1
|
Sheehan WJ, Maghzian N, Rastogi D, Bollard CM, Lin AA. Decreased regulatory B cells in pediatric patients with asthma. Ann Allergy Asthma Immunol 2023; 131:120-121. [PMID: 37100280 PMCID: PMC10436357 DOI: 10.1016/j.anai.2023.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 04/28/2023]
Affiliation(s)
- William J Sheehan
- Center for Cancer and Immunology Research, Children's National Research Institute, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC.
| | - Naseem Maghzian
- Center for Cancer and Immunology Research, Children's National Research Institute, Washington, DC
| | - Deepa Rastogi
- George Washington University School of Medicine and Health Sciences, Washington, DC; Center for Genetic Medicine Research, Children's National Research Institute, Washington, DC
| | - Catherine M Bollard
- Center for Cancer and Immunology Research, Children's National Research Institute, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Adora A Lin
- Center for Cancer and Immunology Research, Children's National Research Institute, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC
| |
Collapse
|
2
|
Vesper SJ, Wymer L, Coull BA, Koutrakis P, Cunningham A, Petty CR, Metwali N, Sheehan WJ, Gaffin JM, Permaul P, Lai PS, Bartnikas LM, Hauptman M, Gold DR, Baxi SN, Phipatanakul W. HEPA filtration intervention in classrooms may improve some students' asthma. J Asthma 2023; 60:479-486. [PMID: 35341426 PMCID: PMC9548522 DOI: 10.1080/02770903.2022.2059672] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The School Inner-City Asthma Intervention Study 2 (SICAS 2) tested interventions to reduce exposures in classrooms of students with asthma. The objective of this post-hoc analysis was limited to evaluating the effect of high-efficiency particulate (HEPA) filtration interventions on mold levels as quantified using the Environmental Relative Moldiness Index (ERMI) and the possible improvement in the students' asthma, as quantified by spirometry testing. METHODS Pre-intervention dust samples were collected at the beginning of the school year from classrooms and corresponding homes of students with asthma (n = 150). Follow-up dust samples were collected in the classrooms at the end of the HEPA or Sham intervention. For each dust sample, ERMI values and the Group 1 and Group 2 mold levels (components of the ERMI metric) were quantified. In addition, each student's lung function was evaluated by spirometry testing, specifically the percentage predicted forced expiratory volume at 1 sec (FEV1%), before and at the end of the intervention. RESULTS For those students with a higher Group 1 mold level in their pre-intervention classroom than home (n = 94), the FEV1% results for those students was significantly (p < 0.05) inversely correlated with the Group 1 level in their classrooms. After the HEPA intervention, the average Group 1 and ERMI values were significantly lowered, and the average FEV1% test results significantly increased by an average of 4.22% for students in HEPA compared to Sham classrooms. CONCLUSIONS HEPA intervention in classrooms reduced Group 1 and ERMI values, which corresponded to improvements in the students' FEV1% test results.
Collapse
Affiliation(s)
- Stephen J. Vesper
- US Environmental Protection Agency, Center for Environmental Measurement and Modeling, Cincinnati, OH, USA
| | - Larry Wymer
- US Environmental Protection Agency, Center for Environmental Measurement and Modeling, Cincinnati, OH, USA
| | - Brent A. Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Amparito Cunningham
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA
| | - Carter R. Petty
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA, USA
| | - Nervana Metwali
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - William J. Sheehan
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jonathan M. Gaffin
- Harvard Medical School, Boston, MA, USA
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Perdita Permaul
- Division of Pediatric Pulmonology, Allergy and Immunology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA
| | - Peggy S. Lai
- Harvard Medical School, Boston, MA, USA
- Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, MA, USA
| | - Lisa M. Bartnikas
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Marissa Hauptman
- Harvard Medical School, Boston, MA, USA
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, MA, USA
| | - Diane R. Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Sachin N. Baxi
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Wanda Phipatanakul
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
3
|
Akar-Ghibril N, Petty CR, Cunningham A, Permaul P, Gaffin JM, Phipatanakul W, Sheehan WJ. Mouse allergen levels in schools over the decade. J Allergy Clin Immunol Pract 2022; 10:3024-3025. [PMID: 35940510 DOI: 10.1016/j.jaip.2022.07.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Nicole Akar-Ghibril
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass; Division of Immunology, Allergy, and Rheumatology, Joe DiMaggio Children's Hospital, Hollywood, Fla
| | - Carter R Petty
- Research Center, Boston Children's Hospital, Boston, Mass
| | - Amparito Cunningham
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Perdita Permaul
- Division of Pediatric Pulmonology, Allergy and Immunology, NY-Presbyterian Hospital/Weill Cornell Medicine, Weill Cornell Medical College, New York, NY
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Wanda Phipatanakul
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
| | - William J Sheehan
- Division of Allergy/Immunology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC
| |
Collapse
|
4
|
Banzon TM, Sheehan WJ, Petty CR, Hauptman M, Flanagan S, Bell D, Shamosh B, Bartnikas LM, Phipatanakul W. The Coronavirus Disease 2019 Pandemic and Mental Health-Related School-Nurse Visits in United States Schools. Acad Pediatr 2022; 23:681-685. [PMID: 36100180 PMCID: PMC9464315 DOI: 10.1016/j.acap.2022.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/10/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE No studies have examined school-nurse visits related to mental health (MH) during the coronavirus disease 2019 (COVID-19) pandemic. We examined changes in the rate of MH-related school-nurse visits before and during the COVID-19 pandemic. METHODS We analyzed school-nurse visit data (n = 3,445,240) for subjects Grade K-12 in US public schools using electronic health record software (SchoolCare, Ramsey, NJ). Data between January 1 and December 31 in 2019 (pre-COVID-19 pandemic) versus January 1 to December 31 in 2020 (during COVID-19 pandemic) were compared. For each year, total visits to a school-nurse were calculated for general MH, anxiety, and self-harm. The exposure was number of school-nurse visits in each time period (2019 vs 2020). The main outcome was change in the rate of general MH, anxiety, and self-harm visits in 2019 versus 2020. RESULTS There were 2,302,239 total school-nurse visits in 2019 versus 1,143,001 in 2020. During the COVID-19 pandemic, the rate of visits for general MH increased by 30% (4.7-6.1 per 10,000 visits, 95% confidence interval [CI] {18%, 43%}; P < .001), and visits for anxiety increased by 25% (24.8-31 per 10,000 visits, 95% CI [20%,30%]; P < .001). There was no significant difference in self-harm visits across all ages during the COVID-19 pandemic. CONCLUSIONS Our study found a significant increase in the rate of school-nurse visits for MH and anxiety during the COVID-19 pandemic, suggesting the pediatric population is at-risk for increased negative MH-effects associated with the pandemic and highlights a critical role of school-nurses in identifying youth with potential MH-needs.
Collapse
Affiliation(s)
- Tina M. Banzon
- Division of Allergy and Immunology, Boston Children's Hospital (TM Banzon, M Hauptman, S Flanagan, LM Bartnikas, and W Phipatanakul), Boston, Mass,Harvard Medical School (TM Banzon, D Bell, LM Bartnikas, and W Phipatanakul), Boston, Mass
| | - William J. Sheehan
- Division of Allergy and Immunology, Children's National Hospital (WJ Sheehan), Washington, DC,George Washington University School of Medicine and Health Sciences (WJ Sheehan), Washington, DC
| | - Carter R. Petty
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital (CR Petty), Boston, Mass
| | - Marissa Hauptman
- Division of Allergy and Immunology, Boston Children's Hospital (TM Banzon, M Hauptman, S Flanagan, LM Bartnikas, and W Phipatanakul), Boston, Mass,Pediatric Environmental Health Center, Division of General Pediatrics, Boston Children's Hospital (M Hauptman and S Flanagan), Boston, Mass
| | - Shelby Flanagan
- Division of Allergy and Immunology, Boston Children's Hospital (TM Banzon, M Hauptman, S Flanagan, LM Bartnikas, and W Phipatanakul), Boston, Mass,Pediatric Environmental Health Center, Division of General Pediatrics, Boston Children's Hospital (M Hauptman and S Flanagan), Boston, Mass
| | - Darin Bell
- Harvard Medical School (TM Banzon, D Bell, LM Bartnikas, and W Phipatanakul), Boston, Mass
| | | | - Lisa M. Bartnikas
- Division of Allergy and Immunology, Boston Children's Hospital (TM Banzon, M Hauptman, S Flanagan, LM Bartnikas, and W Phipatanakul), Boston, Mass,Harvard Medical School (TM Banzon, D Bell, LM Bartnikas, and W Phipatanakul), Boston, Mass
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital (TM Banzon, M Hauptman, S Flanagan, LM Bartnikas, and W Phipatanakul), Boston, Mass; Harvard Medical School (TM Banzon, D Bell, LM Bartnikas, and W Phipatanakul), Boston, Mass.
| |
Collapse
|
5
|
Jackson DJ, Bacharier LB, Gergen PJ, Gagalis L, Calatroni A, Wellford S, Gill MA, Stokes J, Liu AH, Gruchalla RS, Cohen RT, Makhija M, Khurana Hershey GK, O'Connor GT, Pongracic JA, Sherenian MG, Rivera-Spoljaric K, Zoratti EM, Teach SJ, Kattan M, Dutmer CM, Kim H, Lamm C, Sheehan WJ, Segnitz RM, Dill-McFarland KA, Visness CM, Becker PM, Gern JE, Sorkness CA, Busse WW, Altman MC. Mepolizumab for urban children with exacerbation-prone eosinophilic asthma in the USA (MUPPITS-2): a randomised, double-blind, placebo-controlled, parallel-group trial. Lancet 2022; 400:502-511. [PMID: 35964610 PMCID: PMC9623810 DOI: 10.1016/s0140-6736(22)01198-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [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: 03/28/2022] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Black and Hispanic children living in urban environments in the USA have an excess burden of morbidity and mortality from asthma. Therapies directed at the eosinophilic phenotype reduce asthma exacerbations in adults, but few data are available in children and diverse populations. Furthermore, the molecular mechanisms that underlie exacerbations either being prevented by, or persisting despite, immune-based therapies are not well understood. We aimed to determine whether mepolizumab, added to guidelines-based care, reduced the number of asthma exacerbations during a 52-week period compared with guidelines-based care alone. METHODS This is a randomised, double-blind, placebo-controlled, parallel-group trial done at nine urban medical centres in the USA. Children and adolescents aged 6-17 years, who lived in socioeconomically disadvantaged neighbourhoods and had exacerbation-prone asthma (defined as ≥two exacerbations in the previous year) and blood eosinophils of at least 150 cells per μL were randomly assigned 1:1 to mepolizumab (6-11 years: 40 mg; 12-17 years: 100 mg) or placebo injections once every 4 weeks, plus guideline-based care, for 52 weeks. Randomisation was done using a validated automated system. Participants, investigators, and the research staff who collected outcome measures remained masked to group assignments. The primary outcome was the number of asthma exacerbations that were treated with systemic corticosteroids during 52 weeks in the intention-to-treat population. The mechanisms of treatment response were assessed by study investigators using nasal transcriptomic modular analysis. Safety was assessed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT03292588. FINDINGS Between Nov 1, 2017, and Mar 12, 2020, we recruited 585 children and adolescents. We screened 390 individuals, of whom 335 met the inclusion criteria and were enrolled. 290 met the randomisation criteria, were randomly assigned to mepolizumab (n=146) or placebo (n=144), and were included in the intention-to-treat analysis. 248 completed the study. The mean number of asthma exacerbations within the 52-week study period was 0·96 (95% CI 0·78-1·17) with mepolizumab and 1·30 (1·08-1·57) with placebo (rate ratio 0·73; 0·56-0·96; p=0·027). Treatment-emergent adverse events occurred in 42 (29%) of 146 participants in the mepolizumab group versus 16 (11%) of 144 participants in the placebo group. No deaths were attributed to mepolizumab. INTERPRETATION Phenotype-directed therapy with mepolizumab in urban children with exacerbation-prone eosinophilic asthma reduced the number of exacerbations. FUNDING US National Institute of Allergy and Infectious Diseases and GlaxoSmithKline.
Collapse
Affiliation(s)
- Daniel J Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Leonard B Bacharier
- Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Peter J Gergen
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Lisa Gagalis
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | | | | | - Michelle A Gill
- Department of Pediatrics, Washington University, St Louis, MO, USA
| | - Jeffrey Stokes
- Department of Pediatrics, Washington University, St Louis, MO, USA
| | - Andrew H Liu
- Pediatric Pulmonary and Sleep Medicine, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, USA
| | - Rebecca S Gruchalla
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Robyn T Cohen
- Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA
| | - Melanie Makhija
- Division of Allergy and Immunology, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | - George T O'Connor
- Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA
| | - Jacqueline A Pongracic
- Division of Allergy and Immunology, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Michael G Sherenian
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Katherine Rivera-Spoljaric
- Department of Pediatrics, Washington University, St Louis, MO, USA; St Louis Children's Hospital, St Louis, MO, USA
| | - Edward M Zoratti
- Department of Medicine, Henry Ford Health System, Detroit, MI, USA
| | - Stephen J Teach
- Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Meyer Kattan
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Cullen M Dutmer
- Pediatrics-Allergy and Immunology, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, USA
| | - Haejin Kim
- Department of Medicine, Henry Ford Health System, Detroit, MI, USA
| | - Carin Lamm
- Department of Pediatrics, New York Columbia University Medical Center, New York, NY, USA
| | - William J Sheehan
- Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - R Max Segnitz
- Department of Medicine, University of Washington, Seattle, WA, USA
| | | | | | - Patrice M Becker
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - James E Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Christine A Sorkness
- School of Pharmacy, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - William W Busse
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Matthew C Altman
- Department of Medicine, University of Washington, Seattle, WA, USA; Benaroya Research Institute, Seattle, WA, USA
| |
Collapse
|
6
|
Banzon TM, Kelly MS, Bartnikas LM, Sheehan WJ, Cunningham A, Harb H, Crestani E, Valeri L, Greco KF, Chatila TA, Phipatanakul W, Lai PS. Atopic Dermatitis Mediates the Association Between an IL4RA Variant and Food Allergy in School-Aged Children. J Allergy Clin Immunol Pract 2022; 10:2117-2124.e4. [PMID: 35589010 PMCID: PMC9811396 DOI: 10.1016/j.jaip.2022.04.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/14/2022] [Accepted: 04/30/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) and food allergy (FA) may share genetic risk factors. It is unknown whether genetic factors directly cause FA or are mediated through AD, as the dual-allergen hypothesis suggests. OBJECTIVE To test the hypothesis that AD mediates the relationship between an IL-4 receptor alpha chain gene (IL4RA) variant, the human IL-4 receptor alpha chain protein-R576 polymorphism, and FA. METHODS A total of 433 children with asthma enrolled in the School Inner-City Asthma Study underwent genotyping for the IL4RA576 allele. Surveys were administered to determine FA, AD, and associated allergic responses. Mediation analysis was performed adjusting for race and ethnicity, age, sex, and household income. Multivariate models were used to determine the association between genotype and FA severity. RESULTS AD was reported in 193 (45%) and FA in 80 children (19%). Each risk allele increased odds of AD 1.39-fold ([1.03-1.87], P = .03), and AD increased odds of FA 3.67-fold ([2.05- 6.57], P < .01). There was an indirect effect of genotype, mediated by AD, predicting FA; each risk allele increased the odds of FA by 1.13 (odds ratio [95% CI], Q/R = 1.13 [1.02-1.24], R/R = 1.28 [1.04-1.51]; P < .01). Each risk allele increased the odds of severe FA symptoms 2.68-fold ([1.26-5.71], P = .01). CONCLUSIONS In a cohort of children with asthma, AD is part of the causal pathway between an IL4RA variant and FA. This variant is associated with increased risk of severe FA reactions. Addressing AD in children with an IL4RA polymorphism may modulate the risk of FA.
Collapse
Affiliation(s)
- Tina M. Banzon
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Michael S. Kelly
- Harvard Medical School, Boston, MA,Department of Internal Medicine, Massachusetts General Hospital, Boston, MA
| | - Lisa M. Bartnikas
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - William J. Sheehan
- Division of Allergy and Immunology, Children’s National Hospital, Washington DC,George Washington University School of Medicine and Health Sciences, Washington DC
| | | | - Hani Harb
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Elena Crestani
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Linda Valeri
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY
| | - Kimberly F. Greco
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA
| | - Talal A. Chatila
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA,Harvard Medical School, Boston, MA,Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA
| | - Peggy S. Lai
- Harvard Medical School, Boston, MA,Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, MA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| |
Collapse
|
7
|
Akar-Ghibril N, Sheehan WJ, Perzanowski M, Balcer-Whaley S, Newman M, Petty CR, Gaffin JM, Cunningham A, Divjan A, Matsui EC, Phipatanakul W. Predictors of successful mouse allergen reduction in inner-city homes of children with asthma. J Allergy Clin Immunol Pract 2021; 9:4159-4161.e2. [PMID: 34265449 PMCID: PMC8578252 DOI: 10.1016/j.jaip.2021.06.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/20/2021] [Accepted: 06/24/2021] [Indexed: 01/04/2023]
Affiliation(s)
- Nicole Akar-Ghibril
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - William J Sheehan
- Division of Allergy/Immunology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Matthew Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Susan Balcer-Whaley
- Division of Pediatric Allergy/Immunology, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Michelle Newman
- Division of Pediatric Allergy/Immunology, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Carter R Petty
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Mass
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Amparito Cunningham
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Adnan Divjan
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Elizabeth C Matsui
- Departments of Population Health and Pediatrics, Dell Medical School at the University of Texas, Austin, Texas
| | - Wanda Phipatanakul
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
| |
Collapse
|
8
|
Phipatanakul W, Koutrakis P, Coull BA, Petty CR, Gaffin JM, Sheehan WJ, Lai PS, Bartnikas LM, Kang CM, Wolfson JM, Samnaliev M, Cunningham A, Baxi SN, Permaul P, Hauptman M, Trivedi M, Louisias M, Liang L, Thorne PS, Metwali N, Adamkiewicz G, Israel E, Baccarelli AA, Gold DR. Effect of School Integrated Pest Management or Classroom Air Filter Purifiers on Asthma Symptoms in Students With Active Asthma: A Randomized Clinical Trial. JAMA 2021; 326:839-850. [PMID: 34547084 PMCID: PMC8424475 DOI: 10.1001/jama.2021.11559] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [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] [Indexed: 01/02/2023]
Abstract
IMPORTANCE School and classroom allergens and particles are associated with asthma morbidity, but the benefit of environmental remediation is not known. OBJECTIVE To determine whether use of a school-wide integrated pest management (IPM) program or high-efficiency particulate air (HEPA) filter purifiers in the classrooms improve asthma symptoms in students with active asthma. DESIGN, SETTING, AND PARTICIPANTS Factorial randomized clinical trial of a school-wide IPM program and HEPA filter purifiers in the classrooms was conducted from 2015 to 2020 (School Inner-City Asthma Intervention Study). There were 236 students with active asthma attending 41 participating urban elementary schools located in the Northeastern US who were randomized to IPM by school and HEPA filter purifiers by classroom. The date of final follow-up was June 20, 2020. INTERVENTIONS The school-wide IPM program consisted of application of rodenticide, sealing entry points, trap placement, targeted cleaning, and brief educational handouts for school staff. Infestation was assessed every 3 months, with additional treatments as needed. Control schools received no IPM, cleaning, or education. Classroom portable HEPA filter purifiers were deployed and the filters were changed every 3 months. Control classrooms received sham HEPA filters that looked and sounded like active HEPA filter purifiers. Randomization was done independently (split-plot design), with matching by the number of enrolled students to ensure a nearly exact 1:1 student ratio for each intervention with 118 students randomized to each group. Participants, investigators, and those assessing outcomes were blinded to the interventions. MAIN OUTCOMES AND MEASURES The primary outcome was the number of symptom-days with asthma during a 2-week period. Symptom-days were assessed every 2 months during the 10 months after randomization. RESULTS Among the 236 students who were randomized (mean age, 8.1 [SD, 2.0] years; 113 [48%] female), all completed the trial. At baseline, the 2-week mean was 2.2 (SD, 3.9) symptom-days with asthma and 98% of the classrooms had detectable levels of mouse allergen. The results were pooled because there was no statistically significant difference between the 2 interventions (P = .18 for interaction). During a 2-week period, the mean was 1.5 symptom-days with asthma after use of the school-wide IPM program vs 1.9 symptom-days after no IPM across the school year (incidence rate ratio, 0.71 [95% CI, 0.38-1.33]), which was not statistically significantly different. During a 2-week period, the mean was 1.6 symptom-days with asthma after use of HEPA filter purifiers in the classrooms vs 1.8 symptom-days after use of sham HEPA filter purifiers across the school year (incidence rate ratio, 1.47 [95% CI, 0.79-2.75]), which was not statistically significantly different. There were no intervention-related adverse events. CONCLUSIONS AND RELEVANCE Among children with active asthma, use of a school-wide IPM program or classroom HEPA filter purifiers did not significantly reduce symptom-days with asthma. However, interpretation of the study findings may need to consider allergen levels, particle exposures, and asthma symptoms at baseline. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02291302.
Collapse
Affiliation(s)
- Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, Massachusetts
- Harvard University Medical School, Boston, Massachusetts
| | - Petros Koutrakis
- Department of Environmental Health, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Brent A. Coull
- Department of Environmental Health, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Biostatistics, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Carter R. Petty
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, Massachusetts
| | - Jonathan M. Gaffin
- Harvard University Medical School, Boston, Massachusetts
- Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - William J. Sheehan
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, Massachusetts
- Children’s National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Peggy S. Lai
- Harvard University Medical School, Boston, Massachusetts
- Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston
| | - Lisa M. Bartnikas
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, Massachusetts
- Harvard University Medical School, Boston, Massachusetts
| | - Choong-Min Kang
- Department of Environmental Health, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Jack M. Wolfson
- Department of Environmental Health, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Mihail Samnaliev
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, Massachusetts
| | - Amparito Cunningham
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, Massachusetts
| | - Sachin N. Baxi
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, Massachusetts
- Harvard University Medical School, Boston, Massachusetts
| | - Perdita Permaul
- Division of Pediatric Allergy and Immunology, Massachusetts General Hospital, Boston
- Division of Pediatric Pulmonology, Allergy and Immunology, Department of Pediatrics, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York
| | - Marissa Hauptman
- Harvard University Medical School, Boston, Massachusetts
- Division of General Pediatrics, Pediatric Environmental Health Center, Boston Children’s Hospital, Boston, Massachusetts
| | - Michelle Trivedi
- Division of Pediatric Pulmonology and Department of Population and Quantitative Health Sciences, University of Massachusetts Memorial Medical School, Worcester
| | - Margee Louisias
- Division of Allergy and Immunology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Liming Liang
- Department of Biostatistics, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Peter S. Thorne
- Department of Occupational and Environmental Health, University of Iowa, Iowa City
| | - Nervana Metwali
- Department of Occupational and Environmental Health, University of Iowa, Iowa City
| | - Gary Adamkiewicz
- Department of Environmental Health, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Elliot Israel
- Department of Environmental Health, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Divisions of Pulmonary and Critical Care Medicine and Allergy and Immunology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Andrea A. Baccarelli
- Department of Environmental Health, School of Public Health, Columbia University, New York, New York
| | - Diane R. Gold
- Harvard University Medical School, Boston, Massachusetts
- Department of Environmental Health, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Laboratory Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| |
Collapse
|
9
|
Margolis RHF, Patel SJ, Sheehan WJ, Simpson JN, Kachroo N, Bahar B, Teach SJ. Association between pediatric asthma and positive tests for SARS-CoV-2 in the District of Columbia. J Allergy Clin Immunol Pract 2021; 9:3490-3493. [PMID: 34265448 PMCID: PMC8274272 DOI: 10.1016/j.jaip.2021.06.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/06/2021] [Accepted: 06/16/2021] [Indexed: 11/02/2022]
Affiliation(s)
- Rachel H F Margolis
- Center for Translational Research, Children's National Research Institute, Washington, DC
| | - Shilpa J Patel
- Center for Translational Research, Children's National Research Institute, Washington, DC; Division of Emergency Medicine, Children's National Hospital, Washington, DC
| | - William J Sheehan
- Center for Translational Research, Children's National Research Institute, Washington, DC; Division of Allergy and Immunology, Children's National Hospital, Washington, DC
| | - Joelle N Simpson
- Center for Translational Research, Children's National Research Institute, Washington, DC; Division of Emergency Medicine, Children's National Hospital, Washington, DC
| | - Nikita Kachroo
- Center for Translational Research, Children's National Research Institute, Washington, DC
| | - Burak Bahar
- Division of Pathology and Laboratory Medicine, Children's National Hospital, Washington, DC
| | - Stephen J Teach
- Center for Translational Research, Children's National Research Institute, Washington, DC; Division of Emergency Medicine, Children's National Hospital, Washington, DC.
| |
Collapse
|
10
|
Maciag MC, Sheehan WJ, Bartnikas LM, Lai PS, Petty CR, Filep S, Chapman MD, Phipatanakul W. Detection of Food Allergens in School and Home Environments of Elementary Students. J Allergy Clin Immunol Pract 2021; 9:3735-3743. [PMID: 34174494 DOI: 10.1016/j.jaip.2021.06.014] [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] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 05/30/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Little is known about environmental food allergen exposure on school surfaces. OBJECTIVE To compare the distribution of major food allergens in floor dust and table wipe samples from elementary schools and dust samples from students' homes. METHODS In this substudy of the School Inner-City Asthma Study-II, 103 table wipe samples and 98 floor dust samples from cafeterias and classrooms in 18 elementary schools were analyzed for milk, peanut, cashew, hazelnut, and egg using a multiplex array. Home kitchen floor and bed dust samples from 90 students were also analyzed. RESULTS Food allergens were detectable in schools, but at significantly lower levels than in homes (P < .001). In schools, milk and peanut were detected in all table wipe samples; milk and egg were detected in all floor dust samples. Cafeteria table wipe samples contained significantly higher levels of milk, peanut, hazelnut, and egg, compared with classrooms. Cafeteria floor dust samples contained higher levels milk than classrooms. Peanut-restrictive policies did not consistently reduce environmental peanut exposure in schools. Peanut allergen was lower in dust from homes of students with peanut allergy (n = 5) compared with those without peanut allergy (n = 85) (P < .001). Reassuringly, peanut allergen in the schools of peanut-allergic students was not significantly different than in their homes. CONCLUSION Food allergens were readily detectable on tables and floors in elementary schools, but at levels lower than in students' homes. For peanut-allergic students, the levels of detectable peanut in their schools were not higher than their homes. The low levels of detectable food allergens in school environments are unlikely to result in severe allergic reactions.
Collapse
Affiliation(s)
- Michelle C Maciag
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass; Asthma & Allergy Affiliates, Salem, Mass
| | - William J Sheehan
- Division of Allergy and Immunology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Lisa M Bartnikas
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - Peggy S Lai
- Department of Pediatrics, Harvard Medical School, Boston, Mass; Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Mass
| | - Carter R Petty
- Biostatistics and Research Design Core, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Mass
| | | | | | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass.
| |
Collapse
|
11
|
Sheehan WJ, Paul IM, Mauger DT, Moy JN, Szefler SJ, Jackson DJ, Fitzpatrick AM, Cabana MD, Covar R, Robison RG, Phipatanakul W. Adherence rates during a randomized controlled trial evaluating the use of blinded acetaminophen and ibuprofen in children with asthma. Contemp Clin Trials 2021; 104:106334. [PMID: 33652129 DOI: 10.1016/j.cct.2021.106334] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND/AIMS When conducting clinical trials comparing over-the-counter (OTC) medications, the wide availability of these treatments are a potential challenge to maintaining study integrity. We seek to describe adherence to a study protocol involving widely available OTC medications. METHODS To prospectively evaluate associations between acetaminophen use and asthma in 300 children aged 1-5 years, we conducted a double blind, randomized, controlled trial where parents administered blinded forms of either acetaminophen or ibuprofen as needed to their children over a 48 week period. Written and verbal instructions encouraged the exclusive use of the blinded study medication and discouraged OTC use. Adherence was determined by evaluating the frequency of use of per-protocol blinded study medication compared to off-protocol use of OTC medications. RESULTS 4195 doses of acetaminophen or ibuprofen were received by children during the study which included 3664 doses (87.3%) of blinded study medication adhering to the protocol and 531 doses (12.7%) of OTC products deviating from the protocol with better adherence among those randomized to ibuprofen as compared to acetaminophen (89.5% vs. 85.5% of doses, p < 0.01). Individually, 227 participants (75.7%) remained fully adherent by not receiving any OTC medications. Pre-study preference for either acetaminophen or ibuprofen by the participants' families was not associated with differential rates of adherence to the blinded medication. CONCLUSION This parallel study demonstrated greater than 85% of acetaminophen or ibuprofen doses were blinded study medications adhering to the protocol while less than 15% were OTC deviations from the protocol. This successfully implemented study design provides a template to comparatively evaluate these and other OTC medications.
Collapse
Affiliation(s)
- William J Sheehan
- Boston Children's Hospital, Division of Allergy and Immunology, Harvard Medical School, Boston, MA, United States of America; Children's National Hospital, Division of Allergy and Immunology, George Washington University School of Medicine and Health Sciences, Washington DC, United States of America
| | - Ian M Paul
- Penn State College of Medicine, Department of Pediatrics, Hershey, PA, United States of America
| | - David T Mauger
- Penn State College of Medicine, Department of Public Health Sciences, Hershey, PA, United States of America
| | - James N Moy
- Stroger Hospital of Cook County, Department of Pediatrics, Rush University Medical Center, Chicago, IL, United States of America
| | - Stanley J Szefler
- Children's Hospital Colorado, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Daniel J Jackson
- University of Wisconsin School of Medicine and Public Health, Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Madison, WI, United States of America
| | - Anne M Fitzpatrick
- Emory University, Department of Pediatrics, Atlanta, GA, United States of America
| | - Michael D Cabana
- University of California, San Francisco, Department of Pediatrics, San Francisco, CA, United States of America
| | - Ronina Covar
- National Jewish Health, Department of Pediatrics, Denver, CO, United States of America
| | - Rachel G Robison
- Ann and Robert H. Lurie Children's Hospital of Chicago, Division of Allergy and Immunology, Chicago, IL, United States of America
| | - Wanda Phipatanakul
- Boston Children's Hospital, Division of Allergy and Immunology, Harvard Medical School, Boston, MA, United States of America.
| |
Collapse
|
12
|
Clougherty JE, Kinnee EJ, Cardet JC, Mauger D, Bacharier L, Beigelman A, Blake KV, Cabana MD, Castro M, Chmiel JF, Covar R, Fitzpatrick A, Gaffin JM, Gentile D, Israel E, Jackson DJ, Kraft M, Krishnan JA, Kumar HV, Lang JE, Lazarus SC, Lemanske RF, Lima J, Martinez FD, Morgan W, Moy J, Myers R, Naureckas ET, Ortega VE, Peters SP, Phipatanakul W, Pongracic JA, Ross K, Sheehan WJ, Smith LJ, Solway J, Sorkness CA, Wechsler ME, Wenzel S, White SR, Holguin F. Geography, generalisability, and susceptibility in clinical trials. Lancet Respir Med 2021; 9:330-332. [PMID: 33539731 PMCID: PMC8009610 DOI: 10.1016/s2213-2600(21)00046-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Jane E Clougherty
- Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA.
| | - Ellen J Kinnee
- University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, PA, USA
| | - Juan Carlos Cardet
- Department of Internal Medicine, University of South Florida, Tampa, FL, USA
| | - David Mauger
- Department of Public Health Sciences, Penn State University, Hershey, PA, USA
| | - Leonard Bacharier
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Avraham Beigelman
- The Kipper Institute of Allergy and Immunology, Schneider Children's Medical Center of Israel, Tel Aviv University, Tel Aviv, Israel
| | - Kathryn V Blake
- Biomedical Research Department, Nemours Children's Health System, Jacksonville, FL, USA
| | - Michael D Cabana
- Department of Pediatrics, Children's Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mario Castro
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas School of Medicine, Kansas City, KS, USA
| | - James F Chmiel
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ronina Covar
- Department of Pediatrics, National Jewish Health, Denver, CO, USA
| | | | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA
| | | | - Elliot Israel
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard University, Boston MA, USA
| | - Daniel J Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Monica Kraft
- Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Jerry A Krishnan
- Breathe Chicago Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Harsha Vardhan Kumar
- Division of Allergy/Immunology/Pulmonology, University of Illinois at Chicago, Chicago, IL, USA
| | - Jason E Lang
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Stephen C Lazarus
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Robert F Lemanske
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - John Lima
- Pharmacogenomics & Translational Research, Nemours Children's Health System, Jacksonville, FL, USA
| | - Fernando D Martinez
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Wayne Morgan
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - James Moy
- Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Ross Myers
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Victor E Ortega
- Department of Internal Medicine, Winston-Salam, NC, USA; Center for Precision Medicine at the Wake Forest School of Medicine, Winston-Salam, NC, USA
| | | | - Wanda Phipatanakul
- Division of Allergy/Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jacqueline A Pongracic
- Department of Pediatrics, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Kristie Ross
- Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - William J Sheehan
- Division of Allergy/Immunology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Lewis J Smith
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago IL, USA
| | - Julian Solway
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Christine A Sorkness
- Division of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Sally Wenzel
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steven R White
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Fernando Holguin
- Division of Pulmonary Sciences & Critical Care, University of Colorado, Denver, CO, USA
| |
Collapse
|
13
|
Phipatanakul W, Mauger DT, Guilbert TW, Bacharier LB, Durrani S, Jackson DJ, Martinez FD, Fitzpatrick AM, Cunningham A, Kunselman S, Wheatley LM, Bauer C, Davis CM, Geng B, Kloepfer KM, Lapin C, Liu AH, Pongracic JA, Teach SJ, Chmiel J, Gaffin JM, Greenhawt M, Gupta MR, Lai PS, Lemanske RF, Morgan WJ, Sheehan WJ, Stokes J, Thorne PS, Oettgen HC, Israel E. Preventing asthma in high risk kids (PARK) with omalizumab: Design, rationale, methods, lessons learned and adaptation. Contemp Clin Trials 2021; 100:106228. [PMID: 33242697 PMCID: PMC7887056 DOI: 10.1016/j.cct.2020.106228] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 11/27/2022]
Abstract
Asthma remains one of the most important challenges to pediatric public health in the US. A large majority of children with persistent and chronic asthma demonstrate aeroallergen sensitization, which remains a pivotal risk factor associated with the development of persistent, progressive asthma throughout life. In individuals with a tendency toward Type 2 inflammation, sensitization and exposure to high concentrations of offending allergens is associated with increased risk for development of, and impairment from, asthma. The cascade of biological responses to allergens is primarily mediated through IgE antibodies and their production is further stimulated by IgE responses to antigen exposure. In addition, circulating IgE impairs innate anti-viral immune responses. The latter effect could magnify the effects of another early life exposure associated with increased risk of the development of asthma - viral infections. Omalizumab binds to circulating IgE and thus ablates antigen signaling through IgE-related mechanisms. Further, it has been shown restore IFN-α response to rhinovirus and to reduce asthma exacerbations during the viral season. We therefore hypothesized that early blockade of IgE and IgE mediated responses with omalizumab would prevent the development and reduce the severity of asthma in those at high risk for developing asthma. Herein, we describe a double-blind, placebo-controlled trial of omalizumab in 2-3 year old children at high risk for development of asthma to prevent the development and reduce the severity of asthma. We describe the rationale, methods, and lessons learned in implementing this potentially transformative trial aimed at prevention of asthma.
Collapse
Affiliation(s)
- Wanda Phipatanakul
- Boston Children's Hospital, Division of Allergy and Immunology, United States of America; Harvard Medical School, Boston, MA, United States of America.
| | - David T Mauger
- Pennsylvania State University, Hershey, PA, United States of America
| | - Theresa W Guilbert
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America
| | - Leonard B Bacharier
- Washington University and St. Louis Children's Hospital, St. Louis, MO, United States of America
| | - Sandy Durrani
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America
| | | | - Fernando D Martinez
- Asthma and Airway Research Center, University of Arizona, Tucson, AZ, United States of America
| | | | - Amparito Cunningham
- Boston Children's Hospital, Division of Allergy and Immunology, United States of America
| | - Susan Kunselman
- Pennsylvania State University, Hershey, PA, United States of America
| | - Lisa M Wheatley
- NIH/National Institute of Allergy and Infectious Diseases, Bethesda, MD, United States of America
| | - Cindy Bauer
- Phoenix Children's Hospital, Phoenix, AZ, United States of America
| | - Carla M Davis
- Baylor College of Medicine, Texas Children's Hospital, Houston, TX, United States of America
| | - Bob Geng
- Rady Children's Hospital, UC San Diego, San Diego, CA, United States of America
| | - Kirsten M Kloepfer
- Riley Hospital for Children at IU Health, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Craig Lapin
- Connecticut Children's Medical Center, Division of Pulmonary Hartford, CT, United States of America
| | - Andrew H Liu
- Children's Hospital Colorado, University of Colorado, Aurora, CO, United States of America
| | - Jacqueline A Pongracic
- Ann and Robert Lurie Children's Hospital of Chicago, Chicago, IL, United States of America
| | - Stephen J Teach
- Children's National Hospital, Washington, DC, United States of America
| | - James Chmiel
- NIH/National Institute of Allergy and Infectious Diseases, Bethesda, MD, United States of America
| | - Jonathan M Gaffin
- Harvard Medical School, Boston, MA, United States of America; Boston Children's Hospital, Division of Pulmonary Medicine, Boston, MA, United States of America
| | - Matthew Greenhawt
- Children's Hospital Colorado, University of Colorado, Aurora, CO, United States of America
| | - Meera R Gupta
- Baylor College of Medicine, Texas Children's Hospital, Houston, TX, United States of America
| | - Peggy S Lai
- Harvard Medical School, Boston, MA, United States of America; Massachusetts General Hospital, Division of Pulmonary and Critical Care, Boston, MA, United States of America
| | | | - Wayne J Morgan
- Asthma and Airway Research Center, University of Arizona, Tucson, AZ, United States of America
| | - William J Sheehan
- Children's National Hospital, Washington, DC, United States of America
| | - Jeffrey Stokes
- Washington University and St. Louis Children's Hospital, St. Louis, MO, United States of America
| | - Peter S Thorne
- University of Iowa, College of Public Health, Department of Occupational and Environmental Health, Iowa City, IA, United States of America
| | - Hans C Oettgen
- Boston Children's Hospital, Division of Allergy and Immunology, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Elliot Israel
- Harvard Medical School, Boston, MA, United States of America; Brigham and Women's Hospital, Divisions of Pulmonary and Critical Care Medicine and Allergy and Immunology, Boston, MA, United States of America
| |
Collapse
|
14
|
Esty B, Maciag MC, Bartnikas LM, Petty CR, MacGinnitie AJ, Sheehan WJ, Phipatanakul W. Predicting outcomes of baked egg and baked milk oral food challenges by using a ratio of food-specific IgE to total IgE. J Allergy Clin Immunol Pract 2020; 9:1750-1752.e1. [PMID: 33217611 DOI: 10.1016/j.jaip.2020.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/02/2020] [Accepted: 11/02/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Brittany Esty
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - Michelle C Maciag
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - Lisa M Bartnikas
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - Carter R Petty
- Biostatistics and Research Design Core, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Mass
| | - Andrew J MacGinnitie
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - William J Sheehan
- Division of Allergy and Immunology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass.
| |
Collapse
|
15
|
Howard EJ, Vesper SJ, Guthrie BJ, Petty CR, Ramdin VA, Sheehan WJ, Gaffin JM, Permaul P, Lai PS, Bartnikas LM, Cunningham A, Hauptman M, Gold DR, Baxi SN, Phipatanakul W. Asthma Prevalence and Mold Levels in US Northeastern Schools. J Allergy Clin Immunol Pract 2020; 9:1312-1318. [PMID: 33091637 DOI: 10.1016/j.jaip.2020.10.012] [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] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Asthma is among the most common chronic diseases of children in the United States (US). Mold exposures have been linked to asthma development and exacerbation. In homes, mold exposures have been quantified using the Environmental Relative Moldiness Index (ERMI), and higher home ERMI values have been linked to occupant asthma. OBJECTIVE In this analysis of the School Inner-City Asthma Study (SICAS), we aimed to evaluate the ERMI's applicability to measuring mold in schools compared with homes and to examine the prevalence of asthma in relationship to students' demographics and the physical characteristics of school buildings. METHODS Northeastern US schools (n = 32) and homes (n = 33) were selected, and the 36 ERMI molds were quantified in a dust sample from each classroom (n = 114) or home. School building characteristics data were collected from SICAS. Asthma prevalence and student demographics data were obtained from government websites. Linear regression and mixed models were fit to assess the association of the current asthma prevalence and physical characteristics of the school, make-up of the student body, and the ERMI metric. RESULTS Levels of outdoor group 2 molds were significantly (P < .01) greater in schools compared with homes. The presence of air-conditioning in school buildings correlated significantly (P = .02) with lower asthma prevalence. CONCLUSION The prevalence of asthma in student bodies is associated with many factors in schools and homes.
Collapse
Affiliation(s)
- Evin J Howard
- Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, Mass
| | - Stephen J Vesper
- US Environmental Protection Agency, Center for Environmental Measurement and Modeling, Cincinnati, Ohio
| | - Barbara J Guthrie
- Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, Mass
| | - Carter R Petty
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Mass
| | - Valeria A Ramdin
- Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, Mass
| | - William J Sheehan
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Jonathan M Gaffin
- Harvard Medical School, Boston, Mass; Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Mass
| | - Perdita Permaul
- Division of Pediatric Pulmonology, Allergy and Immunology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, NY
| | - Peggy S Lai
- Harvard Medical School, Boston, Mass; Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Mass
| | - Lisa M Bartnikas
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Amparito Cunningham
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Marissa Hauptman
- Harvard Medical School, Boston, Mass; Division of General Pediatrics, Boston Children's Hospital, Boston, Mass; Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, Mass
| | - Diane R Gold
- Harvard Medical School, Boston, Mass; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Sachin N Baxi
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
| |
Collapse
|
16
|
Sheehan WJ, Krouse RZ, Calatroni A, Gergen PJ, Gern JE, Gill MA, Gruchalla RS, Khurana Hershey GK, Kattan M, Kercsmar CM, Lamm CI, Little FF, Makhija MM, Searing DA, Zoratti E, Busse WW, Teach SJ. Aeroallergen Sensitization, Serum IgE, and Eosinophilia as Predictors of Response to Omalizumab Therapy During the Fall Season Among Children with Persistent Asthma. J Allergy Clin Immunol Pract 2020; 8:3021-3028.e2. [PMID: 32376491 PMCID: PMC8775809 DOI: 10.1016/j.jaip.2020.03.051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Perennial aeroallergen sensitization is associated with greater asthma morbidity and is required for treatment with omalizumab. OBJECTIVE To investigate the predictive relationship between the number of aeroallergen sensitizations, total serum IgE, and serum eosinophil count, and response to omalizumab in children and adolescents with asthma treated during the fall season. METHODS This analysis includes inner-city patients with persistent asthma and recent exacerbations aged 6-20 years comprising the placebo- and omalizumab-treated groups in 2 completed randomized clinical trials, the Inner-City Anti-IgE Therapy for Asthma study and the Preventative Omalizumab or Step-Up Therapy for Fall Exacerbations study. Logistic regression modeled the relationship between greater degrees of markers of allergic inflammation and the primary outcome of fall season asthma exacerbations. RESULTS The analysis included 761 participants who were 62% male and 59% African American with a median age of 10 years. Fall asthma exacerbations were significantly higher in children with greater numbers of aeroallergen-specific sensitizations in the placebo group (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.11-1.60; P < .01), but not in the omalizumab-treated children (OR, 1.08; 95% CI, 0.91-1.28; P = .37), indicating a significant differential effect (P < .01). Likewise, there was a differential effect of omalizumab treatment in children with greater baseline total serum IgE levels (P < .01) or greater baseline serum eosinophil counts (P < .01). Multiple aeroallergen sensitization was the best predictor of response to omalizumab; treated participants sensitized to ≥4 different groups of aeroallergens had a 51% reduction in the odds of a fall exacerbation (OR, 0.49; 95% CI, 0.30-0.81; P < .01). CONCLUSIONS In preventing fall season asthma exacerbations, treatment with omalizumab was most beneficial in children with a greater degree of allergic inflammation.
Collapse
Affiliation(s)
- William J Sheehan
- Children's National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC.
| | | | | | - Peter J Gergen
- National Institute of Allergy and Infectious Diseases, Rockville, Md
| | - James E Gern
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Michelle A Gill
- University of Texas Southwestern Medical Center, Dallas, Tex
| | | | | | - Meyer Kattan
- College of Physicians and Surgeons, Columbia University, New York, NY
| | | | - Carin I Lamm
- College of Physicians and Surgeons, Columbia University, New York, NY
| | | | - Melanie M Makhija
- Lurie Children's Hospital and Northwestern University School of Medicine, Chicago, Ill
| | - Daniel A Searing
- Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
| | - Edward Zoratti
- Henry Ford Health System and Wayne State University School of Medicine, Detroit, Mich
| | - William W Busse
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Stephen J Teach
- Children's National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC
| |
Collapse
|
17
|
Gaffin JM, Hauptman M, Petty CR, Haktanir-Abul M, Gunnlaugsson S, Lai PS, Baxi SN, Permaul P, Sheehan WJ, Wolfson JM, Coull BA, Gold DR, Koutrakis P, Phipatanakul W. Differential Effect of School-Based Pollution Exposure in Children With Asthma Born Prematurely. Chest 2020; 158:1361-1363. [PMID: 32450239 DOI: 10.1016/j.chest.2020.05.533] [Citation(s) in RCA: 4] [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: 01/21/2020] [Revised: 04/22/2020] [Accepted: 05/01/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jonathan M Gaffin
- Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
| | - Marissa Hauptman
- Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | | | | | | | - Peggy S Lai
- Harvard Medical School, Boston, MA; Massachusetts General Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA
| | - Sachin N Baxi
- Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Perdita Permaul
- Division of Pediatric Allergy and Immunology, Weill Cornell Medical College, New York, NY
| | - William J Sheehan
- Boston Children's Hospital, Boston, MA; Children's National Health System, Washington, DC
| | | | - Brent A Coull
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Diane R Gold
- Harvard Medical School, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Channing Laboratory, Boston, MA
| | | | - Wanda Phipatanakul
- Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| |
Collapse
|
18
|
Permaul P, Gaffin JM, Petty CR, Baxi SN, Lai PS, Sheehan WJ, Camargo CA, Gold DR, Phipatanakul W. Obesity may enhance the adverse effects of NO 2 exposure in urban schools on asthma symptoms in children. J Allergy Clin Immunol 2020; 146:813-820.e2. [PMID: 32197971 DOI: 10.1016/j.jaci.2020.03.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/26/2020] [Accepted: 03/09/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sparse data address the effects of nitrogen dioxide (NO2) exposure in inner-city schools on obese students with asthma. OBJECTIVE We sought to evaluate relationships between classroom NO2 exposure and asthma symptoms and morbidity by body mass index (BMI) category. METHODS The School Inner-City Asthma Study enrolled students aged 4 to 13 years with asthma from 37 inner-city schools. Students had baseline determination of BMI percentile. Asthma symptoms, morbidity, pulmonary inflammation, and lung function were monitored throughout the subsequent academic year. Classroom NO2 data, linked to enrolled students, were collected twice per year. We determined the relationship between classroom NO2 levels and asthma outcomes by BMI stratification. RESULTS A total of 271 predominantly black (35%) or Hispanic students (35%) were included in analyses. Fifty percent were normal weight (5-84th BMI percentile), 15% overweight (≥85-94th BMI percentile), and 35% obese (≥95th BMI percentile). For each 10-parts per billion increase in NO2, obese students had a significant increase in the odds of having an asthma symptom day (odds ratio [OR], 1.86; 95% CI, 1.15-3.02) and in days caregiver changed plans (OR, 4.24; 95% CI, 2.33-7.70), which was significantly different than normal weight students who exhibited no relationship between NO2 exposure and symptom days (OR, 0.90; 95% CI, 0.57-1.42; pairwise interaction P = .03) and change in caregiver plans (OR, 1.37; 95% CI, 0.67-2.82; pairwise interaction P = .02). Relationships between NO2 levels and lung function and fractional exhaled nitric oxide did not differ by BMI category. If we applied a conservative Holm-Bonferroni correction for 16 comparisons (obese vs normal weight and overweight vs normal weight for 8 outcomes), these findings would not meet statistical significance (all P > .003). CONCLUSIONS Obese BMI status appears to increase susceptibility to classroom NO2 exposure effects on asthma symptoms in inner-city children. Environmental interventions targeting indoor school NO2 levels may improve asthma health for obese children. Although our findings would not remain statistically significant after adjustment for multiple comparisons, the large effect sizes warrant future study of the interaction of obesity and pollution in pediatric asthma.
Collapse
Affiliation(s)
- Perdita Permaul
- Division of Pediatric Pulmonology, Allergy and Immunology, New York-Presbyterian/Weill Cornell Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Carter R Petty
- Clinical Research Center, Boston Children's Hospital, Boston, Mass
| | - Sachin N Baxi
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Peggy S Lai
- Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Mass
| | - William J Sheehan
- Division of Allergy and Immunology, Children's National Health System, Washington, DC; George Washington University School of Medicine, Washington, DC
| | - Carlos A Camargo
- Harvard Medical School, Boston, Mass; Department of Emergency Medicine, Massachusetts General Hospital, Boston, Mass
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
| |
Collapse
|
19
|
Hauptman M, Gaffin JM, Petty CR, Sheehan WJ, Lai PS, Coull B, Gold DR, Phipatanakul W. Proximity to major roadways and asthma symptoms in the School Inner-City Asthma Study. J Allergy Clin Immunol 2020; 145:119-126.e4. [PMID: 31557500 PMCID: PMC6949366 DOI: 10.1016/j.jaci.2019.08.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 07/31/2019] [Accepted: 08/22/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Traffic proximity has been associated with adverse respiratory health outcomes. Less is known about the combined impact of residential and school exposures on pediatric asthma. OBJECTIVE We sought to use spatial analysis methodology to analyze residential and school proximity to major roadways and pediatric asthma morbidity. METHODS The School Inner-City Asthma Study (n = 350) recruited school-aged children with asthma. Each participant's school and home addresses were geocoded, and distances from major roadways were measured to calculate a composite measure accounting for both home and school traffic exposure. Generalized estimating equation models were clustered by subject and adjusted for age, race/ethnicity, sex, income, environmental tobacco smoke, controller medication, upper respiratory tract infections, and seasonality. RESULTS The majority of participants (62%) attended schools within 100 m from major roadways, and 40% also resided within 100 m of major roadways. In multivariate analyses major roadway proximity was independently associated with increased asthma symptom days. At greater than the threshold of 100 m, children had 29% less odds of a symptom day over the past 2 weeks for each 100-m increase in distance from a major roadway (odds ratio, 0.71; 95% CI, 0.58-0.87; P < .01). Children farther from a major roadway also had significantly less reported health care use (odds ratio, 0.63; 95% CI, 0.47-0.85; P < .01) and were significantly less likely to have poor asthma control (odds ratio, 0.80; 95% CI, 0.69-0.94; P < .01). There was not a meaningful association between distance to a major roadway and lung function outcomes. CONCLUSIONS Proximity to a major roadway, a composite measure of home and school exposure but primarily driven by home exposure, was associated with greater asthma morbidity. More studies are needed to evaluate the independent effect of school distance to a roadway on asthma morbidity.
Collapse
Affiliation(s)
- Marissa Hauptman
- Division of General Pediatrics, Boston Children's Hospital, Boston, Mass; Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Jonathan M Gaffin
- Harvard Medical School, Boston, Mass; Division of Respiratory Diseases, Boston Children's Hospital, Boston, Mass
| | - Carter R Petty
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - William J Sheehan
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Peggy S Lai
- Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Mass
| | - Brent Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Diane R Gold
- Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Division of Respiratory Epidemiology, Channing Laboratory, Brigham and Women's Hospital, Boston, Mass
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
| |
Collapse
|
20
|
Bartnikas LM, Huffaker MF, Sheehan WJ, Kanchongkittiphon W, Petty CR, Leibowitz R, Young MC, Phipatanakul W. Racial and socioeconomic differences in school peanut-free policies. J Allergy Clin Immunol Pract 2020; 8:340-342.e1. [PMID: 31319221 PMCID: PMC6960368 DOI: 10.1016/j.jaip.2019.06.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/04/2019] [Accepted: 06/24/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Lisa M Bartnikas
- Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | | | - William J Sheehan
- Boston Children's Hospital, Boston, Mass; Children's National Health System, Washington, DC
| | | | | | | | - Michael C Young
- Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Wanda Phipatanakul
- Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
| |
Collapse
|
21
|
Abstract
The inner-city is a well-established and well-studied location that includes children at high risk for high asthma prevalence and morbidity. A number of intrinsic and extrinsic risk factors contribute to asthma in inner-city populations. This review seeks to explore these risk factors and evaluate how they contribute to increased asthma morbidity. Previous literature has identified risk factors such as race and ethnicity, prematurity, obesity, and exposure to aeroallergens and pollutants. Environmental and medical interventions aimed at individual risk factors and specific asthma phenotypes have contributed to improved outcomes in the inner-city children with asthma.
Collapse
Affiliation(s)
- Amaziah T Coleman
- Division of Allergy and Immunology, Department of Pediatrics, Children's National Health System, 111 Michigan Avenue Northwest, Washington, DC 20010, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
| | - Stephen J Teach
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA; Division of Emergency Medicine, Department of Pediatrics, Children's National Health System, 111 Michigan Avenue Northwest, Washington, DC 20010, USA
| | - William J Sheehan
- Division of Allergy and Immunology, Department of Pediatrics, Children's National Health System, 111 Michigan Avenue Northwest, Washington, DC 20010, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| |
Collapse
|
22
|
Poole JA, Barnes CS, Demain JG, Bernstein JA, Padukudru MA, Sheehan WJ, Fogelbach GG, Wedner J, Codina R, Levetin E, Cohn JR, Kagen S, Portnoy JM, Nel AE. Impact of weather and climate change with indoor and outdoor air quality in asthma: A Work Group Report of the AAAAI Environmental Exposure and Respiratory Health Committee. J Allergy Clin Immunol 2019; 143:1702-1710. [PMID: 30826366 PMCID: PMC10907958 DOI: 10.1016/j.jaci.2019.02.018] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/08/2019] [Accepted: 02/20/2019] [Indexed: 12/14/2022]
Abstract
Weather and climate change are constant and ever-changing processes that affect allergy and asthma. The purpose of this report is to provide information since the last climate change review with a focus on asthmatic disease. PubMed and Internet searches for topics included climate and weather change, air pollution, particulates, greenhouse gasses, traffic, insect habitat, and mitigation in addition to references contributed by the individual authors. Changes in patterns of outdoor aeroallergens caused by increasing temperatures and amounts of carbon dioxide in the atmosphere are major factors linked to increased duration of pollen seasons, increased pollen production, and possibly increased allergenicity of pollen. Indoor air pollution threats anticipated from climate changes include microbial and mold growth secondary to flooding, resulting in displacement of persons and need for respiratory protection of exposed workers. Air pollution from indoor burning of mosquito repellants is a potential anticipatory result of an increase in habitat regions. Air pollution from fossil fuel burning and traffic-related emissions can alter respiratory defense mechanisms and work synergistically with specific allergens to enhance immunogenicity to worsen asthma in susceptible subjects. Community efforts can significantly reduce air pollution, thereby reducing greenhouse gas emission and improving air quality. The allergist's approach to weather pattern changes should be integrated and anticipatory to protect at-risk patients.
Collapse
Affiliation(s)
- Jill A Poole
- Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Neb.
| | - Charles S Barnes
- Division of Allergy, Asthma and Immunology, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Mo
| | - Jeffrey G Demain
- Allergy Asthma & Immunology Center of Alaska, the Department of Pediatrics, University of Washington, and the WWAMI School of Medical Education, University of Alaska, Anchorage, Alaska
| | - Jonathan A Bernstein
- Division of Immunology, Allergy Section, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Mahesh A Padukudru
- Department of Respiratory Medicine, JSS Medical College, JSSAHER, Mysore, India
| | - William J Sheehan
- Division of Allergy, Children's National Medicine Center, Department of Pediatrics, George Washington School of Medicine and Health Sciences, Washington, DC
| | | | - James Wedner
- Division of Allergy & Immunology, John T. Milliken Department of Internal Medicine, Washington University, St Louis, Mo
| | - Rosa Codina
- Allergen Science & Consulting, Lenoir, NC; Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Estelle Levetin
- Department of Biological Science, University of Tulsa, Tulsa, Okla
| | - John R Cohn
- Korman Respiratory Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa
| | - Steve Kagen
- Division of Allergy & Clinical Immunology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wis
| | - Jay M Portnoy
- Division of Allergy, Asthma, & Immunology, Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, Mo
| | - Andre E Nel
- University of California Los Angeles, David Geffen School of Medicine and California NanoSystems Institute, Los Angeles, Calif
| |
Collapse
|
23
|
Baxi SN, Sheehan WJ, Sordillo JE, Muilenberg ML, Rogers CA, Gaffin JM, Permaul P, Lai PS, Louisias M, Petty CR, Fu C, Gold DR, Phipatanakul W. Association between fungal spore exposure in inner-city schools and asthma morbidity. Ann Allergy Asthma Immunol 2019; 122:610-615.e1. [PMID: 30904580 DOI: 10.1016/j.anai.2019.03.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 03/06/2019] [Accepted: 03/14/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Home fungus exposures may be associated with development or worsening of asthma. Little is known about the effects of school/classroom fungus exposures on asthma morbidity in students. OBJECTIVE To evaluate the association of school-based fungus exposures on asthma symptoms in both fungus-sensitized and nonsensitized students with asthma. METHODS In this prospective study, 280 children with asthma from 37 inner-city schools were phenotypically characterized at baseline and followed-up for 1 year. Fungal spores were collected by using a Burkard air sampler twice during the school year. Clinical outcomes were evaluated throughout the school year and linked to classroom-specific airborne spore sampling. The primary outcome was days with asthma symptoms per 2-week period. RESULTS Fungal spores were present in all classroom samples. The geometric mean of the total fungi was 316.9 spores/m3 and ranged from 15.0 to 59,345.7 spores/m3. There was variability in total fungus quantity between schools and classrooms within the same school. Mitospores were the most commonly detected fungal grouping. Investigation of the individual mitospores revealed that exposure to Alternaria was significantly associated with asthma symptom days in students sensitized to Alternaria (OR = 3.61, CI = 1.34-9.76, P = .01), but not in children not sensitized to Alternaria (OR = 1.04, CI = 0.72-1.49, P = .85). Students sensitized to Alternaria and exposed to high levels (≥75th percentile exposure) had 3.2 more symptom days per 2-week period as compared with students sensitized but exposed to lower levels. CONCLUSION Children with asthma who are sensitized to Alternaria and exposed to this fungus in their classroom may have significantly more days with asthma symptoms than those who were sensitized and not exposed. CLINICAL TRIAL REGISTRATION Clinicaltrials.govNCT01756391.
Collapse
Affiliation(s)
- Sachin N Baxi
- Boston Children's Hospital, Division of Allergy and Immunology, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - William J Sheehan
- Boston Children's Hospital, Division of Allergy and Immunology, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Joanne E Sordillo
- Channing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts
| | - Michael L Muilenberg
- Division of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
| | - Christine A Rogers
- Division of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
| | - Jonathan M Gaffin
- Harvard Medical School, Boston, Massachusetts; Boston Children's Hospital, Division of Respiratory Diseases, Boston, Massachusetts
| | - Perdita Permaul
- Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Division of Pediatric Allergy and Immunology, Boston, Massachusetts
| | - Peggy S Lai
- Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Division of Pulmonary and Critical Care, Boston, Massachusetts
| | | | - Carter R Petty
- Brigham and Women's Hospital, Boston, Massachusetts; Boston Children's Hospital, Clinical Research Center Boston, Massachusetts
| | - Chunxia Fu
- Brigham and Women's Hospital, Boston, Massachusetts
| | - Diane R Gold
- Harvard Medical School, Boston, Massachusetts; Brigham and Women's Hospital, Boston, Massachusetts
| | - Wanda Phipatanakul
- Boston Children's Hospital, Division of Allergy and Immunology, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
24
|
Akar-Ghibril N, Sheehan WJ, Petty CR, Phipatanakul W. Mouse Allergen Levels in Schools in Two Inner City Asthma Studies: Past versus Present. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.593] [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: 10/27/2022]
|
25
|
Guilbert TW, Bacharier LB, Mauger DT, Phipatanakul W, Szefler SJ, Boehmer S, Beigelman A, Fitzpatrick AM, Jackson DJ, Baxi SN, Benson M, Burnham CAD, Cabana MD, Castro M, Chmiel JF, Covar R, Daines M, Gaffin JM, Gentile DA, Holguin F, Israel E, Kelly HW, Lazarus SC, Lemanske RF, Ly N, Meade K, Morgan W, Moy J, Olin JT, Peters SP, Pongracic JA, Raissy HH, Ross K, Sheehan WJ, Sorkness C, Teague WG, Thyne S, Martinez FD. Challenges in assessing the efficacy of systemic corticosteroids for severe wheezing episodes in preschool children. J Allergy Clin Immunol 2019; 143:1934-1937.e4. [PMID: 30660645 DOI: 10.1016/j.jaci.2018.10.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 10/11/2018] [Accepted: 10/19/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Theresa W Guilbert
- Department of Pediatrics, University of Cincinnati and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Leonard B Bacharier
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Mo
| | - David T Mauger
- Department of Public Health Sciences, Pennsylvania State University, Hershey, Pa
| | - Wanda Phipatanakul
- Division of Allergy/Immunology, Boston Children's Hospital, Boston, Mass
| | | | - Susan Boehmer
- Department of Public Health Sciences, Pennsylvania State University, Hershey, Pa
| | - Avraham Beigelman
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Mo
| | | | - Daniel J Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Sachin N Baxi
- Division of Allergy/Immunology, Boston Children's Hospital, Boston, Mass
| | | | - Carey-Ann D Burnham
- Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Mo
| | - Michael D Cabana
- Departments of Medicine and Pediatrics, University of California, San Francisco, San Francisco, Calif
| | - Mario Castro
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Mo
| | | | - Ronina Covar
- Department of Pediatrics, National Jewish Health, Denver, Colo
| | - Michael Daines
- Arizona Respiratory Center, University of Arizona, Tucson, Ariz
| | - Jonathan M Gaffin
- Division of Respiratory Diseases, Boston Children's Hospital, Boston, Mass
| | - Deborah A Gentile
- Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pa
| | | | | | - H William Kelly
- Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, NM
| | - Stephen C Lazarus
- Departments of Medicine and Pediatrics, University of California, San Francisco, San Francisco, Calif
| | - Robert F Lemanske
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Ngoc Ly
- Airway Clinical Research Center, University of California, San Francisco, San Francisco, Calif
| | | | - Wayne Morgan
- Arizona Respiratory Center, University of Arizona, Tucson, Ariz
| | - James Moy
- Stroger Hospital of Cook County Pediatric Services, Chicago, Ill
| | - J Tod Olin
- Department of Pediatrics, National Jewish Health, Denver, Colo
| | | | | | - Hengameh H Raissy
- Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, NM
| | - Kristie Ross
- Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | - William J Sheehan
- Division of Allergy/Immunology, Boston Children's Hospital, Boston, Mass
| | | | - W Gerald Teague
- University of Virginia School of Medicine, Charlottesville, Va
| | - Shannon Thyne
- Department of Pediatrics, San Francisco General Hospital, San Francisco, Calif
| | | | | |
Collapse
|
26
|
Kahn PA, Trivedi M, Ramadan AA, Sheehan WJ, Petty CR, Phipatanakul W. A Community-Based Pilot Survey of Pediatric Food Allergies in a Maryland Orthodox Jewish Community. Clin Pediatr (Phila) 2018; 57:1236-1238. [PMID: 29682987 PMCID: PMC6340142 DOI: 10.1177/0009922818770823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Peter A. Kahn
- Albert Einstein College of Medicine, Bronx, NY, USA,Boston Children’s Hospital, Boston, MA, USA
| | | | - Amira A. Ramadan
- Boston Children’s Hospital, Boston, MA, USA,Beth Israel Deaconess Medical Center, Boston, MA
| | - William J. Sheehan
- Boston Children’s Hospital, Boston, MA, USA,Children’s National Medical Center, Washington, DC, USA
| | | | | |
Collapse
|
27
|
Jackson DJ, Bacharier LB, Mauger DT, Boehmer S, Beigelman A, Chmiel JF, Fitzpatrick AM, Gaffin JM, Morgan WJ, Peters SP, Phipatanakul W, Sheehan WJ, Cabana MD, Holguin F, Martinez FD, Pongracic JA, Baxi SN, Benson M, Blake K, Covar R, Gentile DA, Israel E, Krishnan JA, Kumar HV, Lang JE, Lazarus SC, Lima JJ, Long D, Ly N, Marbin J, Moy JN, Myers RE, Olin JT, Raissy HH, Robison RG, Ross K, Sorkness CA, Lemanske RF. Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations. N Engl J Med 2018; 378:891-901. [PMID: 29504498 PMCID: PMC5972517 DOI: 10.1056/nejmoa1710988] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [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] [Indexed: 12/16/2022]
Abstract
BACKGROUND Asthma exacerbations occur frequently despite the regular use of asthma-controller therapies, such as inhaled glucocorticoids. Clinicians commonly increase the doses of inhaled glucocorticoids at early signs of loss of asthma control. However, data on the safety and efficacy of this strategy in children are limited. METHODS We studied 254 children, 5 to 11 years of age, who had mild-to-moderate persistent asthma and had had at least one asthma exacerbation treated with systemic glucocorticoids in the previous year. Children were treated for 48 weeks with maintenance low-dose inhaled glucocorticoids (fluticasone propionate at a dose of 44 μg per inhalation, two inhalations twice daily) and were randomly assigned to either continue the same dose (low-dose group) or use a quintupled dose (high-dose group; fluticasone at a dose of 220 μg per inhalation, two inhalations twice daily) for 7 days at the early signs of loss of asthma control ("yellow zone"). Treatment was provided in a double-blind fashion. The primary outcome was the rate of severe asthma exacerbations treated with systemic glucocorticoids. RESULTS The rate of severe asthma exacerbations treated with systemic glucocorticoids did not differ significantly between groups (0.48 exacerbations per year in the high-dose group and 0.37 exacerbations per year in the low-dose group; relative rate, 1.3; 95% confidence interval, 0.8 to 2.1; P=0.30). The time to the first exacerbation, the rate of treatment failure, symptom scores, and albuterol use during yellow-zone episodes did not differ significantly between groups. The total glucocorticoid exposure was 16% higher in the high-dose group than in the low-dose group. The difference in linear growth between the high-dose group and the low-dose group was -0.23 cm per year (P=0.06). CONCLUSIONS In children with mild-to-moderate persistent asthma treated with daily inhaled glucocorticoids, quintupling the dose at the early signs of loss of asthma control did not reduce the rate of severe asthma exacerbations or improve other asthma outcomes and may be associated with diminished linear growth. (Funded by the National Heart, Lung, and Blood Institute; STICS ClinicalTrials.gov number, NCT02066129 .).
Collapse
Affiliation(s)
- Daniel J Jackson
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Leonard B Bacharier
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - David T Mauger
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Susan Boehmer
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Avraham Beigelman
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - James F Chmiel
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Anne M Fitzpatrick
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Jonathan M Gaffin
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Wayne J Morgan
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Stephen P Peters
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Wanda Phipatanakul
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - William J Sheehan
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Michael D Cabana
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Fernando Holguin
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Fernando D Martinez
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Jacqueline A Pongracic
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Sachin N Baxi
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Mindy Benson
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Kathryn Blake
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Ronina Covar
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Deborah A Gentile
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Elliot Israel
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Jerry A Krishnan
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Harsha V Kumar
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Jason E Lang
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Stephen C Lazarus
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - John J Lima
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Dayna Long
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Ngoc Ly
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Jyothi Marbin
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - James N Moy
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Ross E Myers
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - J Tod Olin
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Hengameh H Raissy
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Rachel G Robison
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Kristie Ross
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Christine A Sorkness
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| | - Robert F Lemanske
- From the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.J.), and the University of Wisconsin-Madison (C.A.S.) - both in Madison; the Department of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children's Hospital, St. Louis (L.B.B., A.B.); the Department of Public Health Sciences, Penn State University, Hershey (D.T.M., S.B.), and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center-University of Pittsburgh School of Medicine (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; the Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland (J.F.C., R.E.M., K.R.); the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Divisions of Respiratory Diseases (J.M.G.) and Allergy-Immunology, Boston Children's Hospital (W.P., W.J.S., S.N.B.), Harvard Medical School, and Brigham and Women's Hospital, Harvard Medical School (E.I.) - all in Boston; the Arizona Respiratory Center, University of Arizona, Tucson (W.J.M., F.D.M.); Wake Forest University School of Medicine, Winston-Salem, NC (S.P.P.); the Departments of Pediatrics (M.D.C., N.L.), Epidemiology (M.D.C.), Biostatistics (M.D.C.), and Medicine (S.C.L.), University of California, San Francisco (UCSF), and UCSF Benioff Children's Hospital (M.D.C.) - both in San Francisco; Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), University of Illinois at Chicago (J.A.K., H.V.K.), and the Department of Pediatrics, Stroger Hospital of Cook County, Rush University Medical Center (J.N.M.) - all in Chicago; UCSF Benioff Children's Hospital Oakland, Oakland (M.B., D.L., J.M.); Nemours Children's Health System, Jacksonville (K.B., J.J.L.), and Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando (J.E.L.) - both in Florida; the Department of Pediatrics, National Jewish Health, Denver (R.C., J.T.O.); and the Department of Pediatrics, University of New Mexico, Albuquerque (H.H.R.)
| |
Collapse
|
28
|
Morris CR, Mauger DT, Suh JH, Phipatanakul W, Sheehan WJ, Moy JN, Paul IM, Szefler SJ, Jackson DJ, Fitzpatrick AM. Glutathione and arginine levels: Predictors for acetaminophen-associated asthma exacerbation? J Allergy Clin Immunol 2018. [PMID: 29518418 DOI: 10.1016/j.jaci.2018.01.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Claudia R Morris
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga
| | - David T Mauger
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, Pa
| | - Jung H Suh
- Children's Hospital Oakland Research Institute, Oakland, Calif
| | - Wanda Phipatanakul
- Division of Allergy/Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - William J Sheehan
- Division of Allergy/Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - James N Moy
- Stroger Hospital of Cook County, Department of Pediatrics, Rush University Medical Center, Chicago, Ill
| | - Ian M Paul
- Department of Pediatrics, College of Medicine, Penn State University, Hershey, Pa
| | - Stanley J Szefler
- Children's Hospital Colorado, the Breathing Institute, and the University of Colorado School of Medicine, Aurora, Colo
| | - Daniel J Jackson
- Pediatrics, Section of Allergy, Immunology and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Anne M Fitzpatrick
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga.
| | | |
Collapse
|
29
|
Lai PS, Kolde R, Franzosa EA, Gaffin JM, Baxi SN, Sheehan WJ, Gold DR, Gevers D, Xavier RJ, Phipatanakul W. The classroom microbiome and asthma morbidity in children attending 3 inner-city schools. J Allergy Clin Immunol 2018. [PMID: 29518428 DOI: 10.1016/j.jaci.2018.02.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Peggy S Lai
- Massachusetts General Hospital, Boston, Mass; Harvard T.H. Chan School of Public Health, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Raivo Kolde
- Massachusetts General Hospital, Boston, Mass
| | | | - Jonathan M Gaffin
- Harvard Medical School, Boston, Mass; Boston Children's Hospital, Boston, Mass
| | - Sachin N Baxi
- Harvard Medical School, Boston, Mass; Boston Children's Hospital, Boston, Mass
| | - William J Sheehan
- Harvard Medical School, Boston, Mass; Boston Children's Hospital, Boston, Mass
| | - Diane R Gold
- Harvard T.H. Chan School of Public Health, Boston, Mass; Harvard Medical School, Boston, Mass; Brigham and Women's Hospital, Boston, Mass
| | - Dirk Gevers
- Broad Institute of MIT and Harvard University, Cambridge, Mass
| | - Ramnik J Xavier
- Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass; Broad Institute of MIT and Harvard University, Cambridge, Mass
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Mass; Broad Institute of MIT and Harvard University, Cambridge, Mass.
| |
Collapse
|
30
|
Dilley MA, Petty CR, Sheehan WJ, Gaffin JM, Hauptman M, Phipatanakul W. Adherence and stress in a population of inner-city children with asthma. Pediatr Allergy Immunol 2017; 28:610-612. [PMID: 28686791 PMCID: PMC5585050 DOI: 10.1111/pai.12756] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Meredith A Dilley
- Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | | | - William J Sheehan
- Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jonathan M Gaffin
- Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Marissa Hauptman
- Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Wanda Phipatanakul
- Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| |
Collapse
|
31
|
Gaffin JM, Petty CR, Hauptman M, Kang CM, Wolfson JM, Awad YA, Di Q, Lai PS, Sheehan WJ, Baxi S, Coull BA, Schwartz JD, Gold DR, Koutrakis P, Phipatanakul W. Modeling indoor particulate exposures in inner-city school classrooms. J Expo Sci Environ Epidemiol 2017; 27:451-457. [PMID: 27599884 PMCID: PMC5340641 DOI: 10.1038/jes.2016.52] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 04/09/2016] [Indexed: 05/24/2023]
Abstract
Outdoor air pollution penetrates buildings and contributes to total indoor exposures. We investigated the relationship of indoor to outdoor particulate matter in inner-city school classrooms. The School Inner City Asthma Study investigates the effect of classroom-based environmental exposures on students with asthma in the northeast United States. Mixed effects linear models were used to determine the relationships between indoor PM2.5 (particulate matter) and black carbon (BC), and their corresponding outdoor concentrations, and to develop a model for predicting exposures to these pollutants. The indoor-outdoor sulfur ratio was used as an infiltration factor of outdoor fine particles. Weeklong concentrations of PM2.5 and BC in 199 samples from 136 classrooms (30 school buildings) were compared with those measured at a central monitoring site averaged over the same timeframe. Mixed effects regression models found significant random intercept and slope effects, which indicate that: (1) there are important PM2.5 sources in classrooms; (2) the penetration of outdoor PM2.5 particles varies by school and (3) the site-specific outside PM2.5 levels (inferred by the models) differ from those observed at the central monitor site. Similar results were found for BC except for lack of indoor sources. The fitted predictions from the sulfur-adjusted models were moderately predictive of observed indoor pollutant levels (out of sample correlations: PM2.5: r2=0.68, BC; r2=0.61). Our results suggest that PM2.5 has important classroom sources, which vary by school. Furthermore, using these mixed effects models, classroom exposures can be accurately predicted for dates when central site measures are available but indoor measures are not available.
Collapse
Affiliation(s)
| | | | - Marissa Hauptman
- Boston Children's Hospital
- Harvard Medical school
- Region 1 New England Pediatric Environmental Health Specialty Unit
| | | | | | | | - Qian Di
- T.H. Chan Harvard School of Public Health
| | - Peggy S. Lai
- Harvard Medical school
- T.H. Chan Harvard School of Public Health
- Massachusetts General Hospital
| | | | - Sachin Baxi
- Boston Children's Hospital
- Harvard Medical school
| | | | | | - Diane R. Gold
- Harvard Medical school
- T.H. Chan Harvard School of Public Health
- Channing Laboratory, Brigham and Women's Hospital
| | | | | |
Collapse
|
32
|
Sheehan WJ, Brough HA, Makinson K, Petty CR, Lack G, Phipatanakul W. Distribution of peanut protein in school and home environments of inner-city children. J Allergy Clin Immunol 2017. [PMID: 28647585 DOI: 10.1016/j.jaci.2017.05.042] [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] [Indexed: 10/19/2022]
Affiliation(s)
- William J Sheehan
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Helen A Brough
- Department of Asthma, Allergy and Respiratory Science, King's College London, Guy's Hospital, London, United Kingdom; St Thomas' Hospital, Children's Allergy Service, London, United Kingdom
| | - Kerry Makinson
- Department of Asthma, Allergy and Respiratory Science, King's College London, Guy's Hospital, London, United Kingdom
| | - Carter R Petty
- Boston Children's Hospital, Clinical Research Center, Boston, Mass
| | - Gideon Lack
- Department of Asthma, Allergy and Respiratory Science, King's College London, Guy's Hospital, London, United Kingdom; St Thomas' Hospital, Children's Allergy Service, London, United Kingdom
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
| |
Collapse
|
33
|
Phipatanakul W, Koutrakis P, Coull BA, Kang CM, Wolfson JM, Ferguson ST, Petty CR, Samnaliev M, Cunningham A, Sheehan WJ, Gaffin JM, Baxi SN, Lai PS, Permaul P, Liang L, Thorne PS, Adamkiewicz G, Brennan KJ, Baccarelli AA, Gold DR. The School Inner-City Asthma Intervention Study: Design, rationale, methods, and lessons learned. Contemp Clin Trials 2017; 60:14-23. [PMID: 28619649 DOI: 10.1016/j.cct.2017.06.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/31/2017] [Accepted: 06/10/2017] [Indexed: 02/08/2023]
Abstract
Asthma is the most common chronic disease of childhood in the United States, causes significant morbidity, particularly in the inner-city, and accounts for billions of dollars in health care utilization. Home environments are established sources of exposure that exacerbate symptoms and home-based interventions are effective. However, elementary school children spend 7 to 12h a day in school, primarily in one classroom. From the observational School Inner-City Asthma Study we learned that student classroom-specific exposures are associated with worsening asthma symptoms and decline in lung function. We now embark on a randomized, blinded, sham-controlled school environmental intervention trial, built on our extensively established school/community partnerships, to determine the efficacy of a school-based intervention to improve asthma control. This factorial school/classroom based environmental intervention will plan to enroll 300 students with asthma from multiple classrooms in 40 northeastern inner-city elementary schools. Schools will be randomized to receive either integrated pest management versus control and classrooms within these schools to receive either air purifiers or sham control. The primary outcome is asthma symptoms during the school year. This study is an unprecedented opportunity to test whether a community of children can benefit from school or classroom environmental interventions. If effective, this will have great impact as an efficient, cost-effective intervention for inner city children with asthma and may have broad public policy implications.
Collapse
Affiliation(s)
- Wanda Phipatanakul
- Boston Children's Hospital, Division of Allergy and Immunology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
| | - Petros Koutrakis
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, United States
| | - Brent A Coull
- Harvard T.H. Chan School of Public Health, Department of Biostatistics, Boston, MA, United States
| | - Choong-Min Kang
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, United States
| | - Jack M Wolfson
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, United States
| | - Stephen T Ferguson
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, United States
| | - Carter R Petty
- Boston Children's Hospital, Clinical Research Center, Boston, MA, United States
| | - Mihail Samnaliev
- Boston Children's Hospital, Clinical Research Center, Boston, MA, United States
| | - Amparito Cunningham
- Boston Children's Hospital, Division of Allergy and Immunology, Boston, MA, United States
| | - William J Sheehan
- Boston Children's Hospital, Division of Allergy and Immunology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Jonathan M Gaffin
- Boston Children's Hospital, Division of Respiratory Diseases, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Sachin N Baxi
- Boston Children's Hospital, Division of Allergy and Immunology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Peggy S Lai
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, United States; Massachusetts General Hospital, Division of Pulmonary and Critical Care, Boston, MA, United States
| | - Perdita Permaul
- Massachusetts General Hospital, Division of Pediatric Allergy and Immunology, Boston, MA, United States
| | - Liming Liang
- Harvard T.H. Chan School of Public Health, Department of Biostatistics, Boston, MA, United States
| | - Peter S Thorne
- University of Iowa, Department of Occupational and Environmental Health, Iowa City, United States
| | - Gary Adamkiewicz
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, United States
| | - Kasey J Brennan
- Columbia University School of Public Health, New York, Department of Environmental Health, New York, United States
| | - Andrea A Baccarelli
- Columbia University School of Public Health, New York, Department of Environmental Health, New York, United States
| | - Diane R Gold
- Harvard Medical School, Boston, MA, United States; Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, United States; Channing Laboratory, Brigham and Women's Hospital, Boston, MA, United States
| |
Collapse
|
34
|
Kopel LS, Petty CR, Gaffin JM, Sheehan WJ, Baxi SN, Kanchongkittiphon W, Fu C, Gold DR, Phipatanakul W. Caregiver stress among inner-city school children with asthma. J Allergy Clin Immunol Pract 2017; 5:1132-1134.e3. [PMID: 28433340 DOI: 10.1016/j.jaip.2017.02.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/03/2017] [Accepted: 02/21/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Lianne S Kopel
- Division of Respiratory Medicine, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Carter R Petty
- Clinical Research Center, Boston Children's Hospital, Boston, Mass
| | - Jonathan M Gaffin
- Division of Respiratory Diseases, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - William J Sheehan
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Sachin N Baxi
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Watcharoot Kanchongkittiphon
- Department of Pediatrics, Children's Hospital of Michigan, Detroit, Mich; Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chunxia Fu
- Division of Respiratory Epidemiology, Channing Laboratory, Brigham and Women's Hospital, Boston, Mass
| | - Diane R Gold
- Division of Respiratory Epidemiology, Channing Laboratory, Brigham and Women's Hospital, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
| |
Collapse
|
35
|
Gaffin JM, Hauptman M, Lai P, Petty CR, Wolfson JM, Kang CM, Sheehan WJ, Baxi SN, Bartnikas LM, Permaul P, Gold DR, Coull B, Koutrakis P, Phipatanakul W. Nitrogen Dioxide Exposure in School Classrooms Is Associated with Airflow Obstruction in Students with Asthma. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.570] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
36
|
Dilley MA, Sheehan WJ, Gaffin JM, Petty CR, Phipatanakul W. Adherence to Asthma Medications in a Population of Inner-City Children with Asthma. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.328] [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: 10/20/2022]
|
37
|
Sheehan WJ, Permaul P, Petty CR, Coull BA, Baxi SN, Gaffin JM, Lai PS, Gold DR, Phipatanakul W. Association Between Allergen Exposure in Inner-City Schools and Asthma Morbidity Among Students. JAMA Pediatr 2017; 171:31-38. [PMID: 27893060 PMCID: PMC5349325 DOI: 10.1001/jamapediatrics.2016.2543] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
IMPORTANCE Home aeroallergen exposure is associated with increased asthma morbidity in children, yet little is known about the contribution of school aeroallergen exposures to such morbidity. OBJECTIVE To evaluate the effect of school-specific aeroallergen exposures on asthma morbidity among students, adjusting for home exposures. DESIGN, SETTING, AND PARTICIPANTS The School Inner-City Asthma Study was a prospective cohort study evaluating 284 students aged 4 to 13 years with asthma who were enrolled from 37 inner-city elementary schools in the northeastern United States between March 1, 2008, and August 31, 2013. Enrolled students underwent baseline clinical evaluations before the school year started and were then observed clinically for 1 year. During that same school year, classroom and home dust samples linked to the students were collected and analyzed for common indoor aeroallergens. Associations between school aeroallergen exposure and asthma outcomes during the school year were assessed, adjusting for home exposures. EXPOSURES Indoor aeroallergens, including rat, mouse, cockroach, cat, dog, and dust mites, measured in dust samples collected from inner-city schools. MAIN OUTCOMES AND MEASURES The primary outcome was maximum days in the past 2 weeks with asthma symptoms. Secondary outcomes included well-established markers of asthma morbidity, including asthma-associated health care use and lung function, measured by forced expiratory volume in 1 second. RESULTS Among 284 students (median age, 8 years [interquartile range, 6-9 years]; 148 boys and 136 girls), exposure to mouse allergen was detected in 441 (99.5%) of 443 school dust samples, cat allergen in 420 samples (94.8%), and dog allergen in 366 samples (82.6%). Levels of mouse allergen in schools were significantly higher than in students' homes (median settled dust level, 0.90 vs 0.14 µg/g; P < .001). Exposure to higher levels of mouse allergen in school (comparing 75th with 25th percentile) was associated with increased odds of having an asthma symptom day (odds ratio, 1.27; 95% CI, 1.05-1.54; P = .02) and 4.0 percentage points lower predicted forced expiratory volume in 1 second (95% CI, -6.6 to -1.5; P = .002). This effect was independent of allergic sensitization. None of the other indoor aeroallergens were associated with worsening asthma outcomes. CONCLUSIONS AND RELEVANCE In this study of inner-city students with asthma, exposure to mouse allergen in schools was associated with increased asthma symptoms and decreased lung function. These findings demonstrate that the school environment is an important contributor to childhood asthma morbidity. Future school-based environmental interventions may be beneficial for this important public health problem.
Collapse
Affiliation(s)
- William J. Sheehan
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, Massachusetts2Harvard Medical School, Boston, Massachusetts
| | - Perdita Permaul
- Harvard Medical School, Boston, Massachusetts3Division of Pediatric Allergy and Immunology, Massachusetts General Hospital, Boston
| | - Carter R. Petty
- Clinical Research Center, Boston Children’s Hospital, Boston, Massachusetts
| | - Brent A. Coull
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts
| | - Sachin N. Baxi
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, Massachusetts2Harvard Medical School, Boston, Massachusetts
| | - Jonathan M. Gaffin
- Harvard Medical School, Boston, Massachusetts6Division of Respiratory Diseases, Boston Children’s Hospital, Boston, Massachusetts
| | - Peggy S. Lai
- Harvard Medical School, Boston, Massachusetts5Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts7Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston
| | - Diane R. Gold
- Harvard Medical School, Boston, Massachusetts5Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts8Channing Laboratory, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, Massachusetts2Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
38
|
Jhun I, Gaffin JM, Coull BA, Huffaker MF, Petty CR, Sheehan WJ, Baxi SN, Lai PS, Kang CM, Wolfson JM, Gold DR, Koutrakis P, Phipatanakul W. School Environmental Intervention to Reduce Particulate Pollutant Exposures for Children with Asthma. J Allergy Clin Immunol Pract 2017; 5:154-159.e3. [PMID: 27641483 PMCID: PMC5222771 DOI: 10.1016/j.jaip.2016.07.018] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 06/29/2016] [Accepted: 07/25/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Home-based interventions to improve indoor air quality have demonstrated benefits for asthma morbidity, yet little is known about the effect of environmental interventions in the school setting. OBJECTIVE We piloted the feasibility and effectiveness of a classroom-based air cleaner intervention to reduce particulate pollutants in classrooms of children with asthma. METHODS In this pilot randomized controlled trial, we assessed the effect of air cleaners on indoor air particulate pollutant concentrations in 18 classrooms (9 control, 9 intervention) in 3 urban elementary schools. We enrolled 25 children with asthma (13 control, 12 intervention) aged 6 to 10 years. Classroom air pollutant measurements and spirometry were completed once before and twice after randomization. Asthma symptoms were surveyed every 3 months. RESULTS Baseline classroom levels of fine particulate matter (particulate matter with diameter of <2.5 μm [PM2.5]) and black carbon (BC) were 6.3 and 0.41 μg/m3, respectively. When comparing the intervention to the control group, classroom PM2.5 levels were reduced by 49% and 42% and BC levels were reduced by 58% and 55% in the first and second follow-up periods, respectively (P < .05 for all comparisons). When comparing the children randomized to intervention and control classrooms, there was a modest improvement in peak flow, but no significant changes in forced expiratory volume in 1 second (FEV1) and asthma symptoms. CONCLUSIONS In this pilot study, a classroom-based air cleaner intervention led to significant reductions in PM2.5 and BC. Future large-scale studies should comprehensively evaluate the effect of school-based environmental interventions on pediatric asthma morbidity.
Collapse
Affiliation(s)
- Iny Jhun
- Harvard Medical School, Boston, Mass
| | - Jonathan M Gaffin
- Harvard Medical School, Boston, Mass; Division of Respiratory Diseases, Boston Children's Hospital, Boston, Mass
| | - Brent A Coull
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Mass
| | - Michelle F Huffaker
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Carter R Petty
- Clinical Research Center, Boston Children's Hospital, Boston, Mass
| | - William J Sheehan
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Sachin N Baxi
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Peggy S Lai
- Harvard Medical School, Boston, Mass; Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Mass; Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Mass
| | - Choong-Min Kang
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Mass
| | - Jack M Wolfson
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Mass
| | - Diane R Gold
- Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Mass
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
| |
Collapse
|
39
|
|
40
|
Dilley MA, Sheehan WJ, Petty CR, Gaffin JM, Hauptman M, Phipatanakul W. Comparison of treatment modalities for inpatient asthma exacerbations among US pediatric hospitals. J Allergy Clin Immunol Pract 2016; 5:855-857.e1. [PMID: 27888031 DOI: 10.1016/j.jaip.2016.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/04/2016] [Accepted: 10/07/2016] [Indexed: 01/14/2023]
Affiliation(s)
- Meredith A Dilley
- Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - William J Sheehan
- Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | | | - Jonathan M Gaffin
- Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Marissa Hauptman
- Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Wanda Phipatanakul
- Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
| |
Collapse
|
41
|
Sheehan WJ, Mauger DT, Paul IM, Moy JN, Boehmer SJ, Szefler SJ, Fitzpatrick AM, Jackson DJ, Bacharier LB, Cabana MD, Covar R, Holguin F, Lemanske RF, Martinez FD, Pongracic JA, Beigelman A, Baxi SN, Benson M, Blake K, Chmiel JF, Daines CL, Daines MO, Gaffin JM, Gentile DA, Gower WA, Israel E, Kumar HV, Lang JE, Lazarus SC, Lima JJ, Ly N, Marbin J, Morgan WJ, Myers RE, Olin JT, Peters SP, Raissy HH, Robison RG, Ross K, Sorkness CA, Thyne SM, Wechsler ME, Phipatanakul W. Acetaminophen versus Ibuprofen in Young Children with Mild Persistent Asthma. N Engl J Med 2016; 375:619-30. [PMID: 27532828 PMCID: PMC5085065 DOI: 10.1056/nejmoa1515990] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [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] [Indexed: 11/19/2022]
Abstract
BACKGROUND Studies have suggested an association between frequent acetaminophen use and asthma-related complications among children, leading some physicians to recommend that acetaminophen be avoided in children with asthma; however, appropriately designed trials evaluating this association in children are lacking. METHODS In a multicenter, prospective, randomized, double-blind, parallel-group trial, we enrolled 300 children (age range, 12 to 59 months) with mild persistent asthma and assigned them to receive either acetaminophen or ibuprofen when needed for the alleviation of fever or pain over the course of 48 weeks. The primary outcome was the number of asthma exacerbations that led to treatment with systemic glucocorticoids. Children in both groups received standardized asthma-controller therapies that were used in a simultaneous, factorially linked trial. RESULTS Participants received a median of 5.5 doses (interquartile range, 1.0 to 15.0) of trial medication; there was no significant between-group difference in the median number of doses received (P=0.47). The number of asthma exacerbations did not differ significantly between the two groups, with a mean of 0.81 per participant with acetaminophen and 0.87 per participant with ibuprofen over 46 weeks of follow-up (relative rate of asthma exacerbations in the acetaminophen group vs. the ibuprofen group, 0.94; 95% confidence interval, 0.69 to 1.28; P=0.67). In the acetaminophen group, 49% of participants had at least one asthma exacerbation and 21% had at least two, as compared with 47% and 24%, respectively, in the ibuprofen group. Similarly, no significant differences were detected between acetaminophen and ibuprofen with respect to the percentage of asthma-control days (85.8% and 86.8%, respectively; P=0.50), use of an albuterol rescue inhaler (2.8 and 3.0 inhalations per week, respectively; P=0.69), unscheduled health care utilization for asthma (0.75 and 0.76 episodes per participant, respectively; P=0.94), or adverse events. CONCLUSIONS Among young children with mild persistent asthma, as-needed use of acetaminophen was not shown to be associated with a higher incidence of asthma exacerbations or worse asthma control than was as-needed use of ibuprofen. (Funded by the National Institutes of Health; AVICA ClinicalTrials.gov number, NCT01606319.).
Collapse
Affiliation(s)
- William J Sheehan
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - David T Mauger
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Ian M Paul
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - James N Moy
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Susan J Boehmer
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Stanley J Szefler
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Anne M Fitzpatrick
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Daniel J Jackson
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Leonard B Bacharier
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Michael D Cabana
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Ronina Covar
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Fernando Holguin
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Robert F Lemanske
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Fernando D Martinez
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Jacqueline A Pongracic
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Avraham Beigelman
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Sachin N Baxi
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Mindy Benson
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Kathryn Blake
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - James F Chmiel
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Cori L Daines
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Michael O Daines
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Jonathan M Gaffin
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Deborah A Gentile
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - W Adam Gower
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Elliot Israel
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Harsha V Kumar
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Jason E Lang
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Stephen C Lazarus
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - John J Lima
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Ngoc Ly
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Jyothi Marbin
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Wayne J Morgan
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Ross E Myers
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - J Tod Olin
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Stephen P Peters
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Hengameh H Raissy
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Rachel G Robison
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Kristie Ross
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Christine A Sorkness
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Shannon M Thyne
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Michael E Wechsler
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| | - Wanda Phipatanakul
- From the Divisions of Allergy and Immunology (W.J.S., S.N.B., W.P.) and Respiratory Diseases (J.M.G.), Boston Children's Hospital and Harvard Medical School, and the Division of Allergy and Pulmonary Medicine, Brigham and Women's Hospital and Harvard Medical School (E.I.) - all in Boston; the Departments of Public Health Sciences (D.T.M., S.J.B.) and Pediatrics (I.M.P.), Penn State College of Medicine, Hershey, and the University of Pittsburgh Asthma Institute at University of Pittsburgh Medical Center (F.H.) and the Department of Pediatrics, Allegheny General Hospital (D.A.G.), Pittsburgh - all in Pennsylvania; Stroger Hospital of Cook County and Department of Pediatrics, Rush University Medical Center (J.N.M.), Ann and Robert H. Lurie Children's Hospital of Chicago (J.A.P., R.G.R.), and University of Illinois at Chicago (H.V.K.) - all in Chicago; the Breathing Institute, Children's Hospital Colorado (S.J.S.), and the Departments of Pediatrics (S.J.S.) and Medicine (M.E.W.), University of Colorado School of Medicine, Aurora, and the Department of Pediatrics (R.C., J.T.O.) and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (M.E.W.), National Jewish Health, Denver - both in Colorado; the Department of Pediatrics, Emory University, Atlanta (A.M.F.); the Section of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (D.J.J., R.F.L.) and the School of Pharmacy, University of Wisconsin-Madison (C.A.S.) - both in Madison; Washington University School of Medicine in St. Louis and the Department of Pediatrics, St. Louis Children's Hospital (L.B.B., A.B.) - both in St. Louis; the Departments of Pediatrics (M.D.C.) and Medicine (S.C.L.) and the Airway Clinical Research Center (N.L.), University of California, San Francisco, San Francisco, Benioff Children's Hospital Oakland, Oakland (M.B., J.M.), and Olive View UCLA Medical Center and Department of Pediatrics, David Geff
| |
Collapse
|
42
|
Gaffin JM, Zhou JS, Cai Q, Petty CR, Fu C, Sheehan WJ, Baxi S, Bailey A, Gold DR, Phipatanakul W. Utility of a portable hand-held forced expiratory volume in 1 second meter for monitoring asthma in an inner-city school setting. Ann Allergy Asthma Immunol 2016; 117:323-4. [PMID: 27424126 DOI: 10.1016/j.anai.2016.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/15/2016] [Accepted: 06/19/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Jonathan M Gaffin
- Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Joseph S Zhou
- Harvard Medical School, Boston, Massachusetts; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts; Asthma and Allergy Physicians of Rhode Island, Providence, Rhode Island
| | - Qiling Cai
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts; Tianjin Nankai Hospital, Tianjin, China
| | - Carter R Petty
- Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts
| | - Chunxia Fu
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts
| | - William J Sheehan
- Harvard Medical School, Boston, Massachusetts; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts
| | - Sachin Baxi
- Harvard Medical School, Boston, Massachusetts; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts
| | - Ann Bailey
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts
| | - Diane R Gold
- Harvard Medical School, Boston, Massachusetts; Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Channing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Massachusetts; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts.
| |
Collapse
|
43
|
Lai PS, Sheehan WJ, Gaffin JM, Petty CR, Coull BA, Gold DR, Phipatanakul W. School Endotoxin Exposure and Asthma Morbidity in Inner-city Children. Chest 2016; 148:1251-1258. [PMID: 26087201 DOI: 10.1378/chest.15-0098] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Endotoxin exposure is associated with airway inflammation. Children spend 6 to 8 h/d in school, yet the effect of school-specific endotoxin exposure on asthma morbidity is not well understood. METHODS In this longitudinal cohort study, 248 students with asthma, from 38 inner-city schools, underwent baseline phenotyping and follow-up. Clinical outcomes were evaluated throughout the academic school year and linked to classroom-specific dust and air endotoxin levels as well as home dust endotoxin levels. The primary outcome was maximum asthma symptom-days per 2-week period. RESULTS Classrooms had higher settled dust endotoxin levels compared with homes (14.3 endotoxin unit/mg vs 11.3 endotoxin unit/mg; P = .02). Airborne endotoxin levels exceeding recommended occupational exposure limits for adults were recorded in 22.0% of classrooms. Classroom air endotoxin levels were independently associated with increased maximum symptom-days in children with nonatopic asthma, but not in those with atopic asthma (interaction P = .03). Adjusting for home exposures, classroom endotoxin exposure was independently associated with a dose-dependent increase in asthma symptom-days for children with nonatopic asthma (adjusted incidence rate ratio, 1.16 [95% CI, 1.03-1.31]; P = .02). In these subjects, maximum symptom-days increased by 1.3 days for each 14-day period when comparing students in classrooms with the lowest endotoxin levels compared with average measured levels. CONCLUSIONS Inner-city children with asthma are exposed to high levels of airborne endotoxin at school, resulting in increased asthma symptoms in children with nonatopic asthma. Mitigation of school-related exposures may represent a strategy to decrease asthma morbidity in this population. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT01756391; URL: www.clinicaltrials.gov.
Collapse
Affiliation(s)
- Peggy S Lai
- Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - William J Sheehan
- Harvard Medical School, Boston, MA; Boston Children's Hospital, Brigham and Women's Hospital, Boston, MA
| | - Jonathan M Gaffin
- Harvard Medical School, Boston, MA; Boston Children's Hospital, Brigham and Women's Hospital, Boston, MA
| | - Carter R Petty
- Boston Children's Hospital, Brigham and Women's Hospital, Boston, MA
| | - Brent A Coull
- Department of Environmental Health, Harvard School of Public Health, Boston, MA; Department of Biostatistics, Harvard School of Public Health, Boston, MA
| | - Diane R Gold
- Harvard Medical School, Boston, MA; Boston Children's Hospital, Brigham and Women's Hospital, Boston, MA; Channing Laboratory, Brigham and Women's Hospital, Boston, MA
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, MA; Boston Children's Hospital, Brigham and Women's Hospital, Boston, MA.
| |
Collapse
|
44
|
Dilley MA, Sheehan WJ, Graham D, Petty C, Phipatanakul W. Comparison of Treatment Modalities for Inpatient Asthma Exacerbation Among U.S. Pediatric Hospitals. J Allergy Clin Immunol 2016. [DOI: 10.1016/j.jaci.2015.12.1278] [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]
|
45
|
Bartnikas LM, Sheehan WJ, Tuttle KL, Petty CR, Schneider LC, Phipatanakul W. Ovomucoid specific immunoglobulin E as a predictor of tolerance to cooked egg. Allergy Rhinol (Providence) 2015; 6:198-204. [PMID: 26686214 PMCID: PMC5391491 DOI: 10.2500/ar.2015.6.0135] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background: Ovomucoid is the dominant allergen in hen's egg. Although several studies evaluated the utility of ovomucoid specific immunoglobulin E (sIgE) levels in predicting baked (e.g., muffin or cupcake) or raw egg food challenge outcomes, studies that evaluated ovomucoid sIgE as a predictor of cooked egg (e.g., scrambled or hard boiled) challenge outcomes are limited. Objective: To determine the relation of ovomucoid sIgE levels with cooked egg food challenge outcomes. Methods: A retrospective review of 44 children who underwent cooked egg food challenge and who had the ovomucoid sIgE level measured. Results: Thirty-six of 44 children (81.8%) passed cooked egg challenge. The ovomucoid sIgE level predicted cooked egg challenge outcome (passed median, <0.35 kU/L [range, <0.35–0.64 kU/L]; failed median, 0.40 kU/L [range, <0.35–3.13 kU/L]; p = 0.004). Ovomucoid sIgE levels correlated with egg white (EW) sIgE levels (Spearman correlation coefficient, 0.588; p < 0.001). Receiver operating characteristic curve analysis of ovomucoid and EW sIgE demonstrated areas under the curve of 0.711 and 0.766, respectively. No significant difference was observed among those immunologic parameters in their abilities to predict cooked egg challenge outcome (p = 0.559). Conclusion: The ovomucoid sIgE level may be helpful in predicting cooked egg challenge outcomes. However, our study did not support a role for ovomucoid sIgE replacing EW sIgE testing in evaluating egg allergy.
Collapse
Affiliation(s)
- Lisa M Bartnikas
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, Massachusetts, USA
| | | | | | | | | | | |
Collapse
|
46
|
Bacharier LB, Guilbert TW, Mauger DT, Boehmer S, Beigelman A, Fitzpatrick AM, Jackson DJ, Baxi SN, Benson M, Burnham CAD, Cabana M, Castro M, Chmiel JF, Covar R, Daines M, Gaffin JM, Gentile DA, Holguin F, Israel E, Kelly HW, Lazarus SC, Lemanske RF, Ly N, Meade K, Morgan W, Moy J, Olin T, Peters SP, Phipatanakul W, Pongracic JA, Raissy HH, Ross K, Sheehan WJ, Sorkness C, Szefler SJ, Teague WG, Thyne S, Martinez FD. Early Administration of Azithromycin and Prevention of Severe Lower Respiratory Tract Illnesses in Preschool Children With a History of Such Illnesses: A Randomized Clinical Trial. JAMA 2015; 314:2034-2044. [PMID: 26575060 PMCID: PMC4757487 DOI: 10.1001/jama.2015.13896] [Citation(s) in RCA: 181] [Impact Index Per Article: 20.1] [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] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Many preschool children develop recurrent, severe episodes of lower respiratory tract illness (LRTI). Although viral infections are often present, bacteria may also contribute to illness pathogenesis. Strategies that effectively attenuate such episodes are needed. OBJECTIVE To evaluate if early administration of azithromycin, started prior to the onset of severe LRTI symptoms, in preschool children with recurrent severe LRTIs can prevent the progression of these episodes. DESIGN, SETTING, AND PARTICIPANTS A randomized, double-blind, placebo-controlled, parallel-group trial conducted across 9 academic US medical centers in the National Heart, Lung, and Blood Institute's AsthmaNet network, with enrollment starting in April 2011 and follow-up complete by December 2014. Participants were 607 children aged 12 through 71 months with histories of recurrent, severe LRTIs and minimal day-to-day impairment. INTERVENTION Participants were randomly assigned to receive azithromycin (12 mg/kg/d for 5 days; n = 307) or matching placebo (n = 300), started early during each predefined RTI (child's signs or symptoms prior to development of LRTI), based on individualized action plans, over a 12- through 18-month period. MAIN OUTCOMES AND MEASURES The primary outcome measure was the number of RTIs not progressing to a severe LRTI, measured at the level of the RTI, that would in clinical practice trigger the prescription of oral corticosteroids. Presence of azithromycin-resistant organisms in oropharyngeal samples, along with adverse events, were among the secondary outcome measures. RESULTS A total of 937 treated RTIs (azithromycin group, 473; placebo group, 464) were experienced by 443 children (azithromycin group, 223; placebo group, 220), including 92 severe LRTIs (azithromycin group, 35; placebo group, 57). Azithromycin significantly reduced the risk of progressing to severe LRTI relative to placebo (hazard ratio, 0.64 [95% CI, 0.41-0.98], P = .04; absolute risk for first RTI: 0.05 for azithromycin, 0.08 for placebo; risk difference, 0.03 [95% CI, 0.00-0.06]). Induction of azithromycin-resistant organisms and adverse events were infrequently observed. CONCLUSIONS AND RELEVANCE Among young children with histories of recurrent severe LRTIs, the use of azithromycin early during an apparent RTI compared with placebo reduced the likelihood of severe LRTI. More information is needed on the development of antibiotic-resistant pathogens with this strategy. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01272635.
Collapse
Affiliation(s)
- Leonard B Bacharier
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Theresa W Guilbert
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - David T Mauger
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Susan Boehmer
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Avraham Beigelman
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Anne M Fitzpatrick
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Daniel J Jackson
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Sachin N Baxi
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Mindy Benson
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Carey-Ann D Burnham
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Michael Cabana
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Mario Castro
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - James F Chmiel
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Ronina Covar
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Michael Daines
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Jonathan M Gaffin
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Deborah Ann Gentile
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Fernando Holguin
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Elliot Israel
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - H William Kelly
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Stephen C Lazarus
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Robert F Lemanske
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Ngoc Ly
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Kelley Meade
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Wayne Morgan
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - James Moy
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Tod Olin
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Stephen P Peters
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Wanda Phipatanakul
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Jacqueline A Pongracic
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Hengameh H Raissy
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Kristie Ross
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - William J Sheehan
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Christine Sorkness
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Stanley J Szefler
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - W Gerald Teague
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Shannon Thyne
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| | - Fernando D Martinez
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri (Bacharier, Beigelman, Castro); Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio (Guilbert); Department of Public Health Sciences, Pennsylvania State University, Hershey (Mauger, Boehmer); Department of Pediatrics, Emory University, Atlanta, Georgia (Fitzpatrick); Pediatrics Section of Allergy, Immunology, and Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison (Jackson); Division of Allergy/Immunology, Boston Children's Hospital, Boston, Massachusetts (Baxi, Phipatanakul, Sheehan); Benioff Children's Hospital, Oakland, California (Benson, Meade); Department of Pathology and Immunology, Washington University in St Louis School of Medicine, St Louis, Missouri (Burnham); University of California, San Francisco, Medicine, San Francisco (Cabana, Lazarus); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Chmiel, Ross); Department of Pediatrics, National Jewish Health, Denver, Colorado (Covar, Olin); University of Arizona, Arizona Respiratory Center, Tucson (Daines, Morgan); Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts (Gaffin); Department of Pediatrics, Allegheny General Hospital, Pittsburgh, Pennsylvania (Gentile); The University of Pittsburgh Asthma Institute, Pittsburgh, Pennsylvania (Holguin); Brigham and Women's Hospital, Boston, Massachusetts (Israel); Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico (Kelly); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison (Lemanske); Airway Clinical Research Center, University of California, San Francisco, San Francisco, California (Ly); Stroger Hospital of Cook County Pediatric Services, Chicago, Illinois (Moy); Wake Forest University School of Medicine, Winston-Salem, North Carolina (Peters); Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois (Pongracic); Department of Pediatrics/Pulmonary, University of New Mexico, Albuquerque (Raissy); University of Wisconsin-Madison, Madison (Sorkness); The Breathing Institute, Children's Hospital Colorado, Denver (Szefler); University of Virginia School of Medicine, Charlottesville (Teague); Department of Pediatrics, San Francisco General Hospital, San Francisco, California (Thyne); Arizona Respiratory Center, University of Arizona, Tucson, Arizona (Martinez)
| |
Collapse
|
47
|
Gaffin JM, Landrum A, Petty CR, Baxi S, Sheehan WJ, Phipatanakul W. Black and Hispanic perceptions of asthma medication in the School Inner-City Asthma Study. Ann Allergy Asthma Immunol 2015; 114:533-4. [PMID: 25868711 PMCID: PMC4449786 DOI: 10.1016/j.anai.2015.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 03/22/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Jonathan M Gaffin
- Harvard Medical School, Boston, Massachusetts; Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts
| | - Aaron Landrum
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts
| | - Carter R Petty
- Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts
| | - Sachin Baxi
- Harvard Medical School, Boston, Massachusetts; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts
| | - William J Sheehan
- Harvard Medical School, Boston, Massachusetts; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Massachusetts; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts.
| |
Collapse
|
48
|
Rao DR, Sordillo JE, Kopel LS, Gaffin JM, Sheehan WJ, Hoffman E, Ozonoff A, Gold DR, Phipatanakul W. Association between allergic sensitization and exhaled nitric oxide in children in the School Inner-City Asthma Study. Ann Allergy Asthma Immunol 2015; 114:256-257.e1. [PMID: 25595887 DOI: 10.1016/j.anai.2014.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/04/2014] [Accepted: 12/08/2014] [Indexed: 11/20/2022]
Affiliation(s)
- Devika R Rao
- Division of Respiratory Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Joanne E Sordillo
- The Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Lianne S Kopel
- Division of Respiratory Diseases, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Jonathan M Gaffin
- Division of Respiratory Diseases, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - William J Sheehan
- Division of Allergy and Immunology, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Elaine Hoffman
- Harvard Medical School, Boston, Massachusetts; TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Al Ozonoff
- Center for Patient Safety and Quality Research, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Diane R Gold
- The Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Wanda Phipatanakul
- The Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Division of Allergy and Immunology, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
49
|
Friedlander JL, Sheehan WJ, Baxi SN, Kopel LS, Gaffin JM, Ozonoff A, Fu C, Gold DR, Phipatanakul W. Food allergy and increased asthma morbidity in a School-based Inner-City Asthma Study. J Allergy Clin Immunol Pract 2015; 1:479-84. [PMID: 24058900 DOI: 10.1016/j.jaip.2013.06.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Children with asthma have increased prevalence of food allergies. The relationship between food allergy and asthma morbidity is unclear. OBJECTIVE We aimed to investigate the presence of food allergy as an independent risk factor for increased asthma morbidity by using the School Inner-City Asthma Study, a prospective study that evaluates risk factors and asthma morbidity among urban children. METHODS We prospectively surveyed, from inner-city schools, 300 children with physician-diagnosed asthma, followed by clinical evaluation. Food allergies were reported, which included symptoms experienced within 1 hour of food ingestion. Asthma morbidity, pulmonary function, and resource utilization were compared between children with food allergies and those without. RESULTS Seventy-three of 300 children with asthma (24%) surveyed had physician-diagnosed food allergy, and 36 (12%) had multiple food allergies. Those with any food allergy independently had increased risk of hospitalization (OR [odds ratio] 2.35 [95% CI, 1.30-4.24]; P = .005) and use of controller medication (OR 1.99 [95% CI, 1.06-3.74]; P = .03). Those with multiple food allergies also had an independently higher risk of hospitalization in the past year (OR 4.10 [95% CI, 1.47-11.45]; P = .007), asthma-related hospitalization (OR 3.52 [95% CI, 1.12-11.03]; P = .03), controller medication use (OR 2.38 [95% CI, 1.00-5.66]; P = .05), and more provider visits (median, 4.5 vs 3.0; P = .008). Furthermore, lung function was significantly lower (percent predicted FEV1 and FEV1/FVC ratios) in both food allergy category groups. CONCLUSIONS Food allergy is highly prevalent in inner-city school-aged children with asthma. Children with food allergies have increased asthma morbidity and health resource utilization with decreased lung function, and this association is stronger in those with multiple food allergies.
Collapse
|
50
|
Kopel LS, Gaffin JM, Ozonoff A, Rao DR, Sheehan WJ, Friedlander JL, Permaul P, Baxi SN, Fu C, Subramanian SV, Gold DR, Phipatanakul W. Perceived neighborhood safety and asthma morbidity in the school inner-city asthma study. Pediatr Pulmonol 2015; 50:17-24. [PMID: 24421055 PMCID: PMC4096619 DOI: 10.1002/ppul.22986] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 05/17/2013] [Accepted: 12/11/2013] [Indexed: 11/09/2022]
Abstract
AIM The aim of this study was to investigate whether neighborhood safety as perceived by primary caregivers is associated with asthma morbidity outcomes among inner-city school children with asthma. METHODS School children with asthma were recruited from 25 inner-city schools between 2009 and 2012 for the School Inner-City Asthma Study (N = 219). Primary caregivers completed a baseline questionnaire detailing their perception of neighborhood safety and their children's asthma symptoms, and the children performed baseline pulmonary function tests. In this cross-sectional analysis, asthma control was compared between children whose caregivers perceived their neighborhood to be unsafe versus safe. RESULTS After adjusting for potential confounders, those children whose primary caregivers perceived the neighborhood to be unsafe had twice the odds of having poorly controlled asthma (odds ratio [OR] adjusted = 2.2, 95% confidence interval [CI] = 1.2-3.9, P = 0.009), four times the odds of dyspnea and rescue medication use (OR adjusted = 4.7; 95% CI = 1.7-13.0, P = 0.003, OR adjusted = 4.0; 95% CI = 1.8-8.8, P < 0.001, respectively), three times as much limitation in activity (OR adjusted = 3.2; 95% CI = 1.4-7.7, P = 0.008), and more than twice the odds of night-time symptoms (OR adjusted = 2.2; 95% CI = 1.3-4.0, P = 0.007) compared to participants living in safe neighborhoods. There was no difference in pulmonary function test results between the two groups. CONCLUSIONS Primary caregivers' perception of neighborhood safety is associated with childhood asthma morbidity among inner-city school children with asthma. Further study is needed to elucidate mechanisms behind this association, and future intervention studies to address social disadvantage may be important.
Collapse
Affiliation(s)
- Lianne S Kopel
- Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|