulative analysis of all washout breaths, the rejection of breaths should be limited. We provide an improved algorithm that accurately detects breaths based on both flow reversal and CO2 concentration.
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Affiliation(s)
- Marc-Alexander Oestreich
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Florian Wyler
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Bettina S. Frauchiger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kathryn A. Ramsey
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- * E-mail:
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14
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Oyewole ORA, Latzin P, Brugger SD, Hilty M. Strain-level resolution and pneumococcal carriage dynamics by single-molecule real-time (SMRT) sequencing of the plyNCR marker: a longitudinal study in Swiss infants. MICROBIOME 2022; 10:152. [PMID: 36138483 PMCID: PMC9502908 DOI: 10.1186/s40168-022-01344-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Pneumococcal carriage has often been studied from a serotype perspective; however, little is known about the strain-specific carriage and inter-strain interactions. Here, we examined the strain-level carriage and co-colonization dynamics of Streptococcus pneumoniae in a Swiss birth cohort by PacBio single-molecule real-time (SMRT) sequencing of the plyNCR marker. METHODS A total of 872 nasal swab (NS) samples were included from 47 healthy infants during the first year of life. Pneumococcal carriage was determined based on the quantitative real-time polymerase chain reaction (qPCR) targeting the lytA gene. The plyNCR marker was amplified from 214 samples having lytA-based carriage for pneumococcal strain resolution. Amplicons were sequenced using SMRT technology, and sequences were analyzed with the DADA2 pipeline. In addition, pneumococcal serotypes were determined using conventional, multiplex PCR (cPCR). RESULTS PCR-based plyNCR amplification demonstrated a 94.2% sensitivity and 100% specificity for Streptococcus pneumoniae if compared to lytA qPCR. The overall carriage prevalence was 63.8%, and pneumococcal co-colonization (≥ 2 plyNCR amplicon sequence variants (ASVs)) was detected in 38/213 (17.8%) sequenced samples with the relative proportion of the least abundant strain(s) ranging from 1.1 to 48.8% (median, 17.2%; IQR, 5.8-33.4%). The median age to first acquisition was 147 days, and having ≥ 2 siblings increased the risk of acquisition. CONCLUSION The plyNCR amplicon sequencing is species-specific and enables pneumococcal strain resolution. We therefore recommend its application for longitudinal strain-level carriage studies of Streptococcus pneumoniae. Video Abstract.
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Affiliation(s)
- Oluwaseun Rume-Abiola Oyewole
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3001, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Silvio D Brugger
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3001, Bern, Switzerland.
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15
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Frauchiger BS, Oestreich MA, Wyler F, Monney N, Willers C, Yammine S, Latzin P. Do clinimetric properties of LCI change after correction of signal processing? Pediatr Pulmonol 2022; 57:1180-1187. [PMID: 35182057 PMCID: PMC9314934 DOI: 10.1002/ppul.25865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/31/2022] [Accepted: 02/12/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The recently described sensor-crosstalk error in the multiple-breath washout (MBW) device Exhalyzer D (Eco Medics AG) could highly influence clinimetric properties and the current interpretation of MBW results. This study reanalyzes MBW data from clinical routine in the corrected software version Spiroware® 3.3.1 and evaluates the effect on outcomes. METHODS We included nitrogen-MBW data from healthy children and children with cystic fibrosis (CF) from previously published trials and ongoing cohort studies. We specifically compared lung clearance index (LCI) analyzed in Spiroware 3.2.1 and 3.3.1 with regard to (i) feasibility, (ii) repeatability, and (iii) validity as outcome parameters in children with CF. RESULTS (i) All previously collected measurements could be reanalyzed and resulted in unchanged feasibility in Spiroware 3.3.1. (ii) Short- and midterm repeatability of LCI was similar in both software versions. (iii) Clinical validity of LCI remained similar in Spiroware 3.3.1; however, this resulted in lower values. Discrimination between health and disease was comparable between both software versions. The increase in LCI over time was less pronounced with 0.16 LCI units/year (95% confidence interval [CI] 0.08; 0.24) versus 0.30 LCI units/year (95% CI 0.21; 0.38) in 3.2.1. Response to intervention in children receiving CF transmembrane conductance-modulator therapy resulted in a comparable improvement in LCI, in both Spiroware versions. CONCLUSION Our study confirms that clinimetric properties of LCI remain unaffected after correction for the cross-sensitivity error in Spiroware software.
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Affiliation(s)
- Bettina S Frauchiger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marc-Alexander Oestreich
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Florian Wyler
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nathalie Monney
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Corin Willers
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Ardura-Garcia C, Abellan A, Cuevas-Ocaña S, Freitag N, Lam YT, Makrinioti H, Slaats M, Storti M, Williams EE, Dassios T, Duijts L, Ersu RH, Fustik S, Morty RE, Proesmans M, Schramm D, Saglani S, Moeller A, Pijnenburg MW. ERS International Congress 2021: highlights from the Paediatric Assembly. ERJ Open Res 2022; 8:00643-2021. [PMID: 35615416 PMCID: PMC9125040 DOI: 10.1183/23120541.00643-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/02/2022] [Indexed: 11/26/2022] Open
Abstract
In this review, Early Career Members of the European Respiratory Society (ERS) and the Chairs of the ERS Assembly 7: Paediatrics present the highlights in paediatric respiratory medicine from the ERS International Congress 2021. The eight scientific Groups of this Assembly cover respiratory physiology and sleep, asthma and allergy, cystic fibrosis (CF), respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology, bronchology, and lung and airway development. We here describe new developments in lung function testing and sleep-disordered breathing diagnosis, early life exposures affecting pulmonary function in children and effect of COVID-19 on sleep and lung function. In paediatric asthma, we present the important role of the exposome in asthma development, and how biologics can provide better outcomes. We discuss new methods to assess distal airways in children with CF, as some details remain blind when using the lung clearance index. Moreover, we summarise the new ERS guidelines for bronchiectasis management in children and adolescents. We present interventions to reduce morbidity and monitor pulmonary function in newborns at risk of bronchopulmonary dysplasia and long-term chronic respiratory morbidity of this disease. In respiratory epidemiology, we characterise primary ciliary dyskinesia, identify early life determinants of respiratory health and describe the effect of COVID-19 preventive measures on respiratory symptoms. Also, we describe the epidemiology of interstitial lung diseases, possible consequences of tracheomalacia and a classification of diffuse alveolar haemorrhage in children. Finally, we highlight that the characterisation of genes and pathways involved in the development of a disease is essential to identify new biomarkers and therapeutic targets.
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Affiliation(s)
| | - Alicia Abellan
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Sara Cuevas-Ocaña
- Nottingham Biodiscovery Institute, School of Medicine, University of Nottingham, Nottingham, UK
| | - Nadine Freitag
- Dept of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Yin Ting Lam
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Heidi Makrinioti
- West Middlesex University Hospital, Chelsea and Westminster Foundation Trust, London, UK
| | - Monique Slaats
- Dept of Paediatrics, Division of Paediatric Respiratory Medicine and Allergology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Matteo Storti
- Dept of Chemical and Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Emma E. Williams
- Dept of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Theodore Dassios
- Dept of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK
| | - Liesbeth Duijts
- Dept of Paediatrics, Division of Paediatric Respiratory Medicine and Allergology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
- Division of Neonatology, Dept of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Refika H. Ersu
- Division of Respirology, University of Ottawa Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Stojka Fustik
- University Children's Hospital, Skopje, North Macedonia
| | - Rory E. Morty
- Dept of Lung Development and Remodelling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
- Dept of Translational Pulmonology and the Translational Lung Research Center Heidelberg, University Hospital Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Marijke Proesmans
- Division Woman and Child, Dept of Paediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Dirk Schramm
- Dept of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Sejal Saglani
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Alexander Moeller
- Division of Paediatric Pulmonology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marielle W. Pijnenburg
- Dept of Paediatrics, Division of Paediatric Respiratory Medicine and Allergology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
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Goth FEM, Schmidt BJ, Juul K, Albertsen P, Agertoft L, Jørgensen IM. Cohort profile: the vitamin A and D and nitric oxide (AD-ON) observational cohort on lung development and symptoms in premature and mature children in North Zealand, Denmark. BMJ Open 2022; 12:e054952. [PMID: 35193916 PMCID: PMC8867307 DOI: 10.1136/bmjopen-2021-054952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
PURPOSE The risk of developing asthma-like symptoms and asthma in childhood is influenced by genetics, environmental exposures, prenatal and early postnatal events, and their interactions. The cohort name refers to vitamins A and D, and nitric oxide (NO) spelt backwards and this cohort profile paper aims to present the data collection and aim of the cohort.The overall aim when establishing this cohort was to investigate if childhood lung function can be traced back to early neonatal lung function and fractional exhaled NO (FeNO) and investigate prenatal and postnatal risk factors including maternal and neonatal vitamin A and D levels in preterm and term born children. PARTICIPANTS One thousand five hundred women and their babies born at Nordsjaellands Hospital in Denmark from 2013 to 2014 were included in the AD-ON research biobank prior to birth.Neonates from the AD-ON research biobank, admitted to the Neonatal Intensive Care Unit at Nordsjaellands Hospital, were included in the AD-ON neonatal cohort. The neonatal cohort consisted of 149 neonates hereof 63 preterm and 86 term born. The children in the cohort have been invited to follow-up visits at age 1 and 6 years. FINDINGS TO DATE Published data from this cohort includes a validated and clinically applicable method to measure FeNO in neonates. We found an age-specific pattern of association between respiratory symptoms at age 1 and neonatal FeNO in preterm children. Moreover, we found that the respiratory symptoms risk was associated with postnatal factors (Respiratory Syncytial Virus infection and parental smoking) in preterm infants and prenatal factors (parental asthma and maternal infection during pregnancy) in term born infants. FUTURE PLANS In the future, the children will be examined continuously with 3-year to 5-year intervals until the age of 18. Lung function, allergy tests, environmental exposure measurements and questionnaires will be collected at each follow-up visit.
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Affiliation(s)
- Fanny Edit Maria Goth
- Department of Paediatrics and Adolescence Medicine, Nordsjaellands Hospital, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Faculty of Health and Medical Science, Copenhagen, Denmark
| | | | - Klaus Juul
- Department of Paediatric Cardiology, Rigshospitalet, Kobenhavn, Denmark
| | - Per Albertsen
- Department of Paediatrics and Adolescence Medicine, Nordsjaellands Hospital, Hillerod, Denmark
| | - Lone Agertoft
- Department of Pediatrics, H.C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Inger Merete Jørgensen
- Department of Paediatrics and Adolescence Medicine, Nordsjaellands Hospital, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Faculty of Health and Medical Science, Copenhagen, Denmark
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18
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Salem Y, Oestreich MA, Fuchs O, Usemann J, Frey U, Surbek D, Amylidi-Mohr S, Latzin P, Ramsey K, Yammine S. Are children born by cesarean delivery at higher risk for respiratory sequelae? Am J Obstet Gynecol 2022; 226:257.e1-257.e11. [PMID: 34364843 DOI: 10.1016/j.ajog.2021.07.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/19/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Globally, the number of children born by cesarean delivery is constantly increasing. However, hormonal and physiological changes associated with labor and vaginal delivery are considered necessary for lung maturation. OBJECTIVE We aimed to assess whether the mode of delivery is associated with changes in respiratory and atopic outcomes during infancy and at school age. STUDY DESIGN We included 578 children, born at ≥37 weeks of gestation, from a prospective birth cohort study. We compared weekly respiratory symptoms throughout the first year of life and infant lung function (tidal breathing and multiple-breath washout) at 5 weeks of age between children born by cesarean delivery (N=114) and those born by vaginal delivery (N=464) after term pregnancy in healthy women. At a follow-up visit conducted at 6 years of age (N=371, of which 65 were delivered by cesarean delivery), we assessed respiratory, atopic, and lung function outcomes (spirometry, body plethysmography, and multiple-breath washout). We performed adjusted regression analyses to examine the association between cesarean delivery and respiratory and atopic outcomes. To account for multiple testing, we used the Bonferroni correction, which led to an adapted significance level of P<.002. RESULTS During infancy, children born by cesarean delivery did not have more respiratory symptoms than those born by vaginal delivery (median, 4 weeks; interquartile range, 7 weeks vs median, 5 weeks; interquartile range, 7 weeks; adjusted incidence rate ratio, 0.8; 95% confidence interval, 0.6-1.0; P=.02). Infant lung function was similar between the groups. Children born by cesarean delivery did not have a higher incidence of "ever wheezing" (adjusted odds ratio, 0.9; 95% confidence interval, 0.5-1.8; P=.78) or current asthma (adjusted odds ratio, 0.4; 95% confidence interval, 0.0-3.5; P=.42) at school age than those born by vaginal delivery. There was no difference in the lung function parameters between the groups. CONCLUSION Cesarean delivery was not associated with respiratory symptoms in the first year of life, nor with different respiratory or atopic outcomes at school age, when compared with vaginal delivery. Our results indicate that there are no long-term consequences on the respiratory health of the child associated with cesarean delivery.
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19
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Fouzas S, Kentgens AC, Lagiou O, Frauchiger BS, Wyler F, Theodorakopoulos I, Yammine S, Latzin P. Novel volumetric capnography indices measure ventilation inhomogeneity in cystic fibrosis. ERJ Open Res 2022; 8:00440-2021. [PMID: 35295235 PMCID: PMC8918935 DOI: 10.1183/23120541.00440-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/14/2021] [Indexed: 11/05/2022] Open
Abstract
BackgroundVolumetric capnography (VCap) is a simpler alternative of multiple-breath washout (MBW) to detect ventilation inhomogeneity (VI) in patients with cystic fibrosis (CF). However, its diagnostic performance is influenced by breathing dynamics. We introduce two novel VCap indices, the Capnographic Inhomogeneity Indices (CIIs) that may overcome this limitation and explore their diagnostic characteristics in a cohort of CF patients.MethodsWe analysed 320 N2-MBW trials from 50 CF patients and 65 controls (age 4-18 years) and calculated classical VCap indices, such as slope III (SIII) and the capnographic index (KPIv). We introduced novel CIIs based on a theoretical lung model, and assessed their diagnostic performance compared to classical VCap indices and the lung clearance index (LCI).ResultsBoth CIIs were significantly higher in CF patients compared with controls (mean±SD CII1 5.9±1.4% versus 5.1±1.0%, p=0.002; CII2 7.7±1.8% versus 6.8±1.4%, p=0.002) and presented strong correlation with LCI (CII1 R2=0.47 and CII2 R2=0.44 in CF patients). Classical VCap indices showed inferior discriminative ability (SIII 2.3±1.0%/L versus 1.9±0.7%/L, P=0.013; KPIv 3.9±1.3% versus 3.5±1.2%, P=0.071), while the correlation with LCI was weak (SIII R2=0.03; KPIv R2=0.08 in CF patients). CIIs showed lower intra-subject inter-trial variability, calculated as coefficient of variation for three and relative difference for two trials, than classical VCap indices, but higher than LCI (CII1 11.1±8.2% and CII2 11.0±8.0% versus SIII 16.3±13.5%; KPIv 15.9±12.8%; LCI 5.9%±4.2%).ConclusionCIIs detect VI better than classical VCap indices and correlate well with LCI. However, further studies on their diagnostic performance and clinical utility are required.
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20
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Decrue F, Gorlanova O, Salem Y, Vienneau D, de Hoogh K, Gisler A, Usemann J, Korten I, Nahum U, Sinues P, Schulzke S, Fuchs O, Latzin P, Röösli M, Frey U. Increased Impact of Air Pollution on Lung Function in Preterm versus Term Infants: The BILD Study. Am J Respir Crit Care Med 2022; 205:99-107. [PMID: 34587471 DOI: 10.1164/rccm.202102-0272oc] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Rationale: Infants born prematurely have impaired capacity to deal with oxidative stress shortly after birth. Objectives: We hypothesize that the relative impact of exposure to air pollution on lung function is higher in preterm than in term infants. Methods: In the prospective BILD (Basel-Bern Infant Lung Development) birth cohort of 254 preterm and 517 term infants, we investigated associations of particulate matter ⩽10 μm in aerodynamic diameter (PM10) and nitrogen dioxide with lung function at 44 weeks' postconceptional age and exhaled markers of inflammation and oxidative stress response (fractional exhaled nitric oxide [FeNO]) in an explorative hypothesis-driven study design. Multilevel mixed-effects models were used and adjusted for known confounders. Measurements and Main Results: Significant associations of PM10 during the second trimester of pregnancy with lung function and FeNO were found in term and preterm infants. Importantly, we observed stronger positive associations in preterm infants (born 32-36 wk), with an increase of 184.9 (95% confidence interval [CI], 79.1-290.7) ml/min [Formula: see text]e per 10-μg/m3 increase in PM10, than in term infants (75.3; 95% CI, 19.7-130.8 ml/min) (pprematurity × PM10 interaction = 0.04, after multiple comparison adjustment padj = 0.09). Associations of PM10 and FeNO differed between moderate to late preterm (3.4; 95% CI, -0.1 to 6.8 ppb) and term (-0.3; 95% CI, -1.5 to 0.9 ppb) infants, and the interaction with prematurity was significant (pprematurity × PM10 interaction = 0.006, padj = 0.036). Conclusions: Preterm infants showed significantly higher susceptibility even to low to moderate prenatal air pollution exposure than term infants, leading to increased impairment of postnatal lung function. FeNO results further elucidate differences in inflammatory/oxidative stress response when comparing preterm infants with term infants.
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Affiliation(s)
- Fabienne Decrue
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yasmin Salem
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Danielle Vienneau
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute Basel, Basel, Switzerland
| | - Kees de Hoogh
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute Basel, Basel, Switzerland
| | | | - Jakob Usemann
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Respiratory Medicine, University Children's Hospital of Zürich, Zürich, Switzerland; and
| | - Insa Korten
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Uri Nahum
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Pablo Sinues
- University Children's Hospital Basel UKBB.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | | | - Oliver Fuchs
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin Röösli
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute Basel, Basel, Switzerland
| | - Urs Frey
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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21
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Gisler A, Korten I, de Hoogh K, Vienneau D, Frey U, Decrue F, Gorlanova O, Soti A, Hilty M, Latzin P, Usemann J. Associations of air pollution and greenness with the nasal microbiota of healthy infants: A longitudinal study. ENVIRONMENTAL RESEARCH 2021; 202:111633. [PMID: 34256075 DOI: 10.1016/j.envres.2021.111633] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Air pollution and greenness are associated with short- and long-term respiratory health in children but the underlying mechanisms are only scarcely investigated. The nasal microbiota during the first year of life has been shown to be associated with respiratory tract infections and asthma development. Thus, an interplay between greenness, air pollution and the early nasal microbiota may contribute to short- and long-term respiratory health. We aimed to examine associations between fine particulate matter (PM2.5), nitrogen dioxide (NO2) and greenness with the nasal microbiota of healthy infants during the first year of life in a European context with low-to-moderate air pollution levels. METHODS Microbiota characterization was performed using 16 S rRNA pyrosequencing of 846 nasal swabs collected fortnightly from 47 healthy infants of the prospective Basel-Bern Infant Lung Development (BILD) cohort. We investigated the association of satellite-based greenness and an 8-day-average exposure to air pollution (PM2.5, NO2) with the nasal microbiota during the first year of life. Exposures were individually estimated with novel spatial-temporal models incorporating satellite data. Generalized additive mixed models adjusted for known confounders and considering the autoregressive correlation structure of the data were used for analysis. RESULTS Mean (SD) PM2.5 level was 17.1 (3.8 μg/m3) and mean (SD) NO2 level was 19.7 (7.9 μg/m3). Increased PM2.5 and increased NO2 were associated with reduced within-subject Ružička dissimilarity (PM2.5: per 1 μg/m3 -0.004, 95% CI -0.008, -0.001; NO2: per 1 μg/m3 -0.004, 95% CI -0.007, -0.001). Whole microbial community comparison with nonmetric multidimensional scaling revealed distinct microbiota profiles for different PM2.5 exposure levels. Increased NO2 was additionally associated with reduced abundance of Corynebacteriaceae (per 1 μg/m3: -0.027, 95% CI -0.053, -0.001). No associations were found between greenness and the nasal microbiota. CONCLUSION Air pollution was associated with Ružička dissimilarity and relative abundance of Corynebacteriaceae. This suggests that even low-to-moderate exposure to air pollution may impact the nasal microbiota during the first year of life. Our results will be useful for future studies assessing the clinical relevance of air-pollution-induced alterations of the nasal microbiota with subsequent respiratory disease development.
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Affiliation(s)
- Amanda Gisler
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Insa Korten
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Urs Frey
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fabienne Decrue
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andras Soti
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Division of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, University of Zurich, Zurich, Switzerland.
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Oestreich MA, Wyler F, Latzin P, Ramsey KA. Shedding light into the black box of infant multiple-breath washout. Pediatr Pulmonol 2021; 56:2642-2653. [PMID: 33991038 DOI: 10.1002/ppul.25464] [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: 07/16/2020] [Revised: 04/22/2021] [Accepted: 05/08/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Multiple-breath inert gas washout (MBW) is a sensitive technique to assess lung volumes and ventilation inhomogeneity in infancy. Poor agreement amongst commercially available setups and a lack of transparency in the underlying algorithms for the computation of infant MBW outcomes currently limit the widespread application of MBW as a surveillance tool in early lung disease. METHODS We determined all computational steps in signal processing and the calculation of MBW outcomes in the current infant WBreath/Exhalyzer D setup (Exhalyzer D device, Eco Medics AG; WBreath software version 3.28.0, ndd Medizintechnik AG; Switzerland). We developed a revised WBreath version based on current consensus guidelines and compared outcomes between the current (3.28.0) and revised (3.52.3) WBreath version. We analyzed 60 visits from 40 infants with cystic fibrosis (CF) and 20 healthy controls at 6 weeks and 1 year of age. RESULTS Investigation into the algorithms in WBreath 3.28.0 revealed discrepancies from current consensus guidelines, which resulted in a potential overestimation of functional residual capacity (FRC) and underestimation of lung clearance index (LCI). We developed a revised WBreath version (3.52.3), which overall resulted in 6.7% lower FRC (mean (SD) -1.78 (0.99) mL/kg) and 14.1% higher LCI (1.11 (0.57) TO) than WBreath version 3.28.0. CONCLUSION Comprehensive investigation into the signal processing and algorithms used for analysis of MBW measurements improves the transparency and robustness of infant MBW data. The revised software version calculates outcomes according to consensus guidelines. Future work is needed to validate and compare outcomes between infant MBW setups.
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Affiliation(s)
- Marc-Alexander Oestreich
- Pediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Florian Wyler
- Pediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Pediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland
| | - Kathryn A Ramsey
- Pediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland
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23
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Martins Costa Gomes G, de Gouveia Belinelo P, Starkey MR, Murphy VE, Hansbro PM, Sly PD, Robinson PD, Karmaus W, Gibson PG, Mattes J, Collison AM. Cord blood group 2 innate lymphoid cells are associated with lung function at 6 weeks of age. Clin Transl Immunology 2021; 10:e1296. [PMID: 34306680 PMCID: PMC8292948 DOI: 10.1002/cti2.1296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 04/27/2021] [Accepted: 05/21/2021] [Indexed: 11/21/2022] Open
Abstract
Objective Offspring born to mothers with asthma in pregnancy are known to have lower lung function which tracks with age. Human group 2 innate lymphoid cells (ILC2) accumulate in foetal lungs, at 10‐fold higher levels compared to adult lungs. However, there are no data on foetal ILC2 numbers and the association with respiratory health outcomes such as lung function in early life. We aimed to investigate cord blood immune cell populations from babies born to mothers with asthma in pregnancy. Methods Cord blood from babies born to asthmatic mothers was collected, and cells were stained in whole cord blood. Analyses were done using traditional gating approaches and computational methodologies (t‐distributed stochastic neighbour embedding and PhenoGraph algorithms). At 6 weeks of age, the time to peak tidal expiratory flow as a percentage of total expiratory flow time (tPTEF/tE%) was determined as well as Lung Clearance Index (LCI), during quiet natural sleep. Results Of 110 eligible infants (March 2017 to November 2019), 91 were successfully immunophenotyped (82.7%). Lung function was attempted in 61 infants (67.0%), and 43 of those infants (70.5% of attempted) had technically acceptable tPTEF/tE% measurements. Thirty‐four infants (55.7% of attempted) had acceptable LCI measurements. Foetal ILC2 numbers with increased expression of chemoattractant receptor‐homologous molecule (CRTh2), characterised by two distinct analysis methodologies, were associated with poorer infant lung function at 6 weeks of age.” Conclusion Foetal immune responses may be a surrogate variable for or directly influence lung function outcomes in early life.
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Affiliation(s)
- Gabriela Martins Costa Gomes
- Priority Research Centre GrowUpWell® - Hunter Medical Research Institute The University of Newcastle Newcastle NSW Australia
| | - Patricia de Gouveia Belinelo
- Priority Research Centre GrowUpWell® - Hunter Medical Research Institute The University of Newcastle Newcastle NSW Australia
| | - Malcolm R Starkey
- Priority Research Centre GrowUpWell® - Hunter Medical Research Institute The University of Newcastle Newcastle NSW Australia.,Priority Research Centre for Healthy Lungs - Hunter Medical Research Institute University of Newcastle Newcastle NSW Australia.,Department of Immunology and Pathology Central Clinical School Monash University Melbourne VIC Australia
| | - Vanessa E Murphy
- Priority Research Centre GrowUpWell® - Hunter Medical Research Institute The University of Newcastle Newcastle NSW Australia
| | - Philip M Hansbro
- Priority Research Centre for Healthy Lungs - Hunter Medical Research Institute University of Newcastle Newcastle NSW Australia.,Centenary UTS Centre for Inflammation Centenary Institute Sydney NSW Australia
| | - Peter D Sly
- Child Health Research Centre University of Queensland Brisbane QLD Australia
| | - Paul D Robinson
- Department of Respiratory Medicine The Children's Hospital at Westmead Sydney NSW Australia
| | | | - Peter G Gibson
- Priority Research Centre for Healthy Lungs - Hunter Medical Research Institute University of Newcastle Newcastle NSW Australia.,Sleep Medicine Department John Hunter Hospital Newcastle NSW Australia
| | - Joerg Mattes
- Priority Research Centre GrowUpWell® - Hunter Medical Research Institute The University of Newcastle Newcastle NSW Australia.,Paediatric Respiratory & Sleep Medicine Department John Hunter Children's Hospital Newcastle NSW Australia
| | - Adam M Collison
- Priority Research Centre GrowUpWell® - Hunter Medical Research Institute The University of Newcastle Newcastle NSW Australia
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24
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Korten I, Oestreich MA, Frey U, Moeller A, Jung A, Spinas R, Mueller-Suter D, Trachsel D, Rochat I, Spycher B, Latzin P, Casaulta C, Ramsey K. Respiratory symptoms do not reflect functional impairment in early CF lung disease. J Cyst Fibros 2021; 20:957-964. [PMID: 34088612 DOI: 10.1016/j.jcf.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lung disease can develop within the first year of life in infants with cystic fibrosis (CF). However, the frequency and severity of respiratory symptoms in infancy are not known. METHODS We assessed respiratory symptoms in 50 infants with CF and 50 healthy matched controls from two prospective birth cohort studies. Respiratory symptoms and respiratory rate were documented by standardized weekly interviews throughout the first year. Infants performed multiple breath washout in the first weeks of life. RESULTS We analyzed 4552 data points (2217 in CF). Respiratory symptoms (either mild or severe) were not more frequent in infants with CF (OR:1.1;95% CI:[0.76, 1.59]; p=0.6). Higher lung clearance index and higher respiratory rate in infants with CF were not associated with respiratory symptoms. CONCLUSIONS We found no difference in respiratory symptoms between healthy and CF infants. These data indicate that early CF lung disease may not be captured by clinical presentation alone.
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Affiliation(s)
- Insa Korten
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Switzerland
| | - Marc-Alexander Oestreich
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland
| | - Urs Frey
- University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Alexander Moeller
- Division of Respiratory Medicine, University Children's Hospital Zurich, Switzerland
| | - Andreas Jung
- Division of Respiratory Medicine, University Children's Hospital Zurich, Switzerland
| | - Renate Spinas
- Division of Respiratory Medicine, University Children's Hospital Zurich, Switzerland
| | | | - Daniel Trachsel
- University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Isabelle Rochat
- Department of Paediatrics, Respiratory Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Ben Spycher
- Institute for Social and Preventive Medicine, University of Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Switzerland
| | - Carmen Casaulta
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Switzerland
| | - Kathryn Ramsey
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Switzerland.
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25
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Soti AL, Usemann J, Schaub B, Frey U, Latzin P, Fuchs O. Can biomarkers in umbilical cord blood predict atopic disease at school age? Pediatr Res 2021; 89:389-392. [PMID: 31810077 DOI: 10.1038/s41390-019-0686-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Andras Laszlo Soti
- Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland.,University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Jakob Usemann
- Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland.,University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Respiratory Medicine, University Children's Hospital Zurich, Zurich, Switzerland
| | - Bianca Schaub
- University Children's Hospital Munich, Pediatric Allergology, Ludwig Maximilian's University, Comprehensive Pulmonary Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Urs Frey
- Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland.,University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Philipp Latzin
- Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland.,University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Oliver Fuchs
- Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland. .,University Children's Hospital Basel (UKBB), Basel, Switzerland. .,Department of Pediatric Pneumology & Allergology, University Children's Hospital Schleswig-Holstein Campus Lübeck, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany.
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26
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Goshen S, Novack L, Erez O, Yitshak-Sade M, Kloog I, Shtein A, Shany E. The effect of exposure to particulate matter during pregnancy on lower respiratory tract infection hospitalizations during first year of life. Environ Health 2020; 19:90. [PMID: 32847589 PMCID: PMC7449075 DOI: 10.1186/s12940-020-00645-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 08/14/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Lower respiratory tract infections (LRTI) in early life, including pneumonia, bronchitis and bronchiolitis, can lead to decreased lung function, persistent lung damage and increased susceptibility to various respiratory diseases such as asthma. In-utero exposure to particulate matter (PM) during pregnancy may disrupt biological mechanisms that regulate fetal growth, maturation and development. We aimed to estimate the association between intrauterine exposure to PM of size < 2.5 μm in diameter (PM2.5) and incidence of LRTIs during the first year of life. METHODS A retrospective population-based cohort study in a population of mothers and infants born in Soroka University Medical Center (SUMC) in the years 2004-2012. All infants < 1 year old that were hospitalized due to LRTIs were included. The main exposure assessment was based on a hybrid model incorporating daily satellite-based predictions at 1 km2 spatial resolution. Data from monitoring stations was used for imputation of main exposure and other pollutants. Levels of environmental exposures were assigned to subjects based on their residential addresses and averaged for each trimester. Analysis was conducted by a multivariable generalized estimating equation (GEE) Poisson regression. Data was analyzed separately for the two main ethnic groups in the region, Jewish and Arab-Bedouin. RESULTS The study cohort included 57,331 deliveries that met the inclusion criteria. Overall, 1871 hospitalizations of infants < 1 year old due to pneumonia or bronchiolitis were documented. In a multivariable analysis, intrauterine exposure to high levels of PM2.5 (> 24 μg/m3) in the first and second trimesters was found to be adversely associated with LRTIs in the Arab-Bedouin population (1st trimester, RR = 1.31, CI 95% 1.08-1.60; 2nd trimester: RR = 1.34, CI 95% 1.09-1.66). CONCLUSION Intrauterine exposure to high levels of PM2.5 is associated with a higher risk of hospitalizations due to lower respiratory tract infections in Arab-Bedouin infants.
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Affiliation(s)
- Sharon Goshen
- Department of Epidemiology, Faculty of Health Sciences, School of Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Lena Novack
- Department of Epidemiology, Faculty of Health Sciences, School of Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Negev Environmental Health Research Institute, Soroka University Medical Center, Beer Sheva, Israel
| | - Offer Erez
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, School of Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Maayan Yitshak-Sade
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alexandra Shtein
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Eilon Shany
- Department of Neonatology, Faculty of Health Sciences, Soroka University Medical Center, School of Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel
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27
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Gorlanova O, Appenzeller R, Mahmoud YS, Ramsey KA, Usemann J, Decrue F, Kuehni CE, Röösli M, Latzin P, Fuchs O, Soti A, Frey U, On Behalf Of The Bild Study Group. Effect of breastfeeding duration on lung function, respiratory symptoms and allergic diseases in school-age children. Pediatr Pulmonol 2020; 55:1448-1455. [PMID: 32181595 DOI: 10.1002/ppul.24733] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 03/06/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND A positive effect of breastfeeding on lung function has been demonstrated in cohorts of children with asthma or risk for asthma. We assessed the impact of breastfeeding on lung function and symptoms at the age of 6 years in an unselected, healthy birth cohort. METHODS We prospectively studied healthy term infants from the Bern-Basel Infant Lung Development (BILD) cohort from birth up to 6 years. Any breastfeeding was assessed by weekly phone calls during the first year of life. Risk factors (eg, smoking exposure, parental history of allergic conditions, and education) were obtained using standardized questionnaires. The primary outcomes were lung function parameters measured at 6 years of age by spirometry forced expiratory volume in 1 second, body plethysmography (functional residual capacity [FRCpleth ], the total lung capacity [TLCpleth ], and the effective respiratory airway resistance [Reff ]) and fractional exhaled nitric oxide (FeNO). Secondary outcomes included ever wheeze (between birth and 6 years), wheeze in the past 12 months, asthma, presence of allergic conditions, atopic dermatitis, rhinitis, and positive skin prick test at the age of 6 years. RESULTS In 377 children the mean breastfeeding duration was 36 weeks (SD 14.4). We found no association of breastfeeding duration with obstructive or restrictive lung function and FeNO. After adjustment for confounders, we found no associations of breastfeeding duration with respiratory symptoms or the presence of allergic conditions. CONCLUSION This study found no evidence of an association between breastfeeding and comprehensive lung function in unselected healthy children with long-term breastfeeding. Our findings do not support the hypothesis that the duration of breastfeeding has a direct impact on lung function in a healthy population with low asthmatic risk.
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Affiliation(s)
- Olga Gorlanova
- Pediatric Pulmonology, University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
- Division of Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Rhea Appenzeller
- Pediatric Pulmonology, University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
- Division of Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yasmin S Mahmoud
- Pediatric Pulmonology, University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
- Division of Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kathryn A Ramsey
- Pediatric Pulmonology, University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
- Division of Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jakob Usemann
- Pediatric Pulmonology, University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
- Division of Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Division of Respiratory Medicine, University Children's Hospital Zurich, Zurich, Switzerland
| | - Fabienne Decrue
- Pediatric Pulmonology, University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
- Division of Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudia E Kuehni
- Institute for Social and Preventive Medicine, Pediatric Respiratory Epidemiology Group, University of Bern, Bern, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute Basel, Environmental Exposures and Health Unit, Basel, Switzerland
| | - Philipp Latzin
- Pediatric Pulmonology, University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
- Division of Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Oliver Fuchs
- Pediatric Pulmonology, University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
- Division of Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andras Soti
- Pediatric Pulmonology, University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
- Division of Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Urs Frey
- Pediatric Pulmonology, University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
- Division of Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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28
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Lacker TJ, Walther A, Fiacco S, Ehlert U. The Relation Between Steroid Secretion Patterns and the Androgen Receptor Gene Polymorphism on Physical Health and Psychological Well-Being-Longitudinal Findings From the Men's Health 40+ Study. Front Hum Neurosci 2020; 14:43. [PMID: 32116617 PMCID: PMC7033643 DOI: 10.3389/fnhum.2020.00043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/29/2020] [Indexed: 11/25/2022] Open
Abstract
Research is increasingly focusing on promoting healthy aging and the related extension of the health span by targeting crucial biological processes responsible for age-related conditions. While age-related gradual changes in steroid hormones such as testosterone, estradiol, or cortisol are well described in men, their interactions among each other or with genetic markers have not been sufficiently investigated with regard to physical health or psychological well-being. More specifically, the examination of age-related alterations in hormone interactions and the androgen receptor polymorphism, which modulates androgen action on target cells, in relation to physical health and psychological well-being represents a promising avenue for research on healthy aging in men. A total of 97 healthy aging men provided complete data on psychometric health measures as well as hormonal and genetic parameters at baseline and a 4-year follow-up assessment. Fasting saliva samples were taken at 8:00 am under standardized laboratory conditions, while the androgen receptor gene polymorphism was analyzed from dried blood spots. Longitudinal analyses revealed that psychological well-being and physical health remained stable over time. Analyses indicated that E2 moderated the course of psychological well-being, while the androgen receptor gene polymorphism moderated the course of physical health. Further, T was a strong predictor of physical health. These results suggest that the hypothalamic-pituitary-gonadal (HPG) axis might be important for the maintenance of psychological well-being in men, while physical health depends more on interindividual differences in the androgen receptor gene and T.
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Affiliation(s)
- Tim Jonas Lacker
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
- Biopsychology, TU Dresden, Dresden, Germany
| | - Serena Fiacco
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
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29
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Usemann J, Decrue F, Korten I, Proietti E, Gorlanova O, Vienneau D, Fuchs O, Latzin P, Röösli M, Frey U. Exposure to moderate air pollution and associations with lung function at school-age: A birth cohort study. ENVIRONMENT INTERNATIONAL 2019; 126:682-689. [PMID: 30870661 DOI: 10.1016/j.envint.2018.12.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 05/06/2023]
Abstract
BACKGROUND Adverse effects of higher air pollution levels before and after birth on subsequent lung function are often reported in the literature. We assessed whether low-to-moderate levels of air pollution during preschool-age impact upon lung function at school-age. METHODS In a prospective birth cohort of 304 healthy term-born infants, 232 (79%) completed lung function at follow-up at six years. Using spatial-temporal models, levels of individual air pollution (nitrogen dioxide (NO2) and ozone (O3), particulate matter with a diameter <10 μm (PM10)) were estimated for the time windows pregnancy, first up to the sixth year of life separately, and birth until follow-up at six years. Time window means were compared to World Health Organization (WHO) guideline limits. Associations of exposure windows with spirometry and body plethysmography indices were analyzed using regression models, adjusting for potential confounders. For subgroup analysis, air pollution exposure was categorized into quartiles (four groups of 52 children). RESULTS Mean NO2 level from birth until follow-up was [mean (range)] [11.8 (4.9 to 35.9 μg/m3)], which is almost 4-times lower than the WHO suggested limit of 40 μg/m3. In the whole population, increased air pollution levels from birth until follow-up were associated with reduced lung function at six years. In the subgroup analysis, the 52 children exposed to NO2 levels from the highest quartile during pregnancy, the first and second years of life and from birth until follow-up, had a significant decrease in forced expiratory volume in 1 s (FEV1). Per interquartile range increase of NO2, FEV1 decreased by [z-score change (95% confidence interval)] [-1.07 (-1.67 to -0.47)], [-1.02 (-1.66 to -0.39)], [-0.51 (-0.86 to -0.17)] and [-0.80 (-1.33 to -0.27)], respectively. Air pollution exposure during pregnancy and childhood resulted in a non-significant decrease in lung volume at six years, as assessed by functional residual capacity measured by body plethysmography (FRCpleth). CONCLUSION Our results suggest that exposure to higher NO2 levels, which are still much lower than WHO guideline limits, especially during the sensitive period of early lung development, may be associated with reduced lung function at school-age. These findings support the concept of age and dose-dependent pollution effects on lung function in healthy school-aged children and underline the importance of pollution reduction measures.
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Affiliation(s)
- Jakob Usemann
- University of Basel Children's Hospital (UKBB), Spitalstrasse 33, 4056 Basel, Switzerland; Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, Freiburgstrasse 15, 3010 Bern, Switzerland
| | - Fabienne Decrue
- University of Basel Children's Hospital (UKBB), Spitalstrasse 33, 4056 Basel, Switzerland
| | - Insa Korten
- University of Basel Children's Hospital (UKBB), Spitalstrasse 33, 4056 Basel, Switzerland; Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, Freiburgstrasse 15, 3010 Bern, Switzerland
| | - Elena Proietti
- University of Basel Children's Hospital (UKBB), Spitalstrasse 33, 4056 Basel, Switzerland; Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, Freiburgstrasse 15, 3010 Bern, Switzerland
| | - Olga Gorlanova
- University of Basel Children's Hospital (UKBB), Spitalstrasse 33, 4056 Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute Basel, Socinstrasse 57, 4051 Basel, Switzerland; University of Basel, Petersplatz 1, 4001 Basel, Switzerland
| | - Oliver Fuchs
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, Freiburgstrasse 15, 3010 Bern, Switzerland
| | - Philipp Latzin
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, Freiburgstrasse 15, 3010 Bern, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute Basel, Socinstrasse 57, 4051 Basel, Switzerland; University of Basel, Petersplatz 1, 4001 Basel, Switzerland
| | - Urs Frey
- University of Basel Children's Hospital (UKBB), Spitalstrasse 33, 4056 Basel, Switzerland.
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30
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Usemann J, Suter A, Zannin E, Proietti E, Fouzas S, Schulzke S, Latzin P, Frey U, Korten I, Anagnostopoulou P, Gorlanova O, Frey U, Latzin P, Proietti E, Usemann J. Variability of Tidal Breathing Parameters in Preterm Infants and Associations with Respiratory Morbidity during Infancy: A Cohort Study. J Pediatr 2019; 205:61-69.e1. [PMID: 30416016 DOI: 10.1016/j.jpeds.2018.10.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/04/2018] [Accepted: 10/02/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To test whether low variability of tidal volume (VT) and capnographic indices are predictive of subsequent respiratory morbidity in preterm infants. STUDY DESIGN In a birth cohort of 133 preterm infants, lung function was performed at 44 weeks postmenstrual age. Associations between the coefficient of variation (CV) of VT (CVVT) and of expired CO2 volume per breath (CVVE,CO2) with rehospitalization, wheeze, and inhalation therapy during infancy were assessed using logistic regression. Area under the curve (AUC) analysis was used to assess whether outcome prediction using bronchopulmonary dysplasia (BPD) classification was enhanced by CVVT or CVVE,CO2. RESULTS For each IQR decrease in CVVT (range, 4%-35%) and CVVE,CO2 (range, 5%-40%), the OR for rehospitalization increased by 2.25 (95% CI, 1.21-4.20) and 2.31 (95% CI, 1.20-4.45), respectively. The predictive value of BPD for rehospitalization was improved when CVVT or CVVE,CO2 was added to the model, with the AUC increasing from 0.56 to 0.66 in both models. No association was found for the other outcomes. CONCLUSIONS Compared with BPD classification alone, including near-term variability of tidal breathing parameters improves the prediction of rehospitalization in infancy. These findings may inform parent counseling and monitoring strategies in preterm infants.
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Affiliation(s)
- Jakob Usemann
- University Children's Hospital Basel, Basel, Switzerland; Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Andrea Suter
- University Children's Hospital Basel, Basel, Switzerland
| | - Emanuela Zannin
- University Children's Hospital Basel, Basel, Switzerland; Departiment of Electronics, Information, and Bioengineering, Polytechnic University of Milan, Milan, Italy
| | - Elena Proietti
- University Children's Hospital Basel, Basel, Switzerland; Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sotirios Fouzas
- Pediatric Respiratory Unit, University Hospital of Patras, Patras, Greece
| | - Sven Schulzke
- University Children's Hospital Basel, Basel, Switzerland
| | - Philipp Latzin
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Urs Frey
- University Children's Hospital Basel, Basel, Switzerland
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Korten I, Kieninger E, Yammine S, Cangiano G, Nyilas S, Anagnostopoulou P, Singer F, Kuehni CE, Regamey N, Frey U, Casaulta C, Spycher BD, Latzin P. Respiratory rate in infants with cystic fibrosis throughout the first year of life and association with lung clearance index measured shortly after birth. J Cyst Fibros 2019; 18:118-126. [DOI: 10.1016/j.jcf.2018.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/26/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
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Neumann RP, Hilty M, Xu B, Usemann J, Korten I, Mika M, Müller L, Latzin P, Frey U. Nasal microbiota and symptom persistence in acute respiratory tract infections in infants. ERJ Open Res 2018; 4:00066-2018. [PMID: 30519565 PMCID: PMC6275129 DOI: 10.1183/23120541.00066-2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 10/26/2018] [Indexed: 12/17/2022] Open
Abstract
Acute respiratory tract infections (ARI) in infancy have been implicated in the development of chronic respiratory disease, but the complex interplay between viruses, bacteria and host is not completely understood. We aimed to prospectively determine whether nasal microbiota changes occur between the onset of the first symptomatic ARI in the first year of life and 3 weeks later, and to explore possible associations with the duration of respiratory symptoms, as well as with host, environmental and viral factors. Nasal microbiota of 167 infants were determined at both time-points by 16S ribosomal RNA-encoding gene PCR amplification and subsequent pyrosequencing. Infants were clustered based on their nasal microbiota using hierarchical clustering methods at both time-points. We identified five dominant infant clusters with distinct microbiota at the onset of ARI but only three clusters after 3 weeks. In these three clusters, symptom persistence was overrepresented in the Streptococcaceae-dominated cluster and underrepresented in the cluster dominated by “Others” (p<0.001). Duration of symptoms was not associated with the type of respiratory virus. Infants with prolonged respiratory symptoms after their first ARI tend to exhibit distinct microbial compositions, indicating close microbiota–host interactions that seem to be of importance for symptom persistence and recovery. Nasal microbiota in infants is associated with symptom persistence after acute symptomatic respiratory infections.http://ow.ly/3Mhh30mC1wJ
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Affiliation(s)
- Roland P Neumann
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Both authors contributed equally
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland.,Dept of Infectious Diseases, Bern University Hospital, Bern, Switzerland.,Both authors contributed equally
| | - Binbin Xu
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Pediatric Respiratory Medicine, Dept of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Insa Korten
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Pediatric Respiratory Medicine, Dept of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Moana Mika
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland.,Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Loretta Müller
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Philipp Latzin
- Pediatric Respiratory Medicine, Dept of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Urs Frey
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
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Usemann J, Xu B, Delgado-Eckert E, Korten I, Anagnostopoulou P, Gorlanova O, Kuehni C, Röösli M, Latzin P, Frey U. Dynamics of respiratory symptoms during infancy and associations with wheezing at school age. ERJ Open Res 2018; 4:00037-2018. [PMID: 30474038 PMCID: PMC6243079 DOI: 10.1183/23120541.00037-2018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 08/28/2018] [Indexed: 12/22/2022] Open
Abstract
Children with frequent respiratory symptoms in infancy have an increased risk for later wheezing, but the association with symptom dynamics is unknown. We developed an observer-independent method to characterise symptom dynamics and tested their association with subsequent respiratory morbidity. In this birth-cohort of healthy neonates, we prospectively assessed weekly respiratory symptoms during infancy, resulting in a time series of 52 symptom scores. For each infant, we calculated the transition probability between two consecutive symptom scores. We used these transition probabilities to construct a Markov matrix, which characterised symptom dynamics quantitatively using an entropy parameter. Using this parameter, we determined phenotypes by hierarchical clustering. We then studied the association between phenotypes and wheezing at 6 years. In 322 children with complete data for symptom scores during infancy (16 864 observations), we identified three dynamic phenotypes. Compared to the low-risk phenotype, the high-risk phenotype, defined by the highest entropy parameter, was associated with an increased risk of wheezing (odds ratio (OR) 3.01, 95% CI 1.15-7.88) at 6 years. In this phenotype, infants were more often male (64%) and had been exposed to environmental tobacco smoke (31%). In addition, more infants had siblings (67%) and attended childcare (38%). We describe a novel method to objectively characterise dynamics of respiratory symptoms in infancy, which helps identify abnormal clinical susceptibility and recovery patterns of infant airways associated with persistent wheezing.
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Affiliation(s)
- Jakob Usemann
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Paediatric Respiratory Medicine, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,These authors contributed equally
| | - Binbin Xu
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,These authors contributed equally
| | | | - Insa Korten
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Paediatric Respiratory Medicine, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Pinelopi Anagnostopoulou
- Paediatric Respiratory Medicine, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Claudia Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Philipp Latzin
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Paediatric Respiratory Medicine, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Urs Frey
- University Children's Hospital Basel (UKBB), Basel, Switzerland
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Lupatsch JE, Kreis C, Korten I, Latzin P, Frey U, Kuehni CE, Spycher BD. Neighbourhood child population density as a proxy measure for exposure to respiratory infections in the first year of life: A validation study. PLoS One 2018; 13:e0203743. [PMID: 30208077 PMCID: PMC6135405 DOI: 10.1371/journal.pone.0203743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 08/27/2018] [Indexed: 12/18/2022] Open
Abstract
Background Assessing exposure to infections in early childhood is of interest in many epidemiological investigations. Because exposure to infections is difficult to measure directly, epidemiological studies have used surrogate measures available from routine data such as birth order and population density. However, the association between population density and exposure to infections is unclear. We assessed whether neighbourhood child population density is associated with respiratory infections in infants. Methods With the Basel-Bern lung infant development study (BILD), a prospective Swiss cohort study of healthy neonates, respiratory symptoms and infections were assessed by weekly telephone interviews with the mother throughout the first year of life. Using population census data, we calculated neighbourhood child density as the number of children < 16 years of age living within a 250 m radius around the residence of each child. We used negative binomial regression models to assess associations between neighbourhood child density and the number of weeks with respiratory infections and adjusted for potential confounders including the number of older siblings, day-care attendance and duration of breastfeeding. We investigated possible interactions between neighbourhood child population density and older siblings assuming that older siblings mix with other children in the neighbourhood. Results The analyses included 487 infants. We found no evidence of an association between quintiles of neighbourhood child density and number of respiratory symptoms (p = 0.59, incidence rate ratios comparing highest to lowest quintile: 1.15, 95%-confidence interval: 0.90–1.47). There was no evidence of interaction with older siblings (p = 0.44). Results were similar in crude and in fully adjusted models. Conclusions Our study suggests that in Switzerland neighbourhood child density is a poor proxy for exposure to infections in infancy.
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Affiliation(s)
- Judith E. Lupatsch
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Institute of Pharmaceutical Medicine, University of Basel, Basel Switzerland
| | - Christian Kreis
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Insa Korten
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- University of Basel, Children’s Hospital (UKBB), Basel, Switzerland
| | - Urs Frey
- University of Basel, Children’s Hospital (UKBB), Basel, Switzerland
| | - Claudia E. Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Ben D. Spycher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- * E-mail:
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Seeni I, Ha S, Nobles C, Liu D, Sherman S, Mendola P. Air pollution exposure during pregnancy: maternal asthma and neonatal respiratory outcomes. Ann Epidemiol 2018; 28:612-618.e4. [PMID: 30153910 PMCID: PMC6232679 DOI: 10.1016/j.annepidem.2018.06.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/01/2018] [Accepted: 06/05/2018] [Indexed: 01/24/2023]
Abstract
PURPOSE Maternal asthma increases adverse neonatal respiratory outcomes, and pollution may further increase risk. Air quality in relation to neonatal respiratory health has not been studied. METHODS Transient tachypnea of the newborn (TTN), asphyxia, and respiratory distress syndrome (RDS) were identified using medical records among 223,375 singletons from the Consortium on Safe Labor (2002-2008). Community Multiscale Air Quality models estimated pollutant exposures. Multipollutant Poisson regression models calculated adjusted relative risks of outcomes for interquartile range increases in average exposure. Maternal asthma and preterm delivery were evaluated as effect modifiers. RESULTS TTN risk increased after particulate matter (PM) less than or equal to 10-micron exposure during preconception and trimester one (9-10%), and whole-pregnancy exposure to PM less than or equal to 2.5 microns (PM2.5; 17%) and carbon monoxide (CO; 10%). Asphyxia risk increased after exposure to PM2.5 in trimester one (48%) and whole pregnancy (84%), CO in trimester two and whole pregnancy (28-32%), and consistently for ozone (34%-73%). RDS risk was associated with increased concentrations of nitrogen oxides (33%-42%) and ozone (9%-21%) during all pregnancy windows. Inverse associations were observed with several pollutants, particularly sulfur dioxide. No interaction with maternal asthma was observed. Restriction to term births yielded similar results. CONCLUSIONS Several pollutants appear to increase neonatal respiratory outcome risks.
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Affiliation(s)
- Indulaxmi Seeni
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Bethesda, MD
| | - Sandie Ha
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Bethesda, MD; University of California, Merced, Social Sciences and Management Building, Merced, CA
| | - Carrie Nobles
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Bethesda, MD
| | - Danping Liu
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Bethesda, MD; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Biostatistics Branch, Rockville, MD
| | | | - Pauline Mendola
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Bethesda, MD.
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The all age asthma cohort (ALLIANCE) - from early beginnings to chronic disease: a longitudinal cohort study. BMC Pulm Med 2018; 18:140. [PMID: 30126401 PMCID: PMC6102875 DOI: 10.1186/s12890-018-0705-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 08/01/2018] [Indexed: 12/03/2022] Open
Abstract
Background Asthma and wheezing disorders in childhood and adulthood are clinically heterogeneous regarding disease presentation, natural course, and response to treatment. Deciphering common disease mechanisms in distinct subgroups requires harmonized molecular (endo-) phenotyping of both children and adult patients with asthma in a prospective, longitudinal setting. Methods The ALL Age Asthma Cohort (ALLIANCE) of the German Center for Lung Research (DZL) is a prospective, multi-center, observational cohort study with seven recruiting sites across Germany. Data are derived from four sources: (a) patient history from medical records, (b) standardized questionnaires and structured interviews, (c) telephone interviews, and (d) objective measurements. Objective measurements include amongst others lung function and quantitative assessment of airway inflammation and exhaled breath, peripheral blood, skin, nasal, pharyngeal, and nasopharyngeal swabs, nasal secretions, primary nasal epithelial cells, and induced sputum. In cases, objective measurements and biomaterial collection are performed regularly, while control subjects are only examined once at baseline. Discussion The standardized and detailed collection of epidemiological and physiological data, and the molecular deep phenotyping of a comprehensive range of biomaterials in a considerable number of study participants across all ages are the outstanding characteristics of this multi-center cohort. Despite extensive biomaterial sampling, and a recruitment strategy that also includes pre-school children as young as 6 months, attrition is low. In children 83.9%, and in adults 90.5% attended the 12-month follow-up. The earliest time-point to include cases, however, is disease manifestation. Therefore, unraveling mechanisms that drive disease onset is limited, as this question can only be answered in a population-based birth cohort. Nonetheless, ALLIANCE offers a unique, integrative and inter-disciplinary framework with a comprehensive molecular approach in a prospective and identical fashion across ages in order to identify biomarkers and predictors for distinct childhood wheeze and asthma trajectories as well as their further course during adulthood. Ultimately, this approach aims to translate its most significant findings into clinical practice, and to improve asthma transition from adolescence to adulthood. Trial registration NCT02496468 for pediatric arm, NCT02419274 for adult arm.
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Cantuaria ML, Usemann J, Proietti E, Blanes-Vidal V, Dick B, Flück CE, Rüedi S, Héritier H, Wunderli JM, Latzin P, Frey U, Röösli M, Vienneau D. Glucocorticoid metabolites in newborns: A marker for traffic noise related stress? ENVIRONMENT INTERNATIONAL 2018; 117:319-326. [PMID: 29778832 DOI: 10.1016/j.envint.2018.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 03/26/2018] [Accepted: 05/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Traffic noise has been associated with an increased risk for several non-auditory health effects, which may be explained by a noise-induced release of stress hormones (e.g. glucocorticoids). Although several studies in children and adults have indicated an increased secretion of glucocorticoids after exposure to noise, information regarding newborns is scarce. OBJECTIVES To investigate the association between residential exposure to road traffic noise and postnatal stress response, as assessed by the concentration of glucocorticoids at five weeks of age. METHODS Residential noise exposure was estimated for each infant based on spatially detailed modeled data. Adjusted multivariable linear regression models were used to estimate the association between noise exposure and the concentration of nine glucocorticoid metabolites measured in urine of 165 infants from a prospective birth cohort in Bern, Switzerland. Noise exposure (Lden, dB) was categorized into tertiles: low (reference), medium and high. RESULTS Indications of a positive association were found between high road traffic noise and cortisol (% change relative to the reference: 12.1% [95% confidence interval: -10.3, 40.1%]) and cortisone (22.6% [-1.8, 53.0%]), but just the latter was borderline significant. Borderline significant associations were also found between downstream metabolites and higher road traffic noise levels; associations were found to be both positive (i.e. for β-cortolone (51.5% [-0.9, 131.5%])) and negative (i.e. for α-cortolone (-18.3% [-33.6, 0.6%]) and tetrahydrocortisol (-23.7% [-42.8, 1.9%])). CONCLUSIONS Our findings suggest a potential association between exposure to higher road traffic noise levels and changes in glucocorticoid metabolism in early postnatal life. A possible physiological relevance and associations with short- and long-term adverse health effects in a larger study population need to be further investigated.
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Affiliation(s)
- Manuella Lech Cantuaria
- The Maersk Mc-Kinney Moller Institute, Faculty of Engineering, University of Southern Denmark, Odense, Denmark
| | - Jakob Usemann
- University Children's Hospital Basel (UKBB), University of Basel, Switzerland; Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Elena Proietti
- University Children's Hospital Basel (UKBB), University of Basel, Switzerland; Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Victoria Blanes-Vidal
- The Maersk Mc-Kinney Moller Institute, Faculty of Engineering, University of Southern Denmark, Odense, Denmark
| | - Bernhard Dick
- Nephrology & Hypertension, University of Bern, Bern, Switzerland
| | - Christa E Flück
- Pediatric Endocrinology, Diabetology and Metabolism, Bern University Children's Hospital, Bern, Switzerland
| | - Simone Rüedi
- University Children's Hospital Basel (UKBB), University of Basel, Switzerland
| | - Harris Héritier
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | | | - Philipp Latzin
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Urs Frey
- University Children's Hospital Basel (UKBB), University of Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
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Lurà MP, Gorlanova O, Müller L, Proietti E, Vienneau D, Reppucci D, Pavlovic R, Dahinden C, Röösli M, Latzin P, Frey U. Response of cord blood cells to environmental, hereditary and perinatal factors: A prospective birth cohort study. PLoS One 2018; 13:e0200236. [PMID: 29979752 PMCID: PMC6034853 DOI: 10.1371/journal.pone.0200236] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 06/20/2018] [Indexed: 11/21/2022] Open
Abstract
Background Many studies investigating the impact of individual risk factors on cord blood immune cell counts may be biased given that cord blood composition is influenced by a multitude of factors. The aim of this study was to comprehensively investigate the relative impact of environmental, hereditary and perinatal factors on cord blood cells. Methods In 295 neonates from the prospective Basel-Bern Infant Lung Development Cohort, we performed complete blood counts and fluorescence-activated cell sorting scans of umbilical cord blood. The associations between risk factors and cord blood cells were assessed using multivariable linear regressions. Results The multivariable regression analysis showed that an increase per 10μg/m3 of the average nitrogen dioxide 14 days before birth was associated with a decrease in leukocyte (6.7%, 95% CI:-12.1,-1.0) and monocyte counts (11.6%, 95% CI:-19.6,-2.8). Maternal smoking during pregnancy was associated with significantly lower cord blood cell counts in multiple cell populations. Moreover, we observed sex differences regarding eosinophilic granulocytes and plasmacytoid dendritic cells. Finally, significantly increased numbers of cord blood cells were observed in infants exposed to perinatal stress. Cesarean section seems to play a significant role in Th1/Th2 balance. Conclusions Our results suggest that all three: environmental, hereditary and perinatal factors play a significant role in the composition of cord blood cells at birth, and it is important to adjust for all of these factors in cord blood studies. In particular, perinatal circumstances seem to influence immune balance, which could have far reaching consequences in the development of immune mediated diseases.
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Affiliation(s)
- Marco Patrick Lurà
- Division of Pulmonology, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
| | - Olga Gorlanova
- Division of Pulmonology, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
- * E-mail:
| | - Loretta Müller
- Division of Pulmonology, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
| | - Elena Proietti
- Division of Pulmonology, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Diana Reppucci
- Division of Pulmonology, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
| | - Rodoljub Pavlovic
- Institute of Immunology, Inselspital, University of Bern, Bern, Switzerland
| | - Clemens Dahinden
- Institute of Immunology, Inselspital, University of Bern, Bern, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Philipp Latzin
- Division of Pulmonology, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
- Division of Respiratory Medicine, Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Urs Frey
- Division of Pulmonology, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
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Kentgens AC, Guidi M, Korten I, Kohler L, Binggeli S, Singer F, Latzin P, Anagnostopoulou P. Infant multiple breath washout using a new commercially available device: Ready to replace the previous setup? Pediatr Pulmonol 2018; 53:628-635. [PMID: 29418075 DOI: 10.1002/ppul.23959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 01/08/2018] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Multiple breath washout (MBW) is a sensitive test to measure lung volumes and ventilation inhomogeneity from infancy on. The commonly used setup for infant MBW, based on ultrasonic flowmeter, requires extensive signal processing, which may reduce robustness. A new setup may overcome some previous limitations but formal validation is lacking. AIM We assessed the feasibility of infant MBW testing with the new setup and compared functional residual capacity (FRC) values of the old and the new setup in vivo and in vitro. METHODS We performed MBW in four healthy infants and four infants with cystic fibrosis, as well as in a Plexiglas lung simulator using realistic lung volumes and breathing patterns, with the new (Exhalyzer D, Spiroware 3.2.0, Ecomedics) and the old setup (Exhalyzer D, WBreath 3.18.0, ndd) in random sequence. RESULTS The technical feasibility of MBW with the new device-setup was 100%. Intra-subject variability in FRC was low in both setups, but differences in FRC between the setups were considerable (mean relative difference 39.7%, range 18.9; 65.7, P = 0.008). Corrections of software settings decreased FRC differences (14.0%, -6.4; 42.3, P = 0.08). Results were confirmed in vitro. CONCLUSION MBW measurements with the new setup were feasible in infants. However, despite attempts to correct software settings, outcomes between setups were not interchangeable. Further work is needed before widespread application of the new setup can be recommended.
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Affiliation(s)
- Anne-Christianne Kentgens
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Respiratory Medicine and Allergy, Radboud University Medical Centre, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Marisa Guidi
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Insa Korten
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lena Kohler
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Severin Binggeli
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Florian Singer
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Respiratory Medicine, University Children's Hospital of Zurich, Zurich, Switzerland
| | - Philipp Latzin
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Pinelopi Anagnostopoulou
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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40
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Lower exhaled nitric oxide in infants with Cystic Fibrosis compared to healthy controls. J Cyst Fibros 2018; 17:105-108. [DOI: 10.1016/j.jcf.2017.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/24/2017] [Accepted: 05/15/2017] [Indexed: 11/17/2022]
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41
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Fouzas S, Theodorakopoulos I, Delgado-Eckert E, Latzin P, Frey U. Breath-to-breath variability of exhaled CO2 as a marker of lung dysmaturity in infancy. J Appl Physiol (1985) 2017; 123:1563-1570. [DOI: 10.1152/japplphysiol.00372.2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The concept of diffusional screening implies that breath-to-breath variations in CO2 clearance, when related to the variability of breathing, may contain information on the quality and utilization of the available alveolar surface. We explored the validity of the above hypothesis in a cohort of young infants of comparable postmenstrual age but born at different stages of lung maturity, namely, in term-born infants ( n = 128), preterm-born infants without chronic lung disease of infancy (CLDI; n = 53), and preterm infants with moderate/severe CLDI ( n = 87). Exhaled CO2 volume (VE,CO2) and concentration (FE,CO2) were determined by volumetric capnography, whereas their variance was assessed by linear and nonlinear variability metrics. The relationship between relative breath-to-breath change of VE,CO2 (ΔVE,CO2) and the corresponding change of tidal volume (ΔVT) was also analyzed. Nonlinear FE,CO2 variability was lower in CLDI compared with term and non-CLDI preterm group ( P < 0.001 for both comparisons). In CLDI infants, most of the VE,CO2 variability was attributed to the variability of VT ( r2 = 0.749), whereas in term and healthy preterm infants this relationship was weaker ( r2 = 0.507 and 0.630, respectively). The ΔVE,CO2 − ΔVT slope was less steep in the CLDI group (1.06 ± 0.07) compared with non-CLDI preterm (1.16 ± 0.07; P < 0.001) and term infants (1.20 ± 0.10; P < 0.001), suggesting that the more dysmature the infant lung, the less efficiently it eliminates CO2 under tidal breathing conditions. We conclude that the temporal variation of CO2 clearance may be related to the degree of lung dysmaturity in early infancy. NEW & NOTEWORTHY Young infants exhibit appreciable breath-to-breath CO2 variability that can be quantified by nonlinear variability metrics and may reflect the degree of lung dysmaturity. In infants with moderate/severe chronic lung disease of infancy (CLDI), the variability of the exhaled CO2 is mainly driven by the variability of breathing, whereas in term-born and healthy preterm infants this relationship is less strong. The slope of the relative CO2-to-volume change is less steep in CLDI infants, suggesting that dysmature lungs are less efficient in eliminating CO2 under tidal breathing conditions.
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Affiliation(s)
- Sotirios Fouzas
- Pediatric Respiratory Unit, University General Hospital of Patras, Patras, Greece
| | | | - Edgar Delgado-Eckert
- Computational Physiology and Biostatistics, University of Basel Children’s Hospital, Basel, Switzerland
| | - Philipp Latzin
- Pediatric Respiratory Medicine, University Children’s Hospital Bern (Inselspital), University of Bern, Bern, Switzerland
| | - Urs Frey
- Division of Pulmonology and Respiratory Research Group, University Children’s Hospital Basel, Basel, Switzerland
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Kieninger E, Yammine S, Korten I, Anagnostopoulou P, Singer F, Frey U, Mornand A, Zanolari M, Rochat I, Trachsel D, Mueller-Suter D, Moeller A, Casaulta C, Latzin P. Elevated lung clearance index in infants with cystic fibrosis shortly after birth. Eur Respir J 2017; 50:50/5/1700580. [PMID: 29122915 DOI: 10.1183/13993003.00580-2017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 08/08/2017] [Indexed: 11/05/2022]
Abstract
It is not known at what age lung function impairment may arise in children with cystic fibrosis (CF). We assessed lung function shortly after birth in infants with CF diagnosed by newborn screening.We performed infant lung function measurements in a prospective cohort of infants with CF and healthy controls. We assessed lung clearance index (LCI), functional residual capacity (FRC) and tidal breathing parameters. The primary outcome was prevalence and severity of abnormal lung function (±1.64 z-scores) in CF.We enrolled 53 infants with CF (mean age 7.8 weeks) and 57 controls (mean age 5.2 weeks). Compared to controls, LCI and FRC were elevated (mean difference 0.30, 95% CI 0.02-0.60; p=0.034 and 14.5 mL, 95% CI 7.7-21.3 mL; p<0.001, respectively), while ratio of time to peak tidal expiratory flow to expiratory time was decreased in infants with CF. In 22 (41.5%) infants with CF, either LCI or FRC exceeded 1.64 z-scores; three infants had both elevated LCI and FRC.Shortly after birth, abnormal lung function is prevalent in CF infants. Ventilation inhomogeneity or hyperinflation may serve as noninvasive markers to monitor CF lung disease and specific treatment effects, and could thus be used as outcome parameters for future intervention studies in this age group.
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Affiliation(s)
- Elisabeth Kieninger
- Paediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland.,Both authors contributed equally to this work
| | - Sophie Yammine
- Paediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland.,Both authors contributed equally to this work
| | - Insa Korten
- Paediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland.,Dept of Paediatrics, University Children's Hospital of Basel, Basel, Switzerland
| | - Pinelopi Anagnostopoulou
- Paediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland
| | - Florian Singer
- Paediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland.,Division of Respiratory Medicine, University Children's Hospital of Zurich, Zurich, Switzerland
| | - Urs Frey
- Dept of Paediatrics, University Children's Hospital of Basel, Basel, Switzerland
| | - Anne Mornand
- Dept of the Child and Adolescent, Children's University Hospital of Geneva, Geneva, Switzerland
| | - Maura Zanolari
- Dept of Paediatrics, Hospital of Bellinzona, Bellinzona, Switzerland
| | - Isabelle Rochat
- Paediatric Pulmonology Unit, Department of Paediatrics, CHUV Lausanne, University Hospital of Lausanne, Lausanne, Switzerland
| | - Daniel Trachsel
- Dept of Paediatrics, University Children's Hospital of Basel, Basel, Switzerland
| | | | - Alexander Moeller
- Division of Respiratory Medicine, University Children's Hospital of Zurich, Zurich, Switzerland
| | - Carmen Casaulta
- Paediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Paediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland
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43
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Usemann J, Demann D, Anagnostopoulou P, Korten I, Gorlanova O, Schulzke S, Frey U, Latzin P. Interrupter technique in infancy: Higher airway resistance and lower short-term variability in preterm versus term infants. Pediatr Pulmonol 2017; 52:1355-1362. [PMID: 28771980 DOI: 10.1002/ppul.23771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/28/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND In preschool children, measurement of airway resistance using interrupter technique (Rint) is feasible to assess the degree of bronchial obstruction. Although some studies measured Rint in infancy, values of Rint and its variability in preterm infants are unknown. In this study, Rint and its variability was measured at infancy and compared between healthy term and preterm infants. METHODS High quality Rint measurements in term (n = 50) and preterm (n = 48) infants were obtained at postmenstrual age of 42-50 weeks in two study centers in Switzerland. Intra-measurement variability of Rint in one measurement and inter-measurement variability between two subsequent measurements was assessed by coefficient of variation (CV). RESULTS Mean Rint in term infants was 4.2 ± (SD; 1.9) kPa · s · L-1 and in preterm infants was 5.6 ± (2.8) kPa · s · L-1 . Mean CV in term infants was 29.6 ± (14.9)% and in preterm infants was 20.2 ± (8.4)%. Rint was significantly lower (95%CI -2.31 to -0.38; P = 0.007) and CV significantly higher (95%CI 4.53-14.3; P < 0.001) in term compared to preterm infants. There were no differences in mean Rint and mean CV between the first and the second measurement obtained in a subgroup of term (n = 24, 48%) and preterm (n = 22, 45%) infants. CONCLUSIONS Our results suggest that differences in airway mechanics between term and preterm infants can be assessed with the interrupter technique during early infancy. Before clinical application of Rint measurements in this age group, reasons underlying the variability of measurements should be further investigated.
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Affiliation(s)
- Jakob Usemann
- University of Basel Children's Hospital (UKBB), Basel, Switzerland.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Désirée Demann
- University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Pinelopi Anagnostopoulou
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Insa Korten
- University of Basel Children's Hospital (UKBB), Basel, Switzerland.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Sven Schulzke
- University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Urs Frey
- University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Philipp Latzin
- University of Basel Children's Hospital (UKBB), Basel, Switzerland.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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44
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Suki B, Frey U. A time-varying biased random walk approach to human growth. Sci Rep 2017; 7:7805. [PMID: 28798412 PMCID: PMC5552693 DOI: 10.1038/s41598-017-07725-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/30/2017] [Indexed: 11/09/2022] Open
Abstract
Growth and development are dominated by gene-environment interactions. Many approaches have been proposed to model growth, but most are either descriptive or describe population level phenomena. We present a random walk-based growth model capable of predicting individual height, in which the growth increments are taken from time varying distributions mimicking the bursting behaviour of observed saltatory growth. We derive analytic equations and also develop a computational model of such growth that takes into account gene-environment interactions. Using an independent prospective birth cohort study of 190 infants, we predict height at 6 years of age. In a subset of 27 subjects, we adaptively train the model to account for growth between birth and 1 year of age using a Bayesian approach. The 5-year predicted heights compare well with actual data (measured height = 0.838*predicted height + 18.3; R2 = 0.51) with an average error of 3.3%. In one patient, we also exemplify how our growth prediction model can be used for the early detection of growth deficiency and the evaluation of the effectiveness of growth hormone therapy.
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Affiliation(s)
- Béla Suki
- Department of Biomedical Engineering, Boston University, 44 Cummington Str., Boston, Massachusetts, 02215, USA.
| | - Urs Frey
- University Children's Hospital Basel, UKBB, University of Basel, Spitalstrasse, PO Box 4031, Basel, Switzerland.
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45
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Korten I, Kieninger E, Klenja S, Mack I, Schläpfer N, Barbani MT, Regamey N, Kuehni CE, Hilty M, Frey U, Gorgievski M, Casaulta C, Latzin P. Respiratory viruses in healthy infants and infants with cystic fibrosis: a prospective cohort study. Thorax 2017; 73:13-20. [PMID: 28778921 DOI: 10.1136/thoraxjnl-2016-209553] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 05/24/2017] [Accepted: 06/26/2017] [Indexed: 12/16/2022]
Abstract
RATIONALE Acute viral respiratory tract infections in children with cystic fibrosis (CF) are known causes of disease exacerbation. The role of viral infections during infancy is, however, less known, although early infancy is thought to be a crucial period for CF disease development.We prospectively assessed symptomatic and asymptomatic viral detection in the first year of life in infants with CF and healthy controls. METHODS In a prospective cohort study, we included 31 infants with CF from the Swiss Cystic Fibrosis Infant Lung Development Cohort and 32 unselected, healthy infants from the Basel Bern Infant Lung Development Cohort and followed them throughout the first year of life. Respiratory symptoms were assessed by weekly telephone interviews. Biweekly nasal swabs were analysed for 10 different viruses and two atypical bacteria with real-time seven duplex PCR (CF=561, controls=712). MEASUREMENTS AND RESULTS Infants with CF and healthy controls showed similar numbers of swabs positive for virus (mean 42% vs 44%; OR 0.91, 95% CI 0.66 to 1.26, p=0.6). Virus-positive swabs were less often accompanied by respiratory symptoms in infants with CF (17% vs 23%; OR 0.64, 95% CI 0.43 to 0.95, p=0.026). This finding was pronounced for symptomatic human rhinovirus detection (7% vs 11%; OR 0.52, 95% CI 0.31 to 0.9, p=0.02). CONCLUSIONS Viral detection is not more frequent in infants with CF and respiratory symptoms during viral detection occur even less often than in healthy controls. It is likely an interplay of different factors such as local epithelial properties and immunological mechanisms that contribute to our findings.
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Affiliation(s)
- Insa Korten
- Department of Pediatrics, Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
- University Children's Hospital (UKBB), Basel, Switzerland
| | - Elisabeth Kieninger
- Department of Pediatrics, Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Shkipe Klenja
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Ines Mack
- Department of Pediatrics, Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- University Children's Hospital (UKBB), Basel, Switzerland
| | - Njima Schläpfer
- Department of Pediatrics, Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Nicolas Regamey
- Department of Pediatrics, Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Division of Respiratory Medicine, Children's Hospital Lucerne, Lucerne, Switzerland
| | - Claudia E Kuehni
- Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
- Department of Infectious Diseases, University Hospital, Bern, Switzerland
| | - Urs Frey
- University Children's Hospital (UKBB), Basel, Switzerland
| | - Meri Gorgievski
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Carmen Casaulta
- Department of Pediatrics, Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Department of Pediatrics, Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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46
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Mika M, Maurer J, Korten I, Allemann A, Aebi S, Brugger SD, Qi W, Frey U, Latzin P, Hilty M. Influence of the pneumococcal conjugate vaccines on the temporal variation of pneumococcal carriage and the nasal microbiota in healthy infants: a longitudinal analysis of a case-control study. MICROBIOME 2017; 5:85. [PMID: 28738889 PMCID: PMC5525364 DOI: 10.1186/s40168-017-0302-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 07/06/2017] [Indexed: 05/31/2023]
Abstract
BACKGROUND Bacterial colonization of the upper airways is a prerequisite for subsequent invasive disease. With the introduction of the 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13), changes in pneumococcal upper airway colonization have been described. It is, however, less evident whether the vaccines lead to compositional changes of the upper airway microbiota. Here, we performed a case-control study using samples from a longitudinal infant cohort from Switzerland. We compared pneumococcal carriage and the nasal microbiota within the first year of life of healthy infants vaccinated with either PCV7 (n = 20, born in 2010) or PCV13 (n = 21, born between 2011 and 2013). Nasal swabs were collected every second week (n = 763 in total). Pneumococcal carriage was analyzed by quantitative PCR of the pneumococcal-specific lytA gene. Analysis of the bacterial core microbiota was performed based on 16S rRNA sequencing and subsequent oligotyping. We exclusively performed oligotyping of the core microbiota members, which were defined as the five most abundant bacterial families (Moraxellaceae, Streptococcaceae, Staphylococcaceae, Corynebacteriaceae, and Pasteurellaceae). Linear mixed effect (LME) and negative binomial regression models were used for statistical analyses. RESULTS We found a higher number of samples positive for pneumococcal carriage in PCV7- compared to PCV13-vaccinated infants (LME model; P = 0.01). In contrast, infants vaccinated in the PCV13 era had an increased alpha diversity as measured by the richness and the Shannon Diversity Index (LME model; P = 0.003 and P = 0.01, respectively). Accordingly, the PCV13 era was associated with clusters of a higher diversity than PCV7-associated clusters. Furthermore, infants vaccinated with PCV13 had a higher binary-based within-subject microbiota similarity, as well as a decreased Jensen-Shannon distance over time as compared to PCV7-vaccinated infants, indicating a higher microbiota stability in the PCV13 era (LME model and t test; P = 0.06 and P = 0.03, respectively). CONCLUSIONS We hypothesize that the higher diversity and stability of the upper airway microbiota in the PCV13 era is the result of the lower pneumococcal carriage rate. This seems to indicate that the nasal bacterial microbiota of infants has changed in recent years as compared to the beginning of this study.
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Affiliation(s)
- Moana Mika
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3010, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Josua Maurer
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3010, Bern, Switzerland
| | - Insa Korten
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Aurélie Allemann
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3010, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Suzanne Aebi
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3010, Bern, Switzerland
| | - Silvio D Brugger
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3010, Bern, Switzerland
- Department of Microbiology, The Forsyth Institute, Cambridge, MA, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Weihong Qi
- Functional Genomics Center, Swiss Federal Institute of Technology Zurich/University of Zurich, Zurich, Switzerland
| | - Urs Frey
- University Children's Hospital (UKBB), Basel, Switzerland
| | - Philipp Latzin
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3010, Bern, Switzerland.
- Department of Infectious Diseases, University Hospital, Bern, Switzerland.
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47
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Jost K, Egger B, Kieninger E, Singer F, Frey U, Latzin P. Changes in minute ventilation after exposure to 4% sulfur hexafluoride (SF 6 ) in infants. Pediatr Pulmonol 2017; 52:151-153. [PMID: 27589241 DOI: 10.1002/ppul.23557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Kerstin Jost
- Department of Pediatrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland.,Department of Biomedical Engineering (DBE), University of Basel, Basel, Switzerland
| | - Barbara Egger
- Department of Pediatrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Elisabeth Kieninger
- Pediatric Respiratory Medicine, University Children's Hospital Bern, University of Bern, Bern, Switzerland
| | - Florian Singer
- Pediatric Respiratory Medicine, University Children's Hospital Bern, University of Bern, Bern, Switzerland.,Department of Pediatrics, University Children's Hospital Zurich, Zurich, Switzerland
| | - Urs Frey
- Department of Pediatrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Philipp Latzin
- Department of Pediatrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland.,Pediatric Respiratory Medicine, University Children's Hospital Bern, University of Bern, Bern, Switzerland
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48
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Fuchs O, Gorlanova O, Latzin P, Schmidt A, Schieck M, Toncheva AA, Michel S, Gaertner VD, Kabesch M, Frey U. 6q12 and 11p14 variants are associated with postnatal exhaled nitric oxide levels and respiratory symptoms. J Allergy Clin Immunol 2017; 140:1015-1023. [PMID: 28109725 DOI: 10.1016/j.jaci.2016.11.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 11/04/2016] [Accepted: 11/14/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Exhaled nitric oxide (eNO) is a biomarker of airway inflammation and seems to precede respiratory symptoms, such as asthma, in childhood. Identifying genetic determinants of postnatal eNO levels might aid in unraveling the role of eNO in epithelial function or airway inflammation and disease. OBJECTIVE We sought to identify genetic determinants of early postnatal eNO levels and subsequent respiratory symptoms during the first year of life. METHODS Within a population-based birth cohort, eNO levels were measured in healthy term infants aged 5 weeks during quiet tidal breathing in unsedated sleep. We assessed associations of single nucleotide polymorphisms with eNO levels in a genome-wide association study and subsequent symptoms of lower respiratory tract infections during the first year of life and asked whether this was modified by prenatal and early-life environmental factors. RESULTS We identified thus far unknown determinants of infant eNO levels: rs208515 (P = 3.3 × 10-8), which is located at 6q12, probably acting in "trans" and explaining 10.3% of eNO level variance, and rs1441519 (P = 1.6 × 10-6), which is located at 11p14, potentially affecting nitric oxide synthase 3 (NOS3) expression, as shown by means of in vitro functional analyses. Moreover, the 6q12 locus was inversely associated with subsequent respiratory symptoms (P < .05) and time to recovery after first respiratory symptoms during the first year of life (P < .05). CONCLUSION The identification of novel genetic determinants of infant eNO levels might implicate that postnatal eNO metabolism in healthy infants before first viral infections and sensitization is related to mechanisms other than those associated with asthma, atopy, or increased risk thereof later in life.
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Affiliation(s)
- Oliver Fuchs
- University Children's Hospital (UKBB), University of Basel, Basel, Switzerland; Dr von Hauner Children's Hospital, Ludwig-Maximilians-Universität, Munch, and the Comprehensive Pneumology Center Munich (CPC-M; Member of the German Center for Lung Research [DZL]), Munich, Germany; Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
| | - Philipp Latzin
- University Children's Hospital (UKBB), University of Basel, Basel, Switzerland; Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Anne Schmidt
- University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
| | - Maximilian Schieck
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany; Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Antoaneta A Toncheva
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany
| | - Sven Michel
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany
| | - Vincent D Gaertner
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany
| | - Michael Kabesch
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany; Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany, and Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Germany (member of the German Center for Lung Research [DZL]), Hannover, Germany
| | - Urs Frey
- University Children's Hospital (UKBB), University of Basel, Basel, Switzerland.
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Korten I, Ramsey K, Latzin P. Air pollution during pregnancy and lung development in the child. Paediatr Respir Rev 2017; 21:38-46. [PMID: 27665510 DOI: 10.1016/j.prrv.2016.08.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 08/11/2016] [Indexed: 01/19/2023]
Abstract
Air pollution exposure has increased extensively in recent years and there is considerable evidence that exposure to particulate matter can lead to adverse respiratory outcomes. The health impacts of exposure to air pollution during the prenatal period is especially concerning as it can impair organogenesis and organ development, which can lead to long-term complications. Exposure to air pollution during pregnancy affects respiratory health in different ways. Lung development might be impaired by air pollution indirectly by causing lower birth weight, premature birth or disturbed development of the immune system. Exposure to air pollution during pregnancy has also been linked to decreased lung function in infancy and childhood, increased respiratory symptoms, and the development of childhood asthma. In addition, impaired lung development contributes to infant mortality. The mechanisms of how prenatal air pollution affects the lungs are not fully understood, but likely involve interplay of environmental and epigenetic effects. The current epidemiological evidence on the effect of air pollution during pregnancy on lung function and children's respiratory health is summarized in this review. While evidence for the adverse effects of prenatal air pollution on lung development and health continue to mount, rigorous actions must be taken to reduce air pollution exposure and thus long-term respiratory morbidity and mortality.
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Affiliation(s)
- Insa Korten
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Switzerland; University Children's Hospital (UKBB), Basel
| | - Kathryn Ramsey
- Cystic Fibrosis Research and Treatment Center, University of North Carolina at Chapel Hill, USA; Telethon Kids Institute, University of Western Australia, Australia
| | - Philipp Latzin
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Switzerland.
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50
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Egger B, Jost K, Anagnostopoulou P, Yammine S, Singer F, Casaulta C, Frey U, Latzin P. Lung clearance index and moment ratios at different cut-off values in infant multiple-breath washout measurements. Pediatr Pulmonol 2016; 51:1373-1381. [PMID: 27214661 DOI: 10.1002/ppul.23483] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 05/02/2016] [Accepted: 05/06/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Multiple-breath washout (MBW) is increasingly used for infant lung function testing. Current guidelines recommend calculating lung clearance index (LCI) and functional residual capacity (FRC) at 2.5% of normalized tracer gas concentration, without clear recommendation for moment ratios (MR). Whether the 2.5% cut-off has the highest discriminative power to detect ventilation inhomogeneity in infants with lung diseases is unknown. METHODS We used sulfur-hexafluoride MBW measurements from 32 infants with cystic fibrosis, 32 preterm infants, and 32 healthy controls at postmenstrual age of 41-54 weeks. We compared the discriminative power to detect pathological values above the upper limit of normal for 12 different cut-offs between 20% and 1.5% for first and second MR (MR1, MR2), LCI, and FRC. RESULTS MR and LCI results changed significantly at different cut-offs. Mean MR2 in infants with cystic fibrosis increased from 2.4 to 7.2 units between 20% and 1.5% SF6 . The ability of MR and LCI to discriminate between health and disease increased significantly with lower cut-offs. The 1.5% cut-off showed highest discriminative power: in infants with cystic fibrosis pathological MR2 values were found in 27 out of 89 (30%) and for LCI in 28/89 (32%). In preterm infants, pathological MR2 values were detected in 39 out of 73 (53%), and for LCI in 35/73 (48%). FRC remained stable throughout the washout. CONCLUSION In infants, the diagnostic performance of MBW strongly depends on the point of analysis. The cut-off with the highest discriminative power to detect ventilation inhomogeneity in infants with cystic fibrosis and after preterm birth was at 1.5% tracer gas concentration. Pediatr Pulmonol. 2016;51:1373-1381. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Barbara Egger
- Department of Pediatrics, University of Basel Children's Hospital (UKBB), Spitalstrasse 33, Basel 4031, Switzerland
| | - Kerstin Jost
- Department of Pediatrics, University of Basel Children's Hospital (UKBB), Spitalstrasse 33, Basel 4031, Switzerland
| | - Pinelopi Anagnostopoulou
- Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital Bern, University of Bern, Switzerland
| | - Sophie Yammine
- Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital Bern, University of Bern, Switzerland
| | - Florian Singer
- Department of Pediatrics, University Children's Hospital Zurich, Zurich, Switzerland
| | - Carmen Casaulta
- Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital Bern, University of Bern, Switzerland
| | - Urs Frey
- Department of Pediatrics, University of Basel Children's Hospital (UKBB), Spitalstrasse 33, Basel 4031, Switzerland
| | - Philipp Latzin
- Department of Pediatrics, University of Basel Children's Hospital (UKBB), Spitalstrasse 33, Basel 4031, Switzerland.,Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital Bern, University of Bern, Switzerland
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