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Ladoux C, Guilleminault L, Michelet M, Mittaine M. What is the future of children and adolescents with severe asthma treated with biological therapy? Pediatr Pulmonol 2024. [PMID: 38818871 DOI: 10.1002/ppul.27052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 04/27/2024] [Indexed: 06/01/2024]
Affiliation(s)
- Clara Ladoux
- Pediatric Pneumology Department, CHU Children's Hospital, Toulouse, France
- Unité de Recherche Clinique Pédiatrique/Module Plurithématique Pédiatrique CIC1436, Toulouse, France
| | - Laurent Guilleminault
- Department of Respiratory and Allergic Diseases, Toulouse University Hospital Center, Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), INSERM UMR1291-CNRS UMR5051, University of Toulouse III, CRISALIS F-CRIN, Toulouse, France
| | - Marine Michelet
- Pediatric Pneumology Department, CHU Children's Hospital, Toulouse, France
- Unité de Recherche Clinique Pédiatrique/Module Plurithématique Pédiatrique CIC1436, Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), INSERM UMR1291-CNRS UMR5051, University of Toulouse III, CRISALIS F-CRIN, Toulouse, France
| | - Marie Mittaine
- Pediatric Pneumology Department, CHU Children's Hospital, Toulouse, France
- Unité de Recherche Clinique Pédiatrique/Module Plurithématique Pédiatrique CIC1436, Toulouse, France
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Custovic A, Custovic D, Fontanella S. Understanding the heterogeneity of childhood allergic sensitization and its relationship with asthma. Curr Opin Allergy Clin Immunol 2024; 24:79-87. [PMID: 38359101 PMCID: PMC10906203 DOI: 10.1097/aci.0000000000000967] [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: 02/17/2024]
Abstract
PURPOSE OF REVIEW To review the current state of knowledge on the relationship between allergic sensitization and asthma; to lay out a roadmap for the development of IgE biomarkers that differentiate, in individual sensitized patients, whether their sensitization is important for current or future asthma symptoms, or has little or no relevance to the disease. RECENT FINDINGS The evidence on the relationship between sensitization and asthma suggests that some subtypes of allergic sensitization are not associated with asthma symptoms, whilst others are pathologic. Interaction patterns between IgE antibodies to individual allergenic molecules on component-resolved diagnostics (CRD) multiplex arrays might be hallmarks by which different sensitization subtypes relevant to asthma can be distinguished. These different subtypes of sensitization are associated amongst sensitized individuals at all ages, with different clinical presentations (no disease, asthma as a single disease, and allergic multimorbidity); amongst sensitized preschool children with and without lower airway symptoms, with different risk of subsequent asthma development; and amongst sensitized patients with asthma, with differing levels of asthma severity. SUMMARY The use of machine learning-based methodologies on complex CRD data can help us to design better diagnostic tools to help practising physicians differentiate between benign and clinically important sensitization.
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Affiliation(s)
- Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
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3
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Färdig M, Hoyer A, Almqvist C, Bains KES, Carlsen KCL, Gudmundsdóttir HK, Granum B, Haugen GN, Hedlin G, Jonassen CM, Konradsen JR, Lie A, Rehbinder EM, Skjerven HO, Staff AC, Vettukattil R, Söderhäll C, Nordlund B. Infant lung function and early skin barrier impairment in the development of asthma at age 3 years. Allergy 2024; 79:667-678. [PMID: 38239099 DOI: 10.1111/all.16024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 12/08/2023] [Accepted: 12/17/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND Largely unexplored, we investigated if lower lung function, impaired skin barrier function by transepidermal water loss (TEWL), eczema, and filaggrin (FLG) mutations in infancy were associated with asthma in early childhood. METHODS From the factorially designed randomized controlled intervention study PreventADALL, we evaluated 1337/2394 children from all randomization groups with information on asthma at age 3 years, and at age 3 months either lung function, TEWL, eczema, and/or FLG mutations. Lower lung function was defined as the time to peak tidal expiratory flow to expiratory time (tPTEF /tE ) <0.25, and skin barrier impairment as a high TEWL >9.50 g/m2 /h. Eczema was clinically observed, and DNA genotyped for FLG mutations. Asthma was defined as asthma-like symptoms (≥3 episodes of bronchial obstruction) between age 2-3 years as well as a history of doctor-diagnosed asthma and/or asthma medication use. Associations were analyzed in logistic regression models, presented with adjusted ORs (aOR) and 95% confidence intervals (CI). RESULTS Lower lung function and skin barrier impairment were associated with asthma in general; aOR (95% CI) 5.4 (2.1, 13.7) and 1.6 (1.1, 2.5), while eczema and FLG mutations were associated with asthma in children with atopic dermatitis or allergic sensitization only. Stratifying for sex, the risk of asthma was only increased in boys with lower lung function; aOR (95% CI) 7.7 (2.5, 23.6), and in girls with FLG mutations; aOR (95% CI) 3.5 (1.5, 8.2). CONCLUSION Lower lung function and impaired skin barrier function in infancy may increase the risk of asthma at age 3 years.
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Affiliation(s)
- Martin Färdig
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Angela Hoyer
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Catarina Almqvist
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Karen Eline S Bains
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Hrefna Katrín Gudmundsdóttir
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Department of Chemical Toxicology, Norwegian Institute of Public Health, Oslo, Norway
| | - Guttorm Nils Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Christine Monceyron Jonassen
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Jon R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anine Lie
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Eva Maria Rehbinder
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Dermatology and Vaenerology, Oslo University Hospital, Oslo, Norway
| | - Håvard O Skjerven
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Louchet M, Tisseyre M, Kaguelidou F, Treluyer JM, Préta LH, Chouchana L. Drug-induced fetal and offspring disorders, beyond birth defects. Therapie 2024; 79:205-219. [PMID: 38008599 DOI: 10.1016/j.therap.2023.11.002] [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: 08/08/2023] [Accepted: 11/09/2023] [Indexed: 11/28/2023]
Abstract
Studies on drug utilization in western countries disclosed that about nine over ten women use at least one or more drugs during pregnancy. Determining whether a drug is safe or not in pregnant women is a challenge of all times. As a developing organism, the fetus is particularly vulnerable to effects of drugs used by the mother. Historically, research has predominantly focused on birth defects, which represent the most studied adverse pregnancy outcomes. However, drugs can also alter the ongoing process of pregnancy and impede the general growth of the fetus. Finally, adverse drug reactions can theoretically damage all developing systems, organs or tissues, such as the central nervous system or the immune system. This extensive review focuses on different aspects of drug-induced damages affecting the fetus or the newborn/infant, beyond birth defects, which are not addressed here.
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Affiliation(s)
- Margaux Louchet
- URP 7323 "Pharmacologie et évaluation des thérapeutiques chez l'enfant et la femme enceinte", Université Paris Cité, 75000 Paris, France; Service de gynécologie-obstétrique, Fédération hospitalo-universitaire PREMA, hôpital Louis-Mourier, AP-HP Nord - Université Paris Cité, 75000 Paris, France
| | - Mylène Tisseyre
- URP 7323 "Pharmacologie et évaluation des thérapeutiques chez l'enfant et la femme enceinte", Université Paris Cité, 75000 Paris, France; Centre régional de pharmacovigilance, service de pharmacologie périnatale, pédiatrique et adulte, hôpitaux Cochin-Necker, AP-HP Centre - Université Paris Cité, 75000 Paris, France
| | - Florentia Kaguelidou
- URP 7323 "Pharmacologie et évaluation des thérapeutiques chez l'enfant et la femme enceinte", Université Paris Cité, 75000 Paris, France; Centre d'investigation clinique pédiatrique, Inserm CIC 1426, hôpital Robert-Debré, AP-HP Nord - Université Paris Cité, 75000 Paris, France
| | - Jean-Marc Treluyer
- URP 7323 "Pharmacologie et évaluation des thérapeutiques chez l'enfant et la femme enceinte", Université Paris Cité, 75000 Paris, France; Centre régional de pharmacovigilance, service de pharmacologie périnatale, pédiatrique et adulte, hôpitaux Cochin-Necker, AP-HP Centre - Université Paris Cité, 75000 Paris, France
| | - Laure-Hélène Préta
- URP 7323 "Pharmacologie et évaluation des thérapeutiques chez l'enfant et la femme enceinte", Université Paris Cité, 75000 Paris, France
| | - Laurent Chouchana
- URP 7323 "Pharmacologie et évaluation des thérapeutiques chez l'enfant et la femme enceinte", Université Paris Cité, 75000 Paris, France; Centre régional de pharmacovigilance, service de pharmacologie périnatale, pédiatrique et adulte, hôpitaux Cochin-Necker, AP-HP Centre - Université Paris Cité, 75000 Paris, France.
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Lejeune S, Bouazza N, Nicaise PR, Jolaine V, Roditis L, Marguet C, Amat F, Berger P, Fayon M, Dubus JC, Valois S, Reix P, Pellan M, Brouard J, Chiron R, Giovannini-Chami L, de Blic J, Deschildre A, Lezmi G. COBRAPed cohort: Do sensitization patterns differentiate children with severe asthma from those with a milder disease? Pediatr Allergy Immunol 2024; 35:e14112. [PMID: 38520021 DOI: 10.1111/pai.14112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND It is unclear whether sensitization patterns differentiate children with severe recurrent wheeze (SRW)/severe asthma (SA) from those with non-severe recurrent wheeze (NSRW)/non-severe asthma (NSA). Our objective was to determine whether sensitization patterns can discriminate between children from the French COBRAPed cohort with NSRW/NSA and those with SRW/SA. METHODS IgE to 112 components (c-sIgE) (ImmunoCAP® ISAC) were analyzed in 125 preschools (3-6 years) and 170 school-age children (7-12 years). Supervised analyses and clustering methods were applied to identify patterns of sensitization among children with positive c-sIgE. RESULTS We observed c-sIgE sensitization in 51% of preschool and 75% of school-age children. Sensitization to house dust mite (HDM) components was more frequent among NSRW than SRW (53% vs. 24%, p < .01). Sensitization to non-specific lipid transfer protein (nsLTP) components was more frequent among SA than NSA (16% vs. 4%, p < .01) and associated with an FEV1/FVC < -1.64 z-score. Among sensitized children, seven clusters with varying patterns were identified. The two broader clusters identified in each age group were characterized by "few sensitizations, mainly to HDM." One cluster (n = 4) with "multiple sensitizations, mainly to grass pollen, HDM, PR-10, and nsLTP" was associated with SA in school-age children. CONCLUSIONS Although children with wheeze/asthma display frequent occurrences and high levels of sensitization, sensitization patterns did not provide strong signals to discriminate children with severe disease from those with milder disease. These results suggest that the severity of wheeze/asthma may depend on both IgE- and non-IgE-mediated mechanisms.
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Affiliation(s)
- Stéphanie Lejeune
- Pediatric Pulmonology and Allergy Department, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, Hôpital Jeanne de Flandre, Univ. Lille, Lille, France
- Clinical Investigation Center, LIRIC UMR 995 Inserm, CIC-1403-Inserm-CHU, Univ. Lille, Lille, France
| | - Naïm Bouazza
- Unité de Recherche Clinique-Centre Investigation Clinique, APHP, Hôpital Necker-Enfants malades, Paris, France
| | - Pascale Roland Nicaise
- Immunology Department, Hôpital Bichat, APHP, Paris, France
- Inserm, PHERE, Université Paris Cité, Paris, France
| | - Valérie Jolaine
- Unité de Recherche Clinique-Centre Investigation Clinique, APHP, Hôpital Necker-Enfants malades, Paris, France
| | - Léa Roditis
- Pediatric Pulmonology and Allergology Unit CHU Toulouse, Children Hospital, Toulouse, France
| | - Christophe Marguet
- Pediatric Respiratory and Allergic Diseases, CF Reference Center, Rouen University Hospital-Charles Nicolle, EA3830-GHRV, Rouen University, Rouen, France
| | - Flore Amat
- Pediatric Pulmonology and Allergology, INSERM UMR 1018, Robert Debré Hospital, University of Paris Cité, Paris, France
| | - Patrick Berger
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Centre d'Investigation Clinique (CIC 1401), Univ. Bordeaux, Bordeaux, France
| | - Michael Fayon
- Unité de Pneumologie Pédiatrique, Centre d'Investigation Clinique (CIC 1401), CHU de Bordeaux, Bordeaux, France
| | - Jean-Christophe Dubus
- Unité de Pneumopédiatrie CHU Timone-Enfants, Aix-Marseille Université, IRD MEPHI, IHU Méditerranée-Infection, Marseille, France
| | - Sophie Valois
- Pédiatrie, CHU Grenoble Alpes, INSERM, Institute for Advanced Biosciences, Université Grenoble Alpes, Grenoble, France
| | - Philippe Reix
- Service de Pneumologie, Allergologie et Mucoviscidose Pédiatrique, CHU de Lyon, Lyon, France
- UMR 5558 (EMET), CNRS, LBBE, Université de Lyon, Villeurbanne, France
| | | | - Jacques Brouard
- Service de Pédiatrie Médicale, CHU Caen, Caen, France
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Normandie Université, Caen, France
| | - Raphael Chiron
- Pediatric Department, Montpellier University Hospital, Montpellier, France
| | | | - Jacques de Blic
- Department of Pediatric Pulmonology and Allergy, AP-HP, Hôpital Necker-Enfants Malades, Université Paris Cité, Paris, France
| | - Antoine Deschildre
- Pediatric Pulmonology and Allergy Department, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, Hôpital Jeanne de Flandre, Univ. Lille, Lille, France
- Clinical Investigation Center, LIRIC UMR 995 Inserm, CIC-1403-Inserm-CHU, Univ. Lille, Lille, France
| | - Guillaume Lezmi
- Department of Pediatric Pulmonology and Allergy, AP-HP, Hôpital Necker-Enfants Malades, Université Paris Cité, Paris, France
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Asseri AA. Characteristics of Allergic, Eosinophilic, and Overlapping Asthma Phenotypes Among Pediatric Patients with Current Asthma: A Cross-Sectional Study from Saudi Arabia. J Asthma Allergy 2023; 16:1297-1308. [PMID: 38058515 PMCID: PMC10697008 DOI: 10.2147/jaa.s439089] [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: 09/07/2023] [Accepted: 11/23/2023] [Indexed: 12/08/2023] Open
Abstract
Purpose Asthma is one of the most common chronic diseases affecting 10%-30% of children in Saudi Arabia. Although data exist on adult asthma phenotyping and endotyping in Saudi Arabia, little is known about asthma phenotypes in Saudi children. Patients and Methods This cross-sectional study enrolled pediatric patients diagnosed with bronchial asthma and followed in the pediatric pulmonology clinic of the Abha Maternity and Children Hospital between August 2021 and May 2023. Results A total of 321 children (aged 5-14 years) were analyzed. The population was classified into allergic [169 (52.6%)], eosinophilic [144 (44.9%)], and overlapping allergic and eosinophilic asthma [97 (30.2%)] phenotypes. Regarding asthma severity, 35.5%, 50.2%, and 14.3% were classified as mild, moderate, and severe, respectively. Of the 321 patients in the study, 124 (38.6%) had at least one asthma exacerbation that required hospitalization. The number of reported missed school days in the previous year was 1571 days [190 (59.2%) patients reported at least one missed school day]. The factors associated with the likelihood of uncontrolled asthma for all study participants included: emergency room (ER) visit last year (OR = 3.7, 95% CI:0.6-15.9]), overlapping eosinophilic and allergic (OR = 3.2, 95% CI = 1.8-5.9), and allergic phenotype (OR = 2.7, 95% CI = 1.3-5.4). The level of asthma control differed significantly among the three asthma phenotypes (p = 0.037). Conclusion Allergic asthma is the most prevalent asthma phenotype in this study, followed by the eosinophilic phenotype. The research has also shown that several factors predict uncontrolled asthma, including a family history of asthma, previous admission to the PICU, and previous hospitalization ever. There is, therefore, a definite need for multicenter cohort studies to better understand the phenotypes and endotypes of childhood asthma, as it could offer therapeutic and prognostic relevance.
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Affiliation(s)
- Ali Alsuheel Asseri
- Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Custovic D, Fontanella S, Custovic A. Understanding progression from pre-school wheezing to school-age asthma: Can modern data approaches help? Pediatr Allergy Immunol 2023; 34:e14062. [PMID: 38146116 DOI: 10.1111/pai.14062] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/27/2023]
Abstract
Preschool wheezing and childhood asthma create a heavy disease burden which is only exacerbated by the complexity of the conditions. Preschool wheezing exhibits both "curricular" and "aetiological" heterogeneity: that is, heterogeneity across patients both in the time-course of its development and in its underpinning pathological mechanisms. Since these are not fully understood, but clinical presentations across patients may nonetheless be similar, current diagnostic labels are imprecise-not mapping cleanly onto underlying disease mechanisms-and prognoses uncertain. These uncertainties also make a identifying new targets for therapeutic intervention difficult. In the past few decades, carefully designed birth cohort studies have collected "big data" on a large scale, incorporating not only a wealth of longitudinal clinical data, but also detailed information from modalities as varied as imaging, multiomics, and blood biomarkers. The profusion of big data has seen the proliferation of what we term "modern data approaches" (MDAs)-grouping together machine learning, artificial intelligence, and data science-to make sense and make use of this data. In this review, we survey applications of MDAs (with an emphasis on machine learning) in childhood wheeze and asthma, highlighting the extent of their successes in providing tools for prognosis, unpicking the curricular heterogeneity of these conditions, clarifying the limitations of current diagnostic criteria, and indicating directions of research for uncovering the etiology of the diseases underlying these conditions. Specifically, we focus on the trajectories of childhood wheeze phenotypes. Further, we provide an explainer of the nature and potential use of MDAs and emphasize the scope of what we can hope to achieve with them.
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Affiliation(s)
- Darije Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sara Fontanella
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
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Maniassom C, Defo A, De Blay F, Elenga N. What's childhood asthma in French Guiana? A cohort study based on children referred for allergology consultations at the Cayenne hospital center. Front Public Health 2023; 11:1198937. [PMID: 37744508 PMCID: PMC10513413 DOI: 10.3389/fpubh.2023.1198937] [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: 04/02/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Background Asthma is a multifactorial chronic disease, whose most frequent etiology is allergy, especially to Blomia tropicalis. In French Guiana, the childhood prevalence of Blomia T sensitization is unkwown. The aim of this study was to determine the proportion of sensitization to Blomia T and other mites in asthmatic children, and to describe the characteristics of childhood asthma in French Guiana. Methods A retrospective cohort study focused on children from 0 to 18 years of age, followed for asthma at the Department of Pediatrics of the Cayenne Hospital Center in French Guiana. All asthmatic children followed by the same paediatric allergist were systematically skin-tested with Bt total extract, and Bt-specific IgE tests were additionally performed to confirm specific sensitization. All follow-up variables were collected from medical records. The outcome was sensitization to Blomia tropicalis and other allergens, and the explanatory variables were those of asthma follow-up. Patients were categorized into Blomia tropicalis sensitization yes/no. Logistic regression analysis was used to assess the relationship between follow-up variables and the outcome. Results 302 patients were followed: 177 cases of allergic rhinitis, 135 allergic conjunctivitis, 105 atopic dermatitis, 153 food allergy, and 14 cases of drug allergy. Poly-allergy (respiratory, food, skin, and medicinal) was present in 239 children. There were 158 children followed for asthma, of whom 103 (65%) were sensitized to Blomia tropicalis. The median age of the asthmatic children sensitized to Blomia tropicalis was 7 years, and 3 years for those who were not sensitized (p < 0.001). Among the girls (n = 58), 67% were sensitized to Blomia; 97 (92%) asthmatic children co-sensitized to Blomia tropicalis, Dermatophagoides pteronyssinus, and Dermatophagoides farinae. Multivariate analysis showed that the childhood asthma in French Guiana is characterized by a median age of 7 years (p < 0.001), a high prevalence of Blomia tropicalis (p < 0.001), co-sensitization to other mites (p < 0.001), and a high prevalence of co-sensitization to cockroaches (p = 0.006). The area under the ROC curve was close to 0.9, confirming the quality of our model. Conclusion In French Guiana, asthma is characterized by a high prevalence of Blomia tropicalis sensitization.
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Affiliation(s)
- Chiméne Maniassom
- Department de Pediatrie, Hôpital de Cayenne “Andrée Rosemon”, Cayenne, French Guiana
| | - Antoine Defo
- Department de Pediatrie, Hôpital de Cayenne “Andrée Rosemon”, Cayenne, French Guiana
| | - Frédéric De Blay
- Pôle de Pathologie Thoracique Hôpitaux Universitaires de Strasbourg, Place de l’Hôpital, Strasbourg, France
| | - Narcisse Elenga
- Department de Pediatrie, Hôpital de Cayenne “Andrée Rosemon”, Cayenne, French Guiana
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Sørensen KG, Øymar K, Dalen I, Halvorsen T, Bruun Mikalsen I. Blood eosinophils during bronchiolitis: Associations with atopy, asthma and lung function in young adults. Acta Paediatr 2023; 112:820-829. [PMID: 36627486 DOI: 10.1111/apa.16666] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/02/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
AIM To study if blood eosinophils during bronchiolitis were associated with atopy, asthma and lung function in young adults and if these associations differed between respiratory syncytial virus (RSV) bronchiolitis and non-RSV bronchiolitis. METHODS This historical cohort enrolled 225 subjects. Blood eosinophils were measured during bronchiolitis in infancy, and the subjects were invited to a follow-up at 17-20 years of age including questionnaires for asthma and examinations of lung function and atopy. RESULTS The level of eosinophils was positively associated with subsequent atopy in the unadjusted analysis, but not in the adjusted analysis, and not with asthma. There was a negative association between the level of eosinophils and forced vital capacity (FVC) (-0.11; -0.19, -0.02) and forced expiratory volume in first second (FEV1 ) (-0.12; -0.21, -0.03) (regression coefficient; 95% confidence interval). The non-RSV group had higher levels of eosinophils during bronchiolitis, but there was no interaction between the level of eosinophils and RSV status for any outcome. CONCLUSIONS The level of eosinophils during bronchiolitis was negatively associated with lung function in young adult age, but we found no associations with atopy or asthma. These associations were not different after RSV bronchiolitis compared to non-RSV bronchiolitis.
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Affiliation(s)
- Karen Galta Sørensen
- Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Knut Øymar
- Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Ingvild Dalen
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Thomas Halvorsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Paediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ingvild Bruun Mikalsen
- Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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10
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Blavier N, Thimmesch M, Bodart E. Prévalence de l’asthme éosinophilique dans la population asthmatique pédiatrique lors du diagnostic d’asthme léger à modéré. REVUE FRANÇAISE D'ALLERGOLOGIE 2023. [DOI: 10.1016/j.reval.2023.103288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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11
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Eldosoky MA, Hammad R, Rushdi A, Ibrahim HF, Tawfeik AM, Mora A, Fahmy SF, El-Ashmawy H, Ali E, Hamed DH, Mohammed AR, Mashaal A, Mohsen H. MicroRNA-146a-5p and microRNA-210-3p Correlate with T Regulatory Cells Frequency and Predict Asthma Severity in Egyptian Pediatric Population. J Asthma Allergy 2023; 16:107-121. [PMID: 36714048 PMCID: PMC9880026 DOI: 10.2147/jaa.s398494] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/10/2023] [Indexed: 01/21/2023] Open
Abstract
Background Severe bronchial asthma (BA) affects 5-10% of children, which imposes socioeconomic burden. Therefore, it is crucial to identify biomarkers for risk stratification in children with BA. T regulatory cells (Tregs) play a balancing role in allergic response regulation. We aimed to investigate the relationship between Treg, miR-210-3p, and miR-146a-5p in relation to asthma phenotypes in search of novel biomarkers of disease severity. Methods This study included 50 children with BA classified into Group 1 (n = 25) children with mild to moderate asthma and Group 2 (n = 25) children with severe asthma. In addition to 26 control subjects. Flow cytometry was used to detect Tregs. Plasma miR-210-3p and miR-146a levels were determined using quantitative real-time PCR. Patients' FEV1 (Forced Expiratory Volume in the first second) was measured. Results miR-210-3p level correlated negatively with Treg frequency (r = -0.828, P < 0.001) and FEV1 (r = -0.621, P < 0.001). The level of miR-146a-5p positively correlated positively with Treg% (r = 0.303, P = 0.032). ROC curve analysis revealed that miR-210-3p was the most sensitive biomarker of severity, with the area under curve (AUC) = 0.923, 96% sensitivity, and 60% specificity. According to multivariate analysis, miR-210-3p is an independent risk factor for BA severity [OR =3.119, P = 0.030], while miR-146a-5p is a protective factor [OR =0.811, P = 0.049]. Conclusion Treg frequency is linked to FEV1, miR-146a-5p and miR-210-3p in childhood BA. Upregulation of miR-210-3p is a sensitive biomarker and an independent risk factor for BA severity in Egyptian children.
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Affiliation(s)
- Mona A Eldosoky
- Clinical Pathology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt
| | - Reham Hammad
- Clinical Pathology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt
| | - Areej Rushdi
- Microbiology and Immunology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt
| | - Hanan F Ibrahim
- Microbiology and Immunology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt
| | - Amany M Tawfeik
- Microbiology and Immunology Department, Faculty of Medicine, Badr University in Cairo (BUC), Cairo, Egypt
| | - Ahmed Mora
- Chemistry Department, Faculty of Science (for Boys), Al-Azhar University, Cairo, Egypt
| | - Sarah F Fahmy
- Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Hossam El-Ashmawy
- Clinical Pathology Department, Faculty of Medicine (for Boys), Al-Azhar University, Assuit, Egypt
| | - Elham Ali
- Molecular Biology, Zoology and Entomology Department, Faculty of Science (For Girls), Al-Azhar University, Cairo, Egypt
| | - Dina H Hamed
- Pediatric Department, Pediatric Allergy and Pulmonology Unit, Children’s Hospital, Cairo University, Cairo, Egypt,Correspondence: Dina H Hamed, Email
| | - Amena Rezk Mohammed
- Biochemistry Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt
| | - Alya Mashaal
- Immunology, Zoology and Entomology Department, Faculty of Science (For Girls), Al-Azhar University, Cairo, Egypt
| | - Hanan Mohsen
- Pediatric Department, Pediatric Allergy and Pulmonology Unit, Children’s Hospital, Cairo University, Cairo, Egypt
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12
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Wang Z, He Y, Cun Y, Li Q, Zhao Y, Luo Z. Transcriptomic analysis identified SLC40A1 as a key iron metabolism-related gene in airway macrophages in childhood allergic asthma. Front Cell Dev Biol 2023; 11:1164544. [PMID: 37123407 PMCID: PMC10133523 DOI: 10.3389/fcell.2023.1164544] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/05/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction: Asthma is the most common chronic condition in children, with allergic asthma being the most common phenotype, accounting for approximately 80% of cases. Growing evidence suggests that disruption of iron homeostasis and iron regulatory molecules may be associated with childhood allergic asthma. However, the underlying molecular mechanism remains unclear. Methods: Three childhood asthma gene expression datasets were analyzed to detect aberrant expression profiles of iron metabolism-related genes in the airways of children with allergic asthma. Common iron metabolism-related differentially expressed genes (DEGs) across the three datasets were identified and were subjected to functional enrichment analysis. Possible correlations between key iron metabolism-related DEGs and type 2 airway inflammatory genes were investigated. Single-cell transcriptome analysis further identified major airway cell subpopulations driving key gene expression. Key iron metabolism-related gene SLC40A1 was validated in bronchoalveolar lavage (BAL) cells from childhood asthmatics with control individuals by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and immunofluorescence. The intracellular iron content in BAL cells was assessed by Perls iron staining and the iron levels in BAL supernatant was measured by iron assay to assess airway iron metabolism status in childhood asthmatics. Results: Five common iron metabolism-related DEGs were identified, which were functionally related to iron homeostasis. Among these genes, downregulated SLC40A1 was strongly correlated with type 2 airway inflammatory markers and the gene signature of SLC40A1 could potentially be used to determine type 2-high and type 2-low subsets in childhood allergic asthmatics. Further single-cell transcriptomic analysis identified airway macrophages driving SLC40A1 expression. Immunofluorescence staining revealed colocalization of FPN (encoded by SLC40A1) and macrophage marker CD68. Down-regulation of SLC40A1 (FPN) was validated by qRT-PCR and immunofluorescence analysis. Results further indicated reduced iron levels in the BAL fluid, but increased iron accumulation in BAL cells in childhood allergic asthma patients. Furthermore, decreased expression of SLC40A1 was closely correlated with reduced iron levels in the airways of children with allergic asthma. Discussion: Overall, these findings reveal the potential role of the iron metabolism-related gene SLC40A1 in the pathogenesis of childhood allergic asthma.
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Affiliation(s)
- Zhili Wang
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yu He
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yupeng Cun
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Qinyuan Li
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yan Zhao
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Zhengxiu Luo
- Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Zhengxiu Luo,
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Skin Barrier Function and Infant Tidal Flow-Volume Loops-A Population-Based Observational Study. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010088. [PMID: 36670639 PMCID: PMC9856825 DOI: 10.3390/children10010088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023]
Abstract
Background: The relationship between the skin barrier- and lung function in infancy is largely unexplored. We aimed to explore if reduced skin barrier function by high transepidermal water loss (TEWL), or manifestations of eczema or Filaggrin (FLG) mutations, were associated with lower lung function in three-month-old infants. Methods: From the population-based PreventADALL cohort, 899 infants with lung function measurements and information on either TEWL, eczema at three months of age and/or FLG mutations were included. Lower lung function by tidal flow-volume loops was defined as a ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE) <0.25 and a tPTEF <0.17 s (<25th percentile). A high TEWL >8.83 g/m2/h (>75th percentile) denoted reduced skin barrier function, and DNA was genotyped for FLG mutations (R501X, 2282del4 and R2447X). Results: Neither a high TEWL, nor eczema or FLG mutations, were associated with a lower tPTEF/tE. While a high TEWL was associated with a lower tPTEF; adjusted OR (95% CI) 1.61 (1.08, 2.42), the presence of eczema or FLG mutations were not. Conclusions: Overall, a high TEWL, eczema or FLG mutations were not associated with lower lung function in healthy three-month-old infants. However, an inverse association between high TEWL and tPTEF was observed, indicating a possible link between the skin barrier- and lung function in early infancy.
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14
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Sun J, Li Y. Pyroptosis and respiratory diseases: A review of current knowledge. Front Immunol 2022; 13:920464. [PMID: 36248872 PMCID: PMC9561627 DOI: 10.3389/fimmu.2022.920464] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Pyroptosis is a relatively newly discovered programmed cell death accompanied by an inflammatory response. In the classical view, pyroptosis is mediated by caspases-1,-4,-5,-11 and executed by GSDMD, however, recently it was demonstrated that caspase-3 and-8 also participate in the process of pyroptosis, by cleaving GSDMD/E and GSDMD respectively. Different from autophagy and apoptosis, many pores are formed on the cell membrane during pyroptosis, which makes the cell membrane lose its integrity, eventually leading to the release of cytokines interleukin(IL)-1β and IL-18. When the body is infected with pathogens or exposed to some stimulations, pyroptosis could play an immune defense role. It is found that pyroptosis exists widely in infectious and inflammatory respiratory diseases such as acute lung injury, bronchial dysplasia, chronic obstructive pulmonary disease, and asthma. Excessive pyroptosis may accompany airway inflammation, tissue injury, and airway damage, and induce an inflammatory reaction, leading to more serious damage and poor prognosis of respiratory diseases. This review summarizes the relationship between pyroptosis and related respiratory diseases.
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15
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Wilson K, Gebretsadik T, Adgent MA, Loftus C, Karr C, Moore PE, Sathyanarayana S, Byington N, Barrett E, Bush N, Nguyen R, Hartman TJ, LeWinn KZ, Calvert A, Mason WA, Carroll KN. The association between duration of breastfeeding and childhood asthma outcomes. Ann Allergy Asthma Immunol 2022; 129:205-211. [PMID: 35552008 PMCID: PMC9442497 DOI: 10.1016/j.anai.2022.04.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Postnatal exposures, including breastfeeding, may influence asthma development. OBJECTIVE To investigate the association between breastfeeding duration and child asthma. METHODS We studied 2021 mother-child dyads in the ECHO PATHWAYS consortium of prospective pregnancy cohorts (GAPPS, CANDLE, TIDES). Women reported the duration of any and exclusive breastfeeding and child asthma outcomes during follow-up at child age 4 to 6 years. Outcomes included current wheeze (previous 12 months), ever asthma, current asthma (having ≥2 of current wheeze, ever asthma, medication use in past 12-24 months), and strict current asthma (ever asthma with either or both current wheeze and medication use in past 12-24 months). We used multivariable logistic regression to assess associations (odds ratios and 95% confidence intervals) between breastfeeding and asthma outcomes adjusting for potential confounders. We assessed effect modification by mode of delivery, infant sex, and maternal asthma. RESULTS Among women, 33%, 13%, 9%, and 45% reported 0 to less than 2, 2 to 4, 5 to 6, and more than 6 months of any breastfeeding, respectively. The duration of any breastfeeding had a protective linear trend with ever asthma but no other outcomes. There was a duration-dependent protective association of exclusive breastfeeding and child asthma outcomes (eg, current asthma adjusted odds ratio [95% confidence interval], 0.64 [0.41-1.02], 0.61 [0.38-0.98], and 0.52 (0.31-0.87) for 2to 4 months, 5 to 6 months, and more than 6 months, respectively, compared with <2 months). For exclusive breastfeeding, protective associations were stronger in dyads with children born by vaginal vs cesarean delivery although interactions did not reach statistical significance (Pinteractions 0.12-0.40). CONCLUSION Longer duration of exclusive breastfeeding had a protective association with child asthma.
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Affiliation(s)
- Keadrea Wilson
- Division of Neonatology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christine Loftus
- Departments of Environmental and Occupational Health Sciences and Pediatrics, University of Washington, Seattle, Washington
| | - Catherine Karr
- Seattle Children's Research Institute, Seattle, Washington
| | - Paul E Moore
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sheela Sathyanarayana
- Departments of Environmental and Occupational Health Sciences and Pediatrics, University of Washington, Seattle, Washington
| | - Nora Byington
- Seattle Children's Research Institute, Seattle, Washington
| | - Emily Barrett
- Department of Biostatistics and Epidemiology, Rutgers University, Piscataway, New Jersey
| | - Nicole Bush
- Department of Pediatrics, University of California San Francisco, San Francisco, California; Weill Institute for Neurosciences, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California
| | - Ruby Nguyen
- Department of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Terry J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kaja Z LeWinn
- Weill Institute for Neurosciences, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California
| | - Alexis Calvert
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - W Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Kecia N Carroll
- Division of General Pediatrics, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
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16
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Liang L, Hu M, Chen Y, Liu L, Wu L, Hang C, Luo X, Xu X. Metabolomics of bronchoalveolar lavage in children with persistent wheezing. Respir Res 2022; 23:161. [PMID: 35718784 PMCID: PMC9208141 DOI: 10.1186/s12931-022-02087-6] [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: 03/10/2022] [Accepted: 06/11/2022] [Indexed: 11/28/2022] Open
Abstract
Background Recent studies have demonstrated the important role of metabolomics in the pathogenesis of asthma. However, the role of lung metabolomics in childhood persistent wheezing (PW) or wheezing recurrence remains poorly understood. Methods In this prospective observational study, we performed a liquid chromatography/mass spectrometry-based metabolomic survey on bronchoalveolar lavage samples collected from 30 children with PW and 30 age-matched infants (control group). A 2-year follow-up study on these PW children was conducted. Results Children with PW showed a distinct characterization of respiratory metabolome compared with control group. Children with PW had higher abundances of choline, oleamide, nepetalactam, butyrylcarnitine, l-palmitoylcarnitine, palmitoylethanolamide, and various phosphatidylcholines. The glycerophospholipid metabolism pathway was the most relevant pathway involving in PW pathophysiologic process. Additionally, different gender, prematurity, and systemic corticoids use demonstrated a greater impact in airway metabolite compositions. Furthermore, for PW children with recurrence during the follow-up period, children who were born prematurely had an increased abundance of butyrylcarnitine relative to those who were carried to term. Conclusions This study suggests that the alterations of lung metabolites could be associated with the development of wheezing, and this early alteration could also be correlated with wheezing recurrence later in life. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-02087-6.
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Affiliation(s)
- Lingfang Liang
- Department of Rheumatology Immunology and Allergy, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310003, People's Republic of China
| | - Minfei Hu
- Department of Rheumatology Immunology and Allergy, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310003, People's Republic of China
| | - Yuanling Chen
- Department of Rheumatology Immunology and Allergy, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310003, People's Republic of China
| | - Lingke Liu
- Department of Rheumatology Immunology and Allergy, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310003, People's Republic of China
| | - Lei Wu
- Department of Rheumatology Immunology and Allergy, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310003, People's Republic of China
| | - Chengcheng Hang
- Department of Rheumatology Immunology and Allergy, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310003, People's Republic of China
| | - Xiaofei Luo
- Department of Rheumatology Immunology and Allergy, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310003, People's Republic of China
| | - Xuefeng Xu
- Department of Rheumatology Immunology and Allergy, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310003, People's Republic of China.
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17
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Söderhäll C, Schoos AMM. Persistent Asthma in Childhood. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9060820. [PMID: 35740757 PMCID: PMC9221718 DOI: 10.3390/children9060820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Cilla Söderhäll
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-17177 Stockholm, Sweden
- Astrid Lindgren’s Children’s Hospital, Karolinska University Hospital, SE-17164 Stockholm, Sweden
- Correspondence: (C.S.); (A.-M.M.S.)
| | - Ann-Marie Malby Schoos
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, 2820 Gentofte, Denmark
- Department of Pediatrics, Slagelse Hospital, 4200 Slagelse, Denmark
- Correspondence: (C.S.); (A.-M.M.S.)
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18
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Koivusaari K, Syrjälä E, Niinistö S, Ahonen S, Åkerlund M, Korhonen TE, Toppari J, Ilonen J, Kaila M, Knip M, Alatossava T, Veijola R, Virtanen SM. Consumption of differently processed milk products and the risk of asthma in children. Pediatr Allergy Immunol 2022; 33:e13659. [PMID: 34472138 DOI: 10.1111/pai.13659] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Consumption of unprocessed cow's milk has been associated with a lower risk of childhood asthma and/or atopy. Not much is known about differently processed milk products. We aimed to study the association between the consumption of differently processed milk products and asthma risk in a Finnish birth cohort. METHODS We included 3053 children from the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study. Asthma and its subtypes were assessed at the age of 5 years, and food consumption by food records, at the age of 3 and 6 months and 1, 2, 3, 4, and 5 years. We used conventional and processing (heat treatment and homogenization)-based classifications for milk products. The data were analyzed using a joint model for longitudinal and time-to-event data. RESULTS At the age of 5 years, 184 (6.0%) children had asthma, of whom 101 (54.9%) were atopic, 75 (40.8%) were nonatopic, and eight (4.3%) could not be categorized. Consumption of infant formulas [adjusted hazard ratio (95% confidence intervals) 1.15 (1.07, 1.23), p < .001] and strongly heat-treated milk products [1.06 (1.01, 1.10), p = .01] was associated with the risk of all asthma. Consumption of all cow's milk products [1.09 (1.03, 1.15), p = .003], nonfermented milk products [1.08 (1.02, 1.14), p = .008], infant formulas [1.23 (1.13, 1.34), p < .001], and strongly heat-treated milk products [1.08 (1.02, 1.15), p = .006] was associated with nonatopic asthma risk. All these associations remained statistically significant after multiple testing correction. CONCLUSIONS High consumption of infant formula and other strongly heat-treated milk products may be associated with the development of asthma.
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Affiliation(s)
- Katariina Koivusaari
- Public Health and Welfare Department, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Essi Syrjälä
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
| | - Sari Niinistö
- Public Health and Welfare Department, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Suvi Ahonen
- Public Health and Welfare Department, Finnish Institute for Health and Welfare, Helsinki, Finland.,Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.,Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Mari Åkerlund
- Public Health and Welfare Department, Finnish Institute for Health and Welfare, Helsinki, Finland.,Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.,Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Tuuli E Korhonen
- Public Health and Welfare Department, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jorma Toppari
- Department of Pediatrics, Turku University Hospital, Turku, Finland.,Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Minna Kaila
- Public Health Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Mikael Knip
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Tampere Center for Child Health Research, Tampere University Hospital, Tampere, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Tapani Alatossava
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Riitta Veijola
- Department of Pediatrics, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Suvi M Virtanen
- Public Health and Welfare Department, Finnish Institute for Health and Welfare, Helsinki, Finland.,Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.,Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, Tampere University Hospital, Tampere, Finland
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19
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Kim YH, Jang H, Kim SY, Jung JH, Kim GE, Park MR, Hong JY, Kim MN, Kim EG, Kim MJ, Kim KW, Sohn MH. Gram-negative microbiota is related to acute exacerbation in children with asthma. Clin Transl Allergy 2021; 11:e12069. [PMID: 34667591 PMCID: PMC8507365 DOI: 10.1002/clt2.12069] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The upper-airway microbiota may be associated with the pathogenesis of asthma and useful for predicting acute exacerbation. However, the relationship between the lower-airway microbiota and acute exacerbation in children with asthma is not well understood. We evaluated the characteristics of the airway microbiome using induced sputum from children with asthma exacerbation and compared the microbiota-related differences of inflammatory cytokines with those in children with asthma. METHODS We analysed the microbiome using induced sputum during acute exacerbation of asthma in children. We identified microbial candidates that were prominent in children with asthma exacerbation and compared them with those in children with stable asthma using various analytical methods. The microbial candidates were analysed to determine their association with inflammatory cytokines. We also developed a predictive functional profile using PICRUSt. RESULTS A total of 95 children with allergic sensitisation including 22 with asthma exacerbation, 67 with stable asthma, and 6 controls were evaluated. We selected 26 microbial candidates whose abundances were significantly increased, decreased, or correlated during acute exacerbation in children with asthma. Among the microbial candidates, Campylobacter, Capnocytophaga, Haemophilus, and Porphyromonas were associated with inflammatory cytokines including macrophage inflammatory protein (MIP)-1β, programmed death-ligand 1, and granzyme B. Both Campylobacter and MIP-1β levels were correlated with sputum eosinophils. Increased lipopolysaccharide biosynthesis and decreased glycan degradation were observed in children with asthma exacerbation. CONCLUSION Gram-negative microbes in the lower airway were related to acute exacerbation in children with asthma. These microbes and associated cytokines may play a role in exacerbating asthma in children.
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Affiliation(s)
- Yoon Hee Kim
- Department of PediatricsGangnam Severance HospitalSeoulKorea
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
| | - Haerin Jang
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Soo Yeon Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Jae Hwa Jung
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Ga Eun Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Mi Reu Park
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Jung Yeon Hong
- Division of Cardiovascular Disease ResearchDepartment for Chronic Disease Convergence ResearchKorea National Institute of HealthCheongjuKorea
| | - Mi Na Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Eun Gyul Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Min Jung Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsYongin Severance HospitalYonginKorea
| | - Kyung Won Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Myung Hyun Sohn
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
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Rhinovirus Infection and Familial Atopy Predict Persistent Asthma and Sensitisation 7 Years after a First Episode of Acute Bronchiolitis in Infancy. CHILDREN-BASEL 2021; 8:children8100850. [PMID: 34682115 PMCID: PMC8534717 DOI: 10.3390/children8100850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022]
Abstract
Background: We set out to assess the risk factors for asthma outcome in a cohort of infants who experienced their first episode of acute bronchiolitis. Methods: A cohort of 222 infants who were included during a first episode of acute bronchiolitis was prospectively followed. Herein, we present the results of their assessments (symptom history, skin prick tests, specific IgE assay, respiratory function tests) at age seven. Results: Of the 68/222 (30.6%) children assessed at age seven, 15 (22.05%) presented with asthma and were mainly males (p = 0.033), 14 (20%) had respiratory allergies, 17 (25%) presented atopic dermatitis and none had a food allergy. Family history of atopy was associated with asthma and sensitisation to aeroallergens at age seven (p = 0.003, p = 0.007). Rhinovirus (hRV) infection and rhinovirus/respiratory syncytial virus (RSV) co-infection were significantly associated with asthma at age seven (p = 0.035, p = 0.04), but not with the initial severity of bronchiolitis. Eosinophil counts at ages three and seven were significantly higher in the asthmatics (p = 0.01, p = 0.046). Conclusion: Any infant, especially male, presenting a first episode of acute bronchiolitis due to hRV with a family history of atopy should be closely monitored via follow-up due to a higher risk for asthma at school age.
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Okasha NM, Sarhan AA, Ahmed EO. Association between house dust mites sensitization and level of asthma control and severity in children attending Mansoura University Children’s Hospital. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2021. [DOI: 10.1186/s43168-021-00082-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
House dust mites (HDM) are considered as a major source of indoor aeroallergen all over the world that precipitate allergic reactions including rhinoconjunctivitis, food allergy, atopic dermatitis, and allergic asthma. In this study, we aimed to assess the clinical and laboratory profile of some Egyptian asthmatic children who are sensitized to house dust mites and determine the association of HDM sensitization and severity of asthma according to recent GINA guidelines.
Results
The most frequent clinical phenotype among the HDM-positive group was a cough (96.7%), while the clinical phenotypic wheeze was frequent in HDM negative group (96.7%). There is a statistically significant difference between studied cases classified according to sensitivity to HDM regarding level of asthma control (50.0% were uncontrolled among cases sensitive to HDM and 56.7% of cases non-sensitive to HDM were controlled (p = 0.001*). Severity according to treatment results was significantly higher among cases sensitive to HDM (26.7% of cases sensitive to HDM versus 3.3% of cases non-sensitive to HDM), p = 0.017.
Conclusions
HDM sensitization is associated mainly with cough asthma phenotype and allergic rhinitis in our studied cases. HDM sensitization increases asthma severity and decreases the ability to control asthma symptoms.
Trial registration
ClinicalTrial.gov, NCT04958616.
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22
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Akan A, Dibek Mısırlıoğlu E, Civelek E, Kocabaş CN. Determining the Best Tool Comparable with Global Initiative for Asthma Criteria for Assessing Pediatric Asthma Control. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2021; 34:89-96. [PMID: 34432544 DOI: 10.1089/ped.2020.1334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background: Guidelines such as Global Initiative for Asthma (GINA) recommend disease control as the mainstay of asthma management. Objective: To investigate which measure of asthma control best correlates with the GINA criteria for determining asthma control in children. Methods: Child asthma-patients at a tertiary hospital were enrolled in the study after evaluation of response to treatment. Asthma control test (ACT)/pediatric asthma control test (PACT), Pediatric Asthma Quality of Life Questionnaire (PAQLQ), fractional exhaled nitric oxide (FeNO), and lung function parameters were evaluated. Patients were examined by asthma specialists and control status was evaluated based on GINA. Results: The median age (interquartile range) of patients was 10.7 (8.4-12.9) years, 57.9% of patients were boys. Of 228 children, 84.2%, 9.6%, and 6.1% displayed "well-controlled", "partially controlled", and "uncontrolled" asthma, respectively, according to GINA. The patients with "partially controlled" and "uncontrolled" asthma were grouped as "not well-controlled." The cutoff levels were 22, 21, and 5.9 for PACT, ACT, and PAQLQ, respectively, for determining "well-controlled" asthma (P < 0.001). With these cutoff values, ACT exhibited higher comparability with GINA than PACT and PAQLQ (κ = 0.473, 0.221, and 0.150, respectively, P < 0.001). PAQLQ had higher agreement with GINA criteria in children ≥12 years old (κ = 0.326, P < 0.001 and κ = 0.151, P = 0.014, respectively). Correctly classified patients with PACT, ACT, and PALQLQ based on GINA with these cutoff levels were 93 (64.1%), 63 (75.9%), and 139 (62.9%), respectively. FeNO and lung function parameters were unsuccessful at revealing control status according to GINA. Conclusion: ACT is better than PACT for comparability with GINA. Better correlation of PAQLQ and ACT and better comparability of PAQLQ and GINA were evident in older children.
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Affiliation(s)
- Ayşegül Akan
- Department of Pediatric Allergy and Immunology, Trabzon Kanuni Research and Training Hospital, Health Sciences University, Trabzon, Turkey
| | - Emine Dibek Mısırlıoğlu
- Department of Pediatric Allergy and Immunology, Ankara City Research and Training Hospital, Health Sciences University, Ankara, Turkey
| | - Ersoy Civelek
- Department of Pediatric Allergy and Immunology, Ankara City Research and Training Hospital, Health Sciences University, Ankara, Turkey
| | - Can Naci Kocabaş
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey
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23
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Carrasco P, Estarlich M, Iñiguez C, Ferrero A, Murcia M, Esplugues A, Vioque J, Marina LS, Zabaleta C, Iriarte G, Fernández-Somoano A, Tardon A, Vrijheid M, Sunyer J, Ballester F, Llop S. Pre and postnatal exposure to mercury and respiratory health in preschool children from the Spanish INMA Birth Cohort Study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 782:146654. [PMID: 33838378 DOI: 10.1016/j.scitotenv.2021.146654] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
Effects of mercury on maturing immune system have been reported, however the association with respiratory and allergy problems during infancy remains unclear. The aim of this study is to evaluate the association between pre and postnatal mercury exposure and respiratory and allergy problems among preschool children and to examine the role of potential modifying factors. Study subjects were children participant in Spanish Childhood and Environment Project (INMA, 2003-2008). We measured total mercury levels in cord blood (n = 1868) and hair at 4 years of age (n = 1347). Respiratory outcomes (wheezing, severe wheezing, chestiness, persistent cough, eczema and otitis) were obtained by questionnaires administered to parents. Associations were investigated by logistic regression adjusted for socio-demographic and lifestyle-related variables in each cohort and subsequent meta-analysis. We tested effect modification by factors related to individual susceptibility, diet and co-exposure with other pollutants. The geometric mean of cord blood and hair total mercury was 8.20 μg/L and 0.97 μg/g, respectively. No statistically significant association between pre or postnatal mercury exposure and respiratory and allergy outcomes was found. Notwithstanding, lower maternal intake of fruits and vegetables increased the risk of some respiratory outcomes due to the prenatal exposure to mercury (pint < 0.05). Moreover, an inverse association between prenatal mercury exposure and some respiratory outcomes was observed among children with higher maternal exposure to organocholorine compounds or smoking (pint < 0.05). Also, sex and postnatal smoking exposure modulated mercury postnatal effects on persistent cough (pint < 0.05). In conclusion, no association between pre and postnatal mercury exposure and respiratory and allergy problems among the whole population at study was found. However, diet and other toxicants could modulate this relation, especially during prenatal period. More research on this topic is warranted due to the limited evidence.
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Affiliation(s)
- Paula Carrasco
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020 Valencia, Spain; Department of Medicine, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071 Castellón de la Plana, Spain
| | - Marisa Estarlich
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; Nursing School, Universitat de València, C/Jaume Roig s/n, 46010, Valencia, Spain.
| | - Carmen Iñiguez
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; Department of Statistics and Computational Research. Universitat de València, València, Dr. Moliner, 50 46100, Spain
| | - Amparo Ferrero
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain
| | - Mario Murcia
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; Servicio de Análisis de Sistemas de Información Sanitaria, Conselleria de Sanitat, Generalitat Valenciana. C/Micer Mascó, 31-33, 46010, Valencia, Spain
| | - Ana Esplugues
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; Nursing School, Universitat de València, C/Jaume Roig s/n, 46010, Valencia, Spain
| | - Jesús Vioque
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; Institute for Health and Biomedical Research (ISABIAL), Avda Pinto Baeza, 12, 03010 AlicanteAlicante, Spain
| | - Loreto Santa Marina
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; Health Department of Basque Government, Sub-directorate of Public Health of Gipuzkoa, Avenida de Navarra 4, 20013 San Sebastián, Spain; Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, Public Health Division of Gipuzkoa, Doctor Begiristain, s/n, 20014 San Sebastián, Spain
| | - Carlos Zabaleta
- Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, Public Health Division of Gipuzkoa, Doctor Begiristain, s/n, 20014 San Sebastián, Spain; Nuestra señora de la Antigua Hospital, OSI Goierri-Alto Urola, OSAKIDETZA-Basque Health Service, Barrio Argixao, s/n, 20700 Zumarraga, Spain
| | - Gorka Iriarte
- Laboratorio de Salud Pública de Alava, Santiago 11, 01002 Vitoria Gasteiz, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; IUOPA-Departamento de Medicina, University of Oviedo, Av. Julián Clavería, 6, 33006 Oviedo, Spain; Institute of Health Research of the Principality of Asturias - Foundation for Biosanitary Research of Asturias (ISPA-FINBA), Avenida Hospital Universitario s/n, 33011, Oviedo, Spain
| | - Adonina Tardon
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; IUOPA-Departamento de Medicina, University of Oviedo, Av. Julián Clavería, 6, 33006 Oviedo, Spain; Institute of Health Research of the Principality of Asturias - Foundation for Biosanitary Research of Asturias (ISPA-FINBA), Avenida Hospital Universitario s/n, 33011, Oviedo, Spain
| | - Martine Vrijheid
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; Barcelona Institute for Global Health (ISGlobal), Dr. Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè 10-12, 08002 Barcelona, Spain
| | - Jordi Sunyer
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; Barcelona Institute for Global Health (ISGlobal), Dr. Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè 10-12, 08002 Barcelona, Spain; Municipal Institute of Medical Research, IMIM-Hospital del Mar, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - Ferran Ballester
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; Nursing School, Universitat de València, C/Jaume Roig s/n, 46010, Valencia, Spain
| | - Sabrina Llop
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain
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Follow-up study of airway microbiota in children with persistent wheezing. Respir Res 2021; 22:213. [PMID: 34315459 PMCID: PMC8314579 DOI: 10.1186/s12931-021-01806-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/19/2021] [Indexed: 12/26/2022] Open
Abstract
Background Increasing evidence revealed that airway microbial dysbiosis was associated with increased risk of asthma, or persistent wheezing (PW). However, the role of lung microbiota in PW or wheezing recurrence remains poorly understood. Methods In this prospective observational study, we performed a longitudinal 16S rRNA-based microbiome survey on bronchoalveolar lavage (BAL) samples collected from 35 infants with PW and 28 age-matched infants (control group). A 2-year follow-up study on these PW patients was conducted. The compositions of lower airway microbiota were analyzed at the phylum and genus levels. Results Our study showed a clear difference in lower airway microbiota between PW children and the control group. Children with PW had a higher abundance of Elizabethkingia and Rothia, and lower abundance of Fusobacterium compared with the control group. At the end of the 2-year follow-up, 20 children with PW (57.1%) experienced at least one episode of wheezing, and 15 (42.9%) did not suffer from wheezing episodes. Furthermore, PW children with recurrence also had increased abundances of Elizabethkingia and Rothia relative to those who had no recurrence. Additionally, wheezing history, different gender, and caesarean section demonstrated a greater impact in airway microbiota compositions. Conclusion This study suggests that the alterations of lower airway microbiota could be strongly associated with the development of wheezing, and early airway microbial changes could also be associated with wheezing recurrence later in life.
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25
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Adam-Bonci TI, Bonci EA, Pârvu AE, Herdean AI, Moț A, Taulescu M, Ungur A, Pop RM, Bocșan C, Irimie A. Vitamin D Supplementation: Oxidative Stress Modulation in a Mouse Model of Ovalbumin-Induced Acute Asthmatic Airway Inflammation. Int J Mol Sci 2021; 22:7089. [PMID: 34209324 PMCID: PMC8268667 DOI: 10.3390/ijms22137089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 01/15/2023] Open
Abstract
Asthma oxidative stress disturbances seem to enable supplementary proinflammatory pathways, thus contributing to disease development and severity. The current study analyzed the impact of two types of oral vitamin D (VD) supplementation regimens on the redox balance using a murine model of acute ovalbumin-induced (OVA-induced) asthmatic inflammation. The experimental prevention group received a long-term daily dose of 50 µg/kg (total dose of 1300 µg/kg), whereas the rescue group underwent a short-term daily dose of 100 µg/kg (total dose of 400 µg/kg). The following oxidative stress parameters were analyzed in serum, bronchoalveolar lavage fluid (BALF) and lung tissue homogenate (LTH): total oxidative status, total antioxidant response, oxidative stress index, malondialdehyde and total thiols. Results showed that VD significantly reduced oxidative forces and increased the antioxidant capacity in the serum and LTH of treated mice. There was no statistically significant difference between the two types of VD supplementation. VD also exhibited an anti-inflammatory effect in all treated mice, reducing nitric oxide formation in serum and the expression of nuclear factor kappa B p65 in the lung. In conclusion, VD supplementation seems to exhibit a protective role in oxidative stress processes related to OVA-induced acute airway inflammation.
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Affiliation(s)
- Teodora-Irina Adam-Bonci
- Department of Pathophysiology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (T.-I.A.-B.); (A.-E.P.)
| | - Eduard-Alexandru Bonci
- Department of Oncological Surgery and Gynecologic Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania;
| | - Alina-Elena Pârvu
- Department of Pathophysiology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (T.-I.A.-B.); (A.-E.P.)
| | - Andrei-Ioan Herdean
- Department of Anatomy and Embryology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
| | - Augustin Moț
- Department of Chemistry, Faculty of Chemistry and Chemical Engineering, “Babeș-Bolyai” University, 400028 Cluj-Napoca, Romania;
| | - Marian Taulescu
- Department of Pathology, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania; (M.T.); (A.U.)
- Synevovet Laboratory, 81 Pache Protopopescu, 021408 Bucharest, Romania
| | - Andrei Ungur
- Department of Pathology, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania; (M.T.); (A.U.)
| | - Raluca-Maria Pop
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (R.-M.P.); (C.B.)
| | - Corina Bocșan
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (R.-M.P.); (C.B.)
| | - Alexandru Irimie
- Department of Oncological Surgery and Gynecologic Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania;
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26
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Molecular analysis of phenotypic interactions of asthma. Cytokine 2021; 143:155524. [PMID: 33849767 DOI: 10.1016/j.cyto.2021.155524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Asthma is a heterogeneous disease characterized by multiples respiratory symptoms; this is a polygenic entity that involves a complex interaction of environmental factors and inherent to the individual. To understand the development of asthma, some phenotypes have been proposed. OBJECTIVE This work's purpose was to explore different molecules related to asthma development and to define each phenotype's specific characteristics. MATERIAL AND METHODS 96 adult patients diagnosed with asthma before any treatment were enrolled in the protocol. Spirometric parameters, circulating leukocytes, serum IgE, body mass index, exhaled nitric oxide (FENO), and leukotrienes (LTB4) in urine were determined in each patient. The presence of asthma phenotypes proposed by the Global Initiative for Asthma (GINA) were explored: A) Allergic asthma, B) Non-allergic asthma, C) Late-onset asthma, D) Asthma with persistent airflow limitation, and E) Asthma with overweight and obesity. RESULTS In the cohort analyzed, we found four of phenotypes proposed by GINA; however, these phenotypes overlapped, due to this, 4 groups were integrated with allergic, non-allergic and obese patients, which were the main phenotypes. The main overlap was that of patients not-obese allergic, and was characterized by earlier onset, elevated levels of IgE, LTB4 and inflammasome related cytokines. Non-allergic patients had a significant association between interleukin (IL)-18 and IL-18 binding protein (BP) with narrow ratio between these cytokines. Finally, LTB4 had remarkable capacity to discriminate between allergic and not allergic patients. CONCLUSIONS Asthmatic phenotypes exist as interrelated characteristics and not as discrete entities. High levels of leukotrienes and IgE are hallmarks in the allergic phenotype of asthma.
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Fainardi V, Esposito S, Chetta A, Pisi G. Asthma phenotypes and endotypes in childhood. Minerva Med 2021; 113:94-105. [PMID: 33576199 DOI: 10.23736/s0026-4806.21.07332-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Asthma is a very heterogeneous disease and since early childhood many classifications have been proposed according to phenotype and endotype. The phenotype includes the clinical features of asthma such as age of onset, triggers, comorbidities, response to treatment and evolution over time. The endotype is more difficult to define, includes the underlying immunopathological mechanisms of the disease and requires reliable biomarkers. A deep knowledge of phenotype and endotype of the patient may guide a tailored therapeutic approach. In this review the main phenotypes and endotypes of asthma acknowledged in children will be discussed.
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Affiliation(s)
- Valentina Fainardi
- Department of Medicine and Surgery, Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Italy -
| | - Susanna Esposito
- Department of Medicine and Surgery, Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Italy
| | - Alfredo Chetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Giovanna Pisi
- Department of Medicine and Surgery, Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Italy
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28
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Wawrzyniak A, Lipińska-Opałka A, Kalicki B, Kloc M. The Effect of Passive Exposure to Tobacco Smoke on the Immune Response in Children with Asthma. Subst Use Misuse 2021; 56:424-430. [PMID: 33427001 DOI: 10.1080/10826084.2020.1869263] [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] [Indexed: 10/22/2022]
Abstract
Introduction: There are a few publications about the impact of tobacco smoke on the children's immune system. Material and Methods: The study group consisted of 43 children with asthma. The control group consisted of 37 healthy children. The exposure to tobacco smoke was assessed by the presence of the cotinine in the urine (metabolit of nicotine). Results: The group of children with asthma exposed to tobacco smoke had significantly higher levels of the IL-1 and lower levels IL-4 than children not exposed to the passive smoking. The children from the control group exposed to tobacco smoke had a significantly higher concentration of IL-4 than unexposed children. In the whole analyzed population, there was a significant positive correlation between cotinine-IL1 and cotinine-CRP. Conclusion: In this study we found that the passive exposure to tobacco smoke has the immunomodulatory effects on the immune system.
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Affiliation(s)
- Agata Wawrzyniak
- Department of Pediatrics, Nephrology, and Allergology, Military Institute of Medicine, Warsaw, Poland
| | - Agnieszka Lipińska-Opałka
- Department of Pediatrics, Nephrology, and Allergology, Military Institute of Medicine, Warsaw, Poland
| | - Bolesław Kalicki
- Department of Pediatrics, Nephrology, and Allergology, Military Institute of Medicine, Warsaw, Poland
| | - Małgorzata Kloc
- The Houston Methodist Research Institute, Houston, Texas, USA
- The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
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Yoon J, Eom EJ, Kim JT, Lim DH, Kim WK, Song DJ, Yoo Y, Suh DI, Baek HS, Shin M, Kwon JW, Jang GC, Yang HJ, Lee E, Kim HS, Seo JH, Woo SI, Kim HY, Shin YH, Lee JS, Jung S, Han M, Yu J. Heterogeneity of Childhood Asthma in Korea: Cluster Analysis of the Korean Childhood Asthma Study Cohort. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2021; 13:42-55. [PMID: 33191676 PMCID: PMC7680825 DOI: 10.4168/aair.2021.13.1.42] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 06/22/2020] [Accepted: 07/08/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Asthma is a heterogeneous airway disease occurring in children, and it has various clinical phenotypes. A clear differentiation of the clinical phenotypes can provide better asthma management and prediction of asthma prognosis. Little is currently known about asthma phenotypes in Korean children. This study was designed to identify asthma phenotypes in school-aged Korean children. METHODS This study enrolled 674 children with physician-diagnosed asthma from the Korean childhood Asthma Study (KAS) cohort. The physicians verified the relevant histories of asthma and comorbid diseases, as well as airway lability and hyper-responsiveness from the results of pulmonary function tests and bronchial provocation tests. Questionnaires regarding the participants' baseline characteristics, their environment and self-rating of asthma control were collected at the time of enrollment. Laboratory tests were performed to assess allergy and airway inflammation. Children with asthma were classified by hierarchical cluster analysis. RESULTS Of the 674 patients enrolled from the KAS cohort, 447 were included in the cluster analysis. Cluster analysis of these 447 children revealed 4 asthma phenotypes: cluster 1 (n = 216, 48.3%) which was characterized by male-dominant atopic asthma; cluster 2 (n = 79, 17.7%) which was characterized by early-onset atopic asthma with atopic dermatitis; cluster 3 (n = 47, 10.5%) which was characterized by puberty-onset, female-dominant atopic asthma with the low lung function; and cluster 4 (n = 105, 23.5%) which was characterized by early-onset, non-atopic dominant asthma. CONCLUSIONS The asthma phenotypes among Korean children can be classified into 4 distinct clusters. Long-term follow-up with these phenotypes will be needed to define their prognosis and response to treatment.
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Affiliation(s)
- Jisun Yoon
- Department of Pediatrics, Mediplex Sejong Hospital, Incheon, Korea
| | - Eun Jin Eom
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Tack Kim
- Department of Pediatrics, School of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's hospital, Uijeongbu, Korea
| | - Dae Hyun Lim
- Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea
| | - Young Yoo
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hey Sung Baek
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Meeyong Shin
- Department of Pediatrics, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Ji Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Hyeon Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Hwan Soo Kim
- Department of Pediatrics, School of Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea
| | - Ju Hee Seo
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
| | - Sung Il Woo
- Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Youn Ho Shin
- Department of Pediatrics, Gangnam CHA Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Minkyu Han
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea
| | - Jinho Yu
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Kim YJ, Yang SI. Seasonality of asthma exacerbation in children caused by respiratory virus infection and allergen sensitization. ALLERGY ASTHMA & RESPIRATORY DISEASE 2021. [DOI: 10.4168/aard.2021.9.4.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Yoo Jin Kim
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Song-I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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31
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Kim MH, Kim TB. Implication of Cluster Analysis in Childhood Asthma. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2021; 13:1-4. [PMID: 33191672 PMCID: PMC7680837 DOI: 10.4168/aair.2021.13.1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 01/03/2023]
Affiliation(s)
- Min Hye Kim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Tae Bum Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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32
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33
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Briley PM, Merlo S. Presence of Allergies and Their Impact on Sleep in Children Who Stutter. ACTA ACUST UNITED AC 2020. [DOI: 10.1044/2020_persp-20-00095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose
Population-based research has identified insomnia or trouble sleeping, sleepiness during the day, and fatigue during the day as frequent coexisting conditions in children who stutter (CWS). Considering that allergies are well known to disturb sleep, the purpose of this study was to explore if there is an association between the presence of allergies and sleep issues among CWS, as well as if allergies are frequent in CWS.
Method
Data from the 2012 National Health Interview Survey were used. Children used in this sample were those whose caregivers answered definitively whether or not the child stuttered within the past 12 months. Additionally, caregivers identified the presence of allergies and/or asthma and the presence of insomnia or trouble sleeping in the sample child.
Results
The sample included 200 CWS and 9,951 children who do not stutter (CWNS). The odds of insomnia/trouble sleeping were greater in CWS who present with allergies and/or asthma, with the exception of food allergy, compared to CWS who do not present with with allergies and/or asthma. Additionally, the odds of insomnia/trouble sleeping were greater in CWS without any allergy, asthma, and coexisting disability (
OR
= 7.48,
p
< .001) as compared to CWNS without any allergy, asthma, and coexisting disability. The presence of either any allergy or an asthma attack was higher among CWS (46.4%) compared to CWNS (29.5%),
p
< .001. Specifically, CWS were found to be at greater odds of presenting with any kind of respiratory allergy (
OR
= 1.72,
p
= .034), food allergy (
OR
= 2.32,
p
= .002), and skin allergy (
OR
= 1.84,
p
= .009) than CWNS.
Conclusions
CWS were found to be at greater odds of allergies and asthma, conditions that also impair sleep. Interestingly, insomnia/trouble sleeping was prevalent among CWS, even when allergies, asthma, and coexisting disabilities were not present. The possible implications of these findings are discussed.
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Affiliation(s)
- Patrick M. Briley
- Department of Communication Sciences & Disorders, East Carolina University, Greenville, NC
| | - Sandra Merlo
- Brazilian Fluency Institute, Sao Paulo, Sao Paulo, Brazil
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34
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Lau N, Smith MJ, Sarkar A, Gao Z. Effects of low exposure to traffic related air pollution on childhood asthma onset by age 10 years. ENVIRONMENTAL RESEARCH 2020; 191:110174. [PMID: 32919973 DOI: 10.1016/j.envres.2020.110174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/11/2020] [Accepted: 09/03/2020] [Indexed: 06/11/2023]
Abstract
Although NO2, a major traffic related air pollutant, has been associated with onset of childhood asthma, young children may be more susceptible to traffic related air pollution exposure compared to other individuals. We linked data from National Longitudinal Survey of Children and Youths Cycle 1-5 (1994-2003) and the National Air Pollution Surveillance Program to determine the association between NO2 exposure and either early or late onset childhood asthma phenotypes. Children diagnosed with asthma from age 0-3 were defined as having early onset asthma. Children diagnosed with asthma from age 4-9 were defined as having late onset asthma. Mean NO2 exposure for each quartile was 6.31 ppb, 9.45 ppb, 11.83 ppb, and 17.9 ppb. Higher levels of NO2 exposure were more strongly associated with early childhood asthma (Quartile 3 OR: 2.11, 95% CI: 1.29, 3.44, Quartile 4 OR: 2.16, 95% CI: 1.27, 3.68) compared to the lowest level of NO2 exposure (Quartile 1). No such association was observed with risk of late childhood asthma onset. Asthma susceptibility to NO2 exposure may vary with the childhood developmental stage, and young children may be susceptible to NO2 exposure at levels well below national and international guidelines. Our study emphasizes the importance of considering the timing of childhood asthma onset in future studies and confirms the increased risk of early onset of childhood asthma associated even with relatively low NO2 exposure levels.
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Affiliation(s)
- Nelson Lau
- Clinical Epidemiology Unit, Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | - Mary Jane Smith
- Discipline of Pediatrics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | - Atanu Sarkar
- Clinical Epidemiology Unit, Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | - Zhiwei Gao
- Clinical Epidemiology Unit, Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, A1B 3V6, Canada.
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35
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Yoshida S, Tanaka S, Adachi Y, Yoshisue H, Kozawa M, Kawakami K. Assessment of asthma severity according to treatment steps in Japanese pediatric patients: a descriptive cross-sectional study using an administrative claims database. J Asthma 2020; 58:1574-1580. [PMID: 32900270 DOI: 10.1080/02770903.2020.1821057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Japan has one of the highest asthma prevalence rates in Asia; however, there is a lack of epidemiological studies on asthma among children in Japan. This study aimed to describe the severity of asthma and the prescription patterns for its treatment among pediatric patients, by using a large-scale claims database. METHODS The analysis datasets were extracted from the JMDC database for the period of April 1, 2009 to March 30, 2015; included records were restricted to patients between 2 and 15 years of age. The Japanese Pediatric Guidelines for the treatment and management of asthma (JPGL) steps were used as a proxy for asthma treatment and severity. We also described the characteristics of asthma in children by stratifying the prevalence and incidence cohorts by index years. RESULTS In the prevalence cohort (56% male), from 2010 to 2014, approximately 80-90% of the children received step 1 or 2 treatment, with the remainder receiving step 3 or 4 treatment, as defined by the JPGL. The majority (approximately 90%) of patients visited clinics for asthma treatment, while a minority visited hospitals. CONCLUSIONS Our study showed the severity of asthma among Japanese pediatric patients, as well as their demographic characteristics, using a large-scale claims database. The majority of pediatric asthma patients received treatment for mild-to-moderate asthma, while less than 10% received treatment for severe asthma.
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Affiliation(s)
- Satomi Yoshida
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Shiro Tanaka
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuichi Adachi
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | | | | | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
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Abstract
PURPOSE OF REVIEW To analyze the status of precision medicine in atopic diseases. RECENT FINDINGS Atopic diseases are increasingly recognized as heterogeneous in nature and they can be quite different in severity, response to therapy, triggers, genetic back ground, ancestral risk and type of inflammation. This significant variability in the landscape of atopic diseases is not reflected in the common treatment guidelines that follow 'one fits all' approach for their management. Such an approach is largely based on minimal 'phenotype' elements, such as severity of disease and response to therapy and does not reflect the information accumulate in the last 20 years about particular pathogenic pathways (endotypes) leading to disease (phenotypes) based on biomolecular analysis of the single individuals. Accumulating data have defined asthma allergic rhinitis, food allergy based on their endotypes and clinically relevant phenotypes. In general, atopic diseases can be largely classified as high or low Th2 inflammatory status, which may explain the severity and response to therapy. SUMMARY Precision medicine is aiming to use known endotype phenotype to guide specific individualized treatment. The work aimed in deep characterization of diseases to guide the disease management is crucial in light of the availability of ever more precise treatment able to target specific pathways.
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37
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Tison KL, Patrawala M, Blaiss MS. Monoclonal Antibody Therapy in Childhood Asthma. Curr Allergy Asthma Rep 2020; 20:26. [PMID: 32430808 DOI: 10.1007/s11882-020-00919-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW There has been an explosion of monoclonal antibodies in the treatment of severe uncontrolled adult asthma. Studies have now been published in severe pediatric asthma. There are numerous questions that need to be answered in determining whether these modalities are appropriate and safe in children. RECENT FINDINGS This is a narrative review examining the latest pediatric literature on monoclonal antibodies, both approved and in the pipeline, for uncontrolled asthma. Presently, all of the biologics are positioned to treat patients with underlying type 2 high disease. Two monoclonal antibodies are approved for children 6 years of age and older, omalizumab and mepolizumab, with more likely approved in the near future. The effect of these agents in controlling severe pediatric asthma is promising. Data is limited to long-term efficacy and safety, and whether any agent has an effect on the natural history of asthma.
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Affiliation(s)
- Katherine L Tison
- Emory University School of Medicine/Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Meera Patrawala
- Emory University School of Medicine/Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Michael S Blaiss
- Medical College of Georgia at Augusta University, Augusta, GA, USA. .,, Roswell, GA, USA.
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38
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Arrais M, Lulua O, Quifica F, Rosado-Pinto J, Gama JM, Brito M, Taborda-Barata L. Sensitisation to aeroallergens in relation to asthma and other allergic diseases in Angolan children: a cross-sectional study. Allergol Immunopathol (Madr) 2020; 48:281-289. [PMID: 32035729 DOI: 10.1016/j.aller.2019.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/06/2019] [Accepted: 10/17/2019] [Indexed: 02/05/2023]
Abstract
INTRODUCTION AND OBJECTIVES In Africa, few studies of sensitisation profiles have been performed in children or adolescents and, in Angola, there are none. The objectives of the present study were to assess the sensitisation profile of Angolan schoolchildren and to determine the relationship between that pattern, sociodemographic factors, asthma and other allergic diseases. MATERIALS AND METHODS Cross-sectional, observational study in 5-14-year-old children, performed between September and November 2017, in the Province of Bengo, Angola. Five schools (15%) were randomly selected in the geographical area of the study: three from an urban area, and two from a rural area. Data were collected using the Portuguese versions of the ISAAC questionnaires for children and adolescents, regarding asthma, rhinitis and eczema. Skin prick tests (SPT) were performed with a battery of 12 aeroallergens. Stools were assessed for the presence of helminths. Descriptive statistics were used, as well as univariate calculation of odds ratios. RESULTS Sensitisation to aeroallergens was low (8%) and most sensitised children were asymptomatic. Most frequent sensitisations involved house dust mites, cockroach or fungi, and a high proportion of children (78.1%) were monosensitised. No relationship was detected between sensitisations and asthma, rhinitis or eczema. Place of residence, gender, age or helminthic infection did not affect the probability of having positive SPTs. CONCLUSIONS The most frequent sensitisations in children from Bengo Province in Angola involve house dust mites, followed by cockroach and fungi. No relationship was found between atopic sensitisation and asthma or other allergic diseases.
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39
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Licari A, Castagnoli R, Manca E, Votto M, Michev A, Marseglia GL. Towards Precision Medicine in Pediatric Severe Asthma: An Update on Current and Emerging Biomarkers. CURRENT RESPIRATORY MEDICINE REVIEWS 2020. [DOI: 10.2174/1573398x15666190423150227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Pediatric severe asthma is actually considered a rare disease with a heterogeneous nature.
Recent cohort studies focusing on children with severe asthma identified different clinical
presentations (phenotypes) and underlying pathophysiological mechanisms (endotypes). Phenotyping
and endotyping asthma represent the current approach to patients with severe asthma and consist in
characterizing objectively measurable and non-invasive indicators (biomarkers) capable of orienting
diagnosis, management and personalized treatment, as advocated by the Precision Medicine
approach. The aim of this review is to provide a practical overview of current and emerging
biomarkers in pediatric severe asthma.
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Affiliation(s)
- Amelia Licari
- Department of Pediatrics, University of Pavia, Pavia, Italy
| | | | - Enrica Manca
- Department of Pediatrics, “Casa del Sollievo e della Sofferenza” Scientific Institute, University of Foggia, Foggia, Italy
| | - Martina Votto
- Department of Pediatrics, University of Pavia, Pavia, Italy
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40
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Roberts G. A new approach to oral allergen immunotherapy for food allergy? Clin Exp Allergy 2019; 48:758-759. [PMID: 29947140 DOI: 10.1111/cea.13187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G Roberts
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
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41
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Roberts G, Almqvist C, Boyle R, Crane J, Hogan SP, Marsland B, Saglani S, Woodfolk JA. Developments in the field of allergy in 2017 through the eyes of Clinical and Experimental Allergy. Clin Exp Allergy 2019; 48:1606-1621. [PMID: 30489681 DOI: 10.1111/cea.13318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this article, we described the development in the field of allergy as described by Clinical and Experimental Allergy in 2017. Experimental models of allergic disease, basic mechanisms, clinical mechanisms, allergens, asthma and rhinitis and clinical allergy are all covered.
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Affiliation(s)
- G Roberts
- Faculty of Medicine, Clinical and Experimental Sciences and Human Development and Health, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
| | - C Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - R Boyle
- Department of Paediatrics, Imperial College London, London, UK
| | - J Crane
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - S P Hogan
- Mary H Weiser Food Allergy Center, Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - B Marsland
- Department of Immunology and Pathology, Monash University, Melbourne, Victoria, Australia
| | - S Saglani
- National Heart & Lung Institute, Imperial College London, London, UK
| | - J A Woodfolk
- Division of Asthma, Allergy and Immunology, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
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42
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Associations between Neighborhood Walkability and Incident and Ongoing Asthma in Children. Ann Am Thorac Soc 2019; 15:728-734. [PMID: 29664674 DOI: 10.1513/annalsats.201708-693oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
RATIONALE Childhood asthma has shown variable associations with children's physical activity. Neighborhood walkability captures community features that promote walking and is protective against some chronic conditions, such as obesity and diabetes. OBJECTIVES We evaluated associations between home neighborhood walkability and incident and ongoing childhood asthma. METHODS In this population-based cohort study, we used prospectively collected administrative healthcare data for the Province of Ontario housed at the Institute for Clinical Evaluative Sciences. We followed an administrative data cohort of 326,383 Toronto children born between 1997 and 2003, inclusive, until ages 8-15 years. Home neighborhood walkability quintile was measured using a validated walkability index with four dimensions: population density, dwelling density, access to retail and services, and street connectivity. Incident asthma was defined by time of entry into the validated Ontario Asthma Surveillance Information System database, which requires two outpatient visits for asthma within two consecutive years or any hospitalization for asthma and follows children with asthma longitudinally starting at any age. Associations between walkability and incident asthma were examined using Cox proportional hazards models. Associations between ongoing asthma and walkability in each year of life were examined using generalized linear mixed models. RESULTS Twenty-one percent of children (n = 69,628) developed incident asthma and were followed longitudinally in the Ontario Asthma Surveillance Information System database. Low birth home neighborhood walkability was associated with an increased incidence of asthma (hazard ratio, 1.11; 95% confidence interval, 1.08-1.14). Among children with asthma, low walkability in a given year of a child`s life was associated with greater odds of ongoing asthma in the same year (odds ratio, 1.12; 95% confidence interval, 1.09-1.14). CONCLUSIONS Children living in neighborhoods with low walkability were at increased risk of incident and ongoing asthma. Neighborhood walkability improvement, such as by adding pedestrian paths to improve street connectivity, offers potential strategies to contribute to primary asthma prevention.
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43
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Klös M, Thürmann L, Bauer M, Heinrich J, Standl M, von Berg A, Schaaf B, Weichenhan D, Mücke O, Plass C, Röder S, Herberth G, Sack U, Borte M, Stangl GI, Eils R, Trump S, Lehmann I. Longitudinal trends of serum IgE and IL5RA expression throughout childhood are associated with asthma but not with persistent wheeze. Allergy 2019; 74:2002-2006. [PMID: 31012487 DOI: 10.1111/all.13837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/11/2019] [Accepted: 03/21/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Matthias Klös
- Molecular Epidemiology Unit Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, associated partner of the German Center for Lung Research (DZL) Berlin Germany
- Department of Environmental Immunology Helmholtz Centre for EnvironmentalResearch – UFZ Leipzig Germany
| | - Loreen Thürmann
- Molecular Epidemiology Unit Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, associated partner of the German Center for Lung Research (DZL) Berlin Germany
- Department of Environmental Immunology Helmholtz Centre for EnvironmentalResearch – UFZ Leipzig Germany
| | - Mario Bauer
- Department of Environmental Immunology Helmholtz Centre for EnvironmentalResearch – UFZ Leipzig Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine University HospitalLMU Munich Germany
- Institute of Epidemiology Helmholtz Zentrum München ‐ German ResearchCenter for Environmental Health Neuherberg Germany
| | - Marie Standl
- Institute of Epidemiology Helmholtz Zentrum München ‐ German ResearchCenter for Environmental Health Neuherberg Germany
| | - Andrea von Berg
- Department of Pediatrics Research Institute Marien‐Hospital Wesel Wesel Germany
| | - Beate Schaaf
- Pediatric Outpatient Department Bad Honnef Germany
| | - Dieter Weichenhan
- Division of Cancer Epigenomics German Cancer Research Center (DKFZ)Heidelberg Germany
| | - Oliver Mücke
- Division of Cancer Epigenomics German Cancer Research Center (DKFZ)Heidelberg Germany
| | - Christoph Plass
- Division of Cancer Epigenomics German Cancer Research Center (DKFZ)Heidelberg Germany
| | - Stefan Röder
- Department of Environmental Immunology Helmholtz Centre for EnvironmentalResearch – UFZ Leipzig Germany
| | - Gunda Herberth
- Department of Environmental Immunology Helmholtz Centre for EnvironmentalResearch – UFZ Leipzig Germany
| | - Ulrich Sack
- Medical Faculty Institute for Clinical Immunology University of Leipzig Leipzig Germany
| | - Michael Borte
- Children's HospitalMunicipal Hospital “St. Georg” Leipzig Germany
| | - Gabriele I. Stangl
- Institute of Agricultural and Nutritional Sciences Martin Luther University Halle‐Wittenberg Halle Germany
| | - Roland Eils
- Center for Digital Health Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, associated partner of the German Center for Lung Research (DZL) Berlin Germany
- Heidelberg University HospitalHealth Data Science Unit Heidelberg Germany
| | - Saskia Trump
- Molecular Epidemiology Unit Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, associated partner of the German Center for Lung Research (DZL) Berlin Germany
- Department of Environmental Immunology Helmholtz Centre for EnvironmentalResearch – UFZ Leipzig Germany
| | - Irina Lehmann
- Molecular Epidemiology Unit Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, associated partner of the German Center for Lung Research (DZL) Berlin Germany
- Department of Environmental Immunology Helmholtz Centre for EnvironmentalResearch – UFZ Leipzig Germany
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44
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Roberts G. Welcome to 2018. Clin Exp Allergy 2019; 48:4-5. [PMID: 29283222 DOI: 10.1111/cea.13073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- G Roberts
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
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45
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Huang X, Mu X, Deng L, Fu A, Pu E, Tang T, Kong X. The etiologic origins for chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2019; 14:1139-1158. [PMID: 31213794 PMCID: PMC6549659 DOI: 10.2147/copd.s203215] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/18/2019] [Indexed: 12/27/2022] Open
Abstract
COPD, characterized by long-term poorly irreversible airway limitation and persistent respiratory symptoms, has resulted in enormous challenges to human health worldwide, with increasing rates of prevalence, death, and disability. Although its origin was thought to be in the interactions of genetic with environmental factors, the effects of environmental factors on the disease during different life stages remain little known. Without clear mechanisms and radical cure for it, early screening and prevention of COPD seem to be important. In this review, we will discuss the etiologic origins for poor lung function and COPD caused by specific adverse effects during corresponding life stages, as well as try to find new insights and potential prevention strategies for this disease.
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Affiliation(s)
- Xinwei Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China.,Medical School, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
| | - Xi Mu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
| | - Li Deng
- The Pathology Department, First People's Hospital of Yunnan Province, Kunming City, Yunnan Province, People's Republic of China
| | - Aili Fu
- Department of Oncology, Yunfeng Hospital, Xuanwei City, Yunnan Province, People's Republic of China
| | - Endong Pu
- Department of Thoracic Surgery, Yunfeng Hospital, Xuanwei City, Yunnan Province, People's Republic of China
| | - Tao Tang
- Medical School, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
| | - Xiangyang Kong
- Medical School, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
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Shah SP, Grunwell J, Shih J, Stephenson S, Fitzpatrick AM. Exploring the Utility of Noninvasive Type 2 Inflammatory Markers for Prediction of Severe Asthma Exacerbations in Children and Adolescents. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:2624-2633.e2. [PMID: 31100552 DOI: 10.1016/j.jaip.2019.04.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Noninvasive markers of type 2 inflammation are needed to identify children and adolescents who might benefit from personalized biologic therapy. OBJECTIVE We hypothesized that blood eosinophil counts would predict 1 or more acute visits for asthma and that prediction could be improved with the addition of a second, noninvasive type 2 inflammatory biomarker. METHODS Children and adolescents 5 to 21 years (N = 589) with an asthma exacerbation necessitating systemic corticosteroid treatment in the previous year completed a characterization visit and telephone calls at 6 and 12 months. The primary outcome was an acute visit for asthma with receipt of systemic corticosteroids. Acute visits were verified by medical record review. Exploratory outcomes included time to first acute visit and hospitalization. RESULTS Acute visits occurred in 106 (35.5%) children and 72 (24.8%) adolescents. Elevated blood eosinophils were associated with increased odds and shorter time to first acute visit, but optimal cut-points differed by age (≥150 vs ≥300 cells/μL for children vs adolescents, respectively). The addition of a second marker of type 2 inflammation did not improve prediction in children, but increased the odds and hazard of an acute visit up to 16.2% and 11.9%, respectively, in adolescents. Similar trends were noted for hospitalizations. CONCLUSIONS Blood eosinophils and other noninvasive markers of type 2 inflammation may be useful in the clinical assessment of children and adolescents with asthma. However, features of type 2 inflammation vary by age. Whether children and adolescents also respond differently to management of type 2 inflammation is unclear and warrants further evaluation.
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Affiliation(s)
- Samar P Shah
- Department of Pediatrics, Emory University, Atlanta, Ga; Center for Cystic Fibrosis and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Ga
| | - Jocelyn Grunwell
- Department of Pediatrics, Emory University, Atlanta, Ga; Center for Cystic Fibrosis and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Ga
| | - Jennifer Shih
- Department of Pediatrics, Emory University, Atlanta, Ga; Center for Cystic Fibrosis and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Ga
| | | | - Anne M Fitzpatrick
- Department of Pediatrics, Emory University, Atlanta, Ga; Center for Cystic Fibrosis and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Ga.
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47
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Oksel C, Granell R, Mahmoud O, Custovic A, Henderson AJ. Causes of variability in latent phenotypes of childhood wheeze. J Allergy Clin Immunol 2019; 143:1783-1790.e11. [PMID: 30528616 PMCID: PMC6505513 DOI: 10.1016/j.jaci.2018.10.059] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/29/2018] [Accepted: 10/12/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Latent class analysis (LCA) has been used extensively to identify (latent) phenotypes of childhood wheezing. However, the number and trajectory of discovered phenotypes differed substantially between studies. OBJECTIVE We sought to investigate sources of variability affecting the classification of phenotypes, identify key time points for data collection to understand wheeze heterogeneity, and ascertain the association of childhood wheeze phenotypes with asthma and lung function in adulthood. METHODS We used LCA to derive wheeze phenotypes among 3167 participants in the ALSPAC cohort who had complete information on current wheeze recorded at 14 time points from birth to age 16½ years. We examined the effects of sample size and data collection age and intervals on the results and identified time points. We examined the associations of derived phenotypes with asthma and lung function at age 23 to 24 years. RESULTS A relatively large sample size (>2000) underestimated the number of phenotypes under some conditions (eg, number of time points <11). Increasing the number of data points resulted in an increase in the optimal number of phenotypes, but an identical number of randomly selected follow-up points led to different solutions. A variable selection algorithm identified 8 informative time points (months 18, 42, 57, 81, 91, 140, 157, and 166). The proportion of asthmatic patients at age 23 to 24 years differed between phenotypes, whereas lung function was lower among persistent wheezers. CONCLUSIONS Sample size, frequency, and timing of data collection have a major influence on the number and type of wheeze phenotypes identified by using LCA in longitudinal data.
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Affiliation(s)
- Ceyda Oksel
- Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom
| | - Raquel Granell
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Osama Mahmoud
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Adnan Custovic
- Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom.
| | - A John Henderson
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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48
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Mensink-Bout SM, van Meel ER, de Jongste JC, Voortman T, Reiss IK, De Jong NW, Jaddoe VWV, Duijts L. Maternal and neonatal 25-hydroxyvitamin D concentrations and school-age lung function, asthma and allergy. The Generation R Study. Clin Exp Allergy 2019; 49:900-910. [PMID: 30866115 PMCID: PMC6850458 DOI: 10.1111/cea.13384] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/29/2019] [Accepted: 02/25/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Vitamin D deficiency in early life might affect the developing lung and immune system, and subsequently influence the risk of asthma and allergy in later life. OBJECTIVE We examined the associations of 25-hydroxyvitamin D concentrations in mid-gestation and at birth with lung function, asthma, inhalant allergic sensitization and inhalant allergy at school-age. METHODS This study among 4951 children and their mothers was embedded in a population-based prospective cohort in Rotterdam, the Netherlands. Maternal venous blood samples in mid-gestation and umbilical cord blood samples at birth were used to determine 25-hydroxyvitamin D concentrations. At age 10 years, lung function was measured by spirometry, current asthma and physician-diagnosed inhalant allergy by questionnaire, and inhalant allergic sensitization by skin prick tests. We used multivariable regression models to examine associations. RESULTS Higher 25-hydroxyvitamin D concentrations in mid-gestation were associated with a higher forced vital capacity (FVC), but a lower forced expiratory volume in 1 second/FVC (FEV1 /FVC) and a lower forced expiratory flow after exhaling 75% of FVC (FEF75 ) (Z-score differences [95% CI] 0.02 [0.00, 0.03], -0.02 [-0.03, -0.01] and -0.01 [-0.03, -0.00], respectively, per 10 nmol/L 25-hydroxyvitamin D), but not with asthma. Furthermore, higher 25-hydroxyvitamin D concentrations in mid-gestation were associated with an increased risk of inhalant allergy (Odds Ratio [95% CI] 1.07 [1.02, 1.12]), but not with inhalant allergic sensitization. After additional adjustment for child's 25-hydroxyvitamin D concentrations at the age of 6 years, only the associations of 25-hydroxyvitamin D concentrations in mid-gestation with FEV1 /FVC and FEF75 remained. We did not find consistent associations of 25-hydroxyvitamin D concentrations at birth with respiratory or allergy outcomes. CONCLUSION AND CLINICAL RELEVANCE Our results suggest that maternal 25-hydroxyvitamin D concentrations in mid-gestation may influence lung development. The clinical implications of the observed associations remain unclear.
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Affiliation(s)
- Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Evelien R van Meel
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Johan C de Jongste
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Irwin K Reiss
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Nicolette W De Jong
- Department of Internal Medicine, Division of Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Machluf Y, Farkash R, Rotkopf R, Fink D, Chaiter Y. Asthma phenotypes and associated comorbidities in a large cohort of adolescents in Israel. J Asthma 2019; 57:722-735. [PMID: 31017024 DOI: 10.1080/02770903.2019.1604743] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objectives: Asthma is a multifactorial, heterogeneous, complex and common chronic respiratory disease driven by diverse mechanisms. Although asthma presents various clinical forms with different levels of severity, it is unclear whether asthma severities are a consequence of disease management or varied etiologies. We sought to investigate this question.Methods: This article presents a cross-sectional study of 113,671 Israeli adolescents. Univariate and multivariable logistic regression models were performed to analyze the independent associations between mild asthma and moderate-to-severe asthma phenotypes and coexistent medical conditions within each gender separately. Hierarchical clustering of the odds ratios of the diverse statistically significant medical conditions associated with asthma severity-gender groups was also performed. We focused on the allergic and neurological-cognitive-mental disorders.Results: Among males, two associations were common to both asthma groups (atopic dermatitis and allergic rhinitis), five unique to mild asthma (urticaria/angioedema, Hymenoptera/bee allergies, allergic conjunctivitis, epilepsy and migraine) and two unique to moderate-to-severe asthma (learning disabilities and ADD/ADHD (Attention-deficit disorder/Attention-deficit/hyperactivity disorder)). Among females, two associations were common to both clinical asthma groups (allergic rhinitis and urticaria/angioedema), and five unique to moderate-to-severe asthma (atopic dermatitis, learning disabilities, ADD/ADHD, anxiety/mood disorders and migraine). Allergic rhinitis was the only condition to be associated with all four groups. Learning disabilities and ADD/ADHD were only associated with moderate-to-severe asthma (but not with mild asthma), in both males and females. Hierarchical clustering analysis uncovered two prominent clusters, separating mild from moderate-to-severe asthma.Conclusions: The differences between mild and moderate-to-severe asthma enhance asthma phenotype characterization, with respect to comorbidities, and indicate varied etiologies.
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Affiliation(s)
- Yossy Machluf
- Medical Corps, IDF, Israel.,Shamir Research Institute, University of Haifa, Kazerin, Israel
| | | | - Ron Rotkopf
- Department of Life Sciences Core Facilities, Faculty of Biochemistry, Weizmann Institute of Science, Rehovot, Israel
| | - Daniel Fink
- Shaarei Zedek Medical Center, Jerusalem, Israel
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50
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Thorsteinsdottir F, Maslova E, Jacobsen R, Frederiksen P, Keller A, Backer V, Heitmann BL. Exposure to Vitamin D Fortification Policy in Prenatal Life and the Risk of Childhood Asthma: Results From the D-Tect Study. Nutrients 2019; 11:nu11040924. [PMID: 31022976 PMCID: PMC6521227 DOI: 10.3390/nu11040924] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/12/2019] [Accepted: 04/18/2019] [Indexed: 01/31/2023] Open
Abstract
Prenatal vitamin D insufficiency may be associated with an increased risk of developing childhood asthma. Results from epidemiological studies are conflicting and limited by short follow-up and small sample sizes. The objective of this study was to examine if children born to women exposed to the margarine fortification policy with a small dose of extra vitamin D during pregnancy had a reduced risk of developing asthma until age 9 years, compared to children born to unexposed women. The termination of a Danish mandatory vitamin D fortification policy constituted the basis for the study design. We compared the risk of inpatient asthma diagnoses in all Danish children born two years before (n = 106,347, exposed) and two years after (n = 115,900, unexposed) the termination of the policy. The children were followed in the register from 0–9 years of age. Data were analyzed using Cox proportional hazards regression. The Hazard Ratio for the first inpatient asthma admission among exposed versus unexposed children was 0.96 (95%CI: 0.90–1.04). When stratifying by sex and age, 0–3 years old boys exposed to vitamin D fortification showed a lower asthma risk compared to unexposed boys (HR 0.78, 95%CI: 0.67–0.92). Prenatal exposure to margarine fortification policy with extra vitamin D did not affect the overall risk of developing asthma among children aged 0–9 years but seemed to reduce the risk among 0–3 years old boys. Taking aside study design limitations, this could be explained by different sensitivity to vitamin D from different sex-related asthma phenotypes in children with early onset, and sex differences in lung development or immune responses.
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Affiliation(s)
- Fanney Thorsteinsdottir
- Fanney Thorsteinsdottir, Research Unit for Dietary Studies, The Parker Institute, Bisbebjerg og Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
| | - Ekaterina Maslova
- Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK.
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, 2300 Copenhagen, Denmark.
| | - Ramune Jacobsen
- Fanney Thorsteinsdottir, Research Unit for Dietary Studies, The Parker Institute, Bisbebjerg og Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
- Department of Pharmacy, University of Copenhagen, 2100 Copenhagen, Denmark.
| | - Peder Frederiksen
- Fanney Thorsteinsdottir, Research Unit for Dietary Studies, The Parker Institute, Bisbebjerg og Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
| | - Amélie Keller
- Fanney Thorsteinsdottir, Research Unit for Dietary Studies, The Parker Institute, Bisbebjerg og Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
| | - Vibeke Backer
- Department of Respiratory Medicine, Bispebjerg University Hospital, 2400 Copenhagen, Denmark.
| | - Berit Lilienthal Heitmann
- Fanney Thorsteinsdottir, Research Unit for Dietary Studies, The Parker Institute, Bisbebjerg og Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, NSW 2006, Australia.
- The Department of Public Health, Section for General Practice, University of Copenhagen, 2100 Copenhagen, Denmark.
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