1
|
Garcia-Marcos L. Grand challenges in genetics and epidemiology of allergic diseases: from genome to exposome and back. Front Allergy 2024; 5:1368259. [PMID: 38375070 PMCID: PMC10875042 DOI: 10.3389/falgy.2024.1368259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/21/2024] Open
Affiliation(s)
- Luis Garcia-Marcos
- Paediatric Allergy and Pulmonology Units, IMIB Bio-Medical Research Institute, Virgen de la Arrixaca University Children’s Hospital, University of Murcia, Murcia, Spain
| |
Collapse
|
2
|
Fernández-Paredes PC, Morales E, Lopez-Soler C, Garcia-Marcos L. Does Asthma Disrupt Psychological Wellbeing in Pregnancy? J Clin Med 2023; 12:6335. [PMID: 37834979 PMCID: PMC10573683 DOI: 10.3390/jcm12196335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: Asthma is a very prevalent disease with special characteristics during pregnancy, however, little is known about its relationship to the psychological wellbeing of women in this period; we aimed to know whether depression and anxiety symptoms are more frequent in asthmatic pregnant women. (2) Methods: Family Apgar (week 20), Edinburgh Postnatal Depression Scale (weeks 20 and 32) and State-Trait Anxiety Inventory (STAI) (week 32) tests were administered to 738 pregnant women (81 asthmatics) in the Nutrition in Early Life and Asthma (NELA) birth cohort. (3) Results: There were no significant differences between asthmatic and non-asthmatic pregnant women in any of the different tests at any of the time points. The mean scores for the different tests and timepoints between asthmatic and non-asthmatic pregnant women were: Apgar 20, 17.9 ± 2.2 vs. 10.0 ± 2.2; Edinburgh 20, 6.7 ± 4.2 vs. 6.9 ± 4.3; Edinburgh 32, 5.9 ± 4.4 vs. 5.6 ± 4.3; and STAI 32, 16.7 ± 8.4 vs. 15.8 ± 8.3. The proportion of pregnant women out of the normal range score for any of the tests and time points was also similar in both populations. (4) Conclusions: asthma is not associated with the psychological wellbeing of pregnant women.
Collapse
Affiliation(s)
| | - Eva Morales
- Department of Public Health Sciences, IMIB Bio-Health Research Institute, University of Murcia, 30120 Murcia, Spain;
| | - Concepción Lopez-Soler
- Clinical Psychology Unit, Arrixaca Children’s University Hospital, University of Murcia, 30120 Murcia, Spain;
| | - Luis Garcia-Marcos
- Paediatric Allergy and Pulmonology Units, Virgen de la Arrixaca University Children’s Hospital, IMIB Bio-Health Research Institute, University of Murcia, 30120 Murcia, Spain
| | | |
Collapse
|
3
|
Urrutia-Pereira M, Mocelin LP, Ellwood P, Garcia-Marcos L, Simon L, Rinelli P, Chong-Neto HJ, Solé D. Prevalence of rhinitis and associated factors in adolescents and adults: a Global Asthma Network study. Rev Paul Pediatr 2023; 41:e2021400. [PMID: 36888752 PMCID: PMC9984151 DOI: 10.1590/1984-0462/2023/41/2021400] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 06/26/2022] [Indexed: 03/08/2023]
Abstract
OBJECTIVE To determine the prevalence of allergic rhinitis and associated factors in adolescents and in their parents/guardians. METHODS A cross-sectional study, applying a standardized and validated written questionnaire. Adolescents (13-14 years old; n=1,058) and their parents/guardians (mean age=42.1 years old; n=896) living in the city of Uruguaiana, southern Brazil, responded to the Global Asthma Network standard questionnaires. RESULTS The prevalence of allergic rhinitis in adolescents was 28.0%, allergic rhinoconjunctivitis, 21.3%, and severe forms of allergic rhinitis, 7.8%. In the adults, the prevalence of allergic rhinitis was 31.7%. Some associated factors with allergic rhinitis in adolescents include low physical exercise (OR 2.16; 95%CI 1.15-4.05), having only one older sibling (OR 1.94; 95CI 1.01-3.72) and daily meat consumption (OR 7.43; 95% CI 1.53-36.11). In contrast, consuming sugar (OR 0.34; 95%CI 0.12-0.93) or olive oil (OR 0.33; 95%CI 0.13-0 .81) once or twice a week, and eating vegetables daily (OR 0.39; 95%CI 0.15-0.99) were considered factors negatively associated. In adults, exposure to fungi at home (OR 5.25; 95%CI 1.01-27.22) and consumption of meat once or twice a week (OR 46.45; 95CI 2.12-1020.71) were factors associated with the medical diagnosis of allergic rhinitis, while low education (OR 0.25; 95%CI 0.07-0.92) was found to be a factor negatively associated. CONCLUSIONS The prevalence of allergic rhinitis in adolescents is high, as well as its medical diagnosis in adults living in Uruguaiana. Environmental factors, especially food habits, were associated with findings in both groups.
Collapse
Affiliation(s)
| | | | | | | | - Laura Simon
- Universidade Federal do Pampa, Bagé, RS, Brazil
| | | | | | - Dirceu Solé
- Universidade Federal de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
4
|
Rodriguez-Martinez CE, Sossa-Briceño MP, Garcia-Marcos L. Use of inhaled corticosteroids on an intermittent or as-needed basis in pediatric asthma: a systematic review of the literature. J Asthma 2022; 59:2189-2200. [PMID: 34806537 DOI: 10.1080/02770903.2021.2008430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/16/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To summarize the principal findings of all available studies that have evaluated the use of inhaled corticosteroids (ICS) on an intermittent or as-needed basis as an add-on therapy to short-acting β2-agonists (SABAs) or fast-acting β2-agonists (FABAs) in pediatric asthmatic patients. Studies could either include or omit the use of ICS during stable periods of the disease. DATA SOURCES Electronic databases MEDLINE, EMBASE, CINAHL, SCOPUS, and the Cochrane Database of Systematic Reviews from inception to February 2021. STUDY SELECTIONS Relevant articles in the literature published by February 2021. RESULTS Of 294 references identified, 14 studies were included. The use of ICS on an intermittent or as-needed basis (as an add-on therapy to SABAs) has been shown to be more effective than treatment with SABA alone and to be similarly or less effective compared to regular daily ICS administration. Furthermore, strategies involving increasing the dose of ICS only when needed (as an add-on therapy to formoterol, a FABA) and keeping it low during stable stages of the disease (i.e. single maintenance and reliever therapy, SMART) have been shown to be similarly or more effective than comparators. CONCLUSION The use of ICS on an intermittent or as-needed basis as an add-on therapy to SABAs or FABAs, with or without ICS use during stable periods of the disease in pediatric asthmatic patients, encompasses several effective treatment strategies.
Collapse
Affiliation(s)
- Carlos E Rodriguez-Martinez
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
- Department of Pediatric Pulmonology, School of Medicine, Universidad El Bosque, Bogota, Colombia
| | - Monica P Sossa-Briceño
- Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | - Luis Garcia-Marcos
- Pediatric Allergy and Pulmonology Units, "Virgen de la Arrixaca" University Children's Hospital, University of Murcia and IMIB Bioresearch Institute, ARADyAL Allergy Network Spain, Murcia, Spain
| |
Collapse
|
5
|
Morales E, Alcantara-Lopez MV, Cabezas-Herrera J, de Diego T, Hernandez-Caselles T, Jimenez-Guerrero P, Larque E, Lopez-Soler C, Martinez-Gracia C, Martinez-Torres A, Martin-Orozco E, Mendiola J, Nieto-Díaz A, Noguera JA, Perez-Fernandez V, Prieto-Sánchez MT, Salvador-Garcia C, Sanchez-Solis M, Santaella-Pascual M, Sola-Martinez RA, Torres-Cantero A, Yagüe-Guirao G, Zornoza-Moreno M, Garcia-Marcos L. The Nutrition in Early Life and Asthma (NELA) birth cohort study: Rationale, design, and methods. Paediatr Perinat Epidemiol 2022; 36:310-324. [PMID: 34841558 DOI: 10.1111/ppe.12826] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Primary prevention strategies for asthma are lacking. Its inception probably starts in utero and/or during the early postnatal period as the developmental origins of health and disease (DOHaD) paradigm suggests. OBJECTIVES The main objective of Nutrition in Early Life and Asthma (NELA) cohort study is to unravel whether the following factors contribute causally to the developmental origins of asthma: (1) maternal obesity/adiposity and foetal growth; (2) maternal and child nutrition; (3) outdoor air pollution; (4) endocrine disruptors; and (5) maternal psychological stress. Maternal and offspring biological samples are used to assess changes in offspring microbiome, immune system, epigenome and volatilome as potential mechanisms influencing disease susceptibility. POPULATION Randomly selected pregnant women from three health areas of Murcia, a south-eastern Mediterranean region of Spain, who fulfilled the inclusion criteria were invited to participate at the time of the follow-up visit for routine foetal anatomy scan at 19-22 weeks of gestation, at the Maternal-Fetal Medicine Unit of the "Virgen de la Arrixaca" University Clinical Hospital over a 36-month period, from March 2015 to April 2018. DESIGN Prospective, population-based, maternal-child, birth cohort study. METHODS Questionnaires on exposures and outcome variables were administered to mothers at 20-24 gestation week; 32-36 gestation week; and delivery. Children were surveyed at birth, 3 and 18 months of age and currently at 5 years. Furthermore, physical examinations were performed; and different measurements and biological samples were obtained at these time points. PRELIMINARY RESULTS Among the 1350 women invited to participate, 738 (54%) were finally enrolled in the study and 720 of their children were eligible at birth. The adherence was high with 612 children (83%) attending the 3 months' visit and 532 children (72%) attending the 18 months' visit. CONCLUSION The NELA cohort will add original and unique knowledge to the developmental origins of asthma.
Collapse
Affiliation(s)
- Eva Morales
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Public Health Sciences, University of Murcia, Murcia, Spain
| | - Maria V Alcantara-Lopez
- Paediatric Psychology Unit, "Virgen de la Arrixaca" Children's University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Juan Cabezas-Herrera
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Molecular Therapy and Biomarkers Research Group, "Virgen de la Arrixaca" University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Teresa de Diego
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Biochemistry, Molecular Biology, University of Murcia, Murcia, Spain
| | - Trinidad Hernandez-Caselles
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Biochemistry, Molecular Biology, University of Murcia, Murcia, Spain
| | - Pedro Jimenez-Guerrero
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Regional Atmospheric Modelling Group, Department of Physics, University of Murcia, Murcia, Spain
| | - Elvira Larque
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Physiology, University of Murcia, Murcia, Spain.,Maternal and Children Health Network (SAMID III), Murcia, Spain
| | - Concepción Lopez-Soler
- Paediatric Psychology Unit, "Virgen de la Arrixaca" Children's University Clinical Hospital, University of Murcia, Murcia, Spain.,Paediatric and Adolescent Clinical Psychology University Research Group (GUIIA-PC), University of Murcia, Murcia, Spain
| | - Carmen Martinez-Gracia
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Food Science and Technology, University of Murcia, Murcia, Spain
| | - Antonela Martinez-Torres
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Paediatric Respiratory and Allergy Units, "Virgen de la Arrixaca" Children's University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Elena Martin-Orozco
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Biochemistry, Molecular Biology, University of Murcia, Murcia, Spain
| | - Jaime Mendiola
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Public Health Sciences, University of Murcia, Murcia, Spain
| | - Anibal Nieto-Díaz
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Materno-Fetal Medicine Unit, Obstetrics and Gynaecology Service, "Virgen de la Arrixaca" University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Jose A Noguera
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Molecular Therapy and Biomarkers Research Group, Clinical Analysis Service, University Clinical Hospital, Murcia, Spain
| | - Virginia Perez-Fernandez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Public Health Sciences, University of Murcia, Murcia, Spain
| | - M Teresa Prieto-Sánchez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Materno-Fetal Medicine Unit, Obstetrics and Gynaecology Service, "Virgen de la Arrixaca" University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Carme Salvador-Garcia
- Microbiology Service, General University Hospital Consortium, University of Valencia, Valencia, Spain
| | - Manuel Sanchez-Solis
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Paediatric Respiratory and Allergy Units, "Virgen de la Arrixaca" Children's University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Marina Santaella-Pascual
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Food Science and Technology, University of Murcia, Murcia, Spain
| | - Rosa A Sola-Martinez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Biochemistry, Molecular Biology, University of Murcia, Murcia, Spain
| | - Alberto Torres-Cantero
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Public Health Sciences, University of Murcia, Murcia, Spain.,Preventive Medicine Service, "Virgen de la Arrixaca" University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Genoveva Yagüe-Guirao
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Microbiology Service, "Virgen de la Arrixaca" University Clinical Hospital, University of Murcia, Murcia, Spain.,Department of Genetics and Microbiology, University of Murcia, Murcia, Spain
| | - Matilde Zornoza-Moreno
- Department of Physiology, University of Murcia, Murcia, Spain.,"Vistalegre-La Flota" Health Center, Health System of Murcia (SMS), Murcia, Spain
| | - Luis Garcia-Marcos
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Paediatric Respiratory and Allergy Units, "Virgen de la Arrixaca" Children's University Clinical Hospital, University of Murcia, Murcia, Spain.,Network of Asthma and Adverse and Allergic Reactions (ARADyAL), Murcia, Spain
| | | |
Collapse
|
6
|
Ferreira WFDS, Carvalho DSD, Wandalsen GF, Solé D, Sarinho ESC, Medeiros D, Melo ACCDB, Prestes EX, Camargos PAM, Luhm KR, Garcia-Marcos L, Mallol J, Rosário NA, Chong-Neto HJ. Associated factors with recurrent wheezing in infants: is there difference between the sexes? J Pediatr (Rio J) 2021; 97:629-636. [PMID: 33567270 PMCID: PMC9432028 DOI: 10.1016/j.jped.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 12/16/2020] [Accepted: 01/05/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Identify associated factors for recurrent wheezing (RW) in male and female infants. METHODS Cross-sectional multicentric study using the standardized questionnaire from the Estudio Internacional sobre Sibilancias en Lactantes (EISL). The questionnaire was applied to parents of 9345 infants aged 12-15 months at the time of immunization/routine visits. RESULTS One thousand two hundred and sixty-one (13.5%) males and nine hundred sixty-three (10.3%) females have had RW (≥3 episodes), respectively (p10 colds episodes (OR = 3.46; IC 95% 2.35-5.07), air pollution (OR = 1.33; IC 95% 1.12-1.59), molds at home (OR = 1.23; IC 95% 1.03-1.47), Afro-descendants (OR = 1.42; IC 95% 1.20-1.69), bronchopneumonia (OR = 1.41; IC; 1.11-1.78), severe episodes of wheezing in the first year (OR = 1.56; IC 95% 1.29-1.89), treatment with bronchodilators (OR = 1.60; IC 95% 1.22-2,1) and treatment with oral corticosteroids (OR = 1,23; IC 95% 0.99-1,52). Associated factors for RW for females were passive smoking (OR = 1.24; IC 95% 1.01-1,51), parents diagnosed with asthma (OR = 1.32; IC 95% 1,08-1,62), parents with allergic rhinitis (OR = 1.26; IC 95% 1.04-1.53), daycare attendance (OR = 1.48; IC 95% 1.17-1,88), colds in the first 6 months of life (OR = 2.19; IC 95% 1.69-2.82), personal diagnosis of asthma (OR = 1.84; IC 95% 1.39-2.44), emergency room visits (OR = 1.78; IC 95% 1.44-2.21), nighttime symptoms (OR = 2.89; IC 95% 2.34-3.53) and updated immunization (OR = 0.62; IC 95% 0.41-0.96). CONCLUSION There are differences in associated factors for RW between genders. Identification of these differences could be useful to the approach and management of RW between boys and girls.
Collapse
Affiliation(s)
| | | | | | - Dirceu Solé
- Universidade Federal de São Paulo, Departamento de Pediatria, São Paulo, SP, Brazil
| | | | - Décio Medeiros
- Universidade Federal de Pernambuco, Departamento de Pediatria, Recife, PE, Brazil
| | | | | | | | - Karin Regina Luhm
- Universidade Federal do Paraná, Departamento de Saúde Coletiva, Curitiba, PR, Brazil
| | - Luis Garcia-Marcos
- University of Murcia, Virgen de la Arrixaca Children University Hospital, Unidade de Alergia e Respiratóra Pediátrica, Murcia, Spain
| | - Javier Mallol
- University of Santiago de Chile (USACH), El Pino Hospital, Departamento de Medicina Respiratória, San Bernardo, Chile
| | | | | |
Collapse
|
7
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
8
|
Garcia-Marcos L, Sanchez-Solis M. Does asthma cause sleep disorders … or the other way around? J Pediatr (Rio J) 2021; 97:366-368. [PMID: 33545025 PMCID: PMC9432254 DOI: 10.1016/j.jped.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Luis Garcia-Marcos
- University of Murcia, Arrixaca University Children's Hospital, Respiratory and Allergy Units, Murcia, Spain; Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain; Carlos III Health Institute, Network of Asthma, and Adverse and Allergy Reactions (ARADyAL) Network, Madrid, Spain.
| | - Manuel Sanchez-Solis
- University of Murcia, Arrixaca University Children's Hospital, Respiratory and Allergy Units, Murcia, Spain; Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain; Carlos III Health Institute, Network of Asthma, and Adverse and Allergy Reactions (ARADyAL) Network, Madrid, Spain
| |
Collapse
|
9
|
Urrutia-Pereira M, Chong-Neto H, Mocellin LP, Ellwood P, Garcia-Marcos L, Simon L, Rinelli P, Solé D. Prevalence of asthma symptoms and associated factors in adolescents and adults in southern Brazil: A Global Asthma Network Phase I study. World Allergy Organ J 2021; 14:100529. [PMID: 33850603 PMCID: PMC8010518 DOI: 10.1016/j.waojou.2021.100529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/02/2021] [Accepted: 02/14/2021] [Indexed: 12/22/2022] Open
Abstract
Background The Global Asthma Network (GAN) aims to find out the current status of the prevalence and severity of asthma, rhinitis, and eczema using global surveillance to achieve worldwide recognition and improve the management of asthma, especially in low- and middle-income countries. The aim of this study was to verify the associated factors for asthma in adolescents and their respective parents/caregivers. Methods Adolescents (13–14 years old; n = 1058) and their respective parents/caregivers (mean age = 42.1 years, n = 896) living in the town of Uruguaiana, Southern Brazil fulfilled the standardized questionnaire. Results Although the prevalence of wheezing in the past 12 months was higher among adults than adolescents (18.4% vs. 15.8%, respectively), adolescents showed more severe wheezing and worse control over the disease revealed by higher consumption of short-acting beta-2 agonists; going to the emergency room; hospitalization in the last year and dry night cough. Smoking and paracetamol use were associated with risk for developing asthma symptoms and consuming seafood/fish was protective. For the adults smoking (10 or more cigarettes/day) and exposure to mould in the house were associated with risk for asthma symptoms. Conclusions Adolescents have a high prevalence of asthma symptoms and few have an action plan. Adults do not have their disease under control and they use more relief than preventive medication. Differences in associated factors could determine the outcomes in asthma control among adolescents and their parents.
Collapse
Affiliation(s)
| | | | - Lucas Pitrez Mocellin
- Department of Collective Health, Faculty of Medicine, Federal University of Pampa, Brazil
| | - Philippa Ellwood
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand
| | - Luis Garcia-Marcos
- Pediatric Allergy and Pulmonology Units, Arrixaca University Children's Hospital, University of Murcia, IMIB Bio-health Research Institute of Murcia (IMIB), ARADyAL Network, Spain
| | - Laura Simon
- Department of Pediatrics, Federal University of Pampa (Unipampa), Brazil
| | - Pietro Rinelli
- Department of Pediatrics, Federal University of Pampa (Unipampa), Brazil
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, Brazil
| |
Collapse
|
10
|
Meghji J, Mortimer K, Agusti A, Allwood BW, Asher I, Bateman ED, Bissell K, Bolton CE, Bush A, Celli B, Chiang CY, Cruz AA, Dinh-Xuan AT, El Sony A, Fong KM, Fujiwara PI, Gaga M, Garcia-Marcos L, Halpin DMG, Hurst JR, Jayasooriya S, Kumar A, Lopez-Varela MV, Masekela R, Mbatchou Ngahane BH, Montes de Oca M, Pearce N, Reddel HK, Salvi S, Singh SJ, Varghese C, Vogelmeier CF, Walker P, Zar HJ, Marks GB. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet 2021; 397:928-940. [PMID: 33631128 DOI: 10.1016/s0140-6736(21)00458-x] [Citation(s) in RCA: 122] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 01/19/2023]
Abstract
Low-income and middle-income countries (LMICs) bear a disproportionately high burden of the global morbidity and mortality caused by chronic respiratory diseases (CRDs), including asthma, chronic obstructive pulmonary disease, bronchiectasis, and post-tuberculosis lung disease. CRDs are strongly associated with poverty, infectious diseases, and other non-communicable diseases (NCDs), and contribute to complex multi-morbidity, with major consequences for the lives and livelihoods of those affected. The relevance of CRDs to health and socioeconomic wellbeing is expected to increase in the decades ahead, as life expectancies rise and the competing risks of early childhood mortality and infectious diseases plateau. As such, the World Health Organization has identified the prevention and control of NCDs as an urgent development issue and essential to the achievement of the Sustainable Development Goals by 2030. In this Review, we focus on CRDs in LMICs. We discuss the early life origins of CRDs; challenges in their prevention, diagnosis, and management in LMICs; and pathways to solutions to achieve true universal health coverage.
Collapse
Affiliation(s)
- Jamilah Meghji
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Kevin Mortimer
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Global Initiative for Asthma (GINA), Fontana, WI, USA; Global Initiative for COPD (GOLD), Fontana, WI, USA; British Thoracic Society Global Health Group, London, UK; Global Asthma Network (GAN), Auckland, New Zealand; Pan African Thoracic Society, Durban, South Africa; International Union Against Tuberculosis and Lung Diseases, Paris, France.
| | - Alvar Agusti
- Global Initiative for COPD (GOLD), Fontana, WI, USA; British Thoracic Society Global Health Group, London, UK; Respiratory Institute, Hospital Clinic, IDIBAPS, University of Barcelona, CIBERES, Barcelona, Spain
| | - Brian W Allwood
- Division of Pulmonology, Department of Medicine, Stellenbosch University, Stellenbosch, South Africa
| | - Innes Asher
- Global Asthma Network (GAN), Auckland, New Zealand; Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Eric D Bateman
- Global Initiative for Asthma (GINA), Fontana, WI, USA; Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Karen Bissell
- Global Asthma Network (GAN), Auckland, New Zealand; School of Population Health, University of Auckland, Auckland, New Zealand
| | - Charlotte E Bolton
- British Thoracic Society Global Health Group, London, UK; NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham UK
| | - Andrew Bush
- British Thoracic Society Global Health Group, London, UK; Imperial College and Royal Brompton Hospital, London, UK
| | - Bartolome Celli
- Global Initiative for COPD (GOLD), Fontana, WI, USA; Harvard Medical School, Boston, MA, USA
| | - Chen-Yuan Chiang
- International Union Against Tuberculosis and Lung Diseases, Paris, France; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Alvaro A Cruz
- Global Initiative for Asthma (GINA), Fontana, WI, USA; Department of Internal Medicine, Federal University of Bahia, Salvador, Brazil
| | - Anh-Tuan Dinh-Xuan
- Cochin Hospital, Université de Paris, Paris, France; European Respiratory Society, Lausanne, Switzerland
| | - Asma El Sony
- Global Asthma Network (GAN), Auckland, New Zealand; International Union Against Tuberculosis and Lung Diseases, Paris, France; Epidemiological Laboratory (EPI Lab) for Public Health and Research, Khartoum, Sudan
| | - Kwun M Fong
- The University of Queensland Thoracic Research Centre and The Prince Charles Hospital, Queensland, QLD, Australia; Asian Pacific Society of Respirology, Tokyo, Japan
| | - Paula I Fujiwara
- International Union Against Tuberculosis and Lung Diseases, Paris, France
| | - Mina Gaga
- Athens Chest Hospital Sotiria, Athens, Greece; World Health Organization, Geneva, Switzerland
| | - Luis Garcia-Marcos
- Global Asthma Network (GAN), Auckland, New Zealand; Paediatric Pulmonology and Allergy Units, Arrixaca Children's University Hospital, University of Murcia, Murcia, Spain; BioHealth Research Institute of Murcia, Murcia, Spain; ARADyAL network, Madrid, Spain
| | - David M G Halpin
- Global Initiative for COPD (GOLD), Fontana, WI, USA; University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - John R Hurst
- British Thoracic Society Global Health Group, London, UK; UCL Respiratory, University College London, London, UK
| | - Shamanthi Jayasooriya
- British Thoracic Society Global Health Group, London, UK; Academic Unit of Primary Care, University of Sheffield, Sheffield, UK
| | - Ajay Kumar
- International Union Against Tuberculosis and Lung Diseases, Paris, France
| | - Maria V Lopez-Varela
- Global Initiative for COPD (GOLD), Fontana, WI, USA; Pulmonary Department, Universidad de la Republica, Montevideo, Uruguay
| | - Refiloe Masekela
- Pan African Thoracic Society, Durban, South Africa; College of Health Sciences, Nelson R Mandela School of Clinical Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Bertrand H Mbatchou Ngahane
- Pan African Thoracic Society, Durban, South Africa; International Union Against Tuberculosis and Lung Diseases, Paris, France; Douala General Hospital, Douala, Cameroon
| | - Maria Montes de Oca
- Global Initiative for COPD (GOLD), Fontana, WI, USA; Pulmonary Department, Universidad Central de Venezuela, Caracas, Venezuela
| | - Neil Pearce
- Global Asthma Network (GAN), Auckland, New Zealand; London School of Hygiene & Tropical Medicine, London, UK
| | - Helen K Reddel
- Global Initiative for Asthma (GINA), Fontana, WI, USA; Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Sundeep Salvi
- Global Initiative for COPD (GOLD), Fontana, WI, USA; Pulmocare Research and Education Foundation, Pune, India
| | - Sally J Singh
- British Thoracic Society Global Health Group, London, UK; Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Cherian Varghese
- Department of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
| | - Claus F Vogelmeier
- Global Initiative for COPD (GOLD), Fontana, WI, USA; Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-Universität Marburg, Marburg, Germany; German Center for Lung Research (DZL), Giessen, Germany
| | - Paul Walker
- British Thoracic Society Global Health Group, London, UK; Department of Respiratory Medicine, Liverpool Teaching Hospitals, Liverpool, UK
| | - Heather J Zar
- Pan African Thoracic Society, Durban, South Africa; Department of Paediatrics & Child Health, Red Cross Childrens Hospital, Cape Town, South Africa; SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Guy B Marks
- Global Asthma Network (GAN), Auckland, New Zealand; International Union Against Tuberculosis and Lung Diseases, Paris, France; Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia; UNSW Medicine, Sydney, NSW, Australia
| |
Collapse
|
11
|
Garcia-Marcos PW, Pastor-Costa P, Mondejar-Lopez P, Sanchez-Solis M, Garcia-Marcos L, Diaz-Manzano JA. Factors associated to functional recovery of left vocal fold motion impairment at two-years-old age in very preterm infants. Int J Pediatr Otorhinolaryngol 2021; 142:110612. [PMID: 33412342 DOI: 10.1016/j.ijporl.2021.110612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To describe a cohort of neonates with left vocal fold motion impairment (LVFMI) and the factors associated to it in the neonatal period; procedures required during LVFMI treatment; and clinical outcomes at the age of 2-years. An additional objective was to study those factors which are likely to be most associated to functional recovery of LVFMI at this age. METHODS A cohort of patients born in a tertiary care hospital with a diagnosis of left VFMI was included. Factors registered were: gender; clinical presentation at the time of examination; diagnosis of other laryngeal defects associated; data related to their neonatal period (gestational age, congenital heart defects corrective surgery required, neurologic disease, bronchopulmonary dysplasia, non-invasive ventilation required, invasive ventilation required, and tracheostomy required); treatment applied for LVFMI (tracheostomy and/or laryngeal surgery); need of language and hearing therapy; and outcomes considered by the pediatric otolaryngologist at the 2 years-old follow-up visit. RESULTS A total of 56 patients with LVFMI diagnosis were included. Only 10 patients (17.9%) showed functional recovery from LVFMI at the age of 2 years. We found significant negative association between this recovery and language and hearing therapy (p = 0.03), which was also associated to psychomotor retardation (p < 0.001). Multivariate analysis produced similar results, being language and hearing therapy the only significant factor associated to a worse outcome (OR = 4.77 [CI95% 1.14; 20.08] p = 0.03). CONCLUSION Psychomotor development retardation is negatively associated to functional recovery of full speech in a preterm infant's population with LVFMI diagnosis, regardless of other factors related to LVFMI etiology and severity.
Collapse
Affiliation(s)
- Patricia W Garcia-Marcos
- Pediatric Pulmonology and Cystic Fibrosis Unit, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | | | - Pedro Mondejar-Lopez
- Pediatric Pulmonology and Cystic Fibrosis Unit, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - Manuel Sanchez-Solis
- Surgery, Pediatric, Obstetric and Gynecology Department, University of Murcia, Murcia, Spain; Biomedical Research Institute Virgen de la Arrixaca of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Luis Garcia-Marcos
- Surgery, Pediatric, Obstetric and Gynecology Department, University of Murcia, Murcia, Spain; Biomedical Research Institute Virgen de la Arrixaca of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Jose A Diaz-Manzano
- Biomedical Research Institute Virgen de la Arrixaca of Murcia (IMIB-Arrixaca), Murcia, Spain; Department of Otolaryngology, Virgen de la Arrixaca University Hospital, Murcia, Spain.
| |
Collapse
|
12
|
Del-Río-Navarro BE, Berber A, Reyes-Noriega N, Navarrete-Rodríguez EM, García-Almaraz R, Ellwood P, Garcia-Marcos L, Saucedo-Ramírez OJ, Mérida-Palacio VJ, Ramos-García BDC, Escalante-Domínguez AJ, Linares-Zapién FJ, Moreno-Gardea HL, Ochoa-López G, Hernández-Mondragón LO, Lozano-Sáenz JS, Sacre-Hazouri JA, Juan-Pineda Á, Sánchez-Coronel MG, Rodríguez-Pérez N, Ambriz-Moreno MDJ. Global Asthma Network Phase I study in Mexico: prevalence of asthma symptoms, risk factors and altitude associations-a cross-sectional study. BMJ Open Respir Res 2020; 7:7/1/e000658. [PMID: 33268340 PMCID: PMC7713197 DOI: 10.1136/bmjresp-2020-000658] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 12/16/2022] Open
Abstract
Background Global Asthma Network (GAN) was established in 2012 as a development to the International Study of Asthma and Allergies in Childhood to improve asthma care globally. Objective To survey asthma, allergic rhinitis and atopic dermatitis in primary and secondary school children and to investigate and evaluate its prevalence, severity, management and risk factors in Mexico. Methods GAN Phase I is a cross-sectional, multicentre survey carried out in 15 centres corresponding to 14 Mexican cities throughout 2016–2019 using the validated Spanish language version of the GAN Phase I questionnaires. The questionnaires were completed by parents of 6–7-year-old primary school pupils (school children) and by 13–14-year-old adolescents. Results A total of 35 780 school children and 41 399 adolescents participated. Wheezing ever prevalence was 26.2% (95% CI 25.8% to 26.7%) in school children and 23.9% (95% CI 23.4% to 24.3%) in adolescents. The corresponding frequencies for current wheeze were 10.2% (95% CI 9.9% to 10.5%) and 11.6% (95% CI 11.2% to 11.9%). In school children, the risk factors for current wheeze were rhinitis (OR 4.484; 95% CI 3.915% to 5.134%) and rash symptoms (OR 1.735; 95% CI 1.461% to 2.059%). For adolescents, rhinitis symptoms (OR 3.492; 95% CI 3.188% to 3.825%) and allergic rhinitis diagnosis (OR 2.144; 95% CI 1.787% to 2.572%) were the most significant. For both groups, there was a negative relation with centres’ sea level altitude higher than 1500 m above mean sea level (p<0.005). Conclusions The most important risk factors for asthma symptoms in both age groups were the presence of rhinitis and rash symptoms or diagnosis. On the other hand, sea level altitude higher than 1500 metres was a protective factor.
Collapse
Affiliation(s)
| | - Arturo Berber
- Allergy and Immunology, Hospital Infantil de México Federico Gomez, Mexico City, Mexico
| | - Nayely Reyes-Noriega
- Allergy and Immunology, Hospital Infantil de México Federico Gomez, Mexico City, Mexico
| | | | | | - Philippa Ellwood
- Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Luis Garcia-Marcos
- Paediatric Allergy and Pulmonology Units 'Virgen de la Arrixaca' University Children's Hospital, University of Murcia, Universidad de Murcia, Murcia, Spain
| | | | | | | | | | - Francisco Javier Linares-Zapién
- Allergy and Immunology, Centro de Investigación, Diagnóstico y Tratamiento de Asma y Alergias, Toluca, Estado de México, Mexico
| | | | | | | | | | | | | | | | - Noel Rodríguez-Pérez
- Allergy and Immunology, Benemérita Universidad Autónoma de Aguascalientes, Aguascalientes, Mexico
| | | | | |
Collapse
|
13
|
Moeller A, Thanikkel L, Duijts L, Gaillard EA, Garcia-Marcos L, Kantar A, Tabin N, Turner S, Zacharasiewicz A, Pijnenburg MWH. COVID-19 in children with underlying chronic respiratory diseases: survey results from 174 centres. ERJ Open Res 2020; 6:00409-2020. [PMID: 33263054 PMCID: PMC7682706 DOI: 10.1183/23120541.00409-2020] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/27/2020] [Indexed: 01/07/2023] Open
Abstract
Background Early reports suggest that most children infected with severe acute respiratory syndrome coronavirus 2 ("SARS-CoV-2") have mild symptoms. What is not known is whether children with chronic respiratory illnesses have exacerbations associated with SARS-CoV-2 virus. Methods An expert panel created a survey, which was circulated twice (in April and May 2020) to members of the Paediatric Assembly of the European Respiratory Society (ERS) and via the social media of the ERS. The survey stratified patients by the following conditions: asthma, cystic fibrosis (CF), bronchopulmonary dysplasia (BPD) and other respiratory conditions. Results In total 174 centres responded to at least one survey. 80 centres reported no cases, whereas 94 entered data from 945 children with coronavirus disease 2019 (COVID-19). SARS-CoV-2 was isolated from 49 children with asthma of whom 29 required no treatment, 19 needed supplemental oxygen and four children required mechanical ventilation. Of the 14 children with CF and COVID-19, 10 required no treatment and four had only minor symptoms. Among the nine children with BPD and COVID-19, two required no treatment, five required inpatient care and oxygen and two were admitted to a paediatric intensive care unit (PICU) requiring invasive ventilation. Data were available from 33 children with other conditions and SARS-CoV-2 of whom 20 required supplemental oxygen and 11 needed noninvasive or invasive ventilation. Conclusions Within the participating centres, in children with asthma and CF, infection with SARS-CoV-2 was well tolerated, but a substantial minority of children with BPD and other conditions required ventilatory support indicating that these latter groups are at risk from SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Alexander Moeller
- Division of Respiratory Medicine and Childhood Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,These authors contributed equally
| | - Leo Thanikkel
- Division of Respiratory Medicine and Childhood Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,These authors contributed equally
| | - Liesbeth Duijts
- Dept of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Erol A Gaillard
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK.,NIHR Biomedical Research Centre (Respiratory Theme), Leicester, UK
| | - Luis Garcia-Marcos
- Pulmonology and Allergy Units, Arrixaca University Children's Hospital, University of Murcia, Biohealth Research Institute of Murcia (IMIB), and ARADyAL network, El Palmar, Spain
| | - Ahmad Kantar
- Pediatric Asthma and Cough Center, Istituti Ospedalieri Bergamaschi, Bergamo, Ponte San Pietro, Italy
| | | | | | - Angela Zacharasiewicz
- Dept of Pediatrics, Wilhelminenspital, Klinikum Ottakring, Teaching Hospital of the University of Vienna, Vienna, Austria
| | - Mariëlle W H Pijnenburg
- Dept of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
14
|
Rutter CE, Silverwood RJ, Asher MI, Ellwood P, Pearce N, Garcia-Marcos L, Strachan DP. Comparison of individual-level and population-level risk factors for rhinoconjunctivitis, asthma, and eczema in the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three. World Allergy Organ J 2020; 13:100123. [PMID: 32642022 PMCID: PMC7334817 DOI: 10.1016/j.waojou.2020.100123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/08/2020] [Accepted: 04/24/2020] [Indexed: 12/22/2022] Open
Abstract
Background Symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema in children cluster at both the individual and population levels. Objectives To assess individual-level and school-level risk factors for symptoms of rhinoconjunctivitis and compare them to corresponding associations with symptoms of asthma and eczema in Phase Three of the International Study of Asthma and Allergies in Childhood. Methods We studied 116,863 children aged 6–7 years from 2163 schools in 59 centres and 22 countries and 224,436 adolescents aged 13–14 years from 2037 schools in 97 centres in 41 countries. Multilevel logistic regression models were fitted with random intercepts for school, centre, and country, adjusting for sex and maternal education at the child level. Associations between symptoms and a range of lifestyle and environmental risk factors were assessed for both the child's exposure and mean exposure at the school. Models were fitted for rhinoconjunctivitis, asthma, and eczema singly (unimorbidity) and for combinations of these conditions (multimorbidity). Results Generally, associations between symptoms and exposures at the school level were similar in direction and magnitude to those at the child level. Associations with multimorbidity were stronger than for unimorbidity, particularly in individuals with symptoms of all three diseases, but risk factor associations found in conventional single disease analyses persisted among children with only one condition, after excluding multimorbid groups. Comparisons of individuals with only one disease showed that many risk factor associations were consistent across the three conditions. More strongly associated with asthma were low birthweight, cat exposure in infancy, and current maternal smoking. Current paracetamol use was more strongly associated with asthma and rhinoconjunctivitis than eczema. Breastfeeding was more strongly associated with eczema than asthma or rhinoconjunctivitis. The direction and magnitude of most risk factor associations were similar in affluent and non-affluent countries, although notable exceptions include farm animal contact in infancy and larger sibships, which were associated with increased risk of rhinoconjunctivitis in non-affluent countries but reduced risk in affluent countries. In both age groups, current paracetamol use increased risk of each disease to a greater extent in affluent countries than in non-affluent countries. Effects of paracetamol and antibiotics in infancy were more consistent between richer and poorer settings. Conclusions Most of the environmental and lifestyle correlates of rhinoconjunctivitis, asthma and eczema in childhood display similarity across the three conditions, even in less affluent settings where allergic sensitisation is less likely to explain the concordant epidemiological patterns. Trial registration Not applicable.
Collapse
Affiliation(s)
- Charlotte E Rutter
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Richard J Silverwood
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Centre for Longitudinal Studies, Department of Social Science, University College London, London, United Kingdom
| | - M Innes Asher
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Philippa Ellwood
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Neil Pearce
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Centre for Global NCDs, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Luis Garcia-Marcos
- Pediatric Allergy and Pulmonology Units, 'Virgen de La Arrixaca' University Children's Hospital, University of Murcia, ARADyAL Network and IMIB Bioresearch Institute, Murcia, Spain
| | - David P Strachan
- Population Health Research Institute, St George's University of London, London, United Kingdom
| | | |
Collapse
|
15
|
Sanchez-Solis M, Garcia-Marcos PW, Agüera-Arenas J, Mondejar-Lopez P, Garcia-Marcos L. Impact of early caffeine therapy in preterm newborns on infant lung function. Pediatr Pulmonol 2020; 55:102-107. [PMID: 31587528 DOI: 10.1002/ppul.24540] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/12/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To know the effect of caffeine therapy on infant lung function in preterm infants with a gestational age less than 31 weeks. MATERIAL AND METHODS Forced vital capacity (FVC), forced expiratory volume at 0.5 seconds (FEV0.5 ), and forced expiratory flows were measured by raised volume rapid thoracoabdominal compression technique; functional residual capacity was measured by plethysmography (FRCpleth ). Compliance of the respiratory system was measured by a single interruption technique (Crs). The Student t test was used to compare lung function measurements between the two groups: treated versus nontreated with caffeine. A multivariate analysis was carried out considering each and every lung function parameter (z-score) as the dependent variable; and gender, gestational age, birth weight (z-score), corrected age, invasive mechanical ventilation (yes/no), and bronchopulmonary dysplasia (BPD) diagnosis (yes/no) as independent ones. Additionally, stratified analyses by BPD diagnosis were performed. RESULTS The multivariate analysis showed significant higher z-scores of FVC and FEV0.5 in preterm infants treated with caffeine (P = .004 and P = .024, respectively). This result only being significant in the group of non-BPD infants (P = .021 and P = .042), after stratifying by BPD diagnosis. Differences were not found in z-scores of FEV0.5/FVC, FEF75, FEF25-75, FRCpleth, nor Crs. CONCLUSION Lung function (FVC and FEV0.5 ) is improved in infants born under 31 weeks of gestation when treated with caffeine. This improvement is driven by the group of infants who did not suffer from BPD. Overall, our results show that there is an early beneficial effect of caffeine treatment in infant lung function.
Collapse
Affiliation(s)
- Manuel Sanchez-Solis
- Surgery, Pediatric, Obstetric and Gynecology Department, University of Murcia, Murcia, Spain.,Biomedical Research Institute Virgen de la Arrixaca of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Patricia W Garcia-Marcos
- Pediatric Pulmonology and Cystic Fibrosis Unit, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - Juan Agüera-Arenas
- Department of Pediatrics-Neonatology, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - Pedro Mondejar-Lopez
- Pediatric Pulmonology and Cystic Fibrosis Unit, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - Luis Garcia-Marcos
- Surgery, Pediatric, Obstetric and Gynecology Department, University of Murcia, Murcia, Spain.,Biomedical Research Institute Virgen de la Arrixaca of Murcia (IMIB-Arrixaca), Murcia, Spain
| |
Collapse
|
16
|
Garcia-Marcos L. A very timely meta-analysis on Omalizumab in chronic spontaneous urticaria. Allergol Immunopathol (Madr) 2019; 47:513-514. [PMID: 31630754 DOI: 10.1016/j.aller.2019.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 10/08/2019] [Indexed: 10/25/2022]
|
17
|
Garcia-Marcos L. The unpredictable levels of vitamin D and their effects on asthma. Allergol Immunopathol (Madr) 2019; 47:409-410. [PMID: 31401986 DOI: 10.1016/j.aller.2019.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/24/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Luis Garcia-Marcos
- Respiratory and Allergy Units, Arrixaca Children's University Hospital, University of Murcia; IMIB Bio-health Research Institute; and ARADyAL allergy network, Spain.
| |
Collapse
|
18
|
Garcia-Marcos L, Edwards J, Kennington E, Aurora P, Baraldi E, Carraro S, Gappa M, Louis R, Moreno-Galdo A, Peroni DG, Pijnenburg M, Priftis KN, Sanchez-Solis M, Schuster A, Walker S. Priorities for future research into asthma diagnostic tools: A PAN-EU consensus exercise from the European asthma research innovation partnership (EARIP). Clin Exp Allergy 2019; 48:104-120. [PMID: 29290104 DOI: 10.1111/cea.13080] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The diagnosis of asthma is currently based on clinical history, physical examination and lung function, and to date, there are no accurate objective tests either to confirm the diagnosis or to discriminate between different types of asthma. This consensus exercise reviews the state of the art in asthma diagnosis to identify opportunities for future investment based on the likelihood of their successful development, potential for widespread adoption and their perceived impact on asthma patients. Using a two-stage e-Delphi process and a summarizing workshop, a group of European asthma experts including health professionals, researchers, people with asthma and industry representatives ranked the potential impact of research investment in each technique or tool for asthma diagnosis and monitoring. After a systematic review of the literature, 21 statements were extracted and were subject of the two-stage Delphi process. Eleven statements were scored 3 or more and were further discussed and ranked in a face-to-face workshop. The three most important diagnostic/predictive tools ranked were as follows: "New biological markers of asthma (eg genomics, proteomics and metabolomics) as a tool for diagnosis and/or monitoring," "Prediction of future asthma in preschool children with reasonable accuracy" and "Tools to measure volatile organic compounds (VOCs) in exhaled breath."
Collapse
Affiliation(s)
- L Garcia-Marcos
- Respiratory and Allergy Units, Arrixaca University Children's Hospital, University of Murcia & IMIB Research Institute, Murcia, Spain
| | | | | | - P Aurora
- Department of Paediatric Respiratory Medicine, Great Ormond Street Hospital for Children, London, UK.,Department of Respiratory, Critical Care and Anaesthesia Unit, University College London (UCL) Great Ormond Street Institute of Child Health, London, UK
| | - E Baraldi
- Women's and Children's Health Department, University of Padua, Padova, Italy
| | - S Carraro
- Women's and Children's Health Department, University of Padua, Padova, Italy
| | - M Gappa
- Children's Hospital & Research Institute, Marienhospital Wesel, Wesel, Germany
| | - R Louis
- Department of Respiratory Medicine, University of Liege, Liege, Belgium
| | - A Moreno-Galdo
- Paediatric Pulmonology Unit, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D G Peroni
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - M Pijnenburg
- Paediatrics/Paediatric Respiratory Medicine, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - K N Priftis
- Department of Paediatrics, Athens University Medical School, Attikon General Hospital, Athens, Greece
| | - M Sanchez-Solis
- Respiratory and Allergy Units, Arrixaca University Children's Hospital, University of Murcia & IMIB Research Institute, Murcia, Spain
| | - A Schuster
- Department of Paediatrics, University Hospital, Düsseldorf, Germany
| | | | | |
Collapse
|
19
|
Garcia-Marcos L. Asthma prevalence trends in Chile: a prelude of the Global Asthma Network findings? Allergol Immunopathol (Madr) 2019; 47:311-312. [PMID: 31277726 DOI: 10.1016/j.aller.2019.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
|
20
|
Garcia-Marcos L. MEDITERRANEAN DIET AND ASTHMA: TIME FOR CLINICAL TRIALS IN CHILDREN. Allergol Immunopathol (Madr) 2019; 47:207-208. [PMID: 30992119 DOI: 10.1016/j.aller.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 02/07/2023]
Affiliation(s)
- Luis Garcia-Marcos
- Respiratory and Allergy Units, Arrixaca Children's University Hospital, University of Murcia; IMIB Bio-health Research Institute; and ARADyAL allergy network, Spain.
| |
Collapse
|
21
|
Rutter CE, Silverwood RJ, Williams HC, Ellwood P, Asher I, Garcia-Marcos L, Strachan DP, Pearce N, Langan SM. Are Environmental Factors for Atopic Eczema in ISAAC Phase Three due to Reverse Causation? J Invest Dermatol 2019; 139:1023-1036. [PMID: 30521836 PMCID: PMC6478380 DOI: 10.1016/j.jid.2018.08.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 11/26/2022]
Abstract
Some previously described environmental associations for atopic eczema may be due to reverse causation. We explored the role of reverse causation by comparing individual- and school-level results for multiple atopic eczema risk factors. The International Study of Asthma and Allergies in Childhood (i.e, ISAAC) Phase Three surveyed children in schools (the sampling unit) regarding atopic eczema symptoms and potential risk factors. We assessed the effect of these risk factors on atopic eczema symptoms using mixed-effect logistic regression models, first with individual-level exposure data and second with school-level exposure prevalence. Overall, 546,348 children from 53 countries were included. At ages 6-7 years, the strongest individual-level associations were with current paracetamol use (odds ratio [OR] = 1.45, 95% confidence interval [CI] = 1.37-1.54), which persisted at school-level (OR = 1.55, 95% CI = 1.10-2.21), early-life antibiotics (OR = 1.41, 95% CI = 1.34-1.48), and early-life paracetamol use (OR = 1.28, 95% CI = 1.21-1.36), with the former persisting at the school level, whereas the latter was no longer observed (OR = 1.35, 95% CI = 1.00-1.82 and OR = 0.94, 95% CI = 0.69-1.28, respectively). At ages 13-14 years, the strongest associations at the individual level were with current paracetamol use (OR = 1.57, 95% CI = 1.51-1.63) and open-fire cooking (OR = 1.46, 95% CI = 1.33-1.62); both were stronger at the school level (OR = 2.57, 95% CI = 1.84-3.59 and OR = 2.38, 95% CI = 1.52-3.73, respectively). Association with exposure to heavy traffic (OR = 1.31, 95% CI = 1.27-1.36) also persisted at the school level (OR = 1.40, 95% CI = 1.07-1.82). Most individual- and school-level effects were consistent, tending to exclude reverse causation.
Collapse
Affiliation(s)
- Charlotte E Rutter
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard J Silverwood
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Hywel C Williams
- Centre of Evidence-Based Dermatology, University of Nottingham, Nottingham, UK
| | - Philippa Ellwood
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Innes Asher
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Luis Garcia-Marcos
- Pediatric Allergy and Pulmonology Units, Virgen de la Arrixaca University Children's Hospital, University of Murcia and IMIB Bioresearch Institute, Murcia, Spain
| | - David P Strachan
- Population Health Research Institute, St George's University of London, London, UK
| | - Neil Pearce
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; Red de Asma, Reacciones Adversas y Alérgicas, Madrid, Spain; Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Sinéad M Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
| |
Collapse
|
22
|
Morales E, Strachan D, Asher I, Ellwood P, Pearce N, Garcia-Marcos L. Combined impact of healthy lifestyle factors on risk of asthma, rhinoconjunctivitis and eczema in school children: ISAAC phase III. Thorax 2019; 74:531-538. [PMID: 30898896 DOI: 10.1136/thoraxjnl-2018-212668] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/24/2019] [Accepted: 02/11/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Asthma is not the key focus of prevention strategies. A Healthy Lifestyle Index (HLI) was developed to examine the combined effect of modifiable lifestyle factors on asthma, rhinoconjunctivitis and eczema using data from the International Study of Asthma and Allergies in Childhood (ISAAC) phase III. METHODS Information on symptoms of asthma, rhinoconjunctivitis, eczema and several lifestyle factors was obtained from children aged 6-7 years through written questionnaires. The HLI combined five lifestyle factors: no parental smoking, child's adherence to Mediterranean diet, child's healthy body mass index, high physical activity and non-sedentary behaviour. The association between the HLI and risk of asthma, rhinoconjunctivitis and eczema was evaluated using multilevel mixed-effects logistic regression models. FINDINGS Data of 70 795 children from 37 centres in 19 countries were analysed. Each additional healthy lifestyle factor was associated with a reduced risk of current wheeze (OR 0.87, 95% CI 0.84 to 0.89), asthma ever (OR 0.89, 95% CI 0.87 to 0.92), current symptoms of rhinoconjunctivitis (OR 0.95, 95% CI 0.92 to 0.97) and current symptoms of eczema (OR 0.92, 95% CI 0.92 to 0.98). Theoretically, if associations were causal, a combination of four or five healthy lifestyle factors would result into a reduction up to 16% of asthma cases (ranging from 2.7% to 26.3 % according to region of the world). CONCLUSIONS These findings should be interpreted with caution given the limitations to infer causality from cross-sectional observational data. Efficacy of interventions to improve multiple modifiable lifestyle factors to reduce the burden asthma and allergy in childhood should be assessed.
Collapse
Affiliation(s)
- Eva Morales
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, Murcia, Spain
| | - David Strachan
- Population Health Research Institute, St George's, University of London, London, UK
| | - Innes Asher
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Philippa Ellwood
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Neil Pearce
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Luis Garcia-Marcos
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, Murcia, Spain
| | | | | |
Collapse
|
23
|
Garcia-Marcos L. SO, AT WHAT AGE CAN ASTHMA BE DIAGNOSED? Allergol Immunopathol (Madr) 2019; 47:105-106. [PMID: 30770040 DOI: 10.1016/j.aller.2019.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 01/29/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Luis Garcia-Marcos
- Respiratory and Allergy Units, Arrixaca Children's University Hospital, University of Murcia; and IMIB Bio-health Research Institute, Spain.
| |
Collapse
|
24
|
Garcia-Marcos L. EARLY PROGRAMMING OF ASTHMA AND ALLERGY: IT IS TIME TO SERIOUSLY THINK OF PRIMARY PREVENTION. Allergol Immunopathol (Madr) 2019; 47:1. [PMID: 30579557 DOI: 10.1016/j.aller.2018.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 12/03/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Luis Garcia-Marcos
- Respiratory and Allergy Units, Arrixaca Children's University Hospital, University of Murcia; and IMIB Bio-health Research Institute. Spain.
| |
Collapse
|
25
|
Garcia-Marcos L. This is what scientific societies are for. The CIBAL consensus. Allergol Immunopathol (Madr) 2018; 46:515-516. [PMID: 30316476 DOI: 10.1016/j.aller.2018.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 09/27/2018] [Indexed: 10/28/2022]
|
26
|
Walker SM, Akdis C, Dahlen SE, Djukanovic R, Edwards J, Garcia-Marcos L, Johnston S, Kupczyk M, Martin T, Myles D, Palkonen S, Papadopoulos N, Powell P, Riley J. Building the investment case for asthma R&D: the European Asthma Research and Innovation Partnership argument. Clin Exp Allergy 2018; 46:1136-8. [PMID: 27574040 DOI: 10.1111/cea.12779] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S M Walker
- Research & Policy, European Asthma Research & Innovation Partnership, Asthma UK, London, UK
| | - C Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), Medical Faculty, University of Zurich, Zurich, Switzerland
| | - S E Dahlen
- Asthma and Allergy Research, IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - R Djukanovic
- Department of Medicine, Southampton NIHR Respiratory Biomedical Research Unit, University of Southampton, Southampton, UK
| | - J Edwards
- Research & Policy, European Asthma Research & Innovation Partnership, Asthma UK, London, UK
| | - L Garcia-Marcos
- Department of Paediatrics, Paediatric Respiratory and Allergy Units, Arrixaca University Children's Hospital, University of Murcia, Murcia, Spain
| | - S Johnston
- Department of Respiratory Medicine, Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - M Kupczyk
- Medical University of Łódź, Łódź, Poland
| | - T Martin
- Respiratory Therapeutic Area, Respiratory Franchise, Novartis Pharmaceuticals, East Hanover, NJ, USA
| | - D Myles
- Asthma Clinical Discovery, Respiratory Therapy Area Unit, GlaxoSmithKline, Hertfordshire, UK
| | - S Palkonen
- European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - N Papadopoulos
- Allergy Department, University of Athens, Athens, Greece.,Allergy & Paediatric Allergy, University of Manchester, Manchester, UK
| | - P Powell
- European Lung Foundation, Sheffield, UK
| | - J Riley
- European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| |
Collapse
|
27
|
Garcia-Marcos L. Wheezing in infants: A pandemic condition that need to be treated with patience. Allergol Immunopathol (Madr) 2018; 46:209. [PMID: 29628073 DOI: 10.1016/j.aller.2018.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 03/26/2018] [Indexed: 10/17/2022]
|
28
|
Caffarelli C, Priftis K, Mastrorilli C, Garcia-Marcos L. Editorial: The Parallel March of Asthma and Allergy in Childhood: A Multi-Perspective Approach. Front Pediatr 2018; 6:135. [PMID: 29868525 PMCID: PMC5954088 DOI: 10.3389/fped.2018.00135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 04/23/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
- Carlo Caffarelli
- Clinica Pediatrica Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Kostas Priftis
- Pediatric Allergy and Pulmonology Units, Third Department of Pediatrics, School of Medicine, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
| | - Carla Mastrorilli
- Clinica Pediatrica Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Luis Garcia-Marcos
- Pediatric Allergy and Pulmonology Units, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca Bio-health Research Institute, University of Murcia, Murcia, Spain
| |
Collapse
|
29
|
Affiliation(s)
- Luis Garcia-Marcos
- Universidad de Murcia, Hospital Clínico Universitario Virgen de la Arrixaca, Unidad Respiratoria, Murcia, Spain; IMIB Bio-Health Research Institute, Murcia, Spain.
| | - Manuel Sanchez-Solis
- Universidad de Murcia, Hospital Clínico Universitario Virgen de la Arrixaca, Unidad Respiratoria, Murcia, Spain; IMIB Bio-Health Research Institute, Murcia, Spain
| |
Collapse
|
30
|
Papadopoulos NG, Androutsopoulou A, Akdis C, Dahlén SE, Djukanovic R, Edwards J, Garcia-Marcos L, Johnston SL, Kupczyk M, Martin TR, Myles D, Palkonen S, Powell P, Riley J, Walker S. Asthma research in Europe: a transformative agenda for innovation and competitiveness. Eur Respir J 2017; 49:49/5/1602294. [PMID: 28461296 DOI: 10.1183/13993003.02294-2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 04/11/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Nikolaos G Papadopoulos
- National Kapodistrian University of Athens, Athens, Greece .,University of Manchester, Manchester, UK
| | | | - Cezmi Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich Faculty of Medicine, Davos, Switzerland
| | - Sven-Erik Dahlén
- IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ratko Djukanovic
- NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton, Southampton, UK
| | | | - Luis Garcia-Marcos
- Paediatric Pulmonology and Allergy, "Virgen de la Arrixaca" University Children's Hospital, University of Murcia, Murcia, Spain
| | | | | | - Thomas R Martin
- Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA, USA
| | | | - Susanna Palkonen
- European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | | | | | | |
Collapse
|
31
|
Garcia-Marcos L. Should countries implement asthma strategies? Some fresh ideas from the Global Asthma Network; and a quote from Carl Sandburg. Allergol Immunopathol (Madr) 2017; 45:103-104. [PMID: 28253981 DOI: 10.1016/j.aller.2017.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 02/06/2017] [Indexed: 11/28/2022]
Affiliation(s)
- L Garcia-Marcos
- Respiratory and Allergy Units, Arrixaca Children's University Hospital, University of Murcia, Spain; IMIB Bio-health Research Institute, Spain
| |
Collapse
|
32
|
Abstract
This review updates the relationship between the adherence to Mediterranean diet (MedDiet) assessed by questionnaire and asthma, allergic rhinitis, or atopic eczema in childhood. It deals with the effect of MedDiet in children on asthma/wheeze, allergic rhinitis, and atopic dermatitis/eczema, and also with the effect of MedDiet consumption by the mother during pregnancy on the inception of asthma/wheeze and allergic diseases in the offspring. Adherence to MedDiet by children themselves seems to have a protective effect on asthma/wheezing symptoms after adjustment for confounders, although the effect is doubtful on lung function and bronchial hyperresponsiveness. By contrast, the vast majority of the studies showed no significant effect of MedDiet on preventing atopic eczema, rhinitis, or atopy. Finally, studies on adherence to MedDiet by the mother during pregnancy showed some protective effect on asthma/wheeze symptoms in the offspring only during the first year of life, but not afterward. Very few studies have shown a protective effect on wheezing, current sneeze, and atopy, and none on eczema. Randomized control trials on the effect of the adherence to MedDiet to prevent (by maternal consumption during pregnancy) or improve (by child consumption) the clinical control of asthma/wheezing, allergic rhinitis, or atopic dermatitis are needed.
Collapse
Affiliation(s)
- Jose A Castro-Rodriguez
- Department of Pediatric Pulmonology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Garcia-Marcos
- Pediatric Allergy and Pulmonology Units, "Virgen de la Arrixaca" University Children's Hospital, IMIB-Arrixaca Bio-health Research Institute, University of Murcia, Murcia, Spain
| |
Collapse
|
33
|
Garcia-Marcos L. Exhaled breath condensate in asthma: Are we stupid if we do not keep it simple? Allergol Immunopathol (Madr) 2017; 45:1. [PMID: 28041585 DOI: 10.1016/j.aller.2016.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 12/15/2016] [Indexed: 10/20/2022]
|
34
|
Garcia-Marcos L, Sánchez-Solís M. The fatum of preterm lungs: Every week counts. Allergol Immunopathol (Madr) 2016; 44:487-488. [PMID: 27836069 DOI: 10.1016/j.aller.2016.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 10/25/2016] [Indexed: 10/20/2022]
|
35
|
Sanchez-Solis M, Perez-Fernandez V, Bosch-Gimenez V, Quesada JJ, Garcia-Marcos L. Lung function gain in preterm infants with and without bronchopulmonary dysplasia. Pediatr Pulmonol 2016; 51:936-42. [PMID: 26865508 DOI: 10.1002/ppul.23393] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 12/17/2015] [Accepted: 01/13/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The aim of our study was to determine whether the development of lung function, during the first 2 years of life, is different in preterm infants who suffered or did not suffer from Bronchopulmonary dysplasia (BPD). We also assessed the role of nutritional status and growth in that development. METHODS Lung function tests were performed in 71 preterm infants at two time points: 6 months of corrected age and 1 year after. FVC, FEV0.5, FEF75 , and FEF25-75 were obtained from maximal expiratory volume curves by means of the raised volume rapid thoraco-abdominal compression technique. RESULTS When comparing lung function measurements, we found that FVC (P = 0.033) FEV0.5 (P = 0.044), FEF75 (P = 0.014), and FEF25-75 (P = 0.036) were significantly lower in BPD infants. We did not find any catch-up of lung function during the study time, in neither the whole group of children nor within the BPD or non-BPD groups. The increase in lung function was directly proportional to the increase in weight and length. The multivariate analysis showed that the increase in z-score of FVC (P = 0.043), FEV0.5 (P = 0.015), and FEF75 (P = 0.042), was related with the height velocity during the study period. CONCLUSIONS Infants who suffered from BPD have lower lung function (FVC, FEV0.5 , FEF75 , and FEF25-75 ), than those non-BPD, at two different time points 1 year apart. During the study period, there was no lung function catch-up in either BPD or non-BPD infants. The increase in length is closely associated to the increase in lung function. Pediatr Pulmonol. 2016; 51:936-942. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Manuel Sanchez-Solis
- Department of Pediatrics, University of Murcia, Murcia, Spain.,Department of Pediatrics, Virgen de la Arrixaca University Hospital, Murcia, Spain.,IMIB Bio-research Institute, Murcia, Spain
| | - Virginia Perez-Fernandez
- Department of Pediatrics, University of Murcia, Murcia, Spain.,Department of Pediatrics, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - Vicente Bosch-Gimenez
- Department of Pediatrics, University of Murcia, Murcia, Spain.,Department of Pediatrics, Virgen de la Arrixaca University Hospital, Murcia, Spain.,IMIB Bio-research Institute, Murcia, Spain
| | - Juan J Quesada
- Department of Pediatrics, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - Luis Garcia-Marcos
- Department of Pediatrics, University of Murcia, Murcia, Spain.,Department of Pediatrics, Virgen de la Arrixaca University Hospital, Murcia, Spain.,IMIB Bio-research Institute, Murcia, Spain
| |
Collapse
|
36
|
Castro-Rodriguez JA, Ramirez-Hernandez M, Padilla O, Pacheco-Gonzalez RM, Pérez-Fernández V, Garcia-Marcos L. Effect of foods and Mediterranean diet during pregnancy and first years of life on wheezing, rhinitis and dermatitis in preschoolers. Allergol Immunopathol (Madr) 2016; 44:400-9. [PMID: 27087566 DOI: 10.1016/j.aller.2015.12.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 12/30/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND There is a conflictive position if some foods and Mediterranean diet (MedDiet) consumed by the mother during pregnancy and by the child during the first years of life can be protective for current wheezing, rhinitis and dermatitis at preschool age. METHODS Questionnaires of epidemiological factors and food intake by the mother during pregnancy and later by the child were filled in by parents in two surveys at two different time points (1.5 yrs and 4 yrs of life) in 1000 preschoolers. RESULTS The prevalences of current wheezing, rhinitis and dermatitis were 18.8%, 10.4%, and 17.2%, respectively. After multiple logistic analysis children who were low fruit consumers (never/occasionally) and high fast-food consumers (≥3 times/week) had a higher risk for current wheezing; while intermediate consumption of meat (1 or 2 times/week) and low of pasta by mothers in pregnancy were protected. For current rhinitis, low fruit consumer children were at higher risk; while those consuming meat <3 times/week were protected. For current dermatitis, high fast food consumption by mothers in pregnancy; and low or high consumption of fruit, and high of potatoes in children were associated to higher prevalence. Children consuming fast food >1 times/week were protected for dermatitis. MedDiet adherence by mother and child did not remain a protective factor for any outcome. CONCLUSION Low consumption of fruits and high of meat by the child, and high consumption of potatoes and pasta by the mother had a negative effect on wheezing, rhinitis or dermatitis; while fast food consumption was inconsistent.
Collapse
Affiliation(s)
- J A Castro-Rodriguez
- Division of Pediatrics, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile; Division of Public Health, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | | | - O Padilla
- Division of Public Health, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - R M Pacheco-Gonzalez
- Pediatric Allergy and Pulmonology Units, "Virgen de la Arrixaca" University Children's Hospital, University of Murcia and IMIB-Arrixaca Research Institute, Murcia, Spain
| | - V Pérez-Fernández
- Pediatric Allergy and Pulmonology Units, "Virgen de la Arrixaca" University Children's Hospital, University of Murcia and IMIB-Arrixaca Research Institute, Murcia, Spain
| | - L Garcia-Marcos
- Pediatric Allergy and Pulmonology Units, "Virgen de la Arrixaca" University Children's Hospital, University of Murcia and IMIB-Arrixaca Research Institute, Murcia, Spain
| |
Collapse
|
37
|
Garcia-Marcos L. Markers of asthma: The quest of the Holy Grail. Allergol Immunopathol (Madr) 2016; 44:189-90. [PMID: 27156988 DOI: 10.1016/j.aller.2016.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
|
38
|
Melbye H, Garcia-Marcos L, Brand P, Everard M, Priftis K, Pasterkamp H. Wheezes, crackles and rhonchi: simplifying description of lung sounds increases the agreement on their classification: a study of 12 physicians' classification of lung sounds from video recordings. BMJ Open Respir Res 2016; 3:e000136. [PMID: 27158515 PMCID: PMC4854017 DOI: 10.1136/bmjresp-2016-000136] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 04/08/2016] [Accepted: 04/10/2016] [Indexed: 12/04/2022] Open
Abstract
Background The European Respiratory Society (ERS) lung sounds repository contains 20 audiovisual recordings of children and adults. The present study aimed at determining the interobserver variation in the classification of sounds into detailed and broader categories of crackles and wheezes. Methods Recordings from 10 children and 10 adults were classified into 10 predefined sounds by 12 observers, 6 paediatricians and 6 doctors for adult patients. Multirater kappa (Fleiss' κ) was calculated for each of the 10 adventitious sounds and for combined categories of sounds. Results The majority of observers agreed on the presence of at least one adventitious sound in 17 cases. Poor to fair agreement (κ<0.40) was usually found for the detailed descriptions of the adventitious sounds, whereas moderate to good agreement was reached for the combined categories of crackles (κ=0.62) and wheezes (κ=0.59). The paediatricians did not reach better agreement on the child cases than the family physicians and specialists in adult medicine. Conclusions Descriptions of auscultation findings in broader terms were more reliably shared between observers compared to more detailed descriptions.
Collapse
Affiliation(s)
- Hasse Melbye
- Faculty of Health Sciences, General Practice Research Unit , UIT the Arctic University of Norway , Tromsø , Norway
| | - Luis Garcia-Marcos
- Pediatric Respiratory and Allergy Units, Arrixaca University Children's Hospital, University of Murcia, Murcia, Spain; IMIB-Arrixaca Biohealth Research Institute, Murcia, Spain
| | - Paul Brand
- Princess Amalia Children's Center, Isala Hospital, Zwolle, The Netherlands; Postgraduate School of Medicine, University Medical Centre and University of Groningen, Groningen, The Netherlands
| | - Mark Everard
- School of Paediatrics, University of Western Australia, Princess Margaret Hospital , Subiaco, Western Australia , Australia
| | - Kostas Priftis
- Children's Respiratory and Allergy Unit, Third Dept of Paediatrics , "Attikon" Hospital, University of Athens Medical School , Athens , Greece
| | - Hans Pasterkamp
- Section of Respirology, Dept of Pediatrics and Child Health , University of Manitoba , Winnipeg, Manitoba , Canada
| |
Collapse
|
39
|
Pacheco-Gonzalez RM, Garcia-Marcos PW, Garcia-Marcos L. Vitamin D and Atopic Dermatitis. Mini Rev Med Chem 2016; 15:927-34. [PMID: 25985948 DOI: 10.2174/1389557515666150519110209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 03/14/2015] [Accepted: 05/12/2015] [Indexed: 12/19/2022]
Abstract
Atopic dermatitis is a chronic inflammatory skin disease that affects a high number of children worldwide. It is mainly caused by a disruption of the epidermal barrier and an abnormal immune response. Vitamin D might have some effects on the innate and adaptive immune system, generally in favour of decreasing allergenic mechanisms, as well as it might improve the skin barrier and decrease the risk of skin colonization. Thus, an increasing body of evidence links this vitamin to atopic dermatitis, although conclusions are not unanimous. Many observational studies have shown that low vitamin D serum levels are associated with a higher prevalence of this epidermal disease in childhood, but others have not. Differences in exposure time, vitamin D dose, age of participants, etc. could explain these conflicting results. Moreover, no study has been performed to date in order to determine whether variations in vitamin D levels at different ages differentially influence the risk of atopic dermatitis. A number of randomized controlled trials have tested the usefulness of systemic vitamin D as a treatment for this condition, but the results are also inconclusive. Nevertheless, topical vitamin D is not recommended because it can worsen skin lesions. Narrowband ultraviolet B is used to treat atopic dermatitis, although there is little evidence relating this type of phototherapy with variations of serum vitamin D levels or to what extent phototherapy benefits are mediated through vitamin D.
Collapse
Affiliation(s)
| | | | - Luis Garcia-Marcos
- Pabellon Docente Universitario, Campus Ciencias de la Salud, Ctra. Madrid-Cartagena, s/n. 30120 El Palmar, Murcia, Spain.
| |
Collapse
|
40
|
Morales E, Sanchez-Solis M, Garcia-Marcos L. Vitamin D Metabolism Genes in Asthma and Atopy. Mini Rev Med Chem 2016; 15:913-26. [PMID: 25985949 DOI: 10.2174/1389557515666150519105944] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 03/14/2015] [Accepted: 05/12/2015] [Indexed: 11/22/2022]
Abstract
Asthma and allergy are complex diseases influenced by poorly understood environmental and genetic factors. The innate and adaptive immune systems play an important role in the pathogenesis of these diseases. Many genes involved in inflammation and immunoregulation pathways have been related to asthma and allergy susceptibility. Among the diverse extra-skeletal actions of vitamin D, growing evidence indicates that vitamin D is an important modulator of the immune system response and may influence the development of asthma and allergy susceptibility through different mechanisms. The vitamin D pathway is under the control of a set of polymorphic genes that code for key enzymes which regulate the synthesis and metabolism of vitamin D (i.e. CYP27A1, GC, CYP27B1 and CYP24A1) and of genes that encode for downstream mediators of vitamin D signalling (i.e. VDR, RXR, PPAR, NCOA and SMAD). This metabolism gene pathway is of fundamental importance in regulating vitamin D availability and biological response. Unravelling the role of vitamin D metabolism genes on asthma and atopy susceptibility may help to understand the impact of vitamin D on the development of these disorders. This review article aims: 1) to describe the genetics of the vitamin D pathway, 2) to revise the potential mechanisms by which vitamin D pathway genes may affect the immune and respiratory systems predisposing to asthma and allergy disorders; and 3) to summarize the influence of genetic variation on vitamin D pathway genes on the development of asthma and allergy.
Collapse
Affiliation(s)
- Eva Morales
- Respiratory Medicine and Allergy Units, Arrixaca University Children's Hospital, IMIB-Arrixaca Research Institute, Murcia, Spain.
| | | | | |
Collapse
|
41
|
Garcia-Marcos L. Mediterranean diet as a protection against asthma: Still another brick in building a causative association. Allergol Immunopathol (Madr) 2016; 44:97-8. [PMID: 26955759 DOI: 10.1016/j.aller.2016.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 02/26/2016] [Indexed: 10/22/2022]
|
42
|
Pacheco-Gonzalez RM, Mallol J, Solé D, Brand PLP, Perez-Fernandez V, Sanchez-Solis M, Garcia-Marcos L. Factors associated with the time to the first wheezing episode in infants: a cross-sectional study from the International Study of Wheezing in Infants (EISL). NPJ Prim Care Respir Med 2016; 26:15077. [PMID: 26796896 PMCID: PMC4721498 DOI: 10.1038/npjpcrm.2015.77] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 10/01/2015] [Accepted: 10/06/2015] [Indexed: 12/17/2022] Open
Abstract
Male gender, asthmatic heredity, perinatal tobacco smoke exposure and respiratory infections have been associated with wheeze in the first years of life, among other risk factors. However, information about what factors modify the time to the first episode of wheeze in infants is lacking. The present study analyses which factors are associated with shorter time to the first episode of wheeze in infants. Parents of 11- to 24-month-old children were surveyed when attending their health-care centres for a control visit. They answered a questionnaire including the age in months when a first wheeze episode (if any) had occurred (outcome variable). The study was performed in 14 centres in Latin America (LA) and in 8 centres in Europe (EU) (at least 1,000 infants per centre). Factors known to be associated with wheezing in the cohort were included in a survival analysis (Cox proportional hazards model). Summary hazard ratios adjusted for all risk factors (aHR) were calculated using the meta-analysis approach with random effects. A total of 15,067 infants had experienced wheezing at least once, out of 35,049 surveyed. Male gender in LA (aHR 1.05, 95% confidence interval (CI) 1.00-1.10, P=0.047), parental asthma in LA and EU (aHR 1.05, 95% CI 1.00-1.11, P=0.037), infant eczema in EU (aHR 1.25, 95% CI 1.12-1.39, P<0.001) and having a cold during the first 3 months in LA and EU (aHR 1.97, 95% CI 1.90-2.04, P<0.001), in LA (aHR 1.98, 95% CI 1.90-2.06, P<0.001) and in EU (aHR 1.91, 95% CI 1.75-2.09, P<0.001) were associated with a shorter period of time to the first episode. Breast feeding for at least 3 months was associated with a longer period, only in LA (aHR 0.91, 95% CI 0.86-0.96, P<0.001). Cold symptoms during the first 3 months is the most consistent factor shortening the time to the first episode of wheezing; breast feeding for ⩾3 months delays it only in LA, whereas eczema shortens it only in EU. Avoiding a common cold in the first months of life could be a good strategy to delay the first wheeze episode; however, cohort studies will help to elucidate this association.
Collapse
Affiliation(s)
- Rosa M Pacheco-Gonzalez
- Pediatric Respiratory and Allergy Unit, 'Virgen de la Arrixaca' University Children's Hospital, University of Murcia, Murcia, Spain
| | - Javier Mallol
- Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Chile, USA
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Paul L P Brand
- Princess Amalia Children's Clinic, Isala Klinieken, Zwolle, The Netherlands.,UMCG Postgraduate School of Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - Manuel Sanchez-Solis
- Pediatric Respiratory and Allergy Unit, 'Virgen de la Arrixaca' University Children's Hospital, University of Murcia, Murcia, Spain
| | - Luis Garcia-Marcos
- Pediatric Respiratory and Allergy Unit, 'Virgen de la Arrixaca' University Children's Hospital, University of Murcia, Murcia, Spain.,IMIB Bioresearch Institute, Murcia, Spain
| | | |
Collapse
|
43
|
Pasterkamp H, Brand PLP, Everard M, Garcia-Marcos L, Melbye H, Priftis KN. Towards the standardisation of lung sound nomenclature. Eur Respir J 2015; 47:724-32. [PMID: 26647442 DOI: 10.1183/13993003.01132-2015] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/26/2015] [Indexed: 11/05/2022]
Abstract
Auscultation of the lung remains an essential part of physical examination even though its limitations, particularly with regard to communicating subjective findings, are well recognised. The European Respiratory Society (ERS) Task Force on Respiratory Sounds was established to build a reference collection of audiovisual recordings of lung sounds that should aid in the standardisation of nomenclature. Five centres contributed recordings from paediatric and adult subjects. Based on pre-defined quality criteria, 20 of these recordings were selected to form the initial reference collection. All recordings were assessed by six observers and their agreement on classification, using currently recommended nomenclature, was noted for each case. Acoustical analysis was added as supplementary information. The audiovisual recordings and related data can be accessed online in the ERS e-learning resources. The Task Force also investigated the current nomenclature to describe lung sounds in 29 languages in 33 European countries. Recommendations for terminology in this report take into account the results from this survey.
Collapse
Affiliation(s)
- Hans Pasterkamp
- Section of Respirology, Dept of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Paul L P Brand
- Princess Amalia Children's Center, Isala Hospital, Zwolle, The Netherlands Postgraduate School of Medicine, University Medical Centre and University of Groningen, Groningen, The Netherlands
| | - Mark Everard
- School of Paediatrics, University of Western Australia, Princess Margaret Hospital, Subiaco, Australia
| | - Luis Garcia-Marcos
- Pediatric Respiratory and Allergy Units, Arrixaca University Children's Hospital, University of Murcia, Murcia, Spain IMIB-Arrixaca Biohealth Research Institute, Murcia, Spain
| | - Hasse Melbye
- General Practice Research Unit, Faculty of Health Sciences, UIT the Arctic University of Norway, Tromsø, Norway
| | - Kostas N Priftis
- Children's Respiratory and Allergy Unit, Third Dept of Paediatrics, "Attikon" Hospital, University of Athens Medical School, Athens, Greece
| |
Collapse
|
44
|
Beckhaus AA, Garcia-Marcos L, Forno E, Pacheco-Gonzalez RM, Celedón JC, Castro-Rodriguez JA. Maternal nutrition during pregnancy and risk of asthma, wheeze, and atopic diseases during childhood: a systematic review and meta-analysis. Allergy 2015; 70:1588-604. [PMID: 26296633 DOI: 10.1111/all.12729] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Epidemiologic studies suggest a relationship between maternal nutrition during pregnancy and the occurrence of asthma and atopic conditions during childhood. However, individual study results are conflicting. The objective of this meta-analysis was to critically examine the current evidence for an association between nutrition (dietary patterns, food groups, vitamins, or oligo-elements) ingestion during pregnancy and asthma, wheeze, or atopic conditions in childhood. METHODS The inclusion criteria were as follows: (i) systematic recording of diet during the gestational period and (ii) documentation of asthma, wheezing, eczema, or other atopic disease in the offspring. The primary outcomes were prevalence of asthma or wheeze among the offspring during childhood; and secondary outcomes were prevalence of eczema, allergic rhinitis, or other atopic conditions. RESULTS We found 120 titles, abstracts, and citations, and 32 studies (29 cohorts) were included in this analysis. Data on vitamins, oligo-elements, food groups, and dietary patterns during pregnancy were collected. A meta-analysis revealed that higher maternal intake of vitamin D [odds ratio (OR) = 0.58, 95% confidence interval (CI) = 0.38-0.88], vitamin E (OR = 0.6, 95% CI = 0.46-0.78), and zinc (OR = 0.62, 95% CI = 0.40-0.97) was associated with lower odds of wheeze during childhood. However, none of these or other nutrients was consistently associated with asthma per se or other atopic conditions. CONCLUSIONS Current evidence suggests a protective effect of maternal intake of each of three vitamins or nutrients (vitamin D, vitamin E, and zinc) against childhood wheeze but is inconclusive for an effect on asthma or other atopic conditions.
Collapse
Affiliation(s)
- A. A. Beckhaus
- Division of Pediatrics; School of Medicine; Pontificia Universidad Católica de Chile; Santiago Chile
| | - L. Garcia-Marcos
- Respiratory and Allergy Units; Arrixaca University Children's Hospital; University of Murcia; Murcia Spain
- IMIB Bio-research Institute; Murcia Spain
| | - E. Forno
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology; Children's Hospital of Pittsburgh of UPMC; University of Pittsburgh; Pittsburgh PA USA
| | - R. M. Pacheco-Gonzalez
- Respiratory and Allergy Units; Arrixaca University Children's Hospital; University of Murcia; Murcia Spain
- IMIB Bio-research Institute; Murcia Spain
| | - J. C. Celedón
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology; Children's Hospital of Pittsburgh of UPMC; University of Pittsburgh; Pittsburgh PA USA
| | - J. A. Castro-Rodriguez
- Division of Pediatrics; School of Medicine; Pontificia Universidad Católica de Chile; Santiago Chile
| |
Collapse
|
45
|
Garcia-Marcos L, Mallol J, Solé D, Brand PLP, Martinez-Torres A, Sanchez-Solis M. Pneumonia and wheezing in the first year: An international perspective. Pediatr Pulmonol 2015; 50:1277-85. [PMID: 25676935 PMCID: PMC7167825 DOI: 10.1002/ppul.23160] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 12/15/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND The relationship between pneumonia and recurrent wheezing (RW) and the factors associated to pneumonia in wheezing and non-wheezing infants have not been compared between affluent and non-affluent populations. METHODS The International Study of Wheezing in Infants (EISL) is a large population-based cross-sectional study carried out in Latin America (LA) and Europe (EU). We used a validated questionnaire for identifying wheeze in the first year of life. The questionnaire also inquired about pneumonia diagnosis, together with other potentially related factors. Associations between both conditions and between potential risk/protective factors for pneumonia were tested by random-effects logit model and adjusting for all factors found previously associated to RW in this cohort. RESULTS Pneumonia and RW were strongly associated to each other in LA and EU (aOR 5.42; 95%CI: 4.87-6.04 and aOR 13.99; 95%CI: 9.61-20.36, respectively). Infant eczema was the most consistent risk factor of pneumonia in both continents, in the whole population and also among wheezers and non-wheezers (aOR ranging from 1.30; 95%CI: 1.11-1.52 to 2.65; 95%CI: 1.68-4.18); while breast feeding for at least 3 months was the most consistent protective factor (aOR ranging from 0.60; 95%CI: 0.51-0.71 to 0.76; 95%CI: 0.69-0.84). Factors associated to pneumonia were similar between continents among wheezers, but differed considerably among non-wheezers. CONCLUSION Pneumonia and RW are associated conditions sharing many risk/protective factors in EU and LA among wheezing infants, but not among non-wheezing infants. The association between pneumonia and RW could be due to shared pathophysiology or by diagnostic confusion between the two conditions.
Collapse
Affiliation(s)
- Luis Garcia-Marcos
- Paediatric Respiratory and Allergy Unit, "Virgen de la Arrixaca" University Children's Hospital, University of Murcia, Murcia, Spain
| | - Javier Mallol
- Department of Paediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Chile
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Paediatrics, Federal University of S, ã, o Paulo (UNIFESP), São Paulo, Brazil
| | - Paul L P Brand
- Princess Amalia Children's Clinic, Isala Klinieken, Zwolle, and UMCG Postgraduate School of Medicine, University Medical Centre Groningen, the Netherlands
| | - Antonela Martinez-Torres
- Paediatric Respiratory and Allergy Unit, "Virgen de la Arrixaca" University Children's Hospital, University of Murcia, Murcia, Spain
| | - Manuel Sanchez-Solis
- Paediatric Respiratory and Allergy Unit, "Virgen de la Arrixaca" University Children's Hospital, University of Murcia, Murcia, Spain
| | | |
Collapse
|
46
|
Garcia-Marcos L. In this issue of A&I. Allergol Immunopathol (Madr) 2015. [DOI: 10.1016/j.aller.2015.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
47
|
Garcia-Marcos L. In this issue of A&I. Allergol Immunopathol (Madr) 2015. [DOI: 10.1016/j.aller.2015.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
48
|
Mallol J, Solé D, Garcia-Marcos L, Rosario N, Aguirre V, Chong H, Urrutia-Pereira M, Szulman G, Niederbacher J, Arruda-Chavez E, Toledo E, Sánchez L, Pinchak C. Prevalence, Severity, and Treatment of Recurrent Wheezing During the First Year of Life: A Cross-Sectional Study of 12,405 Latin American Infants. Allergy Asthma Immunol Res 2015; 8:22-31. [PMID: 26540498 PMCID: PMC4695404 DOI: 10.4168/aair.2016.8.1.22] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/15/2015] [Indexed: 01/09/2023]
Abstract
PURPOSE This study aimed to determine the prevalence and severity of recurrent wheezing (RW) defined as ≥3 episodes of wheezing, risk factors, and treatments prescribed during the first year of life in Latin American infants. METHODS In this international, cross-sectional, and community-based study, parents of 12,405 infants from 11 centers in 6 South American countries (Argentina, Brazil, Chile, Colombia, Peru, and Uruguay) completed a questionnaire about wheezing and associated risk/protective factors, asthma medications, and the frequency of and indications for the prescription of antibiotics and paracetamol during the first year of life. RESULTS The prevalence of RW was 16.6% (95% CI 16.0-17.3); of the 12,405 infants, 72.7% (95% CI 70.7-74.6) visited the Emergency Department for wheezing, and 29.7% (27.7-31.7) was admitted. Regarding treatment, 49.1% of RW infants received inhaled corticosteroids, 55.7% oral corticosteroids, 26.3% antileukotrienes, 22.9% antibiotics ≥4 times mainly for common colds, wheezing, and pharyngitis, and 57.5% paracetamol ≥4 times. Tobacco smoking during pregnancy, household income per month <1,000 USD, history of parental asthma, male gender, and nursery school attendance were significant risk factors for higher prevalence and severity of RW, whereas breast-feeding for at least 3 months was a significant protective factor. Pneumonia and admissions for pneumonia were significantly higher in infants with RW as compared to the whole sample (3.5-fold and 3.7-fold, respectively). CONCLUSIONS RW affects 1.6 out of 10 infants during the first year of life, with a high prevalence of severe episodes, frequent visits to the Emergency Department, and frequent admissions for wheezing. Besides the elevated prescription of asthma medications, there is an excessive use of antibiotics and paracetamol in infants with RW and also in the whole sample, which is mainly related to common colds.
Collapse
Affiliation(s)
- Javier Mallol
- Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Santiago, Chile.
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Luis Garcia-Marcos
- Pediatric Respiratory and Allergy Units, "Virgen de la Arrixaca" University Children's Hospital, University of Murcia, and IMIB Research Institute, Murcia, Spain
| | - Nelson Rosario
- Department of Pediatrics, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Viviana Aguirre
- Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Santiago, Chile
| | - Herberto Chong
- Department of Pediatrics, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, Brazil
| | | | | | - Jurg Niederbacher
- Escuela de Medicina, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Erika Arruda-Chavez
- Section of Allergy and Clinical Immunology, British American Hospital, Lima, Peru
| | - Eliana Toledo
- Hospital de Base de São José do Rio Preto, Faculty of Medicine of Sao José do Rio Preto, São Paulo, Brazil
| | - Lillian Sánchez
- Department of Pediatrics, Federal University of Mato Grosso, Cuiaba, Brazil
| | - Catalina Pinchak
- Clínica Pediátrica "B". Hospital Pereira Rossell, Facultad Medicina, Universidad de la Republica, Montevideo, Uruguay
| | | |
Collapse
|
49
|
Garcia-Marcos L. In this issue of A&I. Allergol Immunopathol (Madr) 2015. [DOI: 10.1016/j.aller.2015.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
50
|
Draaisma E, Garcia-Marcos L, Mallol J, Solé D, Pérez-Fernández V, Brand PLP. A multinational study to compare prevalence of atopic dermatitis in the first year of life. Pediatr Allergy Immunol 2015; 26:359-66. [PMID: 25845445 DOI: 10.1111/pai.12388] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/31/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is common in childhood, with peak prevalence in early childhood. However, international comparisons of prevalence have focused on older children. We analysed differences in prevalence rates of AD and the associations with putative risk and protective factors, among infants in two European and two Central American countries. METHODS In 1-yr old infants participating in the International Study of Wheezing in Infants (EISL), prevalence of AD and putative risk and protective factors were assessed by a questionnaire applied to parents. For each risk/protective factor summary, odds ratios with 95% confidence intervals were calculated by means of random effects meta-analysis. RESULTS Data from 9803 infants were analysed. AD prevalence varied from 10.6% (Valencia, Spain) to 28.2% (San Pedro Sula, Honduras). Average AD prevalences were lower in Europe (14.2%) than in Central America (18.2%, p < 0.01). Consistent with older children, presence of siblings decreased (OR 0.82 [0.72-0.94]), whereas family history of asthma (OR 1.32 [1.10-1.59]), rhinitis (OR 1.33 [1.14-1.54]) and atopic dermatitis (OR 2.40 [1.89-3.05]) increased the risk of infantile AD. However, gender, family size, breastfeeding and socio-economic status were not associated with AD prevalence. CONCLUSIONS This study shows almost threefold differences in the prevalence of AD in infancy between countries. Risk and protective factors involved in the expression of infantile AD differ from those in older children, possibly suggesting a different pathophysiology. There is a need for additional international epidemiological surveys on AD in young children, the peak prevalence age of this condition.
Collapse
Affiliation(s)
- Eelco Draaisma
- Princess Amalia Children's Centre, Isala Hospital, Zwolle, the Netherlands
| | - Luis Garcia-Marcos
- Pediatric Respiratory and Allergy Units, 'Virgen de la Arrixaca' University Children's Hospital, University of Murcia, Murcia, Spain.,Arrixaca Bio-Health Research Institute of Murcia, Murcia, Spain
| | - Javier Mallol
- Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Santiago, Chile
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Virginia Pérez-Fernández
- Pediatric Respiratory and Allergy Units, 'Virgen de la Arrixaca' University Children's Hospital, University of Murcia, Murcia, Spain
| | - Paul L P Brand
- Princess Amalia Children's Centre, Isala Hospital, Zwolle, the Netherlands.,UMCG Postgraduate School of Medicine, University Medical Centre and University of Groningen, Groningen, the Netherlands
| | | |
Collapse
|