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Yang F, Chen C, Deng X, Hu T, Bi D, Li H. Perspectives and experiences of mothers of school-age children with asthma: a qualitative study. J Asthma 2024; 61:444-452. [PMID: 38009785 DOI: 10.1080/02770903.2023.2288322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/19/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION AND AIMS This study aimed to explore the perspectives and experiences of mothers of school-age children with asthma in care. METHODS A phenomenological study was conducted using qualitative research methods from August 2021 to November 2021. Mothers (from Sichuan, China) of school-aged children with asthma who sought outpatient care at the pediatric asthma clinic were purposively sampled based on their occupation, education level, and duration of their child's illness. Semi-structured face-to-face interviews were conducted in consultation room A07 of the pediatric asthma clinic. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically. RESULTS 23 mothers expressed interest, but data saturation was reached after recruiting 15 mothers.Four main themes encompassing ten sub-themes emerged from the analysis: (1) Negative psychological burden, with sub-themes including anxiety shock, fear of death, guilt, and stigma. (2) Family dysfunction, with sub-themes including impaired quality of life, family emotional crisis, and heavy economic burden. (3) Difficulty in seeking medical treatment. (4) Active response, with sub-themes including emotional adjustment, family empowerment, and social support. CONCLUSIONS In this sample, the caregiving experience of mothers of school-age children with asthma is diverse and complex, reflected not only in personal psychological aspects but also in family functioning and social support. Taking into account various factors, such as addressing psychological well-being, emphasizing family and social support, and promoting the sharing of positive experiences, may result in more effective alleviation of caregiving stress for mothers of school-age children with asthma.
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Affiliation(s)
- Fang Yang
- Pediatric Department, Deyang People's Hospital, Deyang, China
| | - Cheng Chen
- Pediatric Department, Deyang People's Hospital, Deyang, China
| | - Xuexue Deng
- Pediatric Department, Deyang People's Hospital, Deyang, China
| | - Tingting Hu
- Pediatric Department, Deyang People's Hospital, Deyang, China
| | - Dan Bi
- Pediatric Department, Deyang People's Hospital, Deyang, China
| | - Huawei Li
- Nephrology Department, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Yuan Y, Zhu H, Huang S, Zhang Y, Shen Y. SFRP5 Partially Inhibits the Proliferation and Migration of Airway Smooth Muscle Cells in Children with Asthma by Regulating the Wnt/β-Catenin Signaling Pathway. Discov Med 2024; 36:323-331. [PMID: 38409837 DOI: 10.24976/discov.med.202436181.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
BACKGROUND Childhood asthma is a chronic inflammatory disease of the respiratory tract characterized by bronchial inflammation, airway hyperresponsiveness, airflow disorder, and obstruction. Secreted frizzled-related protein 5 (SFRP5) may be associated with respiratory inflammatory diseases. This study investigated the effect of SFRP5 on human airway smooth muscle cells (HASMCs) to provide new ideas for treating asthma. METHODS A total of 30 children with asthma and 30 children who had a physical examination at the same time were selected and divided into asthma and healthy groups. Serum SFRP5 levels were determined by enzyme-linked immunosorbent assay (ELISA) and real-time quantitative polymerase chain reaction (RT-qPCR). Lipofectamine 2000™ regent was used to transfect the SFRP5 overexpression plasmid (pc-SFRP5) or corresponding negative control (pc-NC) into HASMCs. HASMCs were treated with 10 μg/L platelet-derived growth factor-BB (PDGF-BB), which is an inducer to mimic the asthma-like condition at the cellular level of childhood asthma. HASMCs were divided into control, PDGF-BB (PDGF-BB treatment), PDGF-BB+pc-NC (pc-NC transfection and PDGF-BB treatment), and PDGF-BB+pc-SFRP5 (pc-SFRP5 transfection and PDGF-BB treatment) groups. Cell proliferation was measured by 5-ethynyl-2'-deoxyuridine (EdU) and cell counting kit-8 (CCK-8) assay. Cell migration was detected by Transwell assay. The protein expression was detected by western blot. RESULTS Serum SFRP5 expression in the asthmatic group was decreased versus the healthy group (p < 0.0001). Induction of PDGF-BB decreased SFRP5 expression in HASMCs (p < 0.01). SFRP5 expression in the pc-SFRP5 group was increased (p < 0.01). The proliferation and migration of HASMCs increased after PDGF-BB treatment (p < 0.001, p < 0.0001), indicating that the asthma model was successfully inducted in vitro. Moreover, the expression of β-catenin, cellular-myelocytomatosis viral oncogene (c-Myc), and cyclinD1 proteins in HASMCs increased after PDGF-BB treatment (p < 0.0001). SFRP5 overexpression partly inhibited PDGF-BB-induced proliferation, migration, and expressions of β-catenin, c-Myc, and cyclinD proteins in HASMCs (p < 0.01, p < 0.001, p < 0.0001). CONCLUSIONS Serum SFRP5 expression decreases in children with asthma. SFRP5 overexpression partially inhibits PDGF-BB-induced HASMC proliferation and migration by regulating the wingless-type mouse mammary tumor virus (MMTV) integration site family (Wnt)/β-catenin pathway.
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Affiliation(s)
- Yuyun Yuan
- Department of Pediatrics, Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, 201999 Shanghai, China
| | - Honghua Zhu
- Department of Medical Imaging, Shanghai Seventh People's Hospital, 200137 Shanghai, China
| | - Sihong Huang
- Department of Pediatrics, Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, 201999 Shanghai, China
| | - Yantao Zhang
- Department of Pediatrics, Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, 201999 Shanghai, China
| | - Yiyun Shen
- Department of Pediatrics, Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, 201999 Shanghai, China
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Khare M, Piparia S, Tantisira KG. Pharmacogenetics of childhood uncontrolled asthma. Expert Rev Clin Immunol 2023:1-14. [PMID: 37190963 PMCID: PMC10657335 DOI: 10.1080/1744666x.2023.2214363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Asthma is a heterogeneous, multifactorial disease with multiple genetic and environmental risk factors playing a role in pathogenesis and therapeutic response. Understanding of pharmacogenetics can help with matching individualized treatments to specific genotypes of asthma to improve therapeutic outcomes especially in uncontrolled or severe asthma. AREAS COVERED In this review, we outline novel information about biology, pathways, and mechanisms related to interindividual variability in drug response (corticosteroids, bronchodilators, leukotriene modifiers, and biologics) for childhood asthma. We discuss candidate gene, genome-wide association studies and newer omics studies including epigenomics, transcriptomics, proteomics, and metabolomics as well as integrative genomics and systems biology methods related to childhood asthma. The articles were obtained after a series of searches, last updated November 2022, using database PubMed/CINAHL DB. EXPERT OPINION Implementation of pharmacogenetic algorithms can improve therapeutic targeting in children with asthma, particularly with severe or uncontrolled asthma who typically have challenges in clinical management and carry considerable financial burden. Future studies focusing on potential biomarkers both clinical and pharmacogenetic can help formulate a prognostic test for asthma treatment response that would represent true bench to bedside clinical implementation.
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Affiliation(s)
- Manaswitha Khare
- Division of Pediatric Hospital Medicine, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Rady Children's Hospital of San Diego, San Diego, CA, USA
| | - Shraddha Piparia
- Division of Pediatric Respiratory Medicine, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Kelan G Tantisira
- Division of Pediatric Respiratory Medicine, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
- Division of Pediatric Respiratory Medicine, Department of Pediatrics, Rady Children's Hospital of San Diego, San Diego, CA, USA
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Ding X, Whelan ME, Clifton DA, Zhu T. Physical activity and asthma symptom control in children during COVID-19 lockdown: A feasibility study. Digit Health 2023; 9:20552076231152165. [PMID: 36845081 PMCID: PMC9944184 DOI: 10.1177/20552076231152165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/03/2023] [Indexed: 02/23/2023] Open
Abstract
Objective The aim was to evaluate the impact of the COVID-19 lockdown on physical activity (PA) and asthma symptom control in children. Methods We conducted a single-cohort observational study on 22 children with a median age of 9 (8-11) years with a diagnosis of asthma being included in the study. Participants were asked to wear a PA tracker for 3 months; during the same 3-month period, the Paediatric Asthma Diary (PAD) was administered daily and the Asthma Control (AC) Questionnaire together with the mini-Paediatric Asthma Quality of Life (AQoL) Questionnaire administered at weekly intervals. Results Compared with the pre-lockdown period, there was a significant reduction in PA levels after the lockdown began. Daily total steps reduced by about 3000 steps (p < 0.001), very active minutes by 9 min (p < 0.001) and fairly active minutes almost halved (p < 0.001); while asthma symptom control marginally improved, with the AC and AQoL score improving by 0.56 (p < 0.005) and 0.47 (p < 0.05), respectively. Further, for those with AC score higher than 1, PA was positively associated with asthma control both before and after the lockdown. Conclusions This feasibility study suggests that PA engagement of children with asthma is negatively affected during the pandemic, but the beneficial effect of PA on asthma symptom control potentially sustains even during a lockdown period. These findings emphasize the importance of wearable device to monitor longitudinal PA and thus better management of PA for achieving the best outcome of asthma symptom control.
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Affiliation(s)
- Xiaorong Ding
- School of Life Science and Technology,
University of
Electronic Science and Technology of China,
Chengdu, China,Institute of Biomedical Engineering,
University of
Oxford, Oxford, UK,Xiaorong Ding, School of Life Science and
Technology, University of Electronic Science and Technology of China, Qingshuihe
Campus, No.2006, Xiyuan Ave, West Hi-Tech Zone, 611731, Chengdu, Sichuan, China.
| | - Maxine E Whelan
- Centre for Intelligent Healthcare, Coventry
University, Coventry, UK
| | - David A Clifton
- Institute of Biomedical Engineering,
University of
Oxford, Oxford, UK,Oxford Suzhou Centre for Advanced Research, Jiangsu, China
| | - Tingting Zhu
- Institute of Biomedical Engineering,
University of
Oxford, Oxford, UK
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Xu T, Zhang H, Zhang Y, Yang P, Yang Z, Jiang X, Shang L. Development and validation of the patient reported outcomes questionnaire of children with asthma in China: A Caregiver's proxy-reported measure. Front Pediatr 2023; 11:1114289. [PMID: 37033182 PMCID: PMC10076647 DOI: 10.3389/fped.2023.1114289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/10/2023] [Indexed: 04/11/2023] Open
Abstract
Background Research on asthma control levels and quality of life is essential for children with asthma during their growth stage. Therefore, it is necessary to develop a questionnaire that can be used for monitoring and evaluating the disease control effectiveness and quality of life of children with asthma in China and to conduct a preliminary evaluation for its reliability, validity, and discriminative ability. Methods The questionnaire was created through a literature review and qualitative interviews for a targeted population. Based on the previous work, 30 caregivers of children with asthma and 5 experienced pediatricians reviewed and discussed a collection of items. Then, 72 items were screened and selected to form the draft questionnaire. After three rounds of investigation (with 240, 503, and 360 participants, respectively), the final questionnaire was established according to the evaluation results. The structure of the questionnaire was explored through confirmatory factor analysis. Exploratory factor analysis and variability analysis were applied based on the first two rounds of investigation. Reliability, construct validity, and discriminative ability were evaluated based on the third round of investigation. Results The questionnaire contains 6 dimensions and 34 items, and the total cumulative variance contribution rate was 54.96%; Cronbach's α coefficient was 0.91; the split-half reliability coefficient was 0.75, and the test-retest reliability coefficient was 0.74. The children's age, gender, residence, asthma attack in the last three months, caregivers' education background, and monthly income per caregiver were correlated with patient-reported outcomes of children with asthma. Conclusion The questionnaire appeared to have good reliability, construct validity, and discriminative ability in children with asthma in China.
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Affiliation(s)
- Tong Xu
- Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China
| | - Haiyue Zhang
- Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China
| | - Yuhai Zhang
- Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China
| | - Peng Yang
- Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China
| | - Zhe Yang
- Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China
| | - Xun Jiang
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University, Xi’an, China
- Correspondence: Lei Shang Xun Jiang
| | - Lei Shang
- Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China
- Correspondence: Lei Shang Xun Jiang
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Zhou P, Xi L, He H, Zhang B, Li Y. A comparison of efficacy and safety of complementary and alternative therapies for children with asthma: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2021; 100:e24946. [PMID: 33725965 PMCID: PMC7982223 DOI: 10.1097/md.0000000000024946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Bronchial Asthma is a chronic, hyperreactive inflammation of the airway that involves a variety of inflammatory cells. Due to the persistence of airway hyperresponsiveness, lung function is progressively damaged, making asthma more stubborn and difficult to heal. In recent years, the prevalence of childhood asthma is still on an increasing trend. Repeated asthma attacks not only affect children's life and learning, but also bring greater economic and mental burden to children's families, and even threaten children's lives. Traditional treatment methods such as oral western medicine, atomization therapy has obvious limitations, and the complementary and alternative therapy is an effective method to treat asthma in children. This study will evaluate the efficacy and safety of various complementary and alternative therapies for children with asthma by means of mesh meta-analysis. In order to provide the basis for clinical rational use. METHODS Use the computer to search the self-built database until January 2021, the China National Knowledge Infrastructure, Wanfang Database, Chinese Scientific Journals Database, China Biomedical Literature Database, PubMed, Cochrance Library, EMBASE, Web of Science, Clinical Trials and other electronic databases to collect RCT studies on complementary and alternative therapies for for children with asthma. We will screen the relevant literature included in the systematic review/meta analysis. At the same time, Revman 5.3 software will be used for meta-analysis, and grade will be used to grade the quality of evidence in the network meta-analysis. RESULTS This study will compare the efficacy and safety of different complementary and alternative therapies to treat childhood asthma, and evaluate and rank different interventions. CONCLUSION The combined use of complementary and alternative therapies for childhood asthma on the basis of conventional basic treatment can improve clinical efficacy, reduce the occurrence of adverse reactions, improve the quality of life of children, and provide strong support for the rational use of clinicians. INPLASY REGISTRATION NUMBER INPLASY202120005.
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Affiliation(s)
- Peng Zhou
- The First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Leiming Xi
- The First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Hongan He
- The First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Baoqing Zhang
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine
| | - Yanning Li
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine
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