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Luukkonen J, Moustgaard H, Martikainen P, Remes H. Does having siblings really protect against childhood atopic diseases? A total population and within-family analysis. Eur J Epidemiol 2024; 39:289-298. [PMID: 38316709 PMCID: PMC10995035 DOI: 10.1007/s10654-024-01104-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 01/20/2024] [Indexed: 02/07/2024]
Abstract
The association between having older siblings and decreased risk for atopic symptoms is well-established. This has been interpreted as evidence for the microbiota hypothesis, i.e. that increased early-childhood microbial exposure caused by siblings protects from immune hypersensitivities. However, possible confounders of the association have received little attention. We used register data on Finnish cohorts born in 1995-2004 (N = 559,077) to assess medication purchases for atopic diseases: antihistamines, eczema medication, asthma medication and Epinephrine. We modelled the probability of atopic medication purchases at ages 0-15 by birth order controlling for important observed confounders and all unobserved genetic and environmental characteristics shared by siblings in a within-family fixed effects model. We further studied medication purchases among first-borns according to the age difference with younger siblings to assess whether having younger siblings in early childhood is beneficial. Having older siblings was associated with a lower probability of atopic medication purchases. Compared to first-borns, the probability was 10-20% lower among second-borns, 20-40% lower among third-borns, and 30-70% lower among subsequent children, depending on medication type. Confounding accounted for up to 75% of these differences, particularly for asthma and eczema medication, but significant differences by birth order remained across all medication types. Among first-borns, a smaller age difference with younger siblings was related to a lower likelihood of atopic medication use. Our results, based on designs that account for unobserved confounding, show that exposure to siblings in early childhood, protects from atopic diseases, and thus strongly support the microbiota hypothesis.
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Affiliation(s)
- Juha Luukkonen
- Population Research Unit, University of Helsinki, Helsinki, Finland.
- Max Planck-University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland.
| | - Heta Moustgaard
- Population Research Unit, University of Helsinki, Helsinki, Finland.
- Max Planck-University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland.
- Helsinki Institute for Social Sciences and Humanities, University of Helsinki, Helsinki, Finland.
| | - Pekka Martikainen
- Population Research Unit, University of Helsinki, Helsinki, Finland
- Max Planck-University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Hanna Remes
- Population Research Unit, University of Helsinki, Helsinki, Finland
- Max Planck-University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland
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Lu MY, Shobnam N, Livinski AA, Saksena S, Salters D, Biete M, Myles IA. Examining allergy related diseases in Africa: A scoping review protocol. PLoS One 2024; 19:e0297949. [PMID: 38377144 PMCID: PMC10878524 DOI: 10.1371/journal.pone.0297949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/11/2024] [Indexed: 02/22/2024] Open
Abstract
During recent decades, allergy related diseases have emerged as a growing area of concern in developing regions of the world, including Africa. Worldwide prevalence of allergic diseases has grown to an estimated 262 million for asthma, 400 million for allergic rhinitis (or hay fever), 171 million with atopic dermatitis (or eczema), and over 200 million for food allergy. In Africa, considerable variability exists in the data surrounding prevalence at the continent-wide, regional, and study site levels. Furthermore, research conducted in many rural areas and underdeveloped countries in Africa remains limited, and presently, little has been done to characterize and map the extremely heterogeneous body of literature which confounds research efforts. This scoping review will seek to identify studies examining the prevalence, management strategies, outcomes, and associated risk factors for allergy related diseases in Africa. The Joanna Briggs Institute's scoping review methods will be followed, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR) was used for writing the protocol. Four databases (Embase, Global Health, PubMed, African Journals Online) will be searched for literature published from 2003 to 2023 in any language. Title and abstract screening and full-text screening will be completed by two independent reviewers using Covidence; conflicts resolved by a third reviewer. Data will be extracted using Covidence by two reviewers independently. To report the results, we will follow the PRISMA-ScR checklist and report descriptive statistics and a narrative summary.
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Affiliation(s)
- Max Yang Lu
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Nadia Shobnam
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Alicia A. Livinski
- National Institutes of Health Library, Office of Research Services, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Sarini Saksena
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Dylan Salters
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Michelle Biete
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Ian A. Myles
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
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Lee E, Lee SY, Kim HB, Yang SI, Yoon J, Suh DI, Oh HY, Ahn K, Kim KW, Shin YH, Hong SJ. Insights from the COCOA birth cohort: The origins of childhood allergic diseases and future perspectives. Allergol Int 2024; 73:3-12. [PMID: 37752021 DOI: 10.1016/j.alit.2023.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023] Open
Abstract
The ongoing COhort for Childhood Origin of Asthma and allergic diseases (COCOA) study is a prospective birth cohort investigating the origin and natural courses of childhood allergic diseases, including atopic dermatitis, food allergy, allergic rhinitis and asthma, with long-term prognosis. Initiated under the premise that allergic diseases result from a complex interplay of immune development alterations, environmental exposures, and host susceptibility, the COCOA study explores these dynamic interactions during prenatal and postnatal periods, framed within the hygiene and microbial hypotheses alongside the developmental origins of health and disease (DOHaD) hypothesis. The scope of the COCOA study extends to genetic predispositions, indoor and outdoor environmental variables affecting mothers and their offsprings such as outdoor and indoor air pollution, psychological factors, diets, and the microbiomes of skin, gut, and airway. We have embarked on in-depth investigations of diverse risk factors and the pathophysiological underpinnings of allergic diseases. By employing multi-omics approaches-proteomics, transcriptomics, and metabolomics-we gain deeper insights into the distinct pathophysiological processes across various endotypes of childhood allergic diseases, incorporating the exposome using extensive resources within the COCOA study. Integration with large-scale datasets, such as national health insurance records, enhances robustness and mitigates potential limitations inherent to birth cohort studies. As part of global networks focused on childhood allergic diseases, the COCOA study fosters collaborative research across multiple cohorts. The findings from the COCOA study are instrumental in informing precision medicine strategies for childhood allergic diseases, underpinning the establishment of disease trajectories.
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Affiliation(s)
- Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Song-I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Jisun Yoon
- Department of Pediatrics, Chung-Ang University College of Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Hea Young Oh
- Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyung Won Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Youn Ho Shin
- Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, South Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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Jacobs A, Wu R, Tomini F, De Simoni A, Mihaylova B. Strong and graded associations between level of asthma severity and all-cause hospital care use and costs in the UK. BMJ Open Respir Res 2023; 10:e002003. [PMID: 38101812 PMCID: PMC10729223 DOI: 10.1136/bmjresp-2023-002003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Hospital admissions account for a large share of the healthcare costs incurred by people with asthma. We assessed the hospital care use and costs associated with asthma severity using the UK Biobank cohort and linked healthcare data. METHODS Adult participants with asthma at recruitment were classified using their prescription data into mild and moderate-to-severe asthma and matched separately to asthma-free controls by age, sex, ethnicity and location. The associations of asthma, by severity, with the annual number of all-cause hospital admissions, days spent in hospital and hospital costs were estimated over a 10-year follow-up period using three specifications of negative binomial regression models that differed according to the sociodemographic and clinical characteristics adjusted for. RESULTS Of the 25 031 participants with active asthma, 80% had mild asthma and 20% had moderate-to-severe asthma. Compared with participants with mild asthma, those with moderate-to-severe asthma were on average 2.7 years older, more likely to be current (13.7% vs 10.4%) or previous (40.2% vs 35.2%) smokers, to have a higher body mass index (BMI), and to be suffering from a variety of comorbid diseases. Following adjustments for age, sex, ethnicity and location, people with mild asthma experienced on average 36% more admissions (95% CI 28% to 40%), 43% more days in hospital (95% CI 35% to 51%) and 36% higher hospital costs (95% CI 31% to 41%) annually than asthma-free individuals, while people with moderate-to-severe asthma experienced excesses of 93% (95% CI 81% to 107%), 142% (95% CI 124% to 162%) and 98% (95% CI 88% to 108%), respectively. Further adjustments for socioeconomic deprivation, smoking status, BMI and comorbidities resulted in smaller though still highly significant positive associations, graded by severity, between asthma and hospital use and costs. CONCLUSIONS Strong graded associations are reported between asthma severity and the extent of hospital use and costs in the UK. These findings could inform future assessments of the value of asthma management interventions.
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Affiliation(s)
- Anya Jacobs
- Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Asthma UK Centre for Applied Research, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Runguo Wu
- Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Florian Tomini
- Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Asthma UK Centre for Applied Research, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Anna De Simoni
- Asthma UK Centre for Applied Research, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Borislava Mihaylova
- Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Asthma UK Centre for Applied Research, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Lee Y, Lee S, Park S, Kang SK, Lee JH, Lee DW, Choi WJ, Lee W. The relationship between exposure to environmental noise and risk of atopic dermatitis, asthma, and allergic rhinitis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 268:115677. [PMID: 37979362 DOI: 10.1016/j.ecoenv.2023.115677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Noise is defined as unwanted sound. It may induce negative emotions and mental health problems and may even lead to increased suicide risk. However, the impact of noise exposure on environmental diseases and disease severity is not well understood. This study aimed to elucidate the association between night-time noise exposure and the prevalence of environmental diseases in South Korea. METHODS We conducted an analysis of the Environmental Disease Database provide by the National Health Insurance Service (NHIS) from 2013 to 2017. After spatially interpolating the noise data provided by the National Noise Information System (NNIS), night-time noise values in the district level were obtained by calculating the mean noise values at the administrative district level. The linear regression analyses were performed to test the association between the age-standardized prevalence ratio (SPR) and the night-time noise exposure in the district level. RESULTS In areas with high night-time noise exposure (≥55 dB), the SPR for atopic dermatitis and allergic rhinitis were 1.0515 (95 % confidence interval [CI]:1.0508-1.0521) and 1.0202 (95 % CI:1.0201-1.0204), respectively, which were higher than those in the general population. The SPR for environmental diseases, including atopic dermatitis, asthma, and allergic rhinitis, was 1.0104 (95 % CI:1.0103-1.0105). Additionally, a significant linear association was observed between the level of nocturnal noise exposure and the total hospitalization period for atopic dermatitis (β = 399.3, p < 0.01). CONCLUSION We provide evidence of a significant association between night-time environmental noise and environmental diseases, particularly atopic dermatitis and allergic rhinitis. Furthermore, we observed a significant linear association between night-time noise exposure and the severity of atopic dermatitis.
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Affiliation(s)
- Yongho Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Republic of Korea
| | - Seunghyun Lee
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Seula Park
- Department of Civil and Environmental Engineering, Seoul National University, Seoul, Republic of Korea
| | - Seong-Kyu Kang
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Republic of Korea; Department of Occupational and Environmental Medicine, Gachon University College of Medicine, Incheon, Republic of Korea
| | - June-Hee Lee
- Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - Dong-Wook Lee
- Department of Occupational and Environmental Medicine, Inha University Hospital, Inha University, Incheon, Republic of Korea
| | - Won-Jun Choi
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Republic of Korea; Department of Occupational and Environmental Medicine, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Wanhyung Lee
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
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Huang AA, Huang SY. Use of feature importance statistics to accurately predict asthma attacks using machine learning: A cross-sectional cohort study of the US population. PLoS One 2023; 18:e0288903. [PMID: 37992024 PMCID: PMC10664888 DOI: 10.1371/journal.pone.0288903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/05/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Asthma attacks are a major cause of morbidity and mortality in vulnerable populations, and identification of associations with asthma attacks is necessary to improve public awareness and the timely delivery of medical interventions. OBJECTIVE The study aimed to identify feature importance of factors associated with asthma in a representative population of US adults. METHODS A cross-sectional analysis was conducted using a modern, nationally representative cohort, the National Health and Nutrition Examination Surveys (NHANES 2017-2020). All adult patients greater than 18 years of age (total of 7,922 individuals) with information on asthma attacks were included in the study. Univariable regression was used to identify significant nutritional covariates to be included in a machine learning model and feature importance was reported. The acquisition and analysis of the data were authorized by the National Center for Health Statistics Ethics Review Board. RESULTS 7,922 patients met the inclusion criteria in this study. The machine learning model had 55 out of a total of 680 features that were found to be significant on univariate analysis (P<0.0001 used). In the XGBoost model the model had an Area Under the Receiver Operator Characteristic Curve (AUROC) = 0.737, Sensitivity = 0.960, NPV = 0.967. The top five highest ranked features by gain, a measure of the percentage contribution of the covariate to the overall model prediction, were Octanoic Acid intake as a Saturated Fatty Acid (SFA) (gm) (Gain = 8.8%), Eosinophil percent (Gain = 7.9%), BMXHIP-Hip Circumference (cm) (Gain = 7.2%), BMXHT-standing height (cm) (Gain = 6.2%) and HS C-Reactive Protein (mg/L) (Gain 6.1%). CONCLUSION Machine Learning models can additionally offer feature importance and additional statistics to help identify associations with asthma attacks.
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Affiliation(s)
- Alexander A. Huang
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Samuel Y. Huang
- Virginia Commonwealth University School of Medicine, Richmond, VA, United States of America
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Chu LM, Rennie DC, Kirychuk S, Cockcroft D, Gordon JR, Pickett W, Dosman J, Lawson JA. Farm Exposures and Allergic Disease Among Children Living in a Rural Setting. J Agromedicine 2023; 28:676-688. [PMID: 37038656 DOI: 10.1080/1059924x.2023.2200427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
OBJECTIVES The purpose of this study was to examine the association between farm exposures and asthma and allergic disease in children while also highlighting the experiences of non-farm rural children. METHODS This was a cross-sectional analysis of data collected from across the province of Saskatchewan, Canada in 2014. Surveys were completed by parents of 2275 rural dwelling children (farm and non-farm) aged 0 to 17 years within 46 rural schools. Questionnaires were distributed through schools for parents to complete. RESULTS Asthma prevalence was 7.6%, of which 29.5% of cases were allergic. After adjustment for potential confounders, home location (farm vs non-farm) and other farm exposures were not associated with asthma and asthma phenotypes. Those who completed farm safety education were more likely to have asthma (11.7% vs. 6.7%; p = .001) compared to children without asthma. In sub-analyses among 6-12-year-old children, boys were more likely to have asthma (non-allergic) and use short-acting beta-agonists compared to girls. Doing farm work in the summer was associated with an increased risk of asthma [adjusted OR (aOR) = 1.71 (1.02-2.88); p = .041]. Doing routine chores with large animals was associated with an increased risk of asthma [aOR = 1.83 (1.07-3.15); p = .027] and allergic asthma [aOR = 2.37 (95%CI = 1.04-5.40); p = .04]. CONCLUSION The present study showed that the prevalence of asthma and asthma phenotypes were similar between farm and non-farm rural children. There did not appear to be differential involvement in farming activities between those with and without asthma although those with asthma had more training suggesting possible attempts to mitigate harm from farm exposures.
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Affiliation(s)
- L M Chu
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - D C Rennie
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - S Kirychuk
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - D Cockcroft
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - J R Gordon
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - W Pickett
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - J Dosman
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - J A Lawson
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Chakaya J, Mecha J, Beekman M. Over-prescription of short-acting β 2-agonists remains a serious health concern in Kenya: results from the SABINA III study. BMC PRIMARY CARE 2023; 24:141. [PMID: 37422638 PMCID: PMC10329295 DOI: 10.1186/s12875-023-02030-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 03/09/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Despite a high asthma burden in Kenya, insights into asthma management practices, including prescription of short-acting β2-agonists (SABAs), are lacking. Therefore, this study describes patient demographics, disease characteristics, and asthma treatment patterns in the Kenyan cohort of the SABA use IN Asthma (SABINA) III study. METHODS Patients with asthma (aged ≥ 12 years) with medical records containing data for ≥ 12 months prior to the study visit from 19 sites across Kenya were included in this cross-sectional study and classified by investigator-defined asthma severity (guided by the 2017 Global Initiative for Asthma [GINA] recommendations) and practice type (primary/specialist care). Data on severe exacerbation history, prescribed asthma treatments, and over-the-counter (OTC) SABA purchases in the 12 months before the study visit and asthma symptom control at the time of the study visit were collated using electronic case report forms. All analyses were descriptive in nature. RESULTS Overall, 405 patients were analyzed (mean age, 44.4 years; female, 68.9%), of whom 54.8% and 45.2% were enrolled by primary care clinicians and specialists, respectively. Most patients were classified with mild asthma (76.0%, GINA treatment steps 1-2) and were overweight or obese (57.0%). Only 19.5% of patients reported full healthcare reimbursement, with 59% receiving no healthcare reimbursement. The mean asthma duration of patients was 13.5 years. Asthma was partly controlled/uncontrolled in 78.0% of patients, with 61.5% experiencing ≥ 1 severe exacerbation in the preceding 12 months. Crucially, 71.9% of patients were prescribed ≥ 3 SABA canisters, defined as over-prescription; 34.8% were prescribed ≥ 10 SABA canisters. Additionally, 38.8% of patients purchased SABA OTC, of whom 66.2% purchased ≥ 3 SABA canisters. Among patients with both SABA purchases and prescriptions, 95.5% and 57.1% had prescriptions for ≥ 3 and ≥ 10 SABA canisters, respectively. Inhaled corticosteroids (ICS), ICS with a long-acting β2-agonist fixed-dose combination, and oral corticosteroid bursts were prescribed to 58.8%, 24.7%, and 22.7% of patients, respectively. CONCLUSIONS SABA over-prescription occurred in almost three-quarters of patients, with over one-third of patients purchasing SABA OTC. Therefore, SABA over-prescription is a major public health concern in Kenya, underscoring an urgent need to align clinical practices with latest evidence-based recommendations.
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Affiliation(s)
- Jeremiah Chakaya
- Department of Medicine, Therapeutics, Dermatology and Psychiatry, Kenyatta University, Nairobi, Kenya.
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
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Herrin MA, Sherris AR, Dearborn LC, Loftus CT, Szpiro AA, Moore PE, Adgent MA, Barrett ES, Nguyen RHN, Carroll KN, Karr CJ. Association between maternal occupational exposure to cleaning chemicals during pregnancy and childhood wheeze and asthma. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1166174. [PMID: 38045485 PMCID: PMC10691794 DOI: 10.3389/fepid.2023.1166174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background Asthma is a leading cause of childhood morbidity in the U.S. and a significant public health concern. The prenatal period is a critical window during which environmental influences, including maternal occupational exposures, can shape child respiratory health. Cleaning chemicals are commonly encountered in occupational settings, yet few studies have examined the potential link between prenatal occupational exposures to cleaning chemicals and risk of childhood wheeze and asthma. Methods We evaluated the potential influence of maternal occupational exposure to cleaning chemicals during pregnancy on pediatric asthma and wheeze at child age 4-6 years in 453 mother-child pairs from two longitudinal pregnancy cohorts, TIDES and GAPPS, part of the ECHO prenatal and early childhood pathways to health (ECHO-PATHWAYS) consortium. Maternal occupational exposure to cleaning chemicals was defined based on reported occupation and frequency of occupational use of chemicals during pregnancy. Child current wheeze and asthma outcomes were defined by parental responses to a widely-used, standardized respiratory outcomes questionnaire administered at child age 4-6 years. Multivariable Poisson regression with robust standard errors was used to estimate relative risk (RR) of asthma in models adjusted for confounding. Effect modification by child sex was assessed using product interaction terms. Results Overall, 116 mothers (25.6%) reported occupational exposure to cleaning chemicals during pregnancy, 11.7% of children had current wheeze, and 10.2% had current asthma. We did not identify associations between prenatal exposure to cleaning chemicals and current wheeze [RRadjusted 1.03, 95% confidence interval (CI): 0.56, 1.90] or current asthma (RRadjusted 0.89, CI: 0.46, 1.74) in the overall sample. Analyses of effect modification suggested an adverse association among females for current wheeze (RR 1.82, CI: 0.76, 4.37), compared to males (RR 0.68, CI: 0.29, 1.58), though the interaction p-value was >0.05. Conclusion We did not observe evidence of associations between maternal prenatal occupational exposure to cleaning chemicals and childhood wheeze or asthma in the multi-site ECHO-PATHWAYS consortium. We leveraged longitudinal U.S. pregnancy cohorts with rich data characterization to expand on limited and mixed literature. Ongoing research is needed to more precisely characterize maternal occupational chemical exposures and impacts on child health in larger studies.
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Affiliation(s)
- Melissa A Herrin
- Department of Medicine, School of Medicine, University of Washington, Seattle, WA, United States
| | - Allison R Sherris
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Logan C Dearborn
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, United States
| | - Paul E Moore
- Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Ruby H N Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Kecia N Carroll
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, United States
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States
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Gutierrez-Albaladejo N, Jimenez-Garcia R, Albaladejo-Vicente R, Villanueva-Orbaiz R, de-Miguel-Diez J, Noriega C, Lopez-de-Andres A. Trends in hospital admissions among children with asthma in Spain (2011-2020). Eur J Pediatr 2023; 182:2409-2419. [PMID: 36917291 PMCID: PMC10011755 DOI: 10.1007/s00431-023-04873-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 01/24/2023] [Accepted: 02/08/2023] [Indexed: 03/16/2023]
Abstract
The purpose of this study is to describe and assess changes in incidence, clinical conditions, use of mechanical ventilation, length of hospital stay (LOHS), and in-hospital mortality (IHM) among children hospitalized with asthma in Spain from 2011 to 2020. We analyzed children aged 0 to 15 years hospitalized with an ICD code for asthma included in the Spanish National Hospital Discharge Database (SNHDD). The analysis was conducted for asthma as the primary diagnosis and with asthma in any diagnosis position. Joinpoint regression was used to assess time trends in incidence. We included a total of 85,664 children hospitalized with asthma; of these, 46,727 (54.55%) had asthma coded as the primary diagnosis. The number of boys was higher than the number of girls, irrespective of age group or diagnostic position. The frequency of asthma as primary diagnosis decreased from 55.7% in 2011 to 43.96% in 2020 (p < 0.001). The incidence of hospitalizations because of asthma decreased significantly from 2011 to 2020, with a faster decrease from 2018 onwards. Over time, the proportion of older children increased. In the year 2020, only 55 children had codes for asthma and COVID-19 in their discharge report, and this infection had no effect on hospitalizations this year. A significant increase in the use of non-invasive ventilation (NIV) was observed over time. Irrespective of the diagnostic position, LOHS and IHM remained stable over time, with the IHM under 0.1%. Conclusion: Our results show a decrease in the incidence of hospital admissions with asthma either as the primary diagnosis or in any position. The age of children hospitalized seems to be increasing as the use of NIV. Better management of the disease from primary care and the emergency department as is the use of NIV could explain the reduction in incidence. What is Known: • Asthma is the most common chronic respiratory in childhood in high income countries. • The incidence of hospital admissions with asthma and associated factors is one of the best sources of information on morbidity trends and prognosis. What is New: • The incidence of hospital admissions for asthma in Spain decreased in children between 2011 and 2020 with a more frequent use of non-invasive mechanical ventilation and low mortality rates. • COVID-19 did not cause an increase in admissions with asthma in the year 2020.
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Affiliation(s)
| | - Rodrigo Jimenez-Garcia
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain.
| | - Romana Albaladejo-Vicente
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Rosa Villanueva-Orbaiz
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Javier de-Miguel-Diez
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Concepción Noriega
- Department of Nursery and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28871, Alcalá de Henares, Madrid, Spain
| | - Ana Lopez-de-Andres
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
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11
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Su JM, Chen KY, Wu SM, Lee KY, Ho SC. A mobile-based airway clearance care system using deep learning-based vision technology to support personalized home-based pulmonary rehabilitation for COAD patients: Development and usability testing. Digit Health 2023; 9:20552076231207206. [PMID: 37841513 PMCID: PMC10571692 DOI: 10.1177/20552076231207206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023] Open
Abstract
Background Excessive mucus secretion is a serious issue for patients with chronic obstructive airway disease (COAD), which can be effectively managed through postural drainage and percussion (PD + P) during pulmonary rehabilitation (PR). Home-based (H)-PR can be as effective as center-based PR but lacks professional supervision and timely feedback, leading to low motivation and adherence. Telehealth home-based pulmonary (TH-PR) has emerged to assist H-PR, but video conferencing and telephone calls remain the main approaches for COAD patients. Therefore, research on effectively assisting patients in performing PD + P during TH-PR is limited. Objective This study developed a mobile-based airway clearance care for chronic obstructive airway disease (COAD-MoAcCare) system to support personalized TH-PR for COAD patients and evaluated its usability through expert validation. Methods The COAD-MoAcCare system uses a mobile device through deep learning-based vision technology to monitor, guide, and evaluate COAD patients' PD + P operations in real time during TH-PR programs. Medical personnel can manage and monitor their personalized PD + P and operational statuses through the system to improve TH-PR performance. Respiratory therapists from different hospitals evaluated the system usability using system questionnaires based on the technology acceptance model, system usability scale (SUS), and task load index (NASA-TLX). Results Eleven participant therapists were highly satisfied with the COAD-MoAcCare system, rating it between 4.1 and 4.6 out of 5.0 on all scales. The system demonstrated good usability (SUS score of 74.1 out of 100) and a lower task load (NASA-TLX score of 30.0 out of 100). The overall accuracy of PD + P operations reached a high level of 97.5% by comparing evaluation results of the system by experts. Conclusions The COAD-MoAcCare system is the first mobile-based method to assist COAD patients in conducting PD + P in TH-PR. It was proven to be usable by respiratory therapists, so it is expected to benefit medical personnel and COAD patients. It will be further evaluated through clinical trials.
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Affiliation(s)
- Jun-Ming Su
- Department of Information and Learning Technology, National University of Tainan, Tainan, Taiwan
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sheng-Ming Wu
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shu-Chuan Ho
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
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12
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Xu D, Li J, Di A, Yang P, Xie X, Xu Y, He J. Sanfu herbal patch applied at acupoints in patients with bronchial asthma: statistical analysis plan for a randomised controlled trial. Trials 2022; 23:1025. [PMID: 36539844 PMCID: PMC9764530 DOI: 10.1186/s13063-022-06990-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Sanfu herbal patch (SHP) is widely used in the prevention and treatment of bronchial asthma in China, but its efficacy and mechanism of action are not completely clear. This trial aims to determine the efficacy of SHP and the underlying mechanism. METHODS/DESIGN We will conduct a multi-centre parallel randomised controlled trial consisting of 72 participants with bronchial asthma recruited and randomly allocated at a ratio of 1:1 into two groups. The patients in one group will receive three courses of SHP treatment, and the patients in the other group will receive placebo treatment, with 24 weeks of follow-up evaluation for both groups. The primary outcome, i.e. forced expiratory volume in the first second (FEV1), which refers to the change in FEV1 from the beginning of the baseline to the end of 3 treatment sessions (TSs), will be assessed and compared via Student's t test or the Mann-Whitney U test. Other outcomes will include questionnaire surveys and laboratory indicators. Detailed and complete statistical analyses in a double-blinded fashion will be provided for evaluating this trial. DISCUSSION The data we obtain will be examined based on the above statistical analysis, which will help to reduce the risk of external reporting bias and data-driven results. TRIAL REGISTRATION Chinese Clinical Trial Registry ( http://www.chictr.org.cn ), ChiCTR1900024616. Registered on 19 July 2019.
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Affiliation(s)
- Danghan Xu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Jialing Li
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Anqi Di
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Peidan Yang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Xiaoyan Xie
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
- Guangdong Provincial Hospital of Chinese Medicine, 510120, Guangzhou, China
| | - Yiming Xu
- School of Basic Medicine, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jun He
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
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13
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Liu M, Gan H, Lin Y, Lin R, Xue M, Zhang T, Cheng ZJ, Sun B. Prevalence and Disability-Adjusted Life Year Rates of Asthma in China: Findings from the GBD Study 2019 of the G20. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14663. [PMID: 36429381 PMCID: PMC9690014 DOI: 10.3390/ijerph192214663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/22/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The credible materials about the burden of asthma in China when compared to other countries in the group of twenty (G20) remain unavailable. OBJECTIVES AND DESIGN Following the popular analysis strategy used in the Global Burden of Disease Study, the age-, sex-, country-specific prevalence, and disability-adjusted life years (DALYs) of asthma in China were analyzed. Meanwhile, the comparison in trends between China and other countries in the G20 was also evaluated. RESULTS In 2019, asthma was the 8th leading cause of the DALYs' burden of 369 diseases in China. From 1990 to 2019, the age-standardized prevalence and DALY rates of asthma in China decreased by 14% and 51%, respectively; further, the decline rate of DALYs was much higher than the global average (-51%: -43%). It is worth noting that the overall population age-standardized DALYs rate of asthma in China was the lowest in the G20 during 2019 (102.81, 95% UI: (72.30,147.42)/100,000). Moreover, the age-standardized asthma prevalence rate peaks in both childhood (178.14, 95% UI: (90.50, 329.01)/100,000) and the elderly (541.80, 95% UI: (397.79, 679.92)/100,000). Moreover, throughout the study, subjects in the 5 to 9 years old interval were a constant focus of our attention. CONCLUSIONS The disease burden of asthma has varied greatly by gender and age over the past 30 years. In contrast to the increasing burden in most other G20 countries, the age-standardized prevalence rate of asthma shows a significant decreasing trend in China, however, the age-standardized DALYs rate shows a fluctuating change, and has even shown a rebound trend in recent years.
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Affiliation(s)
- Mingtao Liu
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Hui Gan
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Yilu Lin
- School of Social Sciences, Main Campus, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
| | - Runpei Lin
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Mingshan Xue
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
- Guangzhou Laboratory, Guangzhou 510005, China
- Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou 510440, China
| | - Teng Zhang
- Faculty of Health Sciences, University of Macau, Taipa, Macau 510060, China
| | - Zhangkai J. Cheng
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
- Guangzhou Laboratory, Guangzhou 510005, China
| | - Baoqing Sun
- Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
- Guangzhou Laboratory, Guangzhou 510005, China
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14
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Mank MM, Reed LF, Fastiggi VA, Peña-García PE, Hoyt LR, Van Der Vliet KE, Ather JL, Poynter ME. Ketone body augmentation decreases methacholine hyperresponsiveness in mouse models of allergic asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2022; 1:282-298. [PMID: 36466740 PMCID: PMC9718535 DOI: 10.1016/j.jacig.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Background Individuals with allergic asthma exhibit lung inflammation and remodeling accompanied by methacholine hyperresponsiveness manifesting in proximal airway narrowing and distal lung tissue collapsibility, and they can present with a range of mild-to-severe disease amenable or resistant to therapeutic intervention, respectively. There remains a need for alternatives or complements to existing treatments that could control the physiologic manifestations of allergic asthma. Objectives Our aim was to examine the hypothesis that because ketone bodies elicit anti-inflammatory activity and are effective in mitigating the methacholine hyperresponsiveness associated with obese asthma, increasing systemic concentrations of ketone bodies would diminish pathologic outcomes in asthma-relevant cell types and in mouse models of allergic asthma. Methods We explored the effects of ketone bodies on allergic asthma-relevant cell types (macrophages, airway epithelial cells, CD4 T cells, and bronchial smooth muscle cells) in vitro as well as in vivo by using preclinical models representative of several endotypes of allergic asthma to determine whether promotion of ketosis through feeding a ketogenic diet or providing a ketone precursor or a ketone ester dietary supplement could affect immune and inflammatory parameters as well as methacholine hyperresponsiveness. Results In a dose-dependent manner, the ketone bodies acetoacetate and β-hydroxybutyrate (BHB) decreased proinflammatory cytokine secretion from mouse macrophages and airway epithelial cells, decreased house dust mite (HDM) extract-induced IL-8 secretion from human airway epithelial cells, and decreased cytokine production from polyclonally and HDM-activated T cells. Feeding a ketogenic diet, providing a ketone body precursor, or supplementing the diet with a ketone ester increased serum BHB concentrations and decreased methacholine hyperresponsiveness in several acute HDM sensitization and challenge models of allergic asthma. A ketogenic diet or ketone ester supplementation decreased methacholine hyperresponsiveness in an HDM rechallenge model of chronic allergic asthma. Ketone ester supplementation synergized with corticosteroid treatment to decrease methacholine hyperresponsiveness in an HDM-driven model of mixed-granulocytic severe asthma. HDM-induced morphologic changes in bronchial smooth muscle cells were inhibited in a dose-dependent manner by BHB, as was HDM protease activity. Conclusions Increasing systemic BHB concentrations through dietary interventions could provide symptom relief for several endotypes of allergic asthmatic individuals through effects on multiple asthma-relevant cells.
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Affiliation(s)
- Madeleine M Mank
- Department of Medicine, Division of Pulmonary Disease and Critical Care, University of Vermont, and The Vermont Lung Center, Burlington
| | - Leah F Reed
- Department of Medicine, Division of Pulmonary Disease and Critical Care, University of Vermont, and The Vermont Lung Center, Burlington
| | - V Amanda Fastiggi
- Department of Medicine, Division of Pulmonary Disease and Critical Care, University of Vermont, and The Vermont Lung Center, Burlington
| | - Paola E Peña-García
- Department of Medicine, Division of Pulmonary Disease and Critical Care, University of Vermont, and The Vermont Lung Center, Burlington
| | - Laura R Hoyt
- Department of Medicine, Division of Pulmonary Disease and Critical Care, University of Vermont, and The Vermont Lung Center, Burlington
| | - Katherine E Van Der Vliet
- Department of Medicine, Division of Pulmonary Disease and Critical Care, University of Vermont, and The Vermont Lung Center, Burlington
| | - Jennifer L Ather
- Department of Medicine, Division of Pulmonary Disease and Critical Care, University of Vermont, and The Vermont Lung Center, Burlington
| | - Matthew E Poynter
- Department of Medicine, Division of Pulmonary Disease and Critical Care, University of Vermont, and The Vermont Lung Center, Burlington
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15
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Khattab A, Madkour A, Ambaram A, Smith C, Muhwa CJ, Mecha JO, Alsayed M, Beekman MJHI. Over-prescription of short-acting β 2-agonists is associated with poor asthma outcomes: results from the African cohort of the SABINA III study. Curr Med Res Opin 2022; 38:1983-1995. [PMID: 36031882 DOI: 10.1080/03007995.2022.2100649] [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: 11/03/2022]
Abstract
BACKGROUND The extent of short-acting β2-agonist (SABA) overuse in Africa remains poorly documented. As part of the SABA use IN Asthma (SABINA) III study, we assessed SABA prescriptions/clinical outcomes in 3 African countries. METHODS Data on disease characteristics/asthma treatments were collected from patients (≥12 years) using electronic case report forms. Patients were classified by investigator-defined asthma severity (guided by the 2017 Global Initiative for Asthma) and practice type (primary/specialist care). Multivariable regression models analyzed associations between SABA prescriptions and outcomes. RESULTS Data from 1778 patients (mean age, 43.7 years) were analyzed. Most patients were female (62.4%) and had moderate-to-severe asthma (63.3%), with 57.1 and 42.9% of patients treated in specialist and primary care, respectively. Asthma was partly controlled/uncontrolled in 66.2% of patients, with 57.9% experiencing ≥1 severe exacerbation in the previous 12 months. Overall, 46.5% of patients were prescribed ≥3 SABA canisters in the preceding 12 months (over-prescription); 26.2% were prescribed ≥10 canisters. SABAs were purchased over-the-counter by 32.6% of patients, of whom 79.3% had received SABA prescriptions; 71.9% and 40.1% for ≥3 and ≥10 canisters, respectively. Higher SABA prescriptions (vs. 1-2 canisters) were associated with increased incidence rate of severe exacerbations and lower odds of having at least partly controlled asthma (except 3-5 canisters). CONCLUSIONS Findings from this African cohort of the SABINA III study indicate that SABA over-prescription and SABA over-the-counter purchase are common and associated with poor asthma-related outcomes. This highlights the need for healthcare providers/policymakers to align clinical practices with the latest treatment recommendations.
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Affiliation(s)
- Adel Khattab
- Pulmonary Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ashraf Madkour
- Pulmonary Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Anish Ambaram
- Department of Pulmonology, Gateway Centre for Respiratory and Gastrointestinal Disease, Durban, South Africa
| | - Clifford Smith
- Morningside Mediclinic, Sandton, Johannesburg, South Africa
| | - Chakaya J Muhwa
- Department of Medicine, Therapeutics and Dermatology, Kenyatta University, Nairobi, Kenya
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Jared O Mecha
- Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya
| | - Mohamed Alsayed
- Medicinal Department, AstraZeneca, Dubai, United Arab Emirates
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16
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Nagayama K, Fukutomi Y, Nakatani E, Hamada Y, Irie M, Azekawa K, Tomita Y, Watai K, Kamide Y, Sekiya K, Nakamura Y, Okada C, Shimoda T, Nagao M, Fujisawa T, Taniguchi M. Longitudinal changes in the prevalence of adult asthma: An epidemiological survey among Japanese salaried employees and their dependents using healthcare insurance claim from 1999 to 2019. Allergol Int 2022; 72:245-251. [PMID: 36443222 DOI: 10.1016/j.alit.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/19/2022] [Accepted: 10/30/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Information on changes in asthma prevalence and the treatment status for asthma is used as basic information for taking medical and administrative measures against asthma. However, this information among adults is relatively limited. METHODS To elucidate changes in the prevalence of asthma and treatment status over time among Japanese adults, health insurance claim data from some health insurance societies covering salaried employees and their dependents were studied longitudinally. Claim data from FY1999 to 2007 were obtained from two health insurance societies, and data from FY 2011 to 2019 were obtained from three different health insurance societies, and changes in standardized asthma prevalence among subjects aged 20-59 years, proportion of asthma patients prescribed ICS, leukotriene receptor antagonist (LTRA), and LABA, and the mean number of acute asthma exacerbations per year were analyzed. RESULTS The prevalence of asthma increased from 1.6% in 1999 to 3.0% in 2007 and 2.9% in 2011 to 4.6% in 2019. Increased trends in asthma prevalence from 2011 to 2019 were more noticeable in subjects in their 50s than those in their 20s for both sexes. The number of emergency visits related to asthma was 1.5 per year in 1999, which decreased to 0.8 per year in 2019. The proportion of people prescribed all anti-asthma medications (ICS, LTRA, and LABA) increased over time. CONCLUSIONS The prevalence of adult asthma among Japanese salaried employees and their dependents has increased over the last 20 years, suggesting more attention should be paid to the prevention of this disease in adults.
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Affiliation(s)
- Kisako Nagayama
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Yuma Fukutomi
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.
| | - Eiji Nakatani
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Yuto Hamada
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Mari Irie
- Nihon Medical Insurance Institute Ltd., Tokyo, Japan
| | | | - Yasuhiro Tomita
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan; Department of Respiratory Medicine, Anjo Kosei Hospital, Anjo, Japan
| | - Kentaro Watai
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan; Shonan Kamakura General Hospital Center for Immunology and Allergology, Kamakura, Japan
| | - Yosuke Kamide
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Kiyoshi Sekiya
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Yoichi Nakamura
- Medical Center for Allergic and Immune Diseases, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Chiharu Okada
- Headquarters, National Hospital Organization, Tokyo, Japan
| | - Terufumi Shimoda
- Department of Allergy, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan
| | - Mizuho Nagao
- Allergy Center, National Hospital Organization Mie National Hospital, Mie, Japan
| | - Takao Fujisawa
- Allergy Center, National Hospital Organization Mie National Hospital, Mie, Japan
| | - Masami Taniguchi
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan; Shonan Kamakura General Hospital Center for Immunology and Allergology, Kamakura, Japan
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17
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Asthma and early smoking associated with high risk of panic disorder in adolescents and young adults. Soc Psychiatry Psychiatr Epidemiol 2022; 57:583-594. [PMID: 34279695 DOI: 10.1007/s00127-021-02146-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Studies have reported a strong link between asthma and panic disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and panic disorder during adolescence and early adulthood. METHODS A total of 162,766 participants aged 11-16 years were categorized into asthma and nonasthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant's gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and panic disorder. RESULTS Our findings revealed that asthma increased the risk of panic disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.70, 95% CI 1.28-2.26). Hospitalizations or visits to the emergency department for asthma exhibited a dose-response effect on the panic disorder (adjusted HR: 2.07, 95% CI 1.30-3.29). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for panic disorder (adjusted HR: 4.95, 95% CI 1.23-19.90). CONCLUSIONS Patients newly diagnosed with asthma had a 1.7-times higher risk of developing panic disorder. Smoking during late childhood or adolescence increased the risk for developing the panic disorder in patients with asthma.
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Bai S, Zhao X, Liu Y, Lin S, Liu Y, Wang Z, Du S, Liu X, Wang Z. The effect window for sulfur dioxide exposure in pregnancy on childhood asthma and wheezing: A case-control study. ENVIRONMENTAL RESEARCH 2022; 204:112286. [PMID: 34743895 DOI: 10.1016/j.envres.2021.112286] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/14/2021] [Accepted: 10/23/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The relationship between prenatal exposure to sulfur dioxide (SO2) and childhood wheezing and asthma is unclear. OBJECTIVE To explore the association between prenatal exposure to SO2 and childhood wheeze and asthma. To investigate the effects for the exposure during different pregnancy trimesters. METHODS We conducted a cross-sectional study firstly in Jinan City to get the prevalence of wheeze and asthma on children aged 18 months to 3 years. And then, we designed a case-control study based on population to evaluate the association between prenatal SO2 exposure and childhood asthma and wheezing. Based on the starting and ending date of pregnancy and specific residential addresses, the individual concentrations of SO2 during pregnancy was evaluated using an inverse distance weighted model. RESULTS The prevalence of wheeze and asthma on children aged 18 months to 3 years was 2.07% in our cross-sectional study. 236 cases and 1445 controls were available for exposure estimates. The OR (95% CI) of 1.296 (1.130-1.491) was significant after adjusting for the covariates. In the first and third trimesters, the effects were enhanced to 1.602 (1.275-2.022) and 1.448 (1.179-1.783) in the multi-pollutant model with adjusting the effects of other trimesters. Coincidentally, the SO2 exposure level of the case in the first trimester was higher than that in the second and third trimesters (P < 0.001); however, there was no significant difference in exposure levels of the case between the second and third trimesters of pregnancy (P = 0.381). CONCLUSION Prenatal exposure to higher concentration of SO2 could increase the risk of asthma and wheezing in younger children. The first trimester might be just the window for the toxic effect, while the third trimester was the sensitive window for the effect of SO2 exposure during pregnancy on childhood asthma.
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Affiliation(s)
- Shuoxin Bai
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Xiaodong Zhao
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, PR China
| | - Yang Liu
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China; Pudong New Area Center for Disease Control and Prevention, Shanghai, PR China
| | - Shaoqian Lin
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, PR China
| | - Yi Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Zhaojun Wang
- Shandong Jinan Ecological Environmental Monitoring Center, Jinan, Shandong, PR China
| | - Shuang Du
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Xiaoxue Liu
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, PR China
| | - Zhiping Wang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China.
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19
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McNamara PS, Clayton D, Burchett C, Compton V, Peak M, Clark J, Jones AP. Humidified and standard oxygen therapy in acute severe asthma in children (HUMOX): A pilot randomised controlled trial. PLoS One 2022; 17:e0263044. [PMID: 35113903 PMCID: PMC8812987 DOI: 10.1371/journal.pone.0263044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/23/2021] [Indexed: 11/19/2022] Open
Abstract
Background
Oxygen (O2) is a mainstay of treatment in acute severe asthma but how it is administered varies widely. The objectives were to examine whether a trial comparing humidified O2 to standard O2 in children is feasible, and specifically to obtain data on recruitment, tolerability and outcome measure stability.
Methods
Heated humidified, cold humidified and standard O2 treatments were compared for children (2–16 years) with acute severe asthma in a multi-centre, open, parallel, pilot randomised controlled trial (RCT). Multiple outcomes were assessed.
Results
Of 258 children screened, 66 were randomised (heated humidified O2 n = 25; cold humidified O2 n = 21; standard O2 n = 20). Median (IQR) length of stay (hours) in hospital was 37.9 (29.1), 52 (35.4) and 49.1 (29.7) for standard, heated humidified and cold humidified respectively and time (hours) on O2 was 15.9 (9.4), 13.6 (14.9) and 13.1 (14.9) for the three groups respectively. The mean (standard deviation) time (hours) taken to step down nebulised to inhaled treatment was 5.6 (14.3), 35.1 (28.2) and 32.7 (20.1). Asthma Severity Score decreased in all three groups similarly, although missing data prevented complete analysis. Humidified O2 was least well tolerated with eight participants discontinuing their randomised treatment early. An important barrier to recruitment was research nurse availability.
Conclusion
Although, the results of this pilot study should not be extrapolated beyond the study sample and inferential conclusions should not be drawn from the results, this is the first RCT to compare humidified and standard O2 therapy in acute severe asthmatics of any age. These findings and accompanying screening data show that a large RCT of O2 therapy is feasible. However, challenges associated with randomisation and data collection should be addressed in any future trial design.
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Affiliation(s)
- Paul S. McNamara
- Department of Child Health (University of Liverpool), Institute in the Park, Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom
- * E-mail:
| | - Dannii Clayton
- Liverpool Clinical Trials Centre, University of Liverpool, a member of the Liverpool Health Partners, Liverpool, United Kingdom
| | - Caroline Burchett
- Paediatric Department, The Longhouse, Countess of Chester Hospital NHS Foundation Trust, Chester, United Kingdom
| | - Vanessa Compton
- Physiotherapy Department, Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom
| | - Matthew Peak
- Clinical Research Division, Institute in the Park, Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom
| | - Janet Clark
- Clinical Research Division, Institute in the Park, Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom
| | - Ashley P. Jones
- Liverpool Clinical Trials Centre, University of Liverpool, a member of the Liverpool Health Partners, Liverpool, United Kingdom
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20
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Mank MM, Reed LF, Walton CJ, Barup MLT, Ather JL, Poynter ME. Therapeutic ketosis decreases methacholine hyperresponsiveness in mouse models of inherent obese asthma. Am J Physiol Lung Cell Mol Physiol 2022; 322:L243-L257. [PMID: 34936508 PMCID: PMC8782644 DOI: 10.1152/ajplung.00309.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 02/03/2023] Open
Abstract
Obese asthmatics tend to have severe, poorly controlled disease and exhibit methacholine hyperresponsiveness manifesting in proximal airway narrowing and distal lung tissue collapsibility. Substantial weight loss in obese asthmatics or in mouse models of the condition decreases methacholine hyperresponsiveness. Ketone bodies are rapidly elevated during weight loss, coinciding with or preceding relief from asthma-related comorbidities. As ketone bodies may exert numerous potentially therapeutic effects, augmenting their systemic concentrations is being targeted for the treatment of several conditions. Circulating ketone body levels can be increased by feeding a ketogenic diet or by providing a ketone ester dietary supplement, which we hypothesized would exert protective effects in mouse models of inherent obese asthma. Weight loss induced by feeding a low-fat diet to mice previously fed a high-fat diet was preceded by increased urine and blood levels of the ketone body β-hydroxybutyrate (BHB). Feeding a ketogenic diet for 3 wk to high-fat diet-fed obese mice or genetically obese db/db mice increased BHB concentrations and decreased methacholine hyperresponsiveness without substantially decreasing body weight. Acute ketone ester administration decreased methacholine responsiveness of normal mice, and dietary ketone ester supplementation of high-fat diet-fed mice decreased methacholine hyperresponsiveness. Ketone ester supplementation also transiently induced an "antiobesogenic" gut microbiome with a decreased Fermicutes/Bacteroidetes ratio. Dietary interventions to increase systemic BHB concentrations could provide symptom relief for obese asthmatics without the need for the substantial weight loss required of patients to elicit benefits to their asthma through bariatric surgery or other diet or lifestyle alterations.
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Affiliation(s)
- Madeleine M Mank
- Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Vermont, Burlington, Vermont
- The Vermont Lung Center, Burlington, Vermont
| | - Leah F Reed
- Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Vermont, Burlington, Vermont
- The Vermont Lung Center, Burlington, Vermont
| | - Camille J Walton
- Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Vermont, Burlington, Vermont
- The Vermont Lung Center, Burlington, Vermont
| | - Madison L T Barup
- Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Vermont, Burlington, Vermont
- The Vermont Lung Center, Burlington, Vermont
| | - Jennifer L Ather
- Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Vermont, Burlington, Vermont
- The Vermont Lung Center, Burlington, Vermont
| | - Matthew E Poynter
- Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Vermont, Burlington, Vermont
- The Vermont Lung Center, Burlington, Vermont
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21
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Safiri S, Carson-Chahhoud K, Karamzad N, Sullman MJM, Nejadghaderi SA, Taghizadieh A, Bell AW, Kolahi AA, Ansarin K, Mansournia MA, Collins GS, Kaufman JS. Prevalence, Deaths, and Disability-Adjusted Life-Years Due to Asthma and Its Attributable Risk Factors in 204 Countries and Territories, 1990-2019. Chest 2022; 161:318-329. [PMID: 34699773 DOI: 10.1016/j.chest.2021.09.042] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Understanding global trends in the point prevalence, deaths, and disability-adjusted life-years (DALYs) for asthma will facilitate evidence-based decision-making. RESEARCH QUESTION What are the global, regional, and national burdens of asthma in 204 countries and territories between 1990 and 2019 by age, sex, and sociodemographic index (SDI)? STUDY DESIGN AND METHODS Publicly available data from the Global Burden of Disease study from 1990 through 2019 were used. All estimates were presented as counts and age-standardized rates per 100,000, along with their associated uncertainty intervals. RESULTS In 2019, the global age-standardized point prevalence and death rates for asthma were 3,415.5 and 5.8 per 100,000, which represent a 24% and 51.3% decrease since 1990, respectively. Moreover, in 2019, the global age-standardized DALY rate was 273.6 and the global point prevalence of asthma was highest in the group 5 to 9 years of age. Also in 2019, the United States (10,399.3) showed the highest age-standardized point prevalence rate of asthma. Generally, the burden of asthma decreased with increasing SDI. Globally, high BMI (16.9%), smoking (9.9%), and occupational asthmagens (8.8%) contributed to the 2019 asthma DALYs. INTERPRETATION Asthma remains an important public health issue, particularly in regions with low socioeconomic development. Future research is needed to examine thoroughly the associations asthma has with its risk factors and the factors impeding optimal self-management. Further research also is needed to understand and implement better the interventions that have reduced the burden of asthma.
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Affiliation(s)
- Saeid Safiri
- Tuberculosis and Lung Disease Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Tehran, Iran; Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Tehran, Iran.
| | - Kristin Carson-Chahhoud
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia; School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Nahid Karamzad
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus; Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Seyed Aria Nejadghaderi
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Tehran, Iran; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Ali Taghizadieh
- Tuberculosis and Lung Disease Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Tehran, Iran
| | - Arielle Wilder Bell
- Health Sciences Integrated Program, Northwestern University, Chicago, IL; Department of Global Health and Social Medicine, Harvard University, Boston, MA
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khalil Ansarin
- Rahat Breath and Sleep Research Center, Tabriz University of Medical Sciences, Tabriz, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Gary S Collins
- Centre for Statistics in Medicine, NDORMS, Botnar Research Centre, University of Oxford, Oxford, England; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, England
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
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22
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D’Accolti M, Soffritti I, Bini F, Mazziga E, Mazzacane S, Caselli E. Pathogen Control in the Built Environment: A Probiotic-Based System as a Remedy for the Spread of Antibiotic Resistance. Microorganisms 2022; 10:microorganisms10020225. [PMID: 35208679 PMCID: PMC8876034 DOI: 10.3390/microorganisms10020225] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 02/05/2023] Open
Abstract
The high and sometimes inappropriate use of disinfectants and antibiotics has led to alarming levels of Antimicrobial Resistance (AMR) and to high water and hearth pollution, which today represent major threats for public health. Furthermore, the current SARS-CoV-2 pandemic has deeply influenced our sanitization habits, imposing the massive use of chemical disinfectants potentially exacerbating both concerns. Moreover, super-sanitation can profoundly influence the environmental microbiome, potentially resulting counterproductive when trying to stably eliminate pathogens. Instead, environmentally friendly procedures based on microbiome balance principles, similar to what applied to living organisms, may be more effective, and probiotic-based eco-friendly sanitation has been consistently reported to provide stable reduction of both pathogens and AMR in treated-environments, compared to chemical disinfectants. Here, we summarize the results of the studies performed in healthcare settings, suggesting that such an approach may be applied successfully also to non-healthcare environments, including the domestic ones, based on its effectiveness, safety, and negligible environmental impact.
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Affiliation(s)
- Maria D’Accolti
- Department of Chemical, Pharmaceutical and Agricultural Sciences and LTTA, University of Ferrara, 44121 Ferrara, Italy; (M.D.); (I.S.); (F.B.); (E.M.)
- CIAS Research Center, University of Ferrara, Via Saragat 13, 44122 Ferrara, Italy;
| | - Irene Soffritti
- Department of Chemical, Pharmaceutical and Agricultural Sciences and LTTA, University of Ferrara, 44121 Ferrara, Italy; (M.D.); (I.S.); (F.B.); (E.M.)
- CIAS Research Center, University of Ferrara, Via Saragat 13, 44122 Ferrara, Italy;
| | - Francesca Bini
- Department of Chemical, Pharmaceutical and Agricultural Sciences and LTTA, University of Ferrara, 44121 Ferrara, Italy; (M.D.); (I.S.); (F.B.); (E.M.)
| | - Eleonora Mazziga
- Department of Chemical, Pharmaceutical and Agricultural Sciences and LTTA, University of Ferrara, 44121 Ferrara, Italy; (M.D.); (I.S.); (F.B.); (E.M.)
| | - Sante Mazzacane
- CIAS Research Center, University of Ferrara, Via Saragat 13, 44122 Ferrara, Italy;
| | - Elisabetta Caselli
- Department of Chemical, Pharmaceutical and Agricultural Sciences and LTTA, University of Ferrara, 44121 Ferrara, Italy; (M.D.); (I.S.); (F.B.); (E.M.)
- CIAS Research Center, University of Ferrara, Via Saragat 13, 44122 Ferrara, Italy;
- Correspondence:
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23
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Kuo CY, Chan CK, Huang JL, Wu CY, Phan DV, Lo HY, Chan CL. Decline in hospitalization for childhood asthma in different air pollution regions in Taiwan, 2001-2012. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:95-105. [PMID: 32073299 DOI: 10.1080/09603123.2020.1729964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
This study aimed to investigate the trends in childhood asthma hospitalization in regions with differing levels of air pollution in Taiwan, 2001-2012. Joinpoint regression was used to identify significant trend changes. The hospitalization rate varied according to gender, geographic region, and age. The incidence of childhood asthma hospitalization decreased from 127.99 to 76.67 (/100,000 population), with an average annual percentage change of around -4.1%; in the Yilan region, the average air pollution concentrations were 19.92 μg/m3, 39.47 μg/m3, 25.99 ppb, 2.19 ppb, and 11.23 ppb for PM2.5, PM10, O3, SO2, and NO2, respectively, which were lower than Taiwan's average values; however, the childhood asthma hospitalization rate was the highest (179.75/100,000 population). The national trend in childhood asthma hospitalization exhibited a significant decrease. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while less association was observed in the lower-level air pollution regions.
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Affiliation(s)
- Ching-Yen Kuo
- Department of Information Management, Yuan Ze University, Taoyuan City, Taiwan
- Department of Medical Administration, Ministry of Health and Welfare, Taoyuan General Hospital, Taoyuan City, Taiwan
| | - Chin-Kan Chan
- Department of Pediatrics, Ministry of Health and Welfare, Taoyuan General Hospital, Taoyuan City, Taiwan
- Department of Biotechnology, Ming Chuan University, Taoyuan City, Taiwan
| | - Jing-Long Huang
- Department of Pediatrics, Division of Allergy, Asthma and Rheumatology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Chiung-Yi Wu
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Dinh-Van Phan
- Department of Information Management, Yuan Ze University, Taoyuan City, Taiwan
- University of Economics, The University of Danang, Da Nang, Vietnam
- Teaching and Research Team for Business Intelligence, University of Economics, the University of Danang, Da Nang, Vietnam
| | - Huei Yu Lo
- Department of Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan City, Taiwan
- Department of Chemistry, Chung Yuan Christian University, Taoyuan City, Taiwan
| | - Chien Lung Chan
- Department of Information Management, Yuan Ze University, Taoyuan City, Taiwan
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, Taoyuan City, Taiwan
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24
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Payet D, Adjibade M, Baudry J, Ghozal M, Camier A, Nicklaus S, Adel-Patient K, Divaret-Chauveau A, Gauvreau-Béziat J, Vin K, Lioret S, Charles MA, Kesse-Guyot E, de Lauzon-Guillain B. Organic Food Consumption During the Complementary Feeding Period and Respiratory or Allergic Diseases Up to Age 5.5 Years in the ELFE Cohort. Front Nutr 2021; 8:791430. [PMID: 34977129 PMCID: PMC8716938 DOI: 10.3389/fnut.2021.791430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/12/2021] [Indexed: 12/23/2022] Open
Abstract
Objectives: To assess (1) whether a history of allergy is associated with feeding with organic foods (OFs) during the complementary feeding period and (2) whether OF consumption in infancy is related to the incidence of respiratory and allergic diseases up to age 5.5 years. Study Design: Analyses involved more than 8,000 children from the nationwide Étude Longitudinale Française depuis l'Enfance (ELFE) birth cohort. Associations between family or infant history of allergy and frequency of OF consumption during the complementary feeding period were assessed with multinomial logistic regression. Associations between OF consumption in infancy and respiratory or allergic diseases between age 1 and 5.5 years were assessed with logistic regression. Results: A family history of allergy or cow's milk protein allergy at age 2 months was strongly and positively related to feeding with OF during the complementary feeding period. Feeding with OF during the complementary feeding period was not related to respiratory diseases or eczema up to age 5.5 years. Compared to infrequent consumption of both organic and commercial complementary foods, frequent OF consumption without commercial complementary foods was associated with a higher risk of food allergy, whereas frequent commercial complementary food consumption without OF use was associated with a lower risk of food allergy. Conclusions: This study suggests that a history of allergy strongly affects feeding with OF during the complementary feeding period. However, OF consumption was not associated with reduced odds of food allergy later in childhood but could be associated with increased odds, which should be examined more deeply.
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Affiliation(s)
- David Payet
- Université de Paris, Inserm, INRAE, CRESS, Paris, France
| | | | - Julia Baudry
- Université Sorbonne Paris Nord, Inserm, INRAE, CNAM, CRESS, Paris, France
| | - Manel Ghozal
- Université de Paris, Inserm, INRAE, CRESS, Paris, France
| | - Aurore Camier
- Université de Paris, Inserm, INRAE, CRESS, Paris, France
| | - Sophie Nicklaus
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| | | | - Amandine Divaret-Chauveau
- EA3450, Université de Lorraine, Vandoeuvre-lès-Nancy, France
- Unité d'allergologie pédiatrique, Hôpital d'Enfants, CHRU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Julie Gauvreau-Béziat
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Food Observatory Unit, Maisons-Alfort, France
| | - Karine Vin
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Food Observatory Unit, Maisons-Alfort, France
| | | | - Marie Aline Charles
- Université de Paris, Inserm, INRAE, CRESS, Paris, France
- Unité mixte Inserm-Ined-EFS Elfe, Ined, Paris, France
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25
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Narh CT, Der JB, Afetor M, Ofosu A, Blettner M, Wollschlaeger D. Sociodemographic factors associated with time to discharge for hospitalised patients with asthma and asthma exacerbation using the Ghana Health Service District Information Management System 2 (DHIMS-2) database, 2012-2017. BMJ Open Respir Res 2021; 8:8/1/e001034. [PMID: 34815230 PMCID: PMC8611432 DOI: 10.1136/bmjresp-2021-001034] [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: 06/24/2021] [Accepted: 10/29/2021] [Indexed: 11/14/2022] Open
Abstract
Objective Data on asthma hospitalisations are a useful source of patient morbidity information. In Ghana, the length of stay (LoS) and sociodemographic factors of patients hospitalised for asthma and its exacerbation are understudied. We aimed to investigate the time to discharge and assessed factors associated with length of hospital stays of asthmatics in Ghana. Methods Retrospective analysis of hospitalised patient with asthma records between 2012 and 2017 from the nationwide Ghana Health Service District Health Information Management System 2 database. We calculated the cumulative incidence function for discharge stratified by age group and sex. Multivariable Cox regression was used to investigate the association of sociodemographic characteristics with the LoS. Results Of 19 926 asthma-associated hospitalisations, 730 (3.7%) were due to asthma exacerbation. Overall mean age was 34 years (SD=24.6), in 12 000 (60.2%) hospitalisations, patients were female. There were 224 deaths (1.1%). Median LoS was 2 days (IQR: 1–3) with almost 90% of all patients discharged by the seventh day. Age and region were among the covariates showing significant association with LoS. Age below 10 years (HR: 1.39 (1.11 to 1.78)) was associated with early discharge while comorbidity and health insurance ownership were associated with late discharge (p<0.001). LoS did not vary by sex. Compared with the Greater Accra region, patients in other regions had shorter LoS, especially the Ashanti and Upper West regions (p<0.001). LoS increased annually, but was highest in 2016 (HR: 0.94 (0.90 to 0.98)). Conclusion Disparities in LoS across regions, and an overall increasing annual trend in Ghana call for tailored healthcare resource allocation. Longer LoS implies that patients are often absent from school or work leading to substantial financial and emotional costs to individuals and families.
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Affiliation(s)
- Clement T Narh
- Department of Epidemiology and Biostatistics, University of Health and Allied Sciences, Ho, Ghana .,Biostatistics Department, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Joyce B Der
- Department of Epidemiology and Biostatistics, University of Health and Allied Sciences, Ho, Ghana
| | - Maxwell Afetor
- Health Information, Ho Polyclinic, Ghana Health Service, Accra, Ghana
| | - Anthony Ofosu
- Center for Health Information Management, Ghana Health Service, Accra, Ghana
| | - Maria Blettner
- Radiation Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Daniel Wollschlaeger
- Radiation Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
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26
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Hu T, Dong Y, Yang C, Zhao M, He Q. Pathogenesis of Children's Allergic Diseases: Refocusing the Role of the Gut Microbiota. Front Physiol 2021; 12:749544. [PMID: 34721073 PMCID: PMC8551706 DOI: 10.3389/fphys.2021.749544] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/24/2021] [Indexed: 12/26/2022] Open
Abstract
Allergic diseases comprise a genetically heterogeneous cluster of immunologically mediated diseases, including asthma, food allergy (FA), allergic rhinitis (AR) and eczema, that have become major worldwide health problems. Over the past few decades, the spread of allergic diseases has displayed an increasing trend, and it has been reported that 22% of 1.39 billion people in 30 countries have a type of allergic disease. Undoubtedly, allergic diseases, which can be chronic, with significant morbidity, mortality and dynamic progression, impose major economic burdens on society and families; thus, exploring the cause of allergic diseases and reducing their prevalence is a top priority. Recently, it has been reported that the gastrointestinal (GI) microbiota can provide vital signals for the development, function, and regulation of the immune system, and the above-mentioned contributions make the GI microbiota a key player in allergic diseases. Notably, the GI microbiota is highly influenced by the mode of delivery, infant diet, environment, antibiotic use and so on. Specifically, changes in the environment can result in the dysbiosis of the GI microbiota. The proper function of the GI microbiota depends on a stable cellular composition which in the case of the human microbiota consists mainly of bacteria. Large shifts in the ratio between these phyla or the expansion of new bacterial groups lead to a disease-promoting imbalance, which is often referred to as dysbiosis. And the dysbiosis can lead to alterations of the composition of the microbiota and subsequent changes in metabolism. Further, the GI microbiota can affect the physiological characteristics of the human host and modulate the immune response of the host. The objectives of this review are to evaluate the development of the GI microbiota, the main drivers of the colonization of the GI tract, and the potential role of the GI microbiota in allergic diseases and provide a theoretical basis as well as molecular strategies for clinical practice.
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Affiliation(s)
- Tingting Hu
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yinmiao Dong
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chenghao Yang
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Mingyi Zhao
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qingnan He
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
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27
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Johnson CC, Havstad SL, Ownby DR, Joseph CLM, Sitarik AR, Biagini Myers J, Gebretsadik T, Hartert TV, Khurana Hershey GK, Jackson DJ, Lemanske RF, Martin LJ, Zoratti EM, Visness CM, Ryan PH, Gold DR, Martinez FD, Miller RL, Seroogy CM, Wright AL, Gern JE. Pediatric asthma incidence rates in the United States from 1980 to 2017. J Allergy Clin Immunol 2021; 148:1270-1280. [PMID: 33964299 PMCID: PMC8631308 DOI: 10.1016/j.jaci.2021.04.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Few studies have examined longitudinal asthma incidence rates (IRs) from a public health surveillance perspective. OBJECTIVE Our aim was to calculate descriptive asthma IRs in children over time with consideration for demographics and parental asthma history. METHODS Data from 9 US birth cohorts were pooled into 1 population covering the period from 1980 to 2017. The outcome was earliest parental report of a doctor diagnosis of asthma. IRs per 1,000 person-years were calculated. RESULTS The racial/ethnic backgrounds of the 6,283 children studied were as follows: 55% European American (EA), 25.5% African American (AA), 9.5% Mexican-Hispanic American (MA) and 8.5% Caribbean-Hispanic American (CA). The average follow-up was 10.4 years (SD = 8.5 years; median = 8.4 years), totaling 65,291 person-years, with 1789 asthma diagnoses yielding a crude IR of 27.5 per 1,000 person-years (95% CI = 26.3-28.8). Age-specific rates were highest among children aged 0 to 4 years, notably from 1995 to 1999, with a decline in EA and MA children in 2000 to 2004 followed by a decline in AA and CA children in 2010 to 2014. Parental asthma history was associated with statistically significantly increased rates. IRs were similar and higher in AA and CA children versus lower but similar in EA and MA children. The differential rates by sex from birth through adolescence principally resulted from a decline in rates among males but relatively stable rates among females. CONCLUSIONS US childhood asthma IRs varied dramatically by age, sex, parental asthma history, race/ethnicity, and calendar year. Higher rates in the 0- to 4-year-olds group, particularly among AA/CA males with a parental history of asthma, as well as changes in rates over time and by demographic factors, suggest that asthma is driven by complex interactions between genetic susceptibility and variation in time-dependent environmental and social factors.
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Affiliation(s)
| | | | - Dennis R Ownby
- Division of Allergy and Immunology, Augusta University, Augusta, Ga
| | | | | | | | | | - Tina V Hartert
- Vanderbilt University School of Medicine, Nashville, Tenn
| | | | - Daniel J Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Robert F Lemanske
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Lisa J Martin
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | | | - Patrick H Ryan
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Diane R Gold
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass
| | - Fernando D Martinez
- Asthma and Airways Research Center, University of Arizona, Tucson, Ariz; Division of Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Arizona, Tucson, Ariz
| | | | - Christine M Seroogy
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Anne L Wright
- Asthma and Airways Research Center, University of Arizona, Tucson, Ariz; Division of Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Arizona, Tucson, Ariz
| | - James E Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
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Cabrera A, Picado C, Rodriguez A, Garcia-Marcos L. Asthma, rhinitis and eczema symptoms in Quito, Ecuador: a comparative cross-sectional study 16 years after ISAAC. BMJ Open Respir Res 2021; 8:8/1/e001004. [PMID: 34580136 PMCID: PMC8477327 DOI: 10.1136/bmjresp-2021-001004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/02/2021] [Indexed: 01/15/2023] Open
Abstract
Background In 2003, the International Study of Asthma and Allergies in Childhood (ISAAC) estimated the prevalence of asthma, rhinitis and eczema symptoms in Quito, Ecuador. Since then, no update of this study has been done in the last years. This study examined changes in the prevalence of asthma–rhinitis–eczema symptoms over a 16 years period in Quito and explored possible risk factors. Methods We conducted a comparative cross-sectional study in an adolescent population following the Global Asthma Network (GAN) methodology. A written questionnaire was used to explore symptoms of asthma–rhinitis–eczema. We calculated the prevalence and 95% CIs for each of the symptoms and compared them with the ISAAC results. We conducted bivariate and multivariate analysis using logistic regression to identify possible risk factors for recent wheeze, rhinitis and eczema. Results A total of 2380 adolescents aged between 13 and 14 years were evaluated. The prevalence of doctor diagnosis for asthma, rhinitis and eczema was 3.4%, 8.5% and 2.2%, respectively. Compared with ISAAC results, we found a lower prevalence of wheeze and eczema symptoms: wheeze ever (37.6% vs 12.7%), recent wheeze (17.8% vs 6.5%), asthma ever (6.9% vs 4.6%), recent rush (22.4% vs 13.9%) and eczema ever (11.7% vs 3.6%). The prevalence of rhinitis symptoms in the GAN study was higher than the ISAAC results: nose symptoms in the past 12 months (36.6% vs 45.8%) and nose and eye symptoms in the past 12 months (23.1% vs 27.9). Significant associations were observed between symptoms of asthma–rhinitis–eczema and sex, race/ethnicity, smoking habit, physical exercise and sedentary activities. Conclusions In the last two decades, the prevalence of asthma and eczema symptoms in adolescent population in the city of Quito has significantly declined; however, the prevalence of rhinitis symptoms has increased. The reduction in asthma symptoms could be related to better managing the disease and changes in local environmental risk factors in the last years. Further studies must be conducted in the country to evaluate the change in trends in asthma and other related allergic diseases.
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Affiliation(s)
- Angelita Cabrera
- Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, Barcelona, Spain.,Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Cesar Picado
- Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Alejandro Rodriguez
- Facultad de Ciencias Médicas de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Luis Garcia-Marcos
- Arrixaca University Children's Hospital, Respiratory and Allergy Units, University of Murcia, Murcia, Spain
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29
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Yan M, Gong J, Liu Q, Li W, Duan X, Cao S, Li S, He L, Yin Z, Lin W, Zhang JJ. The effects of indoor and outdoor air pollution on the prevalence of adults' respiratory diseases in four Chinese cities: a comparison between 2017-2018 and 1993-1996. J Thorac Dis 2021; 13:4560-4573. [PMID: 34422382 PMCID: PMC8339734 DOI: 10.21037/jtd-20-2121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 04/25/2021] [Indexed: 11/24/2022]
Abstract
Background Over the past decades, both ambient and household air pollution have changed in several aspects, including the emission sources and the concentrations of pollutants, in many Chinese cities. It is unknown whether these changes are associated with changes in health conditions, especially given changes in other factors due to rapid economic growth. Methods Two cross-sectional surveys were conducted in two periods spanning more than twenty years (1993–1996 vs. 2017–2018) in four Chinese cities of Chongqing, Wuhan, Lanzhou, and Guangzhou. Data were collected regarding adults’ respiratory disease, smoking status, education, occupation, and household characteristics. Ambient air pollution data were obtained for each study. We first used logistic regression models to construct the district-specific adjusted disease prevalences. In the second stage, first-difference regression models were employed to examine whether the change in respiratory diseases prevalences was associated with the change in outdoor air pollution and indoor air pollution surrogates. Results A total of 7,557 and 9,974 households were participating in Period 1 (1993–1996) and Period 2 (2017–2018), respectively. Compared to Period 1, we found substantial reductions in the ambient air pollution concentrations, and a suggestive improvement in cooking-related indoor air pollution in Period 2. We observed decreases in the district-specific covariate-adjusted prevalences of both asthma and chronic bronchitis among participants, with an average reduction of 3.6% (range: 0.0% to 24.3%). From Period 1 to Period 2, one percent decrease in the proportion of cooking with coal was associated with a 19.0% (95% CI, 0.96–37.04%) decrease in the prevalence of males’ chronic bronchitis and a 1.86% (0.69–3.04%) increase in the prevalence of females’ asthma. Little evidence was observed regarding the potential health benefits associated with the decreases in ambient air pollution levels. Conclusions The substantial reduction in household use of coal for cooking might be an important contributor to the decrease in adults’ respiratory disease prevalence from 1993–1996 to 2017–2019 in four Chinese cities. Changes in this indoor air pollution source, along with other risk factors for respiratory diseases, may have masked respiratory health benefits associated with reductions in outdoor air pollution levels.
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Affiliation(s)
- Meilin Yan
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Qin Liu
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Wenyan Li
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Sai Li
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Lingyan He
- Key Laboratory for Urban Habitat Environmental Science and Technology, School of Environment and Energy, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Zixuan Yin
- Key Laboratory for Urban Habitat Environmental Science and Technology, School of Environment and Energy, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Junfeng Jim Zhang
- Global Health Research Center, Duke Kunshan University, Kunshan, China.,Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, USA.,Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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30
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Liang Y, Mak JCW. Inhaled Therapies for Asthma and Chronic Obstructive Pulmonary Disease. Curr Pharm Des 2021; 27:1469-1481. [PMID: 33243107 DOI: 10.2174/1389201021666201126144057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/23/2020] [Accepted: 10/01/2020] [Indexed: 11/22/2022]
Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are obstructive lung diseases which are characterized by chronic inflammation and an increase in mucus production, and are highly prevalent conditions. Despite recent advances and multiple available therapies, there remains a significant unmet medical need. Over the past 40 years, the introduction of new classes of safe and effective therapy is insufficient. In spite of the high burden of asthma and COPD among patients, there are fewer new approved therapies in comparison to cardiovascular, metabolic and neurological diseases due to few drug candidates and a higher failure rate in the development of respiratory medicine. Lung diseases are amongst the leading causes of death globally with asthma being one of the most prevalent respiratory diseases, which affects people of all ages but, despite effective therapies available, many patients are poorly controlled and have a low quality of life. COPD is currently ranked as the fourth cause of death worldwide and predicted to become the third leading cause of death in 2030. The development of more effective treatments is urgently needed in order to reduce the high mortality rate and the enormous suffering from asthma and COPD. Various inhalation devices with different classes of medications are the foundation as therapies in both asthma and COPD. This article gives a comprehensive review of the promising inhaled therapies in the treatment of asthma and COPD. However, the lack of disease control in asthma and COPD patients may be due to numerous reasons. The association between non-adherence to guidelines on the part of the health care provider and poor inhalation technique and/or non-adherence to the prescribed treatment plan by the patients is common. It is therefore essential to discuss the different delivery systems and the methods used in asthma and COPD patients.
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Affiliation(s)
- Yingmin Liang
- Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Judith C W Mak
- Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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31
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Bronchial hyperresponsiveness is common in Hanoi, Vietnam: Asthma probably underdiagnosed. Respir Med 2021; 186:106513. [PMID: 34246130 DOI: 10.1016/j.rmed.2021.106513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Bronchial hyperresponsiveness (BHR) is a key pathophysiological feature of asthma. Methacholine challenge test (MCT) is a common bronchoprovocation test useful for confirming a diagnosis of asthma. Studies of BHR in the general population of Asian countries are rare. AIM To estimate prevalence and determinants of BHR in Hanoi, Vietnam, and to study the association between BHR and symptoms common in asthma and previously diagnosed asthma. METHODS 1500 out of 5872 randomly selected adults in urban and rural Hanoi, who had participated in a questionnaire survey (83% participated), were randomly selected and invited to clinical examinations. Totally 684 subjects (46%) participated. MCT was performed in 366 subjects. BHR was defined as a FEV1-decrease of ≥20% from baseline following methacholine inhalations (PC20). Cut offs used in the analyses were PC20 ≤ 1 mg/ml, ≤2 mg/ml and ≤8 mg/ml. RESULTS The prevalence of BHR was 16.4% at doses ≤8 mg/ml, while 9.6% reacted on doses ≤2 mg/ml. PC20 ≤ 2 mg/ml was associated with FEV1 <80% of predicted. PC20 ≤ 2 mg/ml, but not PC20 ≤ 8 mg/ml, was associated with multi-sensitization to airborne allergens. BHR defined as PC20 ≤ 8 mg/ml was associated with age >45y. The combination of asthmatic wheeze (wheezing with breathlessness apart from colds) and BHR, irrespectively of magnitude of BHR, was more common than the combination of BHR with previously diagnosed asthma. CONCLUSIONS The results indicate BHR to be more common in Hanoi than previously found in south-east Asia. Although the prevalence of physician diagnosed asthma has increased in Vietnam, our results indicate that asthma still may be underdiagnosed in Vietnam.
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32
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Yalçın SS, Emiralioğlu N, Yalçın S. Evaluation of blood and tooth element status in asthma cases: a preliminary case-control study. BMC Pulm Med 2021; 21:201. [PMID: 34130672 PMCID: PMC8204585 DOI: 10.1186/s12890-021-01565-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background Asthma is a common respiratory disorder; some data were present on the correlation between increased levels of trace elements and the risk of asthma development. It was aimed to evaluate the levels of 13 selected blood and tooth elements (magnesium, phosphorus, calcium, chromium, manganese, iron, copper, zinc, strontium, molybdenum, cadmium, lead, mercury) in a well-controlled asthma group and the control group. Methods During the study period, 17 asthma patients and 26 age and gender-matched healthy children donated shed deciduous teeth having neither decay nor filling and enrolled for the study. The element levels in blood and teeth matrixes were analyzed with inductively coupled plasma mass spectrometry. Differences in blood and tooth elements in groups were evaluated with generalized linear models after adjusting confounding factors. Results After adjusting the child’s “z scores of body mass index for age”, history of iron deficiency anemia, and status of parental smoking, the generalized linear model revealed significantly lower tooth magnesium levels, lower blood zinc levels, and lower blood zinc/copper ratio in the asthma group than the control group (p = 0.042, p = 0.034, p = 0.002, respectively). Other studied elements for tooth and blood matrixes were similar in groups. Conclusion Our study revealed some differences in tooth and blood element levels in the asthma group. Further studies on zinc and magnesium levels of severe asthma cases are necessary for the interpretation of the results. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01565-9.
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Affiliation(s)
- S Songül Yalçın
- Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Nagehan Emiralioğlu
- Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Suzan Yalçın
- Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Selçuk University, Konya, Turkey
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33
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Zepeda-Ortega B, Goh A, Xepapadaki P, Sprikkelman A, Nicolaou N, Hernandez REH, Latiff AHA, Yat MT, Diab M, Hussaini BA, Setiabudiawan B, Kudla U, van Neerven RJJ, Muhardi L, Warner JO. Strategies and Future Opportunities for the Prevention, Diagnosis, and Management of Cow Milk Allergy. Front Immunol 2021; 12:608372. [PMID: 34177882 PMCID: PMC8222906 DOI: 10.3389/fimmu.2021.608372] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 05/04/2021] [Indexed: 12/31/2022] Open
Abstract
The prevalence of food allergy has increased over the last 20-30 years, including cow milk allergy (CMA) which is one of the most common causes of infant food allergy. International allergy experts met in 2019 to discuss broad topics in allergy prevention and management of CMA including current challenges and future opportunities. The highlights of the meeting combined with recently published developments are presented here. Primary prevention of CMA should start from pre-pregnancy with a focus on a healthy lifestyle and food diversity to ensure adequate transfer of inhibitory IgG- allergen immune complexes across the placenta especially in mothers with a history of allergic diseases and planned c-section delivery. For non-breastfed infants, there is controversy about the preventive role of partially hydrolyzed formulae (pHF) despite some evidence of health economic benefits among those with a family history of allergy. Clinical management of CMA consists of secondary prevention with a focus on the development of early oral tolerance. The use of extensive Hydrolysate Formulae (eHF) is the nutrition of choice for the majority of non-breastfed infants with CMA; potentially with pre-, probiotics and LCPUFA to support early oral tolerance induction. Future opportunities are, among others, pre- and probiotics supplementation for mothers and high-risk infants for the primary prevention of CMA. A controlled prospective study implementing a step-down milk formulae ladder with various degrees of hydrolysate is proposed for food challenges and early development of oral tolerance. This provides a more precise gradation of milk protein exposure than those currently recommended.
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Affiliation(s)
- Benjamin Zepeda-Ortega
- Pediatric Allergist Private Practice, Angeles Lomas Hospital Huixquilucan Mexican State, Mexico City, Mexico
| | - Anne Goh
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Aline Sprikkelman
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | | | | | - Miu Ting Yat
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong, China
| | - Mohamed Diab
- Pediatric Department Faculty of Medicine, Children Hospital Cairo University, Cairo, Egypt
| | - Bakr Al Hussaini
- Department of Pediatrics, Abdul Aziz University Hospital, Jeddah, Saudi Arabia
| | - Budi Setiabudiawan
- Department of Child Health, Faculty of Medicine, Univesitas Padjadjaran, Bandung, Indonesia.,Department of Pediatrics, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | | | - R J Joost van Neerven
- R&D, FrieslandCampina, Amersfoort, Netherlands.,Wageningen University & Research, Wageningen, Netherlands
| | - Leilani Muhardi
- Medical Affairs, Friesland Campina AMEA, Singapore, Singapore
| | - John O Warner
- Inflammation Repair and Development, National Heart and Lung Institute Imperial College, London, United Kingdom.,Paediatrics, University of Cape Town, Cape Town, South Africa
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Papadopoulos NG, Miligkos M, Xepapadaki P. A Current Perspective of Allergic Asthma: From Mechanisms to Management. Handb Exp Pharmacol 2021; 268:69-93. [PMID: 34085124 DOI: 10.1007/164_2021_483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Asthma is a result of heterogenous, complex gene-environment interactions with variable clinical phenotypes, inflammation, and remodeling. It affects more than 330 million of people worldwide throughout their educational and working lives, while exacerbations put a heavy cost/burden on productivity. Childhood asthma is characterized by a predominance of allergic sensitization and multimorbidity, while in adults polysensitization has been positively associated with asthma occurrence. Despite significant improvements in recent decades, asthma management remains challenging. Recently, a group of specialists suggested that the term "asthma" should be preferably used as a descriptive term for symptoms. Moreover, type 2 inflammation has emerged as a pivotal disease mechanism including overlapping endotypes of specific IgE production, while type 2-low asthma includes several disease endotypes. Optimal asthma control requires both appropriate pharmacological interventions, tailored to each patient, as well as trigger avoidance measures. Regular monitoring for maintenance of symptom control, preservation of lung function, and detection of treatment-related adverse effects are warranted. Allergen-specific immunotherapy and the advent of new targeted therapies for patients with difficult to control asthma offer diverse treatment options. The current review summarizes up-to-date knowledge on epidemiology, definitions, diagnosis, and current therapeutic strategies.
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Affiliation(s)
- Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece. .,Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK.
| | - Michael Miligkos
- First Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
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Akiki Z, Saadeh D, Farah R, Hallit S, Sacre H, Hosseini H, Salameh P. Asthma prevalence and associated factors among lebanese adults: the first national survey. BMC Pulm Med 2021; 21:162. [PMID: 33985479 PMCID: PMC8120928 DOI: 10.1186/s12890-021-01529-z] [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: 11/01/2020] [Accepted: 05/06/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND No national research has yet explored the prevalence of asthma among adults in Lebanon. This study aims to evaluate the prevalence of physician-diagnosed asthma and current asthma, and their determinants among Lebanese adults 16 years old or above. METHODS A cross-sectional study was carried out using a multistage cluster sampling. The questionnaire used collected information on asthma, respiratory symptoms, and risk factors. RESULTS The prevalence of physician-diagnosed asthma was 6.7% (95% CI 5-8.7%), and that of current asthma was 5% (95% CI 3.6-6.9%). Chronic symptoms such as cough, wheezing, and shortness of breath were worst at night. Factors positively associated with physician-diagnosed asthma were a secondary educational level (adjusted OR, aOR = 4.45), a family history of chronic respiratory diseases (aOR = 2.78), lung problems during childhood (15.9), and allergic rhinitis (4.19). Additionally, consuming fruits and vegetables less than once per week (3.36), a family history of chronic respiratory diseases (3.92), lung problems during childhood (9.43), and allergic rhinitis (8.12) were positively associated with current asthma. CONCLUSIONS The prevalence of asthma was within the range reported from surrounding countries. However, repeated cross-sectional studies are necessary to evaluate trends in asthma prevalence in the Lebanese population.
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Affiliation(s)
- Zeina Akiki
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Danielle Saadeh
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.
- Faculty of Public Health, Lebanese University, Fanar, Lebanon.
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon.
| | - Rita Farah
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Souheil Hallit
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Hassan Hosseini
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Life Sciences and Health Department, Paris-Est University, Paris, France
- Henri Mondor Hospital, Paris, France
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
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Kwizera R, Bongomin F, Olum R, Meya DB, Worodria W, Bwanga F, Fowler SJ, Gore R, Denning DW, Kirenga BJ. Fungal asthma among Ugandan adult asthmatics. Med Mycol 2021; 59:923-933. [PMID: 33945622 DOI: 10.1093/mmy/myab023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 11/15/2022] Open
Abstract
Fungal sensitization is associated with poor asthma control. We aimed to determine the prevalence and factors associated with fungal asthma among Ugandan adults. Individuals aged ≥18 years with a new diagnosis of asthma in the last 12 months participating in the African Severe Asthma Program constituted the study population. Skin prick test results, clinical and demographic data were retrieved from the database, and serum Aspergillus fumigatus specific antibodies and total IgE were measured in stored blood. We enrolled 374 patients, median (IQR) age 34 (25-45) years, 286 (76.5%) females and 286 (76.5%) with severe asthma. Prevalence of Aspergillus fumigatus sensitization was 42.0% (95% CI: 37.1-47.0%), allergic bronchopulmonary aspergillosis (ABPA) 3.2% (1.8-5.5%), severe asthma with fungal sensitization (SAFS) 16% (12.7-20.1%) and allergic bronchopulmonary mycosis (ABPM) 2.9% (1.7-5.2%). Older age (55-64 years) (crude odds ratio (cOR) = 2.6), sensitization to at least one allergen (cOR = 9.38) and hypertension (cOR = 1.99) were significantly associated with Aspergillus sensitization, whereas tertiary education level (cOR = 0.29), severe depression (cOR = 0.15) and strong emotions (cOR = 0.47) were not. High occupational exposure to Aspergillus (cOR = 4.26) and contact with moulds (cOR = 14.28) were significantly associated with ABPA. Palpitations (cOR = 5.54), uncontrolled asthma (cOR = 3.54), eczema/dermatitis (cOR = 3.07), poor lung function (cOR = 2.11) and frequent exacerbations (cOR = 1.01) were significantly associated with SAFS. Eczema/dermatitis (cOR = 1.55) was significantly associated with ABPM, but cold weather trigger (cOR = 0.24) was not. Fungal asthma is a significant problem among Ugandans with asthma and should be particularly considered in individuals who remain uncontrolled despite optimal standard of care for asthma, as it is responsive to available and affordable oral antifungal therapy. LAY SUMMARY This study showed that fungal asthma is a significant problem among Ugandans with asthma with a high prevalence. Fungal asthma should be considered in patients with uncontrolled asthma despite receiving optimal standard of care. This is the first modern attempt to define these endotypes of asthma in Africa.
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Affiliation(s)
- Richard Kwizera
- Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O. Box 22418, Kampala, Uganda.,Makerere University Lung Institute, College of Health Sciences, Makerere University, P.O. Box 7749, Kampala, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology, Faculty of Medicine, Gulu University, P.O. Box, 166, Gulu, Uganda.,Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Ronald Olum
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - David B Meya
- Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O. Box 22418, Kampala, Uganda.,Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - William Worodria
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.,Division of Pulmonology, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda
| | - Freddie Bwanga
- Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Stephen J Fowler
- Manchester Fungal Infection Group, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, UK
| | - Robin Gore
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - David W Denning
- Manchester Fungal Infection Group, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, UK
| | - Bruce J Kirenga
- Makerere University Lung Institute, College of Health Sciences, Makerere University, P.O. Box 7749, Kampala, Uganda.,Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.,Division of Pulmonology, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda
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Decreasing ten-year (2008-2018) trends of the prevalence of childhood asthma and air pollution in Southern Taiwan. World Allergy Organ J 2021; 14:100538. [PMID: 34025904 PMCID: PMC8102795 DOI: 10.1016/j.waojou.2021.100538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 11/24/2022] Open
Abstract
Background Asthma is a common pediatric chronic respiratory disease worldwide. Previous studies showed the prevalence of childhood asthma increased in developed countries as well as in Taiwan in the late 20th century. Recently, several reports from different parts of the world showed a reversed trend in this epidemic of childhood asthma prevalence. This study investigated the trend of childhood asthma through serial cross-section questionnaire surveys in the southern part of Taiwan, and identified associated factors related to this trend in elementary school children. Methods We used the Chinese version of the International Study of Asthma and Allergies in Childhood (ISAAC)29 questionnaire to assess the asthma status of elementary school students aged 6–12 years in Tainan city in 3 independent study periods, namely, 2008–2009, 2010–2012, and 2017–2018. We assessed the trend of “asthma” and “related respiratory symptoms” across 3 study periods. Results Of the 19,633 respondents, 17,545 (89.4%) completed the questionnaires. After adjustment for covariates, the prevalence of asthma and related respiratory symptoms was significantly lower in 2017–2018 than in the 2 earlier periods. Among the protective factors, the increasing rate of breastfeeding might be partly responsible for the observed reduced prevalence of current asthma and exercise-induced wheeze, but not physician-diagnosed asthma. The presence of pets in the house was the risk factor that correlated with the prevalence of nocturnal cough. Pearson correlation analysis showed a significant correlation of the prevalence of physician-diagnosed asthma, current asthma, and exercise-induced wheezing with the concentrations of air pollutant particles with aerodynamic diameter ≤10 μM (PM10) (r = 0.84, 0.77 and 0.81, respectively). Conclusion The prevalence of asthma and related respiratory symptoms has declined in elementary school-age children in southern Taiwan. The increased prevalence of breastfeeding, decreased rate of the presence of pets in the house, and improvement in outdoor air pollution seem to be related to this decreasing trend of asthma in school children. Our findings will provide the scientific base to empower prevention policy to reverse the trend of childhood asthma prevalence. Trial registration N/A
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Key Words
- Air pollution
- Asthma prevalence
- CO, carbon monoxide
- Children
- EPA, Environmental Protection Administration
- ISAAC, International Study of Asthma and Allergies in Childhood
- NO2, nitrogen dioxide pollutant particles with aerodynamic diameter ≤10 μM
- O3, ozone
- OR, odds ratio
- PM10, particles with aerodynamic diameter ≤10 μm (PM10, μg/m3)
- PM2.5, particles with aerodynamic diameter ≤2.5(PM10, μg/m3)
- SO2, sulfur dioxide
- Trend
- ppb, part per billion
- ppm, part per million
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Sahin Onder S, Savran F, Karabulut B, Surmeli M, Cetemen A. Impact of Allergic Rhinitis on Voice in Children. ORL J Otorhinolaryngol Relat Spec 2021; 83:335-340. [PMID: 33652440 DOI: 10.1159/000514120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/22/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The purpose of the present study was to determine the possible effect of allergic rhinitis (AR) on voice change in children with acoustic analysis and Turkish children's voice handicap index-10 (TR-CVHI-10). METHODS This is a case-control study. Forty-one children with AR, and a positive skin prick test, as well as 39 children of controls who had produced a negative skin prick test and lacked a history of allergic disease, were selected for the study. Each assessment included recordings for the purposes of acoustic voice analysis (fundamental frequency [f0], jitter %, shimmer %, and harmonics-to-noise ratio (HNR)), and aerodynamic analysis (maximum phonation time (MPT) and s/z ratio). All participants completed TR-CVHI-10. RESULTS The mean TR-CVHI-10 score of the AR group was significantly higher than the control group (p = 0.013). No difference was observed between the AR and control groups in terms of jitter, shimmer, HNR, and MPT values and s/z ratio (p > 0.05). Conversely, the f0 value was more pronounced in controls (270.9 ± 60.3 Hz) than in the AR group (237.7 ± 54.3 Hz) (p = 0.012). CONCLUSION The study's results revealed that AR can have an effect on fundamental frequency and voice quality in children. The diagnostic process should include AR as a potential cause of voice disorders in children.
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Affiliation(s)
- Serap Sahin Onder
- Department of Otolaryngology, University of Health Sciences Umraniye Research and Education Hospital, Istanbul, Turkey,
| | - Fatih Savran
- Department of Otolaryngology, University of Health Sciences Umraniye Research and Education Hospital, Istanbul, Turkey
| | - Burak Karabulut
- Department of Otolaryngology, University of Health Sciences, Kartal Research and Education Hospital, Istanbul, Turkey
| | - Mehmet Surmeli
- Department of Otolaryngology, University of Health Sciences Umraniye Research and Education Hospital, Istanbul, Turkey
| | - Aysen Cetemen
- Department of Pediatric Allergy, University of Health Sciences Umraniye Research and Education Hospital, Istanbul, Turkey
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Han K, Ran Z, Wang X, Wu Q, Zhan N, Yi Z, Jin T. Traffic-related organic and inorganic air pollution and risk of development of childhood asthma: A meta-analysis. ENVIRONMENTAL RESEARCH 2021; 194:110493. [PMID: 33217436 DOI: 10.1016/j.envres.2020.110493] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 06/11/2023]
Abstract
The effect of early childhood exposure to traffic-related air pollution (TRAP) on the development of asthma remains unclear. The aim of this study was to clarify potential associations between TRAP (fine particulate matter, PM2.5; nitrogen dioxide, NO2; Benzene and total volatile organic pollutants, TVOCs) and childhood asthma by integrating the results from previous studies. Elsevier, LISTA (EBSCO) and Web of Science databases were searched for relevant studies. Adjusted odds ratio (OR) with corresponding 95% confidence interval (CI) for the association between traffic-related air pollutants and health effects were recovered from individual studies and summary effect estimates (meta-OR) were generated in Review Manager 5.3. Twenty-seven studies were included in the meta-analysis and the results showed that TRAP increased the risk of asthma among children: PM2.5 (meta-OR = 1.07, 95% CI:1.00-1.13), NO2 (meta-OR = 1.11, 95% CI:1.06-1.17), Benzene (meta-OR: 1.21, 95% CI:1.13-1.29) and TVOC (meta-OR:1.06, 95% CI: 1.03-1.10). Sensitivity analyses supported these findings. In addition, regional analysis showed that ORs of inorganic TRAP (PM2.5 and NO2) on the risk of childhood asthma were significantly higher in Asia than those in Europe and North America. Subsequent research should focus on the association between organic pollutants in TRAP and childhood asthma. Furthermore, the disentanglement between TRAP and other pollutant sources may be investigated in future studies.
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Affiliation(s)
- Kun Han
- Tianjin Key Laboratory of Urban Transport Emission Research, State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin, 300350, PR China
| | - Zheng Ran
- Tianjin Key Laboratory of Urban Transport Emission Research, State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin, 300350, PR China
| | - Xiuyan Wang
- Tianjin Key Laboratory of Urban Transport Emission Research, State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin, 300350, PR China
| | - Qiong Wu
- Institute of Social Science Survey, Peking University, Beijing, 100871, PR China
| | - Naiyan Zhan
- College of Municipal and Environmental Engineering, Jilin Jianzhu University, Changchun, 130118, PR China
| | - Zhongqin Yi
- Tianjin Key Laboratory of Urban Transport Emission Research, State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin, 300350, PR China
| | - Taosheng Jin
- Tianjin Key Laboratory of Urban Transport Emission Research, State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin, 300350, PR China.
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Mass E, Gentek R. Fetal-Derived Immune Cells at the Roots of Lifelong Pathophysiology. Front Cell Dev Biol 2021; 9:648313. [PMID: 33708774 PMCID: PMC7940384 DOI: 10.3389/fcell.2021.648313] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/05/2021] [Indexed: 12/12/2022] Open
Abstract
Tissue-resident innate immune cells exert a wide range of functions in both adult homeostasis and pathology. Our understanding of when and how these cellular networks are established has dramatically changed with the recognition that many lineages originate at least in part from fetal sources and self-maintain independently from hematopoietic stem cells. Indeed, fetal-derived immune cells are found in most organs and serous cavities of our body, where they reside throughout the entire lifespan. At the same time, there is a growing appreciation that pathologies manifesting in adulthood may be caused by adverse early life events, a concept known as “developmental origins of health and disease” (DOHaD). Yet, whether fetal-derived immune cells are mechanistically involved in DOHaD remains elusive. In this review, we summarize our knowledge of fetal hematopoiesis and its contribution to adult immune compartments, which results in a “layered immune system.” Based on their ontogeny, we argue that fetal-derived immune cells are prime transmitters of long-term consequences of prenatal adversities. In addition to increasing disease susceptibility, these may also directly cause inflammatory, degenerative, and metabolic disorders. We explore this notion for cells generated from erythro-myeloid progenitors (EMP) produced in the extra-embryonic yolk sac. Focusing on macrophages and mast cells, we present emerging evidence implicating them in lifelong disease by either somatic mutations or developmental programming events resulting from maternal and early environmental perturbations.
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Affiliation(s)
- Elvira Mass
- Developmental Biology of the Immune System, Life & Medical Sciences (LIMES) Institute, University of Bonn, Bonn, Germany
| | - Rebecca Gentek
- Centre for Inflammation Research & Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
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Macedo LA, de Oliveira Santos Silva R, Silvestre CC, Alcântara TDS, de Magalhães Simões S, Lyra DP. Effect of pharmacists' interventions on health outcomes of children with asthma: A systematic review. J Am Pharm Assoc (2003) 2021; 61:e28-e43. [PMID: 33608222 DOI: 10.1016/j.japh.2021.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/10/2020] [Accepted: 01/03/2021] [Indexed: 12/12/2022]
Abstract
METHODS A literature search was performed in January 23, 2018 at the Embase, LILACS, OpenThesis, PubMed, Cochrane Library, and Web of Science databases through January 23, 2018, using keywords related to "asthma," "pharmacist," and "children." This systematic review followed the methodologic standards recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included intervention studies on the effect of pharmacists' interventions on pediatric patients with asthma, performed in hospital or ambulatory care settings, with presenting process and outcome indicators as a result of pharmacists' interventions. The methodologic quality of the included studies was assessed independently by 2 researchers. The Cohen kappa index was used to measure the degree of agreement between the 2 investigators. RESULTS The search yielded 3671 records, of which 5 were included in this review. Most of these studies were conducted in the United States (n = 2) and in outpatient clinics (n = 4). All studies described components of pharmacists' interventions. The most reported category concerning pharmacists' work process was the initial assessment of patients' conditions, with the assessment of outcomes (at baseline and follow-up) as the only category present in all studies. The most assessed outcomes at baseline were asthma control, emergency department visits, medication use and technique, and adherence to asthma therapy. At follow-up, emergency department visits were the most evaluated outcome (n = 2), and no study assessed economic outcomes. The average consultation time ranged from 20 to 45 minutes, and the number of encounters ranged from 2 to 3. CONCLUSION This study highlighted the limited number of studies, most with low quality, on the impact of the pharmacist on pediatric asthma. The most assessed outcome was the number of emergency department visits, with positive results after interventions. Heterogeneity regarding assessed outcomes and work processes was noted, which limited comparison of the results and interventions.
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Abushouk A, Alkhalaf H, Aldamegh M, Bin Shigair S, Mahabbat N, Hakami M, Abu-Jaffal AS, Nasr A. IL-35 and IL-37 are negatively correlated with high IgE production among children with asthma in Saudi Arabia. J Asthma 2021; 59:655-662. [PMID: 33492183 DOI: 10.1080/02770903.2021.1878533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Asthma is one of the most prevalent inflammatory disorders among children in Saudi Arabia. OBJECTIVE This study aimed to determine the correlation between the serum levels of vitamin D, immunoglobulin E (IgE), and cytokine (interferon-gamma (IFN-γ), interleukin (IL)-1β, IL-4, IL-6, IL-10, IL-13, IL-35, and IL-37) in relation to the severity of disease in patients with asthma. METHODS This case-control study was carried out at King Abdullah Specialist Children's Hospital, Saudi Arabia, and included 48 patients with asthma and 47 matched controls, aged 6-14 years. A validated questionnaire was administered to the participants, after which each patient with asthma underwent pulmonary function tests. The serum levels of vitamin D, IgE, IFN-γ, IL-1β, IL-4, IL-6, IL-10, IL-13, IL-35, and IL-37 of each participant were also measured. RESULTS Patients with asthma demonstrated significantly higher IgE and cytokine (IL-1β, IL-4, IL-6, IL-10, IL-13, IL-35, and IL-37) levels compared to the control group (p value < .001). The levels of IL-1β, IL-4, IL-10, and IL-13 were consistently positively correlated with the serum levels of IgE among patients with asthma. However, the IgE levels in patients with asthma were consistently negatively correlated with IL-35 and IL-37. CONCLUSIONS We found significantly higher levels of eosinophils, IgE, IL-1β, IL-4, IL-6, IL-10, IL-13, IL-35, and IL-37 in patients with asthma compared to the controls, but no relationship between vitamin D and asthma.
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Affiliation(s)
- Amir Abushouk
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Kingdom of Saudi Arabia.,King Abdullah International Medical Research Centre (KAIMRC), Jeddah, Kingdom of Saudi Arabia
| | - Hamad Alkhalaf
- Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.,King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Kingdom of Saudi Arabia
| | - Moniraa Aldamegh
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Kingdom of Saudi Arabia
| | - Shehana Bin Shigair
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Kingdom of Saudi Arabia
| | - Nadin Mahabbat
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Kingdom of Saudi Arabia
| | - Maumonah Hakami
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Kingdom of Saudi Arabia
| | - Ahmad Saleh Abu-Jaffal
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Amre Nasr
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Kingdom of Saudi Arabia.,Department of Immunology, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia
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Salinas YD, Wang Z, DeWan AT. Discovery and Mediation Analysis of Cross-Phenotype Associations Between Asthma and Body Mass Index in 12q13.2. Am J Epidemiol 2021; 190:85-94. [PMID: 32700739 DOI: 10.1093/aje/kwaa144] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 12/20/2022] Open
Abstract
Twin studies suggest that shared genetics contributes to the comorbidity of asthma and obesity, but candidate-gene studies provide limited evidence of pleiotropy. We conducted genome-wide association analyses of asthma and body mass index (BMI; weight (kg)/height (m)2)) among 305,945 White British subjects recruited into the UK Biobank in 2006-2010. We searched for overlapping signals and conducted mediation analyses on genome-wide-significant cross-phenotype associations, assessing moderation by sex and age at asthma diagnosis, and adjusting for confounders of the asthma-BMI relationship. We identified a genome-wide-significant cross-phenotype association at rs705708 (asthma odds ratio = 1.05, 95% confidence interval: 1.03, 1.07; P = 7.20 × 10-9; and BMI β = -0.065, 95% confidence interval: -0.087, -0.042; P = 1.30 × 10-8). rs705708 resides on 12q13.2, which harbors 9 other asthma- and BMI-associated variants (all P < 5 × 10-5 for asthma; all but one P < 5 × 10-5 for BMI). Follow-up analyses of rs705708 show that most of the BMI association occurred independently of asthma, with consistent magnitude between men and women and persons with and without asthma, irrespective of age at diagnosis; the asthma association was stronger for childhood versus adult asthma; and both associations remained after confounder adjustment. This suggests that 12q13.2 displays pleiotropy for asthma and BMI. Upon further characterization, 12q13.2 might provide a target for interventions that simultaneously prevent or treat asthma and obesity.
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Liu L, Liu C, Chen R, Zhou Y, Meng X, Hong J, Cao L, Lu Y, Dong X, Xia M, Ding B, Qian L, Wang L, Zhou W, Gui Y, Zhang X. Associations of short-term exposure to air pollution and emergency department visits for pediatric asthma in Shanghai, China. CHEMOSPHERE 2021; 263:127856. [PMID: 32822929 DOI: 10.1016/j.chemosphere.2020.127856] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/13/2020] [Accepted: 07/27/2020] [Indexed: 05/08/2023]
Abstract
There is limited evidence regarding the relationship between air pollution and pediatric asthma in developing countries. This study aimed to investigate the association between short-term exposure to ambient air pollutants and pediatric asthma emergency department (ED) visits in Shanghai, China. We collected data on six criteria air pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) and daily ED visits for pediatric asthma patients from 66 hospitals in Shanghai from 2016 to 2018. The generalized additive model combined with polynomial distributed lag model was applied to explore the associations. We fitted two-pollutant models and stratified the analyses by sex, age, and season. In total, we identified 108,817 emergency department visits for pediatric asthma. A 10 μg/m3 increase in the concentrations of PM2.5, NO2, SO2, and O3 was significantly associated with increased risks of pediatric asthma ED visits, with relative risk of pediatric asthma of 1.011 [95% confidence interval (CI): 1.002, 1.021], 1.030 (95%CI: 1.017, 1.043), 1.106 (95%CI: 1.041, 1.174), and 1.009 (95%CI: 1.001, 1.017), respectively. The associations of NO2 remained robust in the two-pollutant models. There were stronger associations for older children (6-18 years) and in warm seasons. The concentration-response curves for pediatric asthma and PM2.5, NO2, SO2, and O3 were steeper at lower and moderate concentrations but became flatter at higher concentrations. This analysis provided evidence that short-term exposure to air pollutants (PM2.5, NO2, SO2, and O3) could increase the risk of asthma exacerbations among children, and health benefits would be gained from improved air quality.
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Affiliation(s)
- Lijuan Liu
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Yufeng Zhou
- Institute of Pediatrics, Children's Hospital of Fudan University, Shanghai, 201102, China; Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Jianguo Hong
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Lanfang Cao
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Yanming Lu
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 201112, China
| | - Xiaoyan Dong
- Department of Respiratory Medicine, Children's Hospital of Shanghai Jiaotong University, Shanghai, 200040, China
| | - Min Xia
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Bo Ding
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 201112, China
| | - Liling Qian
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Libo Wang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Yonghao Gui
- Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Xiaobo Zhang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China.
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Reijula J, Latvala J, Mäkelä M, Siitonen S, Saario M, Haahtela T. Long-term trends of asthma, allergic rhinitis and atopic eczema in young Finnish men: a retrospective analysis, 1926-2017. Eur Respir J 2020; 56:13993003.02144-2019. [PMID: 32764114 DOI: 10.1183/13993003.02144-2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 07/14/2020] [Indexed: 11/05/2022]
Abstract
The aim of this study was to assess the long-term time trends of the prevalence of asthma, allergic rhinitis and atopic eczema in young Finnish men.A retrospective analysis was carried out on cross-sectional data from the Finnish Defence Forces taken from call-up examinations of candidates for military conscription and examinations of conscripts discharged from service because of poor health. Roughly 1.7 million men aged 18‒19 years (98% of men of conscription age) were examined from 1966 to 2017. A proportional but unknown number of young men were examined from 1926 to 1961.The main outcome measures were asthma recorded at call-up examination as the main diagnosis in 1926‒2017 and any diagnosis in 1997‒2017, exemption or discharge from military service due to asthma, and allergic rhinitis and atopic eczema recorded as the main diagnosis in 1966‒2017 and any diagnosis in 1997‒2017.During 1926-1961 the prevalence of asthma remained low at between 0.02% and 0.08%. A linear rise began between 1961 and 1966, with a 12-fold increase in the prevalence from 0.29% in 1966 to 3.44% in 2001. Thereafter, the prevalence of asthma as the main diagnosis stabilised but continued to increase to 5.19% in 2017 if secondary diagnoses of asthma were included. Exemption rates from military service due to asthma have similarly increased but fluctuated more. The prevalence of allergic rhinitis increased from 0.06% to 10.70% and atopic eczema from 0.15% to 2.90% during the period 1966‒2017.In Finland, an increase in asthma and allergic conditions among young men became evident in the mid-1960s. The increase slowed in the 2000s and may be levelling off in the 2020s.
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Affiliation(s)
- Jere Reijula
- Dept of Pulmonology, Helsinki University Central Hospital, Helsinki, Finland .,Dept of Public Health, University of Helsinki, Helsinki, Finland
| | - Jari Latvala
- Finnish Institute of Occupational Health, Oulu, Finland
| | - Mika Mäkelä
- Dept of Dermatology, Allergology and Venereology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - Mari Saario
- The Finnish Defence Forces, Helsinki, Finland
| | - Tari Haahtela
- Dept of Dermatology, Allergology and Venereology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Probiotics function and modulation of the immune system in allergic diseases. Allergol Immunopathol (Madr) 2020; 48:771-788. [PMID: 32763025 DOI: 10.1016/j.aller.2020.04.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 02/08/2023]
Abstract
Allergic diseases have been a global problem over the past few decades. The effect of allergic diseases on healthcare systems and society is generally remarkable and is considered as one of the most common causes of chronic and hospitalized disease. The functional ability of probiotics to modulate the innate/acquired immune system leads to the initiation of mucosal/systemic immune responses. Gut microbiota plays a beneficial role in food digestion, development of the immune system, control/growth of the intestinal epithelial cells and their differentiation. Prescribing probiotics causes a significant change in the intestinal microflora and modulates cytokine secretion, including networks of genes, TLRs, signaling molecules and increased intestinal IgA responses. The modulation of the Th1/Th2 balance is done by probiotics, which suppress Th2 responses with shifts to Th1 and thereby prevent allergies. In general, probiotics are associated with a decrease in inflammation by increasing butyrate production and induction of tolerance with an increase in the ratio of cytokines such as IL-4, IL-10/IFN-γ, Treg/TGF-β, reducing serum eosinophil levels and the expression of metalloproteinase-9 which contribute to the improvement of the allergic disease's symptoms. Finally, it can be said that the therapeutic approach to immunotherapy and the reduction of the risk of side effects in the treatment of allergic diseases is the first priority of treatment and the final approach that completes the first priority in maintaining the condition and sustainability of the tolerance along with the recovery of the individual.
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Navi Z, Fata A, Jafari Rad M, Mogaddas E, Mahmoudi M, Rastin M, Mousavi Bazaz M, Lavi Arab F, Sahab Negah S, Reza Heidari A. Dicrocoelium ova can block the induction phase of experimental autoimmune encephalomyelitis. Parasite Immunol 2020; 42:e12792. [PMID: 32920871 DOI: 10.1111/pim.12792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 11/30/2022]
Abstract
AIMS This study aimed at investigating the impact of Dicrocoelium ova on experimental autoimmune encephalomyelitis (EAE) treatment in C57BL6 mice. METHODS AND RESULTS Twenty-eight C57BL/6 mice were assigned into four groups as PBS, prophylaxis (P), treatment1 (T1) and treatment2 (T2). Prior to induction of EAE in prophylaxis group and on days 7 and 18 in T1 and T2 groups, respectively, Dicrocoelium eggs were injected intraperitoneally to each mouse. The clinical score, weight changes and incidence time of EAE were recorded. IFN-γ and IL-4 expression is quantified on spleen cells. Also, histopathological study by (H&E) and Toluidine-Blue (TB), and Luxol Fast Blue (LFB) were performed. The data were analysed using SPSS version 21. Mean disease scores were significantly lower in P and T1 groups than the PBS group (P = .01). IFN-γ was lower in P and T1 groups than the PBS group. The highest level of IL-4 was observed in T1 group. The total number of neuroglia cells of corpus callosum was similar in all groups, but the density increased in T1 group compared to the PBS group (P = .03). CONCLUSIONS Dicrocoelium eggs have a great potential to stimulate immunomodulation towards treatment of EAE during the initial phase.
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Affiliation(s)
- Zahra Navi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolmajid Fata
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mozhdeh Jafari Rad
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Immunology and Allergy, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Mogaddas
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Mahmoudi
- Immunology Research Center, Bu-Ali Research Institute, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Maryam Rastin
- Immunology Research Center, Bu-Ali Research Institute, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Mojtaba Mousavi Bazaz
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fahimeh Lavi Arab
- Immunology Research Center, Bu-Ali Research Institute, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Sajad Sahab Negah
- Department of Neuroscience, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Iran and Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
| | - Amir Reza Heidari
- Department of Immunology and Allergy, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Cryptolepine, the major alkaloid of Cryptolepis sanguinolenta (Lindl.) Schlechter (Apocynaceae), attenuates early and late-phase symptoms of asthma. SCIENTIFIC AFRICAN 2020. [DOI: 10.1016/j.sciaf.2020.e00540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] Open
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Shan Y, Guo J, Fan W, Li H, Wu H, Song Y, Jalleh G, Wu W, Zhang G. Modern urbanization has reshaped the bacterial microbiome profiles of house dust in domestic environments. World Allergy Organ J 2020; 13:100452. [PMID: 32884612 PMCID: PMC7451671 DOI: 10.1016/j.waojou.2020.100452] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 07/17/2020] [Accepted: 07/24/2020] [Indexed: 02/06/2023] Open
Abstract
Background The prevalence of allergy and other common chronic diseases is higher in developed than developing countries, and higher in urban than rural regions. Urbanization through its modification of environmental microbiomes may play a predominant role in the development of these conditions. However, no studies have been conducted to compare the microbiome in house dust among areas with different urbanization levels. Methods House dust from Xinxiang rural area (XR, n = 74), Xinxiang urban area (XU, n = 33), and Zhengzhou urban area (ZU, n = 32) in central China, and from Australia (AU, n = 58 [with pets AUP, n = 15, without pets AUNP, n = 43]) were collected during a summer season in China and Australia. High-throughput sequencing of 16S rDNA was employed to profile house dust bacterial communities. Results Settled dust collected in China was dominant with 2 bacterial phyla: Proteobacteria and Actinobacteria, while floor dust collected in Australia had a higher proportion of phylum Proteobacteria, Firmicutes, and Actinobacteria. XR dust samples presented higher bacterial richness and diversity compared with XU or ZU samples. Urbanization level (r2 = 0.741 P < 0.001) had a significant correlation with the distribution of house dust bacterial community. At the genus level, there was a positive correlation (r coefficient > 0.5) between urbanization level and bacterial genera Streptococcus, Bartonella, Staphylococcus, Pseudomonas, Acinetobacter, Bacteroides, Corynebacterium_1,and Enhydrobacter and a negative correlation (r coefficient < −0.5) with Rhodanobacter. Conclusion There was a significant difference in house dust microbiota among different urbanization areas. The areas with a lower urbanization level presented higher dust-borne bacterial richness and diversity. Modern urbanization has a significant influence on the bacterial microbiome profiles of indoor dust.
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Affiliation(s)
- Yifan Shan
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, 4353003, P.R. China
- Henan International Laboratory for Air Pollution Health Effects and Intervention, Xinxiang, Henan Province, 4353003, P.R. China
- School of Public Health, Curtin University, Perth, WA, Australia
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Jing Guo
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Wei Fan
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, 450000, P.R. China
| | - Huijun Li
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, 4353003, P.R. China
- Henan International Laboratory for Air Pollution Health Effects and Intervention, Xinxiang, Henan Province, 4353003, P.R. China
| | - Hui Wu
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, 4353003, P.R. China
- School of Public Health, Tianjin Medical University, Tianjin, 300070, P.R. China
- Henan Province General Medical Educations and Research Center, Xinxiang, Henan, 453003, P.R. China
| | - Yong Song
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Geoffrey Jalleh
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Weidong Wu
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, 4353003, P.R. China
- Henan International Laboratory for Air Pollution Health Effects and Intervention, Xinxiang, Henan Province, 4353003, P.R. China
- Corresponding author. School of Public Health, Xinxiang Medical University, 601 Jinsui Street, Xinxiang, Henan Province, 453003, P.R. China.
| | - Guicheng Zhang
- School of Public Health, Curtin University, Perth, WA, Australia
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, 6102, Australia
- Corresponding author. School of Public Health, Curtin University of Technology, Kent St, Bentley, Western Australia, 6102, Australia.
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