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Patel O, Hashmi SS, Chiquet B, Hecht JT. Natural history study of Pseudoachondroplasia: A focus on oral health. Birth Defects Res 2024; 116:e2378. [PMID: 39016146 DOI: 10.1002/bdr2.2378] [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: 01/17/2024] [Revised: 05/15/2024] [Accepted: 06/18/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Pseudoachondroplasia (PSACH) is a rare dwarfing condition characterized by short limbs and fingers, and multiple skeletal abnormalities/complications. There are few natural history studies delineating the medical problems in PSACH leaving a gap in many areas, especially oral health. Our study aimed to obtain information pertaining to oral health and other health-related problems (pregnancy and childbirth, skeletal health, joint pain) in patients with PSACH. METHODS To ascertain this information, an online Qualtrics survey was distributed to members of Little People of America, a support group, and through a PSACH online chatroom. RESULTS Ninety-nine of 115 surveys were completed and included in the descriptive and multivariable analyses. PSACH individuals regularly sought dental care, but flossing was challenging because of short fingers. Untreated carries (5%), bleeding gums (16%) malocclusion (37%), obstructive sleep apnea (9%), and TMJ disorder (3%) occurred less frequently compared to the general population. Delivery was by Caesarean section in 100% of female respondents who delivered a baby. Bowlegs (74%), scoliosis (43%) and osteoarthritis (36%) were the most common skeletal complications. Joint pain was reported by 85% of respondents. CONCLUSIONS This study provides novel insights into oral health, pregnancy and childbirth while confirming previously identified skeletal complications in PSACH. Our findings suggest that oral healthcare in PSACH presents unique challenges.
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Affiliation(s)
- Omkar Patel
- School of Dentistry, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - S Shahrukh Hashmi
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Brett Chiquet
- School of Dentistry, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jacqueline T Hecht
- School of Dentistry, The University of Texas Health Science Center at Houston, Houston, Texas, USA
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas, USA
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Čibirkaitė A, Bubnaitienė V, Hansted E, Gurskis V, Vaidelienė L. Quality-of-Life Assessment in Children with Mild to Moderate Bronchial Asthma. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:771. [PMID: 38792954 PMCID: PMC11122762 DOI: 10.3390/medicina60050771] [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: 04/02/2024] [Revised: 05/03/2024] [Accepted: 05/05/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Assess the quality of life of children aged 2-10 with mild to moderate bronchial asthma. To evaluate the general health condition of children with mild and moderate severity bronchial asthma. To determine health changes in children with mild- and moderate-severity bronchial asthma as they grow older. To evaluate the impact of mild- and moderate-severity bronchial asthma on children's daily and social activities, physical health, emotional state, and general well-being. Materials and Methods: A comparative cross-sectional study was conducted in March-June 2020. Parents or guardians of 2-10-year-old children without bronchial asthma and children with mild to moderate bronchial asthma were interviewed after receiving their written informed consent. The questionnaire was based on the standardized quality-of-life quiz SF-36. A total of 248 questionnaires were collected-106 from the parents or guardians of children with bronchial asthma and 142 from parents/guardians of children without bronchial asthma. For further analysis, 106 children without bronchial asthma and with no chronic conditions were selected. Quantitative variables were compared using the Mann-Whitney U test and qualitative data using the chi-square (χ2) criteria. Quantitative data were described by giving means, medians, and standard deviations (SD); qualitative features by giving relative frequencies. Statistical data were analyzed using SPSS and Excel 2020. Results: Children with mild and moderate asthma exhibit poorer health compared to their healthy counterparts. Only 20.7% of respondents with asthma reported excellent or very good health, contrasting with 64.1% of healthy children (p < 0.001). As children with asthma age, their general condition improves, with 46.2% showing improvement in the past year, while 42.5% of healthy children had a stable condition (p < 0.05). In various activities, children with asthma face more constraints than healthy children (p < 0.05), including energetic activities (sick-59.5%; healthy-10.3%), moderate activities (sick-24.5%; healthy-4.7%), climbing stairs (sick-22.7%; healthy-3.8%), and walking over 100 m (sick-9.4%; healthy-0%). Children with asthma are more likely to experience exhaustion, anxiety, tiredness, lack of energy, and restraint in public activities (p < 0.05). Conclusions: Parents/caregivers of children with mild to moderate bronchial asthma rate their health worse than those of healthy children do. As children with mild to moderate bronchial asthma grow, the disease impact on their overall well-being decreases. Children with mild to moderate bronchial asthma, compared to healthy children, experience more limitations in vigorous or moderate activities; face more difficulties climbing stairs or walking more than 100 m; frequently feel exhaustion, anxiety, fatigue, or lack of energy; and encounter restrictions in social activities.
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Affiliation(s)
- Agnė Čibirkaitė
- Department of Pediatrics, Medical Academy, Lithuanian University of Health Sciences, LT 44307 Kaunas, Lithuania; (V.B.); (E.H.); (V.G.); (L.V.)
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3
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Pérez A, Valencia S, Jani PP, Harrell MB. Use of Electronic Nicotine Delivery Systems and Age of Asthma Onset Among US Adults and Youths. JAMA Netw Open 2024; 7:e2410740. [PMID: 38758558 PMCID: PMC11102021 DOI: 10.1001/jamanetworkopen.2024.10740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/11/2024] [Indexed: 05/18/2024] Open
Abstract
Importance The association of use of electronic nicotine delivery systems (ENDS) with the age of asthma onset is unknown. Objective To explore the association of past 30-day ENDS use with the age of asthma onset in adults and youths who did not have asthma or chronic obstructive pulmonary disease and never used cigarettes. Design, Setting, and Participants This cohort study was a secondary analysis of waves 1 to 6 of the US nationally representative Population of Tobacco and Health Study (2013-2021). Eligible participants included adults (≥18 years) and youths (12-17 years) who did not have asthma or chronic obstructive pulmonary disease at the first wave of participation. Data analysis was conducted from September 2022 to April 2024. Exposure Past 30-day ENDS use at the first wave of participation in the study preceding the onset of asthma. Main outcome and measures Lower and upper age limits were estimated using the age reported at the first wave of participation and the number of weeks between follow-up waves until asthma was first reported or censored. The association of past 30-day ENDS use with the age of asthma onset was estimated using weighted interval-censoring Cox regression. The cumulative hazard function for the age of asthma onset was estimated using interval-censoring survival analysis. Results A total of 24 789 participants were included, with 7766 adults (4461 female [weighted percentage, 59.11%] and 3305 male [weighted percentage, 40.89%]), representing 80.0 million adults, and 17 023 youths (8514 female [weighted percentage, 50.60%] and 8496 male [weighted percentage 49.32%]), representing 33.9 million youths. By age 27 years, 6.2 per 1000 adults reported asthma incidence (hazard ratio [HR], 0.62%; 95% CI, 0.46%-0.75%). While controlling for covariates, there was a 252% increased risk of the onset of asthma at earlier ages for adults who used ENDS in the past 30 days vs adults who did not (adjusted HR, 3.52; 95% CI, 1.24-10.02). For youths, there was no association of ENDS use in the past 30 days with age of asthma onset (adjusted HR, 1.79; 95% CI, 0.67-4.77), which could be due to a lack of statistical power. Conclusion and relevance In this cohort study, past 30-day ENDS use among adults was associated with earlier ages of asthma onset. These findings suggest that prevention and cessation programs directed to adults who use ENDS are needed to educate the public, protect public health, prevent adverse health outcomes, and motivate users to stop. Furthermore, modifying symptom-screening asthma guidelines, resulting in earlier asthma detection and treatment, may reduce morbidity and mortality due to asthma.
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Affiliation(s)
- Adriana Pérez
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, School of Public Health, Austin
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin
| | - Sarah Valencia
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin
| | - Pushan P. Jani
- Division of Pulmonary and Sleep Medicine, The University of Texas Health Science Center at Houston, School of Medicine, Houston
| | - Melissa B. Harrell
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin
- Department of Epidemiology, The University of Texas Health Science Center at Houston, School of Public Health, Austin
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Mehta JS, Pahys JM, Saad A, Sponseller P, Andras L, Marks D, Poon S, Klineberg E, White KK, Helenius I, Welborn M, Redding G. Paediatric syndromic scoliosis: proceedings of the half-day course at the 57th annual meeting of the Scoliosis Research Society. Spine Deform 2024; 12:523-543. [PMID: 38366266 DOI: 10.1007/s43390-024-00822-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/30/2023] [Indexed: 02/18/2024]
Abstract
There are some syndromes that present with unique manifestations pertaining to the spinal column. A good working understanding of these common syndromes is useful for the spinal deformity surgeons and related healthcare providers. This review attempts to encompass these unique features and discuss them in three broad groups: hypermobility syndromes, muscle pathology-related syndromes, and syndromes related to poor bone quality. This review explores the features of these syndromes underpinning the aspects of surgical and medical management. This review represents the proceedings of the Paediatric Half-Day Course at the 57th Annual Meeting of the Scoliosis Research Society.
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Affiliation(s)
| | | | - Ahmed Saad
- Royal Orthopaedics Hospital, Birmingham, England
| | - Paul Sponseller
- Division of Paediatric Orthopaedics, Johns Hopkins Medical Centre, Baltimore, USA
| | - Lindsay Andras
- Spine Surgery, Childrens' Hospital Los Angeles, Los Angeles, USA
| | - David Marks
- Birmingham Childrens' Hospital, Birmingham, England
| | | | - Eric Klineberg
- Orthopaedics and Spinal Surgery, UT Health, Houston, USA
| | - Klane K White
- Pediatric Orthopaedics, Childrens' Hospital Colorado, Aurora, USA
| | - Ilkka Helenius
- Paeditric Orthoapedics, University of Turku, Helsinki, Finland
| | | | - Greg Redding
- Paediatric Pulmonology, Seattle Childrens' Hospital, Seattle, USA
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Zhi L, Bai Y, Liao W, Chen G, Gao T, Wan X, Liang J, Liu L, Chen L, Zhang W, Bai J. The safety and tolerability of a one strength dose-escalation scheme for subcutaneous immunotherapy with a native house dust mite extract in Chinese children: A multicenter, randomized, open label clinical trial. Heliyon 2024; 10:e29450. [PMID: 38655350 PMCID: PMC11036000 DOI: 10.1016/j.heliyon.2024.e29450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
Background Allergen immunotherapy (AIT) is still the only treatment that may affect the natural cause of allergic disease. This study is to investigate whether an accelerated up-dosing scheme for subcutaneous allergen immunotherapy (SCIT) using a native house dust mite (HDM) allergen extract is as safe as the standard 3-strengths dose-escalation scheme in children with moderate to severe allergic rhinitis or rhinoconjunctivitis with or without asthma in China. Methods In this multicenter, open label, randomized controlled trial, the children aged 5-14 years were randomized 1:1 either to One Strength group or the Standard group. The dose escalation scheme for patients in the One Strength group included 6 injections of strength 3, whereas the Standard group comprised 14 injections using strength 1, 2, and 3. All treatment-emergent adverse events (TEAEs) were recorded and analyzed. The 5-point Likert scale was used to assess tolerability (ChiCTR2100050311). Results Overall, 101 children were included in the Safety Set (One Strength group: 50 vs. Standard group: 51). A total of 26 TEAEs were reported for 15 children. TEAEs related to AIT occurred in 10 % of the children in the One Strength group and 11.8 % of the Standard group. The number of systemic adverse reactions was comparable in both groups (One Strength: 5 vs. Standard: 4). No serious TEAEs was recorded for either group. 90.0 % of patients in the One Strength group reached the maintenance dose without an interventional dose adjustment due to adverse events, compared to 78.4 % in the Standard group. All patients who completed the dose-escalation phase reached the recommended maintenance dose of 1.0 ml of strength 3.Investigators and patients rated the tolerability of the One Strength regimen slightly better than the Standard scheme. Conclusions This exploratory study suggests that the accelerated One Strength dose-escalation scheme is comparable in safety and tolerability to the Standard regimen. However, due to the preliminary nature and small sample size, further research with larger sample sizes and robust study designs is necessary for confirmation.
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Affiliation(s)
- Lili Zhi
- Department of Allergy, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014, China
| | - Yan Bai
- Department of Pediatrics, Union Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Wang Liao
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Guohua Chen
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Tingting Gao
- Department of Allergy, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014, China
| | - Xia Wan
- Department of Pediatrics, Union Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Jiawen Liang
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Lingling Liu
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Liang Chen
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Wenna Zhang
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Jun Bai
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
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Frati F, Beni ND, Marastoni L, Compalati E, Ciprandi G. Safety of subcutaneous and sublingual immunotherapy with allergoids in children: a real-life pharmacovigilance study. Immunotherapy 2024; 16:43-53. [PMID: 38018469 DOI: 10.2217/imt-2023-0126] [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] [Indexed: 11/30/2023] Open
Abstract
Aims: Allergen-specific immunotherapy uses a sublingual (sublingual immunotherapy [SLIT]) or subcutaneous (subcutaneous immunotherapy [SCIT]) route. This pharmacovigilance study aimed to determine the number and type of adverse drug reactions (ADRs) for SLIT and SCIT using carbamylated monomeric allergoids (CMAs) in children. Materials & methods: This pharmacovigilance study analyzed real-world post-marketing reports collected from a safety database of Lais sublingual tablets and injective Lais-in, containing CMAs for over 10 years. Results & conclusion: From January 2009 to September 2022, 26,107 doses of Lais-in were administered in children; only two nonserious related ADRs (incidence: 0.000077%) were reported. Regarding SLIT, the results showed only 12 spontaneous nonserious ADR reports (incidence: 0.000004%). These data showed the excellent safety profile of both SLIT and SCIT CMAs.
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Affiliation(s)
- Franco Frati
- Medical Department, Lofarma S.p.A., Milan, Italy
| | | | | | | | - Giorgio Ciprandi
- Outpatients Depatrment, Allergy Center, Casa di Cura Villa Montallegro, 16145, Via Montezovetto, Genoa, Italy
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Cheng Y, Sun D, Zou L, Li S, Tang L, Yu X, Tang B, Wu Y, Fang H. Elucidation of the mechanisms and molecular targets of KeChuanLiuWei-Mixture for treatment of severe asthma based on network pharmacology. Chem Biol Drug Des 2023; 102:1034-1049. [PMID: 37574823 DOI: 10.1111/cbdd.14302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/23/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023]
Abstract
KeChuanLiuWei-Mixture (KCLW) is widely used as a Chinese medicine prescription to treat severe asthma. However, the underlying therapeutic mechanism of KCLW remains unclear. In this study, a network pharmacology method was used to identify the chemical constituents of KCLW by the TCMSP database and ultra-performance liquid chromatography coupled with time-of-flight mass spectrometry. Differential expression identification, protein-protein interaction (PPI) network and functional enrichment analysis were used to screen key targets of KCLW for severe asthma. Our results confirmed that quercetin, luteolin, kaempferol, and wogonin are the most critical active ingredients in KCLW. Moreover, the 16 relevant severe asthma-related targets of KCLW were obtained by overlapping the PPI networks of the KCLW putative targets and severe asthma-related genes, among which the most important targets were IL-6, NOS2, VEGFA, CXCL2, and PLAT. Functionally, the 16-targets and their interacting differentially expressed genes were primarily related to biological functions and pathways related to immunity and inflammation, such as inflammatory response, T cell differentiation, Nrf2/HO-1 signaling pathway, TGF-β/Smad signaling pathway, and NF-κB signaling pathway. KCLW inhibited inflammation in PDGF-BB-induced airway smooth muscle cells. In summary, this study demonstrates the active substance and potential therapeutic mechanism of KCLW in severe asthma, and offers a clinical direction for KCLW against severe asthma.
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Affiliation(s)
- Yanqi Cheng
- Prevention and Health Care Department of TCM, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ding Sun
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lu Zou
- Teaching and Practising Center, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shaobin Li
- Prevention and Health Care Department of TCM, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ling Tang
- Prevention and Health Care Department of TCM, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao Yu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Binqing Tang
- Department of Respiratory Medicine, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yingen Wu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hong Fang
- Prevention and Health Care Department of TCM, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Sapouna V, Dimitriadis Z, Douros K, Kapreli E, Kortianou EA. Technical Factors That May Influence mHealth Adherence in Children With Chronic Pulmonary Diseases: Scoping Review. Pediatr Phys Ther 2023; 35:468-477. [PMID: 37656982 DOI: 10.1097/pep.0000000000001039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
PURPOSE To synthesize the technical factors influencing adherence to nonpharmacological treatment (NPhT) in children with chronic pulmonary diseases (CPDs), using mobile health (mHealth) technology. METHODS Five electronic databases were searched from inception to October 12, 2022, with terms related to pediatrics, CPDs, adherence, NPhT, and mHealth. The methodological quality was assessed using the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool checklist. RESULTS Eleven articles were included. Six major technical themes were supported by the evidence that may influence adherence to NPhT: design and context, technical support/business model, connectivity, free availability, privacy and security, and cultural readiness. CONCLUSIONS The design of mHealth applications (apps) should be done according to the needs of pediatric patients. This may mitigate any barriers and potentially foster adherence to the use of the apps. WHAT THIS ADDS TO THE EVIDENCE Six major technical themes may influence adherence to NPhT in children with chronic respiratory diseases.Video Abstract: Supplemental digital content available at http://links.lww.com/PPT/A487 .
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Affiliation(s)
- Vaia Sapouna
- Clinical Exercise Physiology and Rehabilitation Laboratory (Ms Sapouna and Drs Kapreli and Kortianou) and Health Assessment and Quality of Life Laboratory (Dr Dimitriadis), Physiotherapy Department, University of Thessaly, Lamia, Greece; Pediatric Allergy and Pulmonology Unit (Dr Douros), 3rd Department of Pediatrics, National and Kapodistrian University, Athens, Greece
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Ashmawy R, Zaki A, Baess A, El Sayed I. Efficacy and safety of inhaled heparin in asthmatic and chronic obstructive pulmonary disease patients: a systematic review and a meta-analysis. Sci Rep 2023; 13:13326. [PMID: 37587208 PMCID: PMC10432425 DOI: 10.1038/s41598-023-40489-8] [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: 03/22/2023] [Accepted: 08/10/2023] [Indexed: 08/18/2023] Open
Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are prevalent chronic respiratory disorders that cause significant morbidity and mortality. Some studies evaluated the use of inhaled unfractionated heparin (UFH) in the treatment of asthma and COPD. We aimed to synthesize the available evidence for the efficacy and safety of inhaled heparin in improving lung functions among asthmatic and COPD patients. A comprehensive search was performed using Pubmed, Embase, EBSCO, Scopus, Web of Science, Cochrane CENTRAL, WHO Clinical trials, clinicaltrials.gov, Iranian Clinical trials, Google Scholar, Research Gate, ProQuest Thesis, OVID, and medRxiv databases. Two independent reviewers included all pertinent articles according to PRISMA guidelines, and extract data independently. The two reviewers checked the quality of studies using the ROB2 tool. To determine the pooled effect estimate of the efficacy and safety of inhaled heparin, a meta-analysis was carried out using the R programming language. Publication bias was evaluated using Egger's regression test. The heterogeneity was explained using a meta-regression, and the quality of evidence was assessed by the GRADE approach. Twenty-six studies with a total of 581 patients were included in the qualitative analysis and 16 in the meta-analysis. The primary outcome was treatment success (improvement of lung function) that was measured by standardized mean differences (SMD) of the forced expiratory volume per second (FEV1) either per ml or percentage. Heparin has a large effect on both FEV1% and FEV1 ml when compared to the control group (SMD 2.7, 95% CI 1.00; 4.39; GRADE high, SMD 2.12, 95% CI - 1.49; 5.72: GRADE moderate, respectively). Secondary outcomes are other lung functions improving parameters such as PC20 (SMD 0.91, 95% CI - 0.15; 1.96). Meta-regression and subgroup analysis show that heparin type, dose, year of publication, study design, and quality of studies had a substantial effect. Regarding safety, inhaled heparin showed a good coagulation profile and mild tolerable side effects. Inhaled heparin showed improvement in lung functions either alone or when added to standard care. More large parallel RCTs are needed including COPD patients, children, and other types, and stages of asthmatic patients.
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Affiliation(s)
- Rasha Ashmawy
- Department of Clinical Research, Maamora Chest Hospital, MoHP, Alexandria, Egypt
| | - Adel Zaki
- Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Ayman Baess
- Department of Chest Diseases, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Iman El Sayed
- Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt.
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Lupu A, Jechel E, Mihai CM, Mitrofan EC, Fotea S, Starcea IM, Ioniuc I, Mocanu A, Ghica DC, Popp A, Munteanu D, Sasaran MO, Salaru DL, Lupu VV. The Footprint of Microbiome in Pediatric Asthma-A Complex Puzzle for a Balanced Development. Nutrients 2023; 15:3278. [PMID: 37513696 PMCID: PMC10384859 DOI: 10.3390/nu15143278] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/22/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023] Open
Abstract
Considered to be of greater complexity than the human genome itself, the microbiome, the structure of the body made up of trillions of bacteria, viruses, and fungi, has proven to play a crucial role in the context of the development of pathological processes in the body, starting from various infections, autoimmune diseases, atopies, and culminating in its involvement in the development of some forms of cancer, a diagnosis that is considered the most disabling for the patient from a psychological point of view. Therefore, being a cornerstone in the understanding and optimal treatment of a multitude of ailments, the body's microbiome has become an intensively studied subject in the scientific literature of the last decade. This review aims to bring the microbiome-asthma correlation up to date by classifying asthmatic patterns, emphasizing the development patterns of the microbiome starting from the perinatal period and the impact of pulmonary dysbiosis on asthmatic symptoms in children. Likewise, the effects of intestinal dysbiosis reflected at the level of homeostasis of the internal environment through the intestine-lung/vital organs axis, the circumstances in which it occurs, but also the main methods of studying bacterial variability used for diagnostic purposes and in research should not be omitted. In conclusion, we draw current and future therapeutic lines worthy of consideration both in obtaining and maintaining remission, as well as in delaying the development of primary acute episodes and preventing future relapses.
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Affiliation(s)
- Ancuta Lupu
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Jechel
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | | | | | - Silvia Fotea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800008 Galati, Romania
| | - Iuliana Magdalena Starcea
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ileana Ioniuc
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adriana Mocanu
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dragos Catalin Ghica
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alina Popp
- Faculty of General Medicine, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Dragos Munteanu
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Maria Oana Sasaran
- Faculty of General Medicine, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania
| | - Delia Lidia Salaru
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Vasile Valeriu Lupu
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
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11
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Ling XJ, Wei JF, Zhu Y. Aiming to IgE: Drug development in allergic diseases. Int Immunopharmacol 2023; 121:110495. [PMID: 37348229 DOI: 10.1016/j.intimp.2023.110495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023]
Abstract
The incidence of allergic disease significantly increases in recent decades, causing it become a major public health problem all over the world. The common allergic diseases such as allergic dermatitis, allergy rhinitis, allergic asthma and food allergy are mediated, at least in part, by immunoglobulin E (IgE), and so IgE acts as a central role in allergic diseases. IgE can interact with its high-affinity receptor (FcεRⅠ) which is primarily expressed on tissue-resident mast cells and circulating basophils, initiating intracellular signal transduction and then causing the activation and degranulation of mast cells and basophils. On the other hand, IgE interaction with its low-affinity receptor (CD23), can regulate various IgE-mediated immune responses including IgE-allergen complex presentation, IgE synthesis, the growth and differentiation of both B and T cells, and the secretion of pro-inflammatory mediators. With the deeper mechanism research for allergic diseases, new therapeutic strategies for interfering IgE are developed and receive a great attention. In this review, we summarize a current profile of therapeutic strategies for interfering IgE in allergic diseases. Besides, we suggest that targeting memory B cells (including long-lived plasma cells and (or) IgE+ memory B cells) may help to completely control allergic diseases, and highlight that the development of drugs synergistically aiming to multiple targets can be a better choice for improving treatment efficacy which results from allergic diseases as the systemic disorders caused by an impaired immune system.
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Affiliation(s)
- Xiao-Jing Ling
- Department of Pharmacy, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Ji-Fu Wei
- Department of Pharmacy, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
| | - Ying Zhu
- Department of Blood Transfusion, Ganzhou Key Laboratory of Anesthesiology, Anesthesia and Surgery Center, First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
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Salai G, Vrazic H, Kovacevic I, Janes LM, Marasovic I, Ranilovic D, Vukoja D, Zelenika Margeta M, Huljev-Sipos I, Lalic K, Spoljaric M, Tekavec-Trkanjec J, Vergles M, Lucijanic M, Luksic I, Ljubicic D. Investigating the role of obstructive pulmonary diseases and eosinophil count at admission on all-cause mortality in SARS-CoV-2 patients : A single center registry-based retrospective cohort study. Wien Klin Wochenschr 2023; 135:235-243. [PMID: 37093279 PMCID: PMC10124688 DOI: 10.1007/s00508-023-02180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/25/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION The impact of asthma and chronic obstructive pulmonary disease (COPD) in the setting of severe acute respiratory syndrome coronavirus 2 (SARS-CoV‑2) infection is not clearly defined. Blood eosinophil count is a standard diagnostic test which, according to the previously published literature, might have a potential prognostic role on mortality in patients with SARS-CoV‑2 infection. AIM To investigate the potential prognostic value of peripheral blood eosinophil count on all-cause mortality of patients hospitalized with SARS-CoV‑2 infection, as well as to assess the impact of asthma or COPD premorbidity on all-cause mortality. MATERIAL AND METHODS We conducted a retrospective registry-based cohort study. Survival analysis was performed by employing the Cox proportional hazards regression model at 30 days of follow-up. Prognostic value of eosinophil count on all-cause mortality was assessed using receiver-operating characteristic (ROC) curve analysis. RESULTS A total of 5653 participants were included in the study. Our model did not reveal that pre-existing asthma or COPD is a statistically significant covariate for all-cause mortality but, indicated that higher eosinophil count at admission might have a protective effect (hazard ratio, HR 0.13 (95% confidence interval, CI 0.06-0.27), p = 0.0001). ROC curve analysis indicates cut-off value of 20 cells/mm3 (81% specificity; 30.9% sensitivity). CONCLUSION Our results indicate that eosinophil count at hospital admission might have a potential prognostic role for all-cause mortality at 30 days of follow-up; however this was not demonstrated for pre-existing obstructive lung diseases.
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Affiliation(s)
- Grgur Salai
- Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
| | - Hrvoje Vrazic
- Healthcare Provision and Innovation Management, Austrian Social Insurance, Vienna, Austria
- University Hospital Centre Varaždin, University North, Varaždin, Croatia
| | - Ivona Kovacevic
- Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
| | | | - Ivan Marasovic
- Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
| | - Darjan Ranilovic
- Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
| | - Damir Vukoja
- Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
| | | | | | - Kristina Lalic
- Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
| | - Marko Spoljaric
- Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
| | | | - Mirna Vergles
- Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia
| | - Marko Lucijanic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivica Luksic
- Department of Maxillofacial and Oral SurgCroatiaery, University Hospital Dubrava, Dubrava, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Divo Ljubicic
- Department of Pulmonology, University Hospital Dubrava, Zagreb, Croatia.
- School of Medicine, University of Zagreb, Zagreb, Croatia.
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Abbott T, Balmaceda C, Zamorano P, Giglio A, Espinoza M. Cost-Effectiveness of Mepolizumab Add-On in the Treatment of Severe Eosinophilic Asthma in Chile. Value Health Reg Issues 2023; 35:69-77. [PMID: 36889021 DOI: 10.1016/j.vhri.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 10/07/2022] [Accepted: 12/03/2022] [Indexed: 03/08/2023]
Abstract
OBJECTIVE Asthma is one of the 4 leading causes of death worldwide. Severe asthma is associated with poor quality of life, decreased life expectancy, and higher health resources consumption such as the use of oral corticosteroids (OCSs). This study aimed to assess the cost-effectiveness of mepolizumab as an add-on compared with the standard care of the Chilean public health system (combined inhaled corticosteroid therapy and a long-acting beta-agonist, short-acting beta-agonist, and OCS). MATERIALS AND METHODS A Markov model was adapted to represent the day-to-day of patients with severe asthma over a lifetime horizon. Deterministic and probabilistic sensitivity analyses were performed to account for the second-order uncertainty of the model. In addition, a risk subgroup analysis was conducted to evaluate the cost-effectiveness of mepolizumab across different risk populations. RESULTS Mepolizumab produces more benefits than standard of care alone (1 additional quality-adjusted life-year, a decrease of OCS usage, an approximated 11 avoided exacerbations) but it cannot be considered cost-effective in the light of the Chilean threshold (incremental cost-effectiveness ratio: US dollars [USD] 105 967/quality-adjusted life-year vs USD 14 896). Despite this, cost-effectiveness increases in specific subgroups, with an incremental cost-effectiveness ratio of USD 44 819 in patients with eosinophil count ≥ 300 cell/mcL and exacerbation history of at least 4 exacerbations in the past year. CONCLUSION Mepolizumab cannot be considered a cost-effective strategy for the Chilean health system. Nevertheless, price discount in specific subgroups improves its cost-effectiveness profile significantly and may offer opportunities for access to specific subgroups.
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Affiliation(s)
- Tomas Abbott
- Unidad de Evaluación de Tecnologías Sanitarias, Centro de Investigación Clínica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carlos Balmaceda
- Unidad de Evaluación de Tecnologías Sanitarias, Centro de Investigación Clínica and Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paula Zamorano
- Unidad de Evaluación de Tecnologías Sanitarias, Centro de Investigación Clínica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andres Giglio
- Servicio de Medicina Interna, Complejo asistencial Sotero del Rio, Santiago, Chile
| | - Manuel Espinoza
- Unidad de Evaluación de Tecnologías Sanitarias, Centro de Investigación Clínica and Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Adabla S, Nabors LA, Sanyaolu O, Olaniyan A, Bernstein JA. Scoping review: multiple stakeholders and child asthma management interventions. J Asthma 2023:1-10. [PMID: 36744817 DOI: 10.1080/02770903.2023.2176775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study reviewed research to identify interventions aimed at improving asthma management among children by educating parents and other professionals. DATA SOURCES PubMed, Medline, and Embase databases were utilized. STUDY SELECTIONS Three databases were searched for child asthma management interventions published between 2012-2022 in English. Search terms included children, asthma, intervention(s), community pediatrics, coaches, schools, and stakeholders. Inclusion criteria were being an experimental study focused on children with asthma (birth-18 years), including stakeholder involvement, education, and a community focus. The search yielded 153 articles; nine were reviewed. RESULTS In general, stakeholders developed programs that resulted in improvements in asthma symptoms, knowledge of asthma management, perceptions of health care, and decreased emergency health care visits. Successful interventions involved education about asthma management, providing medications, and partnerships with school staff, healthcare teams, and community members. Effective coordination and communication contributed to successful program implementation. Using technology for asthma management education was effective in tracking access to care and facilitated the delivery of medications. CONCLUSION The findings indicate that interventions were effective in improving child asthma management. Stakeholder partnerships were critical to the effectiveness of interventions. Marketing the intervention and encouraging communication with parents also fostered success. Being able to assess the home environment and staying in contact with parents were barriers to these interventions. Conducting randomized controlled trials using the interventions found effective in these studies to assess change in symptoms and emergency care visits over time would yield important information about their long-term success and cost for implementation.
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Affiliation(s)
- Samuel Adabla
- Health Promotion and Education Program, School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Laura A Nabors
- Health Promotion and Education Program, School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Olutosin Sanyaolu
- Health Promotion and Education Program, School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Afolakemi Olaniyan
- Health Promotion and Education Program, School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Jonathan A Bernstein
- Department of Internal Medicine, Division of Immunology/Allergy Section, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Madani NA, Carpenter DO. Patterns of Emergency Room Visits for Respiratory Diseases in New York State in Relation to Air Pollution, Poverty and Smoking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3267. [PMID: 36833962 PMCID: PMC9966596 DOI: 10.3390/ijerph20043267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/30/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
We have explored differences in rates of emergency room (ER) visits for respiratory diseases in the counties of New York State (NYS) in relation to levels of air pollution, poverty, and smoking. Air pollution information was derived from the National Emissions Inventory, which provides information on road, non-road, point, and non-point sources of 12 different air pollutants. This information is only available at the county level. Four types of respiratory diseases were considered: asthma, chronic obstructive pulmonary disease (COPD), acute lower respiratory diseases, and acute upper respiratory diseases. Asthma ER visits were elevated in counties with greater total air pollution. All forms of respiratory diseases were elevated in counties with a greater rate of poverty, although this may reflect the fact that poor people often use ERs for routine care. There was a very strong association between rates of smoking for COPD and acute lower respiratory diseases. There was an apparent negative association between smoking and asthma ER visits, but this must reflect the fact that smoking was much more common in upstate counties while asthma was more common in the New York City area, where air pollution is high. Air pollution was much greater in urban than in rural areas. Our evidence indicates that air pollution is the greatest risk factor for asthma attacks, whereas smoking is the greatest risk factor for chronic obstructive pulmonary disease (COPD) and lower respiratory disease. Poor people are more vulnerable to all forms of respiratory diseases.
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Affiliation(s)
- Najm Alsadat Madani
- Department of Environmental Health Science, School of Public Health, 1 University Place, University at Albany, Rensselaer, NY 12144, USA
- Institute for Health and the Environment, 5 University Place, University at Albany, Rensselaer, NY 12144, USA
| | - David O. Carpenter
- Department of Environmental Health Science, School of Public Health, 1 University Place, University at Albany, Rensselaer, NY 12144, USA
- Institute for Health and the Environment, 5 University Place, University at Albany, Rensselaer, NY 12144, USA
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16
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Relation of Maternal Pre-Pregnancy Factors and Childhood Asthma: A Cross-Sectional Survey in Pre-School Children Aged 2-5 Years Old. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59010179. [PMID: 36676802 PMCID: PMC9867101 DOI: 10.3390/medicina59010179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/31/2022] [Accepted: 01/13/2023] [Indexed: 01/17/2023]
Abstract
Background and Objectives: Asthma constitutes a constant, prolonged, inflammation-related pulmonary disorder in childhood with serious public health concerns. Several maternal risk factors can enhance the prevalence of its development in this stage of life; however, the currently available data remain contradictory and/or inconsistent. We aim to evaluate the potential impacts of mothers' sociodemographic, anthropometric and prenatal and perinatal factors on the prevalence of developing asthma in pre-school children. Materials and Methods: This is a retrospective cross-sectional survey, which includes 5133 women and their matched pre-school children. Childhood asthma was diagnosed using validated questionnaires. Statistical analysis was accomplished to evaluate whether maternal sociodemographic, anthropometric and prenatal and perinatal factors can increase the probability of childhood asthma in pre-school age. Results: A prevalence of 4.5% of childhood asthma was recorded in pre-school age. Maternal age and pre-pregnancy overweight and obesity, caesarean section, gestational diabetes and hypertension and not breastfeeding were associated with childhood asthma after adjustment for multiple confounding factors. Conclusion: Our research showed that several maternal factors increase the prevalence of childhood asthma in pre-school age. Suitable and effective health policies and strategies should be taken into account to confront the predominant maternal factors that increase its prevalence in pre-school age.
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17
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Price D, Hughes KM, Dona DW, Taylor PE, Morton DAV, Stevanovic S, Thien F, Choi J, Torre P, Suphioglu C. The perfect storm: temporal analysis of air during the world's most deadly epidemic thunderstorm asthma (ETSA) event in Melbourne. Ther Adv Respir Dis 2023; 17:17534666231186726. [PMID: 37646293 PMCID: PMC10469229 DOI: 10.1177/17534666231186726] [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: 04/07/2023] [Accepted: 06/22/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND There have been 26 epidemic thunderstorm asthma (ETSA) events worldwide, with Melbourne at the epicentre of ETSA with 7 recorded events, and in 2016 experienced the deadliest ETSA event ever recorded. Health services and emergency departments were overwhelmed with thousands requiring medical care for acute asthma and 10 people died. OBJECTIVES This multidisciplinary study was conducted across various health and science departments with the aim of improving our collective understanding of the mechanism behind ETSA. DESIGN This study involved time-resolved analysis of atmospheric sampling of the air for pollen and fungal spores, and intact and ruptured pollen compared with different weather parameters, pollution levels and clinical asthma presentations. METHODS Time-resolved pollen and fungal spore data collected by Deakin AirWATCH Burwood, underwent 3-h analysis, to better reflect the 'before', 'during' and 'after' ETSA time points, on the days leading up to and following the Melbourne 2016 event. Linear correlations were conducted with atmospheric pollution data provided by the Environment Protection Authority (EPA) of Victoria, weather data sourced from Bureau of Meteorology (BOM) and clinical asthma presentation data from the Victorian Agency for Health Information (VAHI) of Department of Health. RESULTS Counts of ruptured grass pollen grains increased 250% when the thunderstorm outflow reached Burwood. Increased PM10, high relative humidity, decreased temperature and low ozone concentrations observed in the storm outflow were correlated with increased levels of ruptured grass pollen. In particular, high ozone levels observed 6 h prior to this ETSA event may be a critical early indicator of impending ETSA event, since high ozone levels have been linked to increasing pollen allergen content and reducing pollen integrity, which may in turn contribute to enhanced pollen rupture. CONCLUSION The findings presented in this article highlight the importance of including ruptured pollen and time-resolved analysis to forecast ETSA events and thus save lives.
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Affiliation(s)
- Dwan Price
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Burwood, VIC, Australia
- Deakin AirWATCH Pollen and Spore Counting and Forecasting Facility, Deakin University, VIC, Australia
- Victorian Department of Health, Melbourne, VIC, Australia
- Centre for Sustainable Bioproducts (CSB), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, VIC, Australia
| | - Kira M Hughes
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Burwood, VIC, Australia
- Deakin AirWATCH Pollen and Spore Counting and Forecasting Facility, Deakin University, VIC, Australia
- Centre for Sustainable Bioproducts (CSB), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, VIC, Australia
| | - Dulashi Withanage Dona
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Deakin AirWATCH Pollen and Spore Counting and Forecasting Facility, Deakin University, VIC, Australia
- Centre for Sustainable Bioproducts (CSB), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, VIC, Australia
| | - Philip E Taylor
- Pharmacy and Biomedical Science, School of Molecular Sciences, La Trobe University, Bendigo, VIC, Australia
| | - David A V Morton
- School of Engineering, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
| | - Svetlana Stevanovic
- School of Engineering, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
| | - Francis Thien
- Respiratory Medicine, Eastern Health, Box Hill Hospital and Monash University, Box Hill, VIC, Australia
| | - Jason Choi
- Environment Protection Authority, Centre for Applied Sciences, Macleod, VIC, Australia
| | - Paul Torre
- Environment Protection Authority, Centre for Applied Sciences, Macleod, VIC, Australia
| | - Cenk Suphioglu
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds Campus, 75 Pidgons Road, Geelong, VIC 3216, Australia
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Burwood, VIC, Australia
- Deakin AirWATCH Pollen and Spore Counting and Forecasting Facility, Deakin University, VIC, Australi
- Centre for Sustainable Bioproducts (CSB), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, VIC, Australia
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Xu M, Hu J, Yang L, Gen G, Fu Z, Luo Z, Zou W. Knockdown of Brg1 reduced mucus secretion in HDM stimulated airway inflammation. Mol Immunol 2023; 153:42-50. [PMID: 36427449 DOI: 10.1016/j.molimm.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/13/2022] [Accepted: 11/09/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The Brg1 (Brahma-related gene 1) is an important chromatin remodeling factor protein. The Brg1 protein can promote the transcriptional activation or inhibit target genes through regulating ATP hydrolysis which rearranges the nucleosomes position and the histone DNA interaction. In this study, we explored the role of Brg1 in house dust mite (HDM) stimulated airway inflammation. METHODS The wild-type C57BL/6 mice (wild-type, WT) and alveolar epithelial cells specifically knockout Brg1 mice (Brg1fl/fl) were selected as the experimental subjects. HDM was used to stimulate human bronchial epithelial cells (16HBE) to construct an model of airway inflammation in vitro. The asthma group was established with HDM, and the control group was treated with normal saline. Wright's staining for the detection of differential counts of inflammatory cells in bronchoalveolar lavage fluid (BALF). Invasive lung function was used to assess the airway compliance. Hematoxylin and eosin (HE) staining and periodic acid-schiff (PAS) staining were used to detect mucus secretion. Immunohistochemistry was used to measure mucin glycoprotein 5AC (MUC5AC) protein expression in airway epithelium. Western blotting was used to detect the MUC5AC and JAK1/2-STAT6 proteins in mouse lung tissues and 16HBE cells. Co-immunoprecipitation (Co-IP) and Chromatin Immunoprecipitation (CHIP) were used to detect whether Brg1 could regulate the JAK1/2-STAT6 signaling pathway. RESULTS The airway inflammation, pulmonary ventilation resistance, airway mucus secretion, MUC5AC and IL-13 in BALF and MUC5AC protein expression in lung tissue of Brg1 knockout mice stimulated by HDM were lower than those of wild-type mice. The expression of MUC5AC protein in HDM stimulated Brg1 knockdown 16HBE cells was significantly lower than that in the control group. In vivo and in vitro, it was found that the activation of JAK1/2-STAT6 signal pathway in mouse lung tissue or 16HBE cells was inhibited after knockdown of Brg1 gene. The Co-IP and CHIP results showed that Brg1 could bind to the JAK1/2 promoter region and regulate the expression of JAK1/2 gene. CONCLUSION The Brg1 may promote the secretion of airway mucus stimulated by HDM through regulating the JAK1/2-STAT6 pathway. Knockdown of Brg1 reduced mucus secretion in HDM stimulated airway inflammation.
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Affiliation(s)
- Maozhu Xu
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China
| | - Jie Hu
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China
| | - Lili Yang
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China
| | - Gang Gen
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China
| | - Zhou Fu
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China
| | - Zhengxiu Luo
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China; Chongqing Key Laboratory of Pediatrics, China.
| | - Wenjing Zou
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China; Chongqing Key Laboratory of Pediatrics, China.
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May AM, Billings ME. Racial Differences in Positive Airway Pressure Adherence in the Treatment of Sleep Apnea. Sleep Med Clin 2022; 17:543-550. [PMID: 36333073 PMCID: PMC10260288 DOI: 10.1016/j.jsmc.2022.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Although data are limited, studies suggest on average lower positive airway pressure use in Black, indigenous, and people of color (BIPOC) compared with Whites in most but not all studies. Most of these observational studies are certainly limited by confounding by socioeconomic status and other unmeasured factors that likely contribute to differences. The etiology of these observed disparities is likely multifactorial, due in part to financial limitations, differences in sleep opportunity, poor sleep quality due to environmental disruptions, and so forth. These disparities in sleep health are likely related to chronic inequities, including experiences of racism, neighborhood features, structural, and contextual factors. Dedicated studies focusing on understanding adherence in BIPOC are lacking. Further research is needed to understand determinants of PAP use in BIPOC subjects and identify feasible interventions to improve sleep health and reduce sleep apnea treatment disparities.
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Affiliation(s)
- Anna M May
- Research Section and Sleep Section, VA Northeast Ohio Healthcare System, Cleveland, OH, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Martha E Billings
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Washington School of Medicine, UW Medicine Sleep Center, Harborview Medical Center, Box 359803, 325 Ninth Avenue, Seattle, WA 98104, USA
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20
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Park JW, Choi J, Lee J, Park JM, Kim SM, Min JH, Seo DY, Goo SH, Kim JH, Kwon OK, Lee K, Ahn KS, Oh SR, Lee JW. Methyl P-Coumarate Ameliorates the Inflammatory Response in Activated-Airway Epithelial Cells and Mice with Allergic Asthma. Int J Mol Sci 2022; 23:ijms232314909. [PMID: 36499236 PMCID: PMC9736825 DOI: 10.3390/ijms232314909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/03/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022] Open
Abstract
Methyl p-coumarate (methyl p-hydroxycinnamate) (MH) is a natural compound found in a variety of plants. In the present study, we evaluated the ameliorative effects of MH on airway inflammation in an experimental model of allergic asthma (AA). In this in vitro study, MH was found to exert anti-inflammatory activity on PMA-stimulated A549 airway epithelial cells by suppressing the secretion of IL-6, IL-8, MCP-1, and ICAM-1. In addition, MH exerted an inhibitory effect not only on NF-κB (p-NF-κB and p-IκB) and AP-1 (p-c-Fos and p-c-Jun) activation but also on A549 cell and EOL-1 cell (eosinophil cell lines) adhesion. In LPS-stimulated RAW264.7 macrophages, MH had an inhibitory effect on TNF-α, IL-1β, IL-6, and MCP-1. The results from in vivo study revealed that the increases in eosinophils/Th2 cytokines/MCP-1 in the bronchoalveolar lavage fluid (BALF) and IgE in the serum of OVA-induced mice with AA were effectively inhibited by MH administration. MH also exerted a reductive effect on the immune cell influx, mucus secretion, and iNOS/COX-2 expression in the lungs of mice with AA. The effects of MH were accompanied by the inactivation of NF-κB. Collectively, the findings of the present study indicated that MH attenuates airway inflammation in mice with AA, suggesting its potential as an adjuvant in asthma therapy.
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Affiliation(s)
- Ji-Won Park
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
| | - Jinseon Choi
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea
| | - Juhyun Lee
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
- College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Jin-Mi Park
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea
| | - Seong-Man Kim
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
| | - Jae-Hong Min
- Laboratory Animal Resources Division, Toxicological Evaluation and Research Department, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Osong Health Technology Administration Complex, Cheongju 28159, Republic of Korea
| | - Da-Yun Seo
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea
| | - Soo-Hyeon Goo
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
| | - Ju-Hee Kim
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
| | - Ok-Kyoung Kwon
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
- Natural Product Central Bank, Korea Research Institute of Bioscience and Biotechnology, Cheonju 28116, Republic of Korea
| | - Kihoon Lee
- Laboratory Animal Resource Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
| | - Kyung-Seop Ahn
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
| | - Sei-Ryang Oh
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
- Natural Product Central Bank, Korea Research Institute of Bioscience and Biotechnology, Cheonju 28116, Republic of Korea
- Correspondence: (S.-R.O.); (J.-W.L.)
| | - Jae-Won Lee
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
- Correspondence: (S.-R.O.); (J.-W.L.)
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Pavlidou E, Mantzorou M, Tolia M, Antasouras G, Poutsidi A, Psara E, Poulios E, Fasoulas A, Vasios GK, Giaginis C. Childhood overweight and obesity and abnormal birth anthropometric measures are associated with a higher prevalence of childhood asthma in pre-school age. J Asthma 2022; 60:1316-1325. [PMID: 36332163 DOI: 10.1080/02770903.2022.2144354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Childhood asthma is one of the most common non-communicable diseases in the world. Several perinatal and postnatal factors have been associated with increased risk of developing childhood asthma. The present study aims to assess whether childhood overweight and obesity and abnormal birth anthropometric measures affect the risk of developing childhood asthma in preschool age. METHODS In this study, 5215 preschool children at the age of 2-5 years were enrolled after applying several inclusion and exclusion criteria and they examined whether they present asthma symptoms. Non-adjusted and adjusted statistical analysis was performed to assess whether perinatal and postnatal factors increase the risk of developing childhood asthma. RESULTS A prevalence of 4.5% of childhood asthma was recorded. Among children diagnosed with asthma, 19.4% were affected by overweight and 13.9% were obese. Childhood overweight/obesity was indepedently associated with a 76% higher risk of childhood asthma than normal weight. Abnormal birth anthropometric measures, i.e. birth weight, length, and head circumference, were independently associated with higher odds (87%, 29%, and 23%, respectively) of childhood asthma than normal ranges. CONCLUSIONS This is a cross-sectional, nationally representative study which supported evidence that childhood overweight/obesity and abnormal birth anthropometric measures may independently increase the risk of childhood asthma in preschool age. Emergent health policies and strategies are recommended to promote a healthy lifestyle, preventing childhood obesity at the early stages of life.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Lemnos, Greece
| | - Maria Mantzorou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Lemnos, Greece
| | - Maria Tolia
- Department of Radiotherapy, School of Medicine, University of Crete, Heraklio, Crete, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Lemnos, Greece
| | - Antigoni Poutsidi
- Department of Surgery, School of Medicine, University of Thessaly, Larisa, Greece
| | - Evmorfia Psara
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Lemnos, Greece
| | - Efthymios Poulios
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Lemnos, Greece
| | - Aristeidis Fasoulas
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Lemnos, Greece
| | - Georgios K Vasios
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Lemnos, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Lemnos, Greece
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Heluf H, Assefa N, Dessie Y, Goshu AT, Fekadu G, Abdisa L, Tamiru D. Factors associated with uncontrolled asthma among adult asthmatic patients in eastern Ethiopia: A multicenter study. SAGE Open Med 2022; 10:20503121221132165. [PMID: 36277438 PMCID: PMC9583198 DOI: 10.1177/20503121221132165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Asthma is a major public health problem worldwide. Despite various attempts, it is still uncontrolled in most parts of the world. Moreover, it is contributing to the national and global burden of non-communicable diseases. Studying factors associated with uncontrolled asthma in different parts of Ethiopia is crucial to control the disease and improving the quality of life of asthmatic patients. Thus, this study aimed to determine the factors associated with uncontrolled asthma among adult asthmatic patients in Eastern Ethiopia. METHODS Facility-based cross-sectional study was employed from 1st October 2020 to 30th January 2021. A total of 416 adult asthmatic patients participated in the study from six hospitals follow-up clinics. Asthma control test was used to assess the participants level of asthma control and a score of ⩽19 were regarded to have uncontrolled asthma. Data were analyzed using SPSS version 24. Bivariable and multivariable analyses were carried out to identify factors associated with uncontrolled asthma and variables with a p value of less than 0.05 were considered statistically significant. RESULT The prevalence of uncontrolled asthma was 66.1 % (95% confidence interval: 61.5-70.4). Not attending scheduled medical follow-up (adjusted odds ratio: 2.54; 95% confidence interval: 1.28-4.99), poor knowledge about asthma (adjusted odds ratio = 4.59; 95% confidence interval: 2.01-10.51), negative attitude toward asthma (adjusted odds ratio = 3.72; 95% confidence interval: 1.83-7.59), and poor adherence to medications (adjusted odds ratio = 2.53; 95% confidence interval: 1.25-5.13) were significantly associated with uncontrolled asthma. CONCLUSION In this study, the prevalence of uncontrolled asthma was considerably high. Not attending scheduled medical follow-up, poor knowledge about asthma, negative attitude toward asthma, and poor adherence to anti-asthma medications were associated with uncontrolled asthma. Therefore, it is crucial to focus on increasing the patients' level of awareness about asthma control, improving medication adherence, and avoiding triggering factors.
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Affiliation(s)
- Helina Heluf
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia,Helina Heluf, School of Nursing and
Midwifery, College of Health and Medical Sciences, Haramaya University, PO Box:
235, Harar, Ethiopia.
| | - Nega Assefa
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of
Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abel Tibebu Goshu
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gelana Fekadu
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemesa Abdisa
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Tamiru
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Antioxidant Activity, Metal Chelating Ability and DNA Protective Effect of the Hydroethanolic Extracts of Crocus sativus Stigmas, Tepals and Leaves. Antioxidants (Basel) 2022; 11:antiox11050932. [PMID: 35624796 PMCID: PMC9137568 DOI: 10.3390/antiox11050932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 02/04/2023] Open
Abstract
The present study investigated the antioxidant activity, metal chelating ability and genoprotective effect of the hydroethanolic extracts of Crocus sativus stigmas (STG), tepals (TPL) and leaves (LV). We evaluated the antioxidant and metal (Fe2+ and Cu2+) chelating activities of the stigmas, tepals and leaves of C. sativus. Similarly, we examined the genotoxic and DNA protective effect of these parts on rat leukocytes by comet assay. The results showed that TPL contains the best polyphenol content (64.66 µg GA eq/mg extract). The highest radical scavenging activity is shown by the TPL (DPPH radical scavenging activity: IC50 = 80.73 µg/mL). The same extracts gave a better ferric reducing power at a dose of 50 µg/mL, and better protective activity against β-carotene degradation (39.31% of oxidized β-carotene at a 100 µg/mL dose). In addition, they showed a good chelating ability of Fe2+ (48.7% at a 500 µg/mL dose) and Cu2+ (85.02% at a dose of 500 µg/mL). Thus, the antioxidant activity and metal chelating ability in the C. sativus plant is important, and it varies according to the part and dose used. In addition, pretreatment with STG, TPL and LV significantly (p < 0.001) protected rat leukocytes against the elevation of percent DNA in the tail, tail length and tail moment in streptozotocin- and alloxan-induced DNA damage. These results suggest that C. sativus by-products contain natural antioxidant, metal chelating and DNA protective compounds, which are capable of reducing the risk of cancer and other diseases associated with daily exposure to genotoxic xenobiotics.
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Li Y, Lan F, Yang Y, Xu Y, Chen Y, Qin X, Lv Z, Wang W, Ying S, Zhang L. The absence of IL-9 reduces allergic airway inflammation by reducing ILC2, Th2 and mast cells in murine model of asthma. BMC Pulm Med 2022; 22:180. [PMID: 35524325 PMCID: PMC9074312 DOI: 10.1186/s12890-022-01976-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/18/2022] [Indexed: 11/16/2022] Open
Abstract
Allergic asthma is an allergic inflammatory disease of the airways, in which numerous cell types and cytokines have been shown to contribute to pathogenesis of the disease. Although increased expression of IL-9 has been shown to influence the activity of structural as well as eosinophils and mast cells in asthma, the influence of IL-9 on function of ILC2 and Th2 cells remains unclear. This study therefore aimed to elucidate the role of IL-9 on ILC2 and Th2 cells using a murine model of asthma. A murine model of asthma was established using wild type (WT) and IL-9-deficient (Il9−/−) transgenic mice sensitized to house dust mite (HDM). Bronchoalveolar lavage fluid (BALF) and lung tissues were collected, and analysed for inflammatory cells (eosinophils, mast cells, Th2 cells and ILC2 cells), histopathological changes, and several cytokines. HDM challenge significantly increased accumulation of ILC2 cells, Th2 cells and mast cells, as well as goblet cell hyperplasia, and the expression of cytokines IL-4, IL-5 and IL-13, but not IFN-γ, in WT mice compared to saline-challenged control group. In contrast, all pathological changes, including infiltration of ILC2 cells, Th2 cells and mast cells, were significantly attenuated in HDM-challenged Il9−/− mice. Furthermore, the number of Ki67+ILC2 cells, Ki67+Th2 cells and Ki67+mast cells were significantly reduced in the absence of IL-9 signalling. These data suggest that IL-9 promotes the proliferation and type 2 cytokine production of type 2 cells in the murine models of asthma, and therefore might be a potential therapeutic target for asthma treatment.
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Affiliation(s)
- Yan Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Otorhinolaryngology, Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Key Laboratory of Nasal Diseases, No. 17, HouGouHuTong, DongCheng District, Beijing, 100730, China
| | - Feng Lan
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Otorhinolaryngology, Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Key Laboratory of Nasal Diseases, No. 17, HouGouHuTong, DongCheng District, Beijing, 100730, China
| | - Yiran Yang
- Department of Immunology, School of Basic Medical Sciences, Capital Medical University, 10 Xi Tou Tiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Yingjie Xu
- Department of Immunology, School of Basic Medical Sciences, Capital Medical University, 10 Xi Tou Tiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Yalin Chen
- Department of Thyroid Head and Neck Surgery, Qingdao Central Hospital, Qingdao University, Qingdao, China
| | - Xiaofeng Qin
- Department of Immunology, School of Basic Medical Sciences, Capital Medical University, 10 Xi Tou Tiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Zhe Lv
- Department of Immunology, School of Basic Medical Sciences, Capital Medical University, 10 Xi Tou Tiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Wei Wang
- Department of Immunology, School of Basic Medical Sciences, Capital Medical University, 10 Xi Tou Tiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Sun Ying
- Department of Immunology, School of Basic Medical Sciences, Capital Medical University, 10 Xi Tou Tiao, You An Men Wai, Fengtai District, Beijing, 100069, China.
| | - Luo Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Otorhinolaryngology, Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Key Laboratory of Nasal Diseases, No. 17, HouGouHuTong, DongCheng District, Beijing, 100730, China.
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25
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Hill J, Harrison J, Christian D, Reed J, Clegg A, Duffield SJ, Goodson N, Marson T. The prevalence of comorbidity in rheumatoid arthritis: a systematic review and meta-analysis. Br J Community Nurs 2022; 27:232-241. [PMID: 35522453 DOI: 10.12968/bjcn.2022.27.5.232] [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] [Indexed: 12/29/2022]
Abstract
This systematic review and meta-analysis estimates the prevalence of common comorbid health disorders in adults with rheumatoid arthritis (RA). A multi-database search strategy was undertaken. Screening, data extraction and quality assessment were carried out by two independent reviewers. A meta-analysis and meta-regression were used to generate a pooled prevalence estimate and identify relevant moderators. After study selection, 33 studies (74633 participants) were included in the meta-analysis. Some 31 studies were judged to be of low risk of bias, and two studies were judged to be at moderate risk of bias. The three most common comorbidities in RA were anxiety disorders (62.1%, 95% Cl: 43.6%; 80.6%), hypertension (37.7%, 95% Cl: 29.2%; 46.2%) and depression (32.1%, 95% Cl: 21.6%; 42.7%). There was substantial statistically significant heterogeneity for all comorbidities (I2 ≥77%). Meta-regression identified that the covariate of mean age (unit increase) had a statistically significant effect on the prevalence of hypertension (+2.3%, 95% Cl: 0.4%; 4.2%), depression (-0.5%, 95% Cl: -0.6%; -0.4%) and cancer (0.5%, 95% Cl: 0.2%; 0.8%) in adults with RA. A country's income was identified to have a statistically significant effect on the prevalence of depression, with low-to moderate-income countries having 40% (95% Cl: 14.0%; 66.6%) higher prevalence than high-income countries. No studies consider health inequalities. It is concluded that comorbidities are prevalent among people with RA, particularly those associated with mental health and circulatory conditions. Provision of health services should reflect the importance of such multimorbidity and the consequences for quality and length of life.
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Affiliation(s)
- James Hill
- Senior Research Fellow in Evidence Synthesis, Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire
| | - Joanna Harrison
- Research Fellow in Evidence Synthesis & Summary, Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire
| | - Danielle Christian
- Research Associate, Stroke Research Team, University of Central Lancashire
| | - Janet Reed
- Library Customer Services Manager, Heriot-Watt University, Edinburgh
| | - Andrew Clegg
- Professor of Health Services Research, Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire
| | - Stephen J Duffield
- Senior Analyst - Methods and Standards, National Institute for Health and Care Excellence, Manchester
| | - Nicola Goodson
- Consultant Rheumatologist and Senior Lecturer, University Hospital Aintree, Liverpool
| | - Tony Marson
- Professor of Neurology, University of Liverpool
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Devi K, Soni S, Tripathi V, Pandey R, Moharana B. Ethanolic Extract of Tridax procumbens Mitigates Pulmonary Inflammation via Inhibition of NF-κB/p65/ERK Mediated Signalling in an Allergic Asthma Model. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 99:154008. [PMID: 35263673 DOI: 10.1016/j.phymed.2022.154008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/22/2022] [Accepted: 02/16/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Tridax procumbens is a traditionally used medicinal plant with high content of active phytoconstituents having anti-inflammatory activity. Accumulating evidences have shown that Tridax procumbens efficaciously diminished oxidative stress and inflammation. However the anti-inflammatory role of Tridax procumbens is not obscured in allergic asthma. PURPOSE Aim of this study was to decipher the anti-inflammatory role of Tridax procumbens in allergic asthma and its underlying mechanism. METHODS Ethanolic extract of Tridax procumbens (TP) was prepared and major phytoconstituents (flavonoids) were characterized by biochemical and UPLC/MS analysis. Rats were sensitized and challenged with environmental allergen ovalbumin (OVA) and lipopolysaccharide (LPS) to establish an allergic asthma model. Persuasive anti-inflammatory role of TP was demonstrated in vivo (100, 200 and 400 mg/kg) and in vitro (250, 125, 75 and 25 µg/ml) experiments. RESULTS Characterization by UPLC/MS analysis showed the presence of various bioactive flavonoids. In in vitro study, significant reduction in ROS production, apoptosis and mitochondrial dysfunction were observed in alveolar type II cells upon pre-treatment with TP (250, 125, 75 and 25 µg/ml) in a concentration-dependant manner. In vivo, TP (200 mg/kg) oral administration showed robust anti-oxidative activity. TP treatment abrogated bronchial wall thickening, immune cell infiltration and bronchial wall fibre deposition. Immunohistochemical analysis showed the diminished expression of IL-1β, IL-6 in bronchial epithelium and vascular endothelium. TP abrogated inflammation by reducing the level of inflammatory cytokines including IL-2, IFN-γ, IL-6 and MCP-1, as well as inflammatory markers including TWEAK, TNF-α, TNF-R1 and its downstream transcription factor NF-ҡB/p65 activation and its nuclear translocation. Western blot analysis of TP treated lung tissue and alveolar type II cells showed reduced phosphorylation of ERK1/2 significantly. CONCLUSION TP exhibited anti-inflammatory activity by inhibition of ROS production and down-regulation of NF-ҡB/ERK signalling in vitro and in vivo asthma model. Thus, TP can be envisaged as an effective anti-inflammatory agent for OVA-induced allergic asthma.
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Affiliation(s)
- Kusum Devi
- Division of Pharmacology, CSIR-CDRI, Lucknow, India; Academy of Scientific & Innovative Research (AcSIR), Kamla Nehru Nagar, Ghaziabad, Uttar Pradesh, 201002, India
| | - Sakshi Soni
- Division of Pharmacology, CSIR-CDRI, Lucknow, India
| | | | - Richa Pandey
- Division of Medicinal and Process Chemistry, CSIR-CDRI, Lucknow, India
| | - Baisakhi Moharana
- Division of Pharmacology, CSIR-CDRI, Lucknow, India; Academy of Scientific & Innovative Research (AcSIR), Kamla Nehru Nagar, Ghaziabad, Uttar Pradesh, 201002, India.
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27
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Liang H, Zhang Y, Miao Z, Cheng R, Jiang F, Ze X, Shen X, He F. Anti-allergic effects of two potential probiotic strains isolated from infant feces in China. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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28
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Alghamdi M, Aljaafri ZA, Alhadlaq KH, Alamro SA, Alfaryan SM, Al Swaidan O, Mohamud M. Association Between Asthmatic Patients' Asthma Control Test Score and the Number of Exacerbations per Year in King Abdulaziz Medical City, Riyadh. Cureus 2022; 14:e24001. [PMID: 35547440 PMCID: PMC9086837 DOI: 10.7759/cureus.24001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2022] [Indexed: 11/05/2022] Open
Abstract
Background Asthma is a reactive airway disease that has a high prevalence across the globe. Asthma exacerbations can occur due to various bacterial and viral infections that irritate nerve endings in the airways. With time, airway obstruction follows, and patients with asthma have various symptoms that occur intermittently. Asthma symptoms primarily include breathlessness, wheezing, coughing, and chest tightness. This research focused on the association between the Asthma Control Test (ACT) score and number of exacerbations per year. Methods A questionnaire-based, cross-sectional study was conducted at the outpatient pulmonary clinic, King Abdulaziz Medical City, a tertiary hospital in Riyadh. The study included 227 adult patients who were diagnosed with asthma and had no other pulmonary diseases or other medical diseases that could mimic asthma exacerbation. Data was collected by direct interview with the patients and through the BESTCare system in King Abdulaziz Medical City. All the data were collected through Microsoft Excel 2010 (Microsoft, Redmond, WA, USA) and analyzed using Statistical Package for Social Sciences (SPSS) Statistics version 23 (IBM Corp., Armonk, NY, US). The categorical data we used were presented by percentages and frequencies such as gender, whereas the numerical data were prescribed as mean and standard deviation such as age and number of exacerbations. For inferential statistics, Chi square was used to find the association between the categorical variable while T-test and ANOVA test were used to find the relationship between asthma control test score of asthmatic patients, which was divided into three different groups based on their scores that include: well-controlled, partially controlled, or uncontrolled, and the number of exacerbations per year. Results A total of 227 adult asthma patients were enrolled in this study, most of them were females (72.7%). Average age of the participants was 47.3 ± 13.8 years. The average ACT score was found to be 18.5 ± 4.9 out of 25. Uncontrolled asthma was present in 26% of the patients, 22.9% were partially controlled and 51.1% had well-controlled asthma; to relieve the exacerbation most of the patients used salbutamol (51.5%), 35.2% used oxygen and 30.4% did not use any medication. Gender and age were not associated with ACT score (P = 0.787 and 0.797, respectively), whereas number of exacerbations was significantly associated with ACT score (P = 0.000), as fewer exacerbations were reported with higher ACT scores. Conclusion About one-quarter of the patients had uncontrolled asthma, slightly less than one-quarter of the patients had partially controlled asthma while more than half of the patients had well-controlled asthma. Number of exacerbations was found to be significantly associated with asthma control test score as fewer exacerbations were reported in well-controlled asthmatic patients.
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Affiliation(s)
- Majed Alghamdi
- Pulmonary Medicine, Ministry of the National Guard Health Affairs, Riyadh, SAU
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Ziad A Aljaafri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Khalid H Alhadlaq
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Sultan A Alamro
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Saud M Alfaryan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Osama Al Swaidan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Mohamud Mohamud
- Medical Education, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Asthma and Allergy: Unravelling a Tangled Relationship with a Focus on New Biomarkers and Treatment. Int J Mol Sci 2022; 23:ijms23073881. [PMID: 35409241 PMCID: PMC8999577 DOI: 10.3390/ijms23073881] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 12/19/2022] Open
Abstract
Asthma is a major driver of health care costs across ages. Despite widely disseminated asthma-treatment guidelines and a growing variety of effective therapeutic options, most patients still experience symptoms and/or refractoriness to standard of care treatments. As a result, most patients undergo a further intensification of therapy to optimize symptom control with a subsequent increased risk of side effects. Raising awareness about the relevance of evaluating aeroallergen sensitizations in asthmatic patients is a key step in better informing clinical practice while new molecular tools, such as the component resolved diagnosis, may be of help in refining the relationship between sensitization and therapeutic recommendations. In addition, patient care should benefit from reliable, easy-to-measure and clinically accessible biomarkers that are able to predict outcome and disease monitoring. To attain a personalized asthma management and to guide adequate treatment decisions, it is of paramount importance to expand clinicians' knowledge about the tangled relationship between asthma and allergy from a molecular perspective. Our review explores the relevance of allergen testing along the asthma patient's journey, with a special focus on recurrent wheezing children. Here, we also discuss the unresolved issues regarding currently available biomarkers and summarize the evidence supporting the eosinophil-derived neurotoxin as promising biomarker.
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30
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Rathod A, Zhang H, Arshad SH, Ewart S, Relton CL, Karmaus W, Holloway JW. DNA Methylation and Asthma Acquisition during Adolescence and Post-Adolescence, an Epigenome-Wide Longitudinal Study. J Pers Med 2022; 12:202. [PMID: 35207690 PMCID: PMC8877984 DOI: 10.3390/jpm12020202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/19/2022] [Indexed: 02/01/2023] Open
Abstract
The role of epigenetics in the pathogenesis of asthma acquisition in adolescence and post-adolescence has been unknown. We carried out a longitudinal epigenome-wide association study, using data from the Isle of Wight Birth Cohort (IOWBC). To improve statistical power, we first screened CpGs based on associations of DNA methylation (DNAm) at an age of 10 years (pre-adolescence) with asthma acquisition at 10-18 years (during adolescence). A logistic regression with repeated measures was applied to CpGs that passed screening to examine the associations of pre-adolescence DNAm with asthma acquisition from 10-18 years and 18-26 years, with an interaction term to evaluate transition period specificity. Findings were further tested in an independent birth cohort, ALSPAC. In total, 205 CpGs (with 150 being females) showed associations with asthma acquisition (main or interaction effects) at FDR = 0.05 in IOWBC, of which 112 (90 being females) showed consistent associations in the ALSPAC. Genes that the identified CpGs were mapped to, e.g., AKAP1 and ENO1, have been shown to be associated with the risk of asthma. Our findings indicated that DNAm at specific CpGs was associated with asthma acquisition. CpGs showing such associations were likely to be different between males and females and, at certain CpGs, were unique to a specific transition period.
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Affiliation(s)
- Aniruddha Rathod
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN 38111, USA; (A.R.); (W.K.)
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN 38111, USA; (A.R.); (W.K.)
| | - Syed Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
- The David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight PO30 5TG, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton SO16 6YD, UK;
| | - Susan Ewart
- College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA;
| | - Caroline L. Relton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 1QU, UK;
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1QU, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol BS8 2BN, UK
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN 38111, USA; (A.R.); (W.K.)
| | - John W. Holloway
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton SO16 6YD, UK;
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
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Ezhuthachan ID, Banks TA, Cerise JE, Wong SC, Ponda P. Allergen Immunotherapy Extract Shortages and Their Effects on Clinical Care: A Work Group Report of the AAAAI Immunotherapy, Allergen Standardization, and Allergy Diagnostics Committee. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:444-452. [PMID: 34840110 DOI: 10.1016/j.jaip.2021.10.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/10/2021] [Accepted: 10/13/2021] [Indexed: 06/13/2023]
Abstract
Allergen immunotherapy (AIT) is the only disease-modifying therapy indicated for treatment of allergic asthma, rhinitis, conjunctivitis, and Hymenoptera hypersensitivity. Manufacturing of the extracts used in AIT involve multistep complex processes as well as regulatory oversight. Furthermore, some source materials are vulnerable to unexpected events of nature. Given these circumstances, allergen extract supply can be disrupted with a potential to adversely impact patient care. A group of members from the American Academy of Allergy, Asthma, and Immunology (AAAAI) Immunotherapy, Allergy Standardization and Allergy Diagnostic Committee formed a workgroup to assess the frequency and effects of allergen extract shortages and associated factors. This workgroup developed a survey that was distributed to a random 20% of the AAAAI membership. In addition, the group also performed a review of the scientific literature on allergen extract supply and shortage. Based on the findings of the survey study and literature review, the workgroup reports frequency and extent of shortages, potential ways to improve communication with suppliers, and need for further guidance in patient care during times of shortage.
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Affiliation(s)
- Idil Daloglu Ezhuthachan
- Division of Allergy and Immunology, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY.
| | - Taylor A Banks
- Allergy/Immunology Division, Naval Medical Center Portsmouth, Portsmouth, Va
| | - Jane E Cerise
- Biostatistics Unit, Feinstein Institute for Medical Research, Manhasset, NY
| | - Stephen C Wong
- Allergy/Immunology Division, Carl R. Darnall Army Medical Center, Fort Hood, Tex
| | - Punita Ponda
- Division of Allergy and Immunology, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY
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Cabral MD, Patel DR, Greydanus DE, Deleon J, Hudson E, Darweesh S. Medical perspectives on pediatric sports medicine–Selective topics. Dis Mon 2022; 68:101327. [DOI: 10.1016/j.disamonth.2022.101327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Santin JR, Benvenutti L, Broering MF, Nunes R, Goldoni FC, Patel YBK, de Souza JA, Kopp MAT, de Souza P, da Silva RDCV, Pastor MVD, de Souza AB, Testoni LD, Couto AG, Bresolin TMB, Quintão NLM. Sambucus nigra: A traditional medicine effective in reducing inflammation in mice. JOURNAL OF ETHNOPHARMACOLOGY 2022; 283:114736. [PMID: 34648899 DOI: 10.1016/j.jep.2021.114736] [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: 07/14/2021] [Revised: 10/06/2021] [Accepted: 10/09/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Sambucus nigra L. is a plant of European origin and popularly known as elder, elderberry, black elder, European elder, European elderberry, and European black elderberry, being described in pharmacopoeia of several countries. Its flowers and berries have been used in folk medicine to treat feverish conditions, coughing, nasal congestion, and influenza besides its popular use as anti-inflammatory, analgesic, and diuretic agent. AIM OF THE STUDY The aim of this investigation was to elucidate the anti-inflammatory and the relaxant effect of the lyophilized aqueous extract obtained from S. nigra's flowers on in vivo and in vitro inflammation assays and on the isolated rat vascular and airway smooth muscle tissue. MATERIAL AND METHODS The anti-inflammatory activity of the extract was investigated using carrageenan-induced inflammation model in the subcutaneous tissue of male Swiss mice orally treated with S. nigra extract (30, 100, 300 or 600 mg/kg). Leukocyte influx and the secretion of chemical mediators were quantified in the inflamed exudate. Additionally, histological analysis of the pouches was performed. N-Formyl-methionine-leucine-phenylalanine-induced chemotaxis, lipopolysaccharide-induced TNF, IL-6, IL-1β, IL-10 and NO production, and adhesion molecule expression (CD62L, CD49d and CD18, flow cytometry) were analyzed in vitro using oyster glycogen-recruited peritoneal neutrophils or macrophages (RAW 264.7) stimulated with LPS and treated with the extract (1, 10 or 100 μg/mL). The resolution of inflammation was accessed by efferocytosis assay, and the antinociceptive activity was investigated using carrageenan-induced mechanical hypersensitivity. Finally, the effect of the extract was evaluated in isolated rat aorta and trachea rings. RESULTS The oral treatment with S. nigra promoted reduction in the neutrophil migration as well as the decrease of TNF, IL-1β and IL-6 levels in the inflamed exudate. In vitro treatment with S. nigra decreased NO2-, TNF, IL-1β and IL-6 and promoted increase of IL-10 in LPS-stimulated neutrophils. Similarly, the extract reduced the NO2-, TNF and IL-6 in LPS-stimulated macrophages. Rutin, the major constituent of S. nigra extract reduced NO2-, TNF, IL-1β, and IL-6 and promoted the increase of IL-10 in LPS-stimulated neutrophils supernatant. The extract also shed CD62L and CD18 expressions. The extract was able to increase the efferocytosis of apoptotic neutrophils by increasing the IL-10 and decreasing the TNF levels. Additionally, the extract reduced the hypersensitivity induced by carrageenan and promoted a relaxant effect in isolated vascular and non-vascular rat tissue. CONCLUSIONS S. nigra flowers extract presents anti-inflammatory effect by modulating macrophage and neutrophil functions including the production of inflammatory mediators and cell migration, by promoting efferocytosis and consequently the resolution of acute inflammation, besides exerting antinociceptive effects, scientifically proving its popular use as medicinal plant. Allied to the relaxant effect in both vascular and non-vascular smooth muscle tissue, S. nigra extract represents an important tool for the management of acute inflammation.
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Affiliation(s)
- José Roberto Santin
- Postgraduate Program in Pharmaceutical Science, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | - Larissa Benvenutti
- Postgraduate Program in Pharmaceutical Science, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | - Milena Fronza Broering
- Postgraduate Program in Pharmaceutical Science, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | - Roberta Nunes
- Postgraduate Program in Pharmaceutical Science, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | - Fernanda Capitanio Goldoni
- Biomedicine Course, School of Health Sciences, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | | | - Jade André de Souza
- Biomedicine Course, School of Health Sciences, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | - Mainara Adriane Tesser Kopp
- Biomedicine Course, School of Health Sciences, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | - Priscila de Souza
- Postgraduate Program in Pharmaceutical Science, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | | | | | - Angelita Boldieri de Souza
- Postgraduate Program in Pharmaceutical Science, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | - Letícia Debatin Testoni
- Pharmacy Course, School of Health Sciences, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | - Angélica Garcia Couto
- Postgraduate Program in Pharmaceutical Science, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | - Tania Mari Belle Bresolin
- Postgraduate Program in Pharmaceutical Science, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil
| | - Nara Lins Meira Quintão
- Postgraduate Program in Pharmaceutical Science, Universidade Do Vale Do Itajaí, Itajaí, Santa Catarina, Brazil.
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Esteban-Zubero E, García-Muro C, Alatorre-Jiménez MA, Johal V, López-García CA, Marín-Medina A. High Flow Nasal Cannula Therapy in the Emergency Department: Main Benefits in Adults, Pediatric Population and against COVID-19: A Narrative Review. ACTA MEDICA (HRADEC KRALOVE, CZECH REPUBLIC) 2022; 65:45-52. [DOI: 10.14712/18059694.2022.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
This review aims to summarize the literature’s main results about high flow nasal cannula therapy (HFNC) HFNC benefits in the Emergency Department (ED) in adults and pediatrics, including new Coronavirus Disease (COVID-19). HFNC has recently been established as the usual treatment in the ED to provide oxygen support. Its use has been generalized due to its advantages over traditional oxygen therapy devices, including decreased nasopharyngeal resistance, washing out of the nasopharyngeal dead space, generation of positive pressure, increasing alveolar recruitment, easy adaptation due to the humidification of the airways, increased fraction of inspired oxygen and improved mucociliary clearance. A wide range of pathologies has been studied to evaluate the potential benefits of HFNC; some examples are heart failure, pneumonia, chronic pulmonary obstructive disease, asthma, and bronchiolitis. The regular use of this oxygen treatment is not established yet due to the literature’s controversial results. However, several authors suggest that it could be useful in several pathologies that generate acute respiratory failure. Consequently, the COVID-19 irruption has generated the question of HFNC as a safety and effective treatment. Our results suggested that HFNC seems to be a useful tool in the ED, especially in patients affected by acute hypoxemic respiratory failure, acute heart failure, pneumonia, bronchiolitis, asthma and acute respiratory distress syndrome in patients affected by COVID-19. Its benefits in hypercapnic respiratory failure are more discussed, being only observed benefits in patients with mild-moderate disease. These results are based in clinical as well as cost-effectiveness outcomes. Future studies with largest populations are required to confirm these results as well as establish a practical guideline to use this device.
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Landete P, Prieto Romo JI, Giacomini F. Experience on the Management of Patients with Asthma or Chronic Obstructive Pulmonary Disease During the COVID-19 Pandemic: the NEUMOBIAL Study. Adv Ther 2022; 39:5216-5228. [PMID: 36114950 PMCID: PMC9483441 DOI: 10.1007/s12325-022-02313-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/01/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) and asthma are treatable but greatly underdiagnosed disorders. Telemedicine made it possible to continue diagnosis, follow-up visits and treatment modifications during the COVID-19 pandemic. The present study describes the management of patients with COPD and asthma, and their treatments during the pandemic from the pulmonologist's perspective. METHODS NEUMOBIAL was an ecological study with aggregated data. A total of 279 Spanish pulmonologists answered a 60-question survey about their last 10 patients, focused on the characterisation and changes in visits and treatments during the pandemic. RESULTS Most pulmonologists (72.0%) considered that the pandemic negatively altered the diagnosis and follow-up of patients with asthma or COPD. Diagnostic tests were reduced during the pandemic, mainly because they were not recommended by pulmonologists (68.1% and 72.7% in the case of COPD and asthma tests, respectively). Moreover, 17.3% of the COPD and 19.1% of the asthma visits were remote visits. According to pulmonologists, low adherence to treatment was mainly due to a lack of patient knowledge about their disease (75.3% and 81.7% in COPD and asthma, respectively). Other factors that also influenced adherence were inadequate use of the inhaler (59.5% for COPD and 57.7% for asthma) and a lack of knowledge about the device (57.3% for COPD and 57.7% for asthma). Pulmonologists chose Zonda® for COPD because of the ease of use of the device (73.1%) and the ability to check whether the entire dose was inhaled (69.5%). For asthma, Spiromax® was chosen because of the ease of use of the device (85.7%) and the possibility of using a single device for maintenance and reliever treatment (82.4%). CONCLUSION According to pulmonologists, during the pandemic, treatments for COPD and asthma were mainly chosen on the basis of their ease of use; treatment adherence was good; and the number of remote visits increased.
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Affiliation(s)
- Pedro Landete
- Servicio de Neumología, Hospital de la Princesa, Madrid, Spain ,Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
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Wang Q, Ying Q, Zhu W, Chen J. Vitamin D and asthma occurrence in children: A systematic review and meta-analysis. J Pediatr Nurs 2022; 62:e60-e68. [PMID: 34366195 DOI: 10.1016/j.pedn.2021.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 11/30/2022]
Abstract
PROBLEM The association between serum 25-Hydroxyvitamin D (25-OHD) level and asthma occurrence in children was controversial. ELIGIBILITY CRITERIA The Pubmed, Ovid Medline, Embase, Cochrane Library were systematically searched up to April 13th 2020. All the study measured the serum 25-OHD level in children, or classified the children based on the 25-OHD level into severe vitamin D deficiency, insufficient deficiency and comparing the prevalence of asthma in childhood were included in our study. SAMPLE A total of 35 studies were included in our meta-analysis. Among them, 24 studies were included for analyzing the association between 25-OHD level and asthma, and 12 studies evaluated the treatment effect of vitamin D. RESULTS The children with asthma (5711 participants) had significant lower 25-OHD level than children without asthma (21,561 participants) (21.7 ng/ml versus 26.5 ng/ml, SMD = -1.36, 95% = -2.40--0.32, P = 0.010). Besides, the children with asthma treated with vitamin D supplement had a significantly lower recurrence rate than the placebo group (18.4% versus 35.9%, RR = 0.35, 95%CI = 0.35-0.79, P = 0.002). CONCLUSIONS Children with asthma had a lower 25-OHD level than healthy children. Vitamin D supplement could decrease the asthma recurrence rate in the follow-up years. IMPLICATIONS This study implies that lower 25-OHD may cause asthma in childhood.
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Affiliation(s)
- Qiong Wang
- Department of Pediatrics, Second Hospital of Jiaxing City, Zhejiang Province, PR China
| | - Qinlai Ying
- Department of Pediatrics, Second Hospital of Jiaxing City, Zhejiang Province, PR China
| | - Wen Zhu
- Department of Pediatrics, Second Hospital of Jiaxing City, Zhejiang Province, PR China
| | - Junguo Chen
- Department of Pediatrics, Second Hospital of Jiaxing City, Zhejiang Province, PR China.
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Wang C, Huang CF, Li M. Sodium houttuynia alleviates airway inflammation in asthmatic mice by regulating FoxP3/RORγT expression and reversing Treg/Th17 cell imbalance. Int Immunopharmacol 2021; 103:108487. [PMID: 34959187 DOI: 10.1016/j.intimp.2021.108487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/03/2021] [Accepted: 12/16/2021] [Indexed: 11/05/2022]
Abstract
Synthetized from a natural oil of Houttuynia cordata, sodium houttuynia was reported to have anti-inflammatory effects. The present study aimed to investigate whether sodium houttuynia could alleviate the characteristic airway inflammation and Treg/Th17 cell imbalance of asthma in vivo. Experimental mice with neutrophilic asthma were injected with sodium houttuynia or dexamethasone (alone or in combination) intraperitoneally. The airway reactivity was measured, and bronchoalveolar lavage fluid was collected for cell count. Hematoxylin/eosin and periodic acid-Schiff staining were performed to assess pulmonary inflammation and mucus hypersecretion. Immunohistochemical analysis was conducted to determine the expression of IL-10, IL-17A, FoxP3, and RORγT in the lung tissue, and the serum levels of IL-10 and IL-17A were analyzed by ELISA. The proportion of CD4+CD25+FoxP3+ Treg and Th17 cells within the CD4+ T cell subset of splenocytes was analyzed by flow cytometry. FoxP3 and RORγT mRNA and protein expressions in the lung were analyzed by real-time PCR and western blot, respectively. Overall, sodium houttuynia was found to ameliorate the Treg/Th17 cell imbalance and reduce the airway inflammation, hyperresponsiveness, and mucus hypersecretion by increasing the frequency of CD4+CD25+FoxP3+ Treg cells and the secretion of IL-10, while decreasing the proportion of Th17 cells and IL-17A production. Although the regulatory effect of sodium houttuynia was not as good as that achieved with dexamethasone, combination of the two compounds showed improved inhibitory effects on airway hyperresponsiveness, inflammation, and mucus hypersecretion. Hence, sodium houttuynia may be beneficial for the treatment of asthma.
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Affiliation(s)
- Chao Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Chen-Feng Huang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Miao Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China.
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Association of infant antibiotic exposure and risk of childhood asthma: A meta-analysis. World Allergy Organ J 2021; 14:100607. [PMID: 34934469 DOI: 10.1016/j.waojou.2021.100607] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 01/01/2023] Open
Abstract
Background Infant antibiotic exposure may be associated with childhood asthma development. Objective To examine and detail this association considering potential confounders. Study design PubMed, EMBASE, Web of Science, and the Cochrane Library were searched for publications from January 2011 to March 2021. Eligible studies were independently reviewed to extract data and assess quality. Random effect model was used to pool odds ratio (OR) and corresponding 95% confidence intervals (CIs). Results A total of 52 studies were included. The association of infant antibiotic exposure and childhood asthma was statistically significant for overall analysis (OR, 1.37; 95% CI, 1.29-1.45) and for studies that addressed reverse causation (RC) and confounding by indication (CbI) (1.19; 95% CI, 1.11-1.28). Significance remained after stratification by adjustment for maternal antibiotic exposure, medical consultation, sex, smoke exposure, parental allergy, birth weight, and delivery mode. In detailed analyses, macrolides (OR, 1.56; 95% CI, 1.31-1.86), antibiotic course≥5 (OR, 1.79; 95% CI, 1.36-2.36), exposure within 1 week of birth (OR, 1.82; 95% CI, 1.34-2.47), asthma developed among 1-3 years (OR, 1.84; 95% CI, 1.63-2.08), short time lag between exposure and asthma onset (OR, 2.05; 95% CI, 1.91-2.20), persistent asthma (OR, 2.61; 95% CI, 1.49-4.59), and atopic asthma (OR, 2.14; 95% CI, 1.58-2.90) showed higher pooled estimates. Conclusion Infant antibiotic exposure is associated with increased risk of childhood asthma considering confounding, and the association varied with different settings of exposure and outcomes. This highlights the need for prevention of asthma after early antibiotic exposure. Heterogeneity among studies called for caution when interpretation.
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De La Cruz N, Hines JH, Shaw C, Appiah D. Geographic Disparity in Asthma Hospitalizations: The Role of Race/Ethnicity, Socioeconomic Status, and Other Factors. Cureus 2021; 13:e20015. [PMID: 34873552 PMCID: PMC8631481 DOI: 10.7759/cureus.20015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 11/05/2022] Open
Abstract
Background In the United States, asthma is the most common chronic disease in children, and is associated with low sociodemographic, economic, and environmental factors. Objective To investigate geographic disparities in asthma hospitalizations and the roles that race/ethnicity, health insurance, and other environmental factors played on these disparities in Lubbock County, Texas. Methods Data were obtained from the Texas Inpatient Public Use Data File for the years 1999-2018. International classification of disease codes were used to identify primary diagnoses of asthma among all severe inpatient admissions. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Of the 248,768 patients admitted for severe conditions, 4,224 had a primary diagnosis of asthma. In multivariable-adjusted models, the odds of asthma hospitalizations varied across geographic regions of Lubbock with the Northeast having the highest age-adjusted prevalence (7.17 per 1,000) and ORs for asthma hospitalizations (OR: 1.25, CI: 1.12-1.40). Data suggested that non-Hispanic Blacks using federal insurance in the Northeast region had the highest odds for asthma hospitalizations (OR: 4.88, CI: 3.06-7.79; p-interaction = 0.001). Across all regions, a 1 μg/m3 increase in particulate matter 2.5 was associated with a 27% higher likelihood of asthma hospitalization (OR: 1.27, 95% CI: 1.23-1.31). Conclusion In this study, geographic disparities in asthma hospitalizations were observed within Lubbock County and were significantly influenced by a disparate distribution of socioeconomic factors related to health insurance and race/ethnicity. The potential contributory role of particulate matter needs further investigation.
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Affiliation(s)
- Noah De La Cruz
- College of Osteopathic Medicine, Sam Houston State University, Conroe, USA
| | - Jonathon H Hines
- College of Osteopathic Medicine, Sam Houston State University, Conroe, USA
| | - Chip Shaw
- Public Health, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Duke Appiah
- Public Health, Texas Tech University Health Sciences Center, Lubbock, USA
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Inhaled Drug Therapy-Associated Adverse Reactions in Obstructive Respiratory Diseases: A Review of a Decade of Reporting to the Portuguese Pharmacovigilance System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312411. [PMID: 34886135 PMCID: PMC8656767 DOI: 10.3390/ijerph182312411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/25/2022]
Abstract
Inhaled medication used for treatment of chronic obstructive lung diseases (asthma, chronic obstructive pulmonary disease-COPD, and Asthma-COPD overlap) may be associated with adverse drug reactions (ADRs). The aim of this study was to characterise spontaneous reports (SRs) of suspected ADRs received by the Portuguese Pharmacovigilance System (PPS), from 2007 to 2017. Methods: Retrospective observational study of SRs associated with single substance and combination inhalers, analysed in terms of pharmacological class of the involved drugs, sex and age range of the involved patients, and seriousness and type of ADRs. Results: 230 SRs were analysed, accounting for a total of 599 suspected ADRs. Inhaled corticosteroid/long-acting beta-2 agonist combination had the highest frequency in SRs (32.2%) and in ADRs (32.7%). There was a slight predominance in men (51.3%) and non-elderly adults were the most affected age group (39.1%). Most SRs were serious (70.4%). In total, “respiratory, thoracic and mediastinal diseases” ADRs were the most reported (19.5%), with “dyspnea” being the most frequent (4.8%). Conclusions: Most SRs were associated with controller medications and were expected. Most ADRs involved non-elderly adults, were serious and of respiratory nature and many were due to overuse of reliever medication.
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Shulhan-Kilroy J, Elliott SA, Scott SD, Hartling L. Parents' self-reported experiences and information needs related to acute pediatric asthma exacerbations: A mixed studies systematic review. PEC INNOVATION 2021; 1:100006. [PMCID: PMC10194336 DOI: 10.1016/j.pecinn.2021.100006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/29/2021] [Accepted: 10/29/2021] [Indexed: 05/30/2023]
Abstract
Objective To systematically review the scientific literature examining parents' experiences and information needs for the management of their child's asthma exacerbations. Methods We searched five databases for quantitative and qualitative studies in Canada and the United States from 2002 onwards. A convergent integrated approach and the Mixed Method Appraisal Tool were used to analyze and appraise the evidence, respectively. Results We included 84 studies (27 quantitative, 54 qualitative, 3 mixed methods). Some parents lacked confidence in recognizing or managing exacerbations. A few parents were uncertain when and where to seek medical help. The main barrier to accessing care was cost. Impacts on parents included poor sleep, distress, and lifestyle disruptions. Parents felt they lacked information and wanted education on treatments and how to recognize and manage exacerbations via education sessions, written materials, community outreach and online resources. Conclusion Improved education for parents may help reduce parents' stress, asthma-related morbidities for children and use of urgent health services. Innovation The development of tailored interventions and knowledge translation strategies with input from target audiences (e.g. parents, health care providers) is necessary to meet their information needs and support adherence to clinical recommendations. 84 studies reviewed and analyzed using the convergent integrated approach Parents lacked confidence in recognizing, treating or seeking care for exacerbations Cost was a barrier to care; parents affected by psychosocial impacts Parent's desired education on treatments and how to recognize and manage exacerbations Interventions and knowledge translation strategies must be developed with parents
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Affiliation(s)
- Jocelyn Shulhan-Kilroy
- Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Sarah A. Elliott
- Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Shannon D. Scott
- Evidence in Child Health to Enhance Outcomes (ECHO), Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, Edmonton, Canada
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Kim Y, Hou V, Huff RD, Aguiar JA, Revill S, Tiessen N, Cao Q, Miller MS, Inman MD, Ask K, Doxey AC, Hirota JA. Potentiation of long-acting β 2-agonist and glucocorticoid responses in human airway epithelial cells by modulation of intracellular cAMP. Respir Res 2021; 22:266. [PMID: 34666750 PMCID: PMC8527633 DOI: 10.1186/s12931-021-01862-1] [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: 04/16/2021] [Accepted: 10/09/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Over 300 million people in the world live with asthma, resulting in 500,000 annual global deaths with future increases expected. It is estimated that around 50–80% of asthma exacerbations are due to viral infections. Currently, a combination of long-acting beta agonists (LABA) for bronchodilation and glucocorticoids (GCS) to control lung inflammation represent the dominant strategy for the management of asthma, however, it is still sub-optimal in 35–50% of moderate-severe asthmatics resulting in persistent lung inflammation, impairment of lung function, and risk of mortality. Mechanistically, LABA/GCS combination therapy results in synergistic efficacy mediated by intracellular cyclic adenosine monophosphate (cAMP). Hypothesis Increasing intracellular cAMP during LABA/GCS combination therapy via inhibiting phosphodiesterase 4 (PDE4) and/or blocking the export of cAMP by ATP Binding Cassette Transporter C4 (ABCC4), will potentiate anti-inflammatory responses of mainstay LABA/GCS therapy. Methods Expression and localization experiments were performed using in situ hybridization and immunohistochemistry in human lung tissue from healthy subjects, while confirmatory transcript and protein expression analyses were performed in primary human airway epithelial cells and cell lines. Intervention experiments were performed on the human airway epithelial cell line, HBEC-6KT, by pre-treatment with combinations of LABA/GCS with PDE4 and/or ABCC4 inhibitors followed by Poly I:C or imiquimod challenge as a model for viral stimuli. Cytokine readouts for IL-6, IL-8, CXCL10/IP-10, and CCL5/RANTES were quantified by ELISA. Results Using archived human lung and human airway epithelial cells, ABCC4 gene and protein expression were confirmed in vitro and in situ. LABA/GCS attenuation of Poly I:C or imiquimod-induced IL-6 and IL-8 were potentiated with ABCC4 and PDE4 inhibition, which was greater when ABCC4 and PDE4 inhibition was combined. Modulation of cAMP levels had no impact on LABA/GCS modulation of Poly I:C-induced CXCL10/IP-10 or CCL5/RANTES. Conclusion Modulation of intracellular cAMP levels by PDE4 or ABCC4 inhibition potentiates LABA/GCS efficacy in human airway epithelial cells challenged with viral stimuli. The data suggest further exploration of the value of adding cAMP modulators to mainstay LABA/GCS therapy in asthma for potentiated anti-inflammatory efficacy.
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Affiliation(s)
- Yechan Kim
- Firestone Institute for Respiratory Health-Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada
| | - Vincent Hou
- Firestone Institute for Respiratory Health-Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada
| | - Ryan D Huff
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, V6H 3Z, Canada
| | - Jennifer A Aguiar
- Department of Biology, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Spencer Revill
- Firestone Institute for Respiratory Health-Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada
| | - Nicholas Tiessen
- Firestone Institute for Respiratory Health-Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada
| | - Quynh Cao
- Firestone Institute for Respiratory Health-Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada
| | - Matthew S Miller
- Department of Biochemistry, McMaster University, Hamilton, ON, L8S 4K1, Canada.,McMaster Immunology Research Centre, McMaster University, Hamilton, ON, L8S 4K1, Canada.,Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Mark D Inman
- Firestone Institute for Respiratory Health-Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada
| | - Kjetil Ask
- Firestone Institute for Respiratory Health-Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada.,McMaster Immunology Research Centre, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Andrew C Doxey
- Firestone Institute for Respiratory Health-Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada.,Department of Biology, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Jeremy A Hirota
- Firestone Institute for Respiratory Health-Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, L8N 4A6, Canada. .,Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, V6H 3Z, Canada. .,Department of Biology, University of Waterloo, Waterloo, ON, N2L 3G1, Canada. .,McMaster Immunology Research Centre, McMaster University, Hamilton, ON, L8S 4K1, Canada.
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Shih MC, Rappazzo C, Hudson C, Ongkasuwan J. Videofluoroscopic Swallow Studies and Diagnostic Outcomes in Otherwise Healthy Infants With Dysphagia. Ann Otol Rhinol Laryngol 2021; 131:892-896. [PMID: 34553623 DOI: 10.1177/00034894211047786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate videofluoroscopic swallow study (VFSS) findings in infants with dysphagia and without prior diagnoses, and to characterize the outcomes and any diagnoses that follow. METHODS A chart review of all pediatric patients who received a VFSS at a tertiary children's hospital from November 2008 to March 2017 was performed. RESULTS There were 106 infants (57 males and 49 females) with 108 VFSS. VFSS was normal in 18 (16.98%) infants. Regarding airway protection, 50 (47.17%) infants had laryngeal penetration, and 8 (7.55%) had tracheal aspiration; 3 (2.83%, 37.5% of all aspirators) exhibited silent aspiration. Of the 75 infants with minimum 2-year follow-up, 35 (46.67%) had no sequelae of disease and received no diagnoses. The most common diagnoses and pathologic sequelae were gastroesophageal reflux (n = 18, 24.00%), asthma (n = 8, 10.67%), laryngomalacia (n = 6, 8.00%), and tracheomalacia (n = 4, 5.33%), all consistent with United States pediatric data on prevalence. All infants (n = 51) with follow-up for dysphagia had resolution of symptoms within 9 months from VFSS order date. CONCLUSIONS Otherwise healthy infants may show signs of dysphagia and not develop later illness. Parents can thus be counseled on the implications of dysphagia in a previously healthy infant. Our findings provide comparative statistics for future research in pediatric dysphagia.
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Affiliation(s)
| | - Christina Rappazzo
- Speech, Language, and Learning, Texas Children's Hospital, Houston, TX, USA
| | - Caroline Hudson
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Julina Ongkasuwan
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA.,Pediatric Otolaryngology, Texas Children's Hospital, Houston, TX, USA
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MG149 inhibits histone acetyltransferase KAT8-mediated IL-33 acetylation to alleviate allergic airway inflammation and airway hyperresponsiveness. Signal Transduct Target Ther 2021; 6:321. [PMID: 34493712 PMCID: PMC8423820 DOI: 10.1038/s41392-021-00667-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/28/2021] [Accepted: 05/31/2021] [Indexed: 11/12/2022] Open
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Severcan EU, Bal CM, Tanac R, Gulen F, Demir E. Retrospective Cross-sectional Analysis of Factors Associated with Asthma in a Pediatric Cohort from Turkey. KLINISCHE PADIATRIE 2021; 234:14-19. [PMID: 34331302 DOI: 10.1055/a-1500-8264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND It is difficult to identify young children at increased risk of developing asthma amongst those with recurrent wheezing. In this study, we aimed to determine factors associated with asthma in Turkish children. METHODS We performed a retrospective cross-sectional analysis on factors associated with asthma in 651 children (200 girls, 451 boys) admitted for recurrent wheezing. RESULTS Amongst all included children, asthma frequency was 57.7%. Maturity, consanguinity, family income, passive smoking, father's, siblings' asthma were not found to be associated with asthma. Factors associated with asthma were: family's, parents', siblings' atopy, family's, mother's asthma, allergic rhinitis and atopic dermatitis, respiratory symptoms between wheezing attacks. The sensitivity (SN) of the modified asthma predictive index (mAPI) was 59.2% with a specificity (SP) of 91.3%, positive predictive index (PPI) of 65.1% and negative predictive index (NPI) of 82.3%. The SN of the modified Prevention and Incidence of Asthma and Mite Allergy (PIAMA) score was 22.9% with a SP of 89.2%, PPI of 84.6%, and NPI of 42.2%. Adjusted odds ratio for mAPI was 12.9, and for the modified PIAMA score 4. CONCLUSION Our analysis confirmed previously described factors associated with asthma. Although the SN is limited, the mAPI and PIAMA risk scores can be used to predict asthma in Turkish children. Differential diagnoses and overlaps with other chronic pediatric diseases such as immunodeficiencies need to be carefully excluded when confirming the diagnosis asthma.
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Affiliation(s)
- Ezgi Ulusoy Severcan
- Department of Pediatric Immunology and Allergy, Ege University Faculty of Medicine, Izmir, Turkey
| | - Cem Murat Bal
- Department of Pediatric Pulmonology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Remziye Tanac
- Department of Pediatric Immunology and Allergy, Ege University Faculty of Medicine, Izmir, Turkey
| | - Figen Gulen
- Department of Pediatric Immunology and Allergy, Ege University Faculty of Medicine, Izmir, Turkey
| | - Esen Demir
- Department of Pediatric Immunology and Allergy, Ege University Faculty of Medicine, Izmir, Turkey
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Matos-Semedo F, Cruz C, Inácio F, Gama JMR, Nwaru BI, Taborda-Barata L. House dust mite (HDM) and storage mite (SM) molecular sensitisation profiles and association with clinical outcomes in allergic asthma and rhinitis: protocol for a systematic review. BMJ Open 2021; 11:e046519. [PMID: 34312197 PMCID: PMC8314702 DOI: 10.1136/bmjopen-2020-046519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Identification and characterisation of single allergens at molecular level is important. Component-resolved diagnosis offers the possibility of higher diagnostic precision, thereby allowing better patient management. House dust mites (HDM) have a worldwide distribution. Studies from different countries have shown that IgE-mediated allergy to storage mites (SM) is important in rural and urban populations. With the availability of HDM and SM molecular allergen components, studies have investigated whether different molecular sensitisation profiles are associated with clinical disease outcomes. However, no previous systematic review has synthesised the underlying evidence. METHODS AND ANALYSIS We will search Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), MEDLINE, EMBASE, CINAHL, AMED, ISI Web of Science (Science and Social Science Index) from inception to March 2020. Unpublished and ongoing work, as well as research in progress will be searched in www.ClinicalTrials.gov; www.controlledtrials.com and wwwanzctrorgau. We will contact an international panel of experts in this field. No language restrictions will apply; translations will be undertaken where necessary. The Critical Appraisal Skills Programme quality assessment tool will be used to appraise the methodological quality of included studies. A descriptive summary with data tables will be constructed, and if adequate, meta-analysis using random effects will be performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be followed for reporting. ETHICS AND DISSEMINATION Since this systematic review will be only based on published and retrievable literature, no ethics approval is required. We will publish the systematic review in an international peer-reviewed journal. TRIAL REGISTRATION NUMBER reviewregistry959.
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Affiliation(s)
- Filipa Matos-Semedo
- Department of Immunoallergy, Hospital da Luz, Lisbon, Portugal
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Cíntia Cruz
- Department of Immunoallergy, Hospital da Luz, Lisbon, Portugal
| | - Filipe Inácio
- Department of Immunoallergology, Hospital de São Bernardo, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Jorge M R Gama
- Mathematics, Centre of Mathematics and Applications, University of Beira Interior, Covilhã, Portugal
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Luís Taborda-Barata
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
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Wang X, Zhou L, Wei G, Zhang H, Yang B. Prevalence of allergen-specific IgE in southern China: a multicenter research. Aging (Albany NY) 2021; 13:18894-18911. [PMID: 34297699 PMCID: PMC8351705 DOI: 10.18632/aging.203341] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 06/29/2021] [Indexed: 02/05/2023]
Abstract
Identifying allergen distribution is meaningful and significant for effective diagnosis and treatment of allergic diseases. This study compared the allergen sensitivity in four southern China cities. We enrolled 55,432 participants (27,408 male, 28,024 female) between 2007 and 2019. The allergen-specific IgE levels were compared by the χ2 test. The five prevalent sensitivities were for mite mix (10,985, 19.82%), cockroach (4,860, 8.77%), crab (4,450, 8.03%), fish mix (3,874, 6.99%), and house dust (3,486, 6.29%). Almost all allergen sensitivities decreased with age, particularly from infant to middle aged participants (p < 0.05). An exception was Shenzhen, where food allergen positive rates remained constant in all age groups studied. The proportion of male sensitive to at least one food allergen (OR 1.130; 95% CI 1.088–1.174, p < 0.0025) or aeroallergen (OR, 1.117; 95% CI, 1.078–1.158, p < 0.0025) was higher than female in all four cities. Except for dog dander and tree mix, all aeroallergens differed significantly between seasons (p < 0.05). Liuzhou had the highest rates of food allergen- and aeroallergen-positive participants. The allergen-specific IgE distribution differed among the studied cities, with significant seasonal differences. Young age, male sex, and aeroallergens were risk factors for allergic disease.
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Affiliation(s)
- Xue'an Wang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Long Zhou
- Department of Laboratory Medicine, Chongqing University Sanxia Hospital, Chongqing 404000, China
| | - Guixi Wei
- Department of Laboratory Medicine, Liuzhou People's Hospital, Liuzhou 545000, China
| | - Hui Zhang
- Department of Laboratory Medicine, Shenzhen Second People's Hospital, Shenzhen 518048, China
| | - Bin Yang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
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Rajasekar N, Sivanantham A, Kar A, Mukhopadhyay S, Mahapatra SK, Paramasivam SG, Rajasekaran S. Anti-asthmatic effects of tannic acid from Chinese natural gall nuts in a mouse model of allergic asthma. Int Immunopharmacol 2021; 98:107847. [PMID: 34126339 DOI: 10.1016/j.intimp.2021.107847] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 12/31/2022]
Abstract
Asthma is a chronic inflammatory disease of the airways, which is characterized by infiltration of inflammatory cells, airway hyperresponsiveness (AHR), and airway remodeling. This study aimed to explore the role and mechanism of tannic acid (TA), a naturally occurring plant-derived polyphenol, in murine asthma model. BALB/c mice were given ovalbumin (OVA) to establish an allergic asthma model. The results revealed that TA treatment significantly decreased OVA-induced AHR, inflammatory cells infiltration, and the expression of various inflammatory mediators (Th2 and Th1 cytokines, eotaxin, and total IgE). Additionally, TA treatment also attenuated increases in mucins (Muc5ac and Muc5b) expression, mucus production in airway goblet cells, mast cells infiltration, and airway remodeling induced by OVA exposure. Furthermore, OVA-induced NF-κB (nuclear factor- kappa B) activation and cell adhesion molecules expression in the lungs was suppressed by TA treatment. In conclusion, TA effectively attenuated AHR, inflammatory response, and airway remodeling in OVA-challenged asthmatic mice. Therefore, TA may be a potential therapeutic option against allergic asthma in clinical settings.
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Affiliation(s)
- Nandhine Rajasekar
- Department of Biotechnology, BIT-Campus, Anna University, Tiruchirappalli, Tamil Nadu, India
| | - Ayyanar Sivanantham
- Department of Biotechnology, BIT-Campus, Anna University, Tiruchirappalli, Tamil Nadu, India
| | - Amrita Kar
- Department of Paramedical and Allied Health Sciences, Midnapore City College, Midnapore, West Bengal, India
| | - Sramana Mukhopadhyay
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Santanu Kar Mahapatra
- Department of Paramedical and Allied Health Sciences, Midnapore City College, Midnapore, West Bengal, India
| | | | - Subbiah Rajasekaran
- Department of Biochemistry, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India.
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Zhou P, Xiang CX, Wei JF. The clinical significance of spondin 2 eccentric expression in peripheral blood mononuclear cells in bronchial asthma. J Clin Lab Anal 2021; 35:e23764. [PMID: 33998076 PMCID: PMC8183911 DOI: 10.1002/jcla.23764] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/04/2021] [Accepted: 03/06/2021] [Indexed: 12/18/2022] Open
Abstract
Background Bronchial asthma (BA) was a heterogeneous disease characterized by chronic airway inflammation. Spondin 2 (SPON2) was reported to be implicated in the integrin pathway, protein metabolism, and drug‐induced lupus erythematosus. The purpose of this study was to evaluate the significance of SPON2 in BA diagnosis and treatment. Methods Peripheral blood samples were obtained from 137 BA pediatric patients (61 mild‐to‐moderate BA and 76 severe BA) and 59 healthy children. Subject's information, clinical indexes, pulmonary ventilation functions were recorded in the two groups. Peripheral blood mononuclear cells (PBMCs) were isolated from patients’ samples. qRT‐PCR and ELISA assays were employed to examine the levels of SPON2 and inflammatory cytokines, respectively. Pearson's correlation analysis confirmed the association between SPON2 and inflammatory cytokines. Receiver operating characteristic (ROC) analysis was used to evaluate the potentials of SPON2 in terms of BA detection and discriminating against the severity of BA. Results Bioinformatics analysis showed that SPON2, OLFM4, XIST, and TSIX were significantly upregulated, while KDM5D and RPS4Y1 were reduced in BA. GO analysis verified that these six genes were mainly involved in neutrophil degranulation, neutrophil activation involved in immune response, neutrophil activation, and neutrophil‐mediated immunity. After isolating PBMCs, we found that SPON2 was remarkably increased in BA pediatric group compared with healthy children, and the relative levels of SPON2 were related to the severity of BA. The receiver operating characteristic (ROC) analysis revealed the high potentials of SPON2 in BA diagnosis (AUC was 0.8080) and severity distinctions (AUCs were 0.7341 and 0.8541, respectively). Also, we found that there were significant differences in fractional exhaled nitric oxide (FeNO), forced expiratory volume in 1 s (FEV1)%, FEV1/ forced vital capacity (FVC)%, immunoglobulin E (IgE), serum eosinophils, and serum neutrophils between mild‐to‐moderate BA group and severe BA group. Finally, SPON2 was negatively correlated with IL‐12 while positively associated with IL‐4, IL‐13, and IL‐17A. Conclusions SPON2 was a viable biomarker for diagnosing and degree of severity in BA, providing more insight into exploring BA and treatment's pathogenesis.
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Affiliation(s)
- Peng Zhou
- Department of Pediatric, Shengzhou People's Hospital (the First Affiliated Hospital of Zhejiang University Shengzhou Branch), Shengzhou, China
| | - Cai-Xia Xiang
- Department of Pediatric, Shengzhou People's Hospital (the First Affiliated Hospital of Zhejiang University Shengzhou Branch), Shengzhou, China
| | - Jin-Feng Wei
- Department of Respiratory, Hangzhou Children's Hospital, Hangzhou, China
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Severcan EU, Bal CM, Gülen F, Tanaç R, Demir E. Identifying wheezing phenotypes in a pediatric Turkish cohort. J Asthma 2021; 59:1298-1304. [PMID: 33906564 DOI: 10.1080/02770903.2021.1922916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Characterization of wheezing phenotypes in children might help to identify the underlying mechanisms through which asthma occurs. In our study, we aimed to describe wheezing phenotypes in Turkish children and to identify risk factors according to phenotypes. METHODS 651 wheezy children were evaluated and 5 wheezing phenotypes were described according to age of onset, atopy and persistence at 6 years of age and risk factors were identified. RESULTS Distribution of wheezing phenotypes was transient early wheeze (TEW)(34.9%) non-atopic wheeze (NAW) (18%), atopic wheeze (AW) (22.3%), intermediate onset wheeze (IOW) (11.1%), late onset wheeze (LOW) (11.7%). LOW, AW, and IOW were associated with, father's, sibling's and family's atopy (p:0.001) whereas LOW and AW were associated with mother's asthma and atopy as well as family's asthma (p < 0.05). Atopic dermatitis and allergic rhinitis were common of patients with LOW, AW, and IOW (p < 0.05). İnfection was the major trigger for TEW and NAW whereas multiple triggers were common of AW, LOW, and IOW. Allergens were mostly associated with AW, IOW and LOW. Aeroallergen-specific IgE positivity was mostly with AW, IOW, and LOW phenotype. Skin prick tests showed multiple allergen sensitivity in IOW, LOW groups and mostly single allergen in AW phenotype. Modified asthma predictive index (mAPI) positivity was high in all groups except TEW and NAW. CONCLUSIONS With this study we classified five wheeze phenotypes and found that atopy and family's atopy history, maternal asthma were strongly associated with AW, LOW, and IOW phenotypes which were usually effected by allergens or multiple triggers.
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Affiliation(s)
- Ezgi Ulusoy Severcan
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Cem Murat Bal
- Department of Pediatrics, Division of Pediatric Pulmonology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Figen Gülen
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Remziye Tanaç
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Esen Demir
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Ege University Faculty of Medicine, İzmir, Turkey
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