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Yammine S, Latzin P. Lung function trajectories and determinants in early life. Lancet Child Adolesc Health 2024; 8:386-387. [PMID: 38621407 DOI: 10.1016/s2352-4642(24)00081-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/17/2024]
Affiliation(s)
- Sophie Yammine
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland.
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Siebeneichler AS, Schumann DM, Karakioulaki M, Brachsler N, Darie AM, Grize L, Heck TG, Tamm M, Latzin P, Stolz D. Single and multiple breath nitrogen washout compared with the methacholine test in patients with suspected asthma and normal spirometry. BMJ Open Respir Res 2024; 11:e001919. [PMID: 38697675 PMCID: PMC11086282 DOI: 10.1136/bmjresp-2023-001919] [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: 06/28/2023] [Accepted: 04/05/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Methods used to assess ventilation heterogeneity through inert gas washout have been standardised and showed high sensitivity in diagnosing many respiratory diseases. We hypothesised that nitrogen single or multiple breath washout tests, respectively nitrogen single breath washout (N2SBW) and nitrogen multiple breath washout (N2MBW), may be pathological in patients with clinical suspicion of asthma but normal spirometry. Our aim was to assess whether N2SBW and N2MBW are associated with methacholine challenge test (MCT) results in this population. We also postulated that an alteration in SIII at N2SBW could be detected before the 20% fall of forced expiratory volume in the first second (FEV1) in MCT. STUDY DESIGN AND METHODS This prospective, observational, single-centre study included patients with suspicion of asthma with normal spirometry. Patients completed questionnaires on symptoms and health-related quality-of-life and underwent the following lung function tests: N2SBW (SIII), N2MBW (Lung clearance index (LCI), Scond, Sacin), MCT (FEV1 and sGeff) as well as N2SBW between each methacholine dose. RESULTS 182 patients were screened and 106 were included in the study, with mean age of 41.8±14 years. The majority were never-smokers (58%) and women (61%). MCT was abnormal in 48% of participants, N2SBW was pathological in 10.6% at baseline and N2MBW abnormality ranged widely (LCI 81%, Scond 18%, Sacin 43%). The dose response rate of the MCT showed weak to moderate correlation with the subsequent N2SBW measurements during the provocation phases (ρ 0.34-0.50) but no correlation with N2MBW. CONCLUSIONS Both MCT and N2 washout tests are frequently pathological in patients with suspicion of asthma with normal spirometry. The weak association and lack of concordance across the tests highlight that they reflect different but not interchangeable pathological pathways of the disease.
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Affiliation(s)
| | | | | | - Nora Brachsler
- Clinic of Pneumology, University Hospital Basel, Basel, Switzerland
| | - Andrei M Darie
- Clinic of Pneumology, University Hospital Basel, Basel, Switzerland
| | - Leticia Grize
- Clinic of Pneumology, University Hospital Basel, Basel, Switzerland
| | | | - Michael Tamm
- Clinic of Pneumology, University Hospital Basel, Basel, Switzerland
| | - Philipp Latzin
- Inselspital, Kinderklinik, University of Bern, Bern, Switzerland
| | - Daiana Stolz
- Clinic of Pneumology, University Hospital Basel, Basel, Switzerland
- Clinic of Pneumology, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Steinberg R, Marty V, Korten I, Aebi C, Latzin P, Agyeman PKA. Epidemiology and Clinical Characteristics of Human Metapneumovirus Infections in Hospitalized Children in Two Consecutive Postpandemic Years. Pediatr Infect Dis J 2024; 43:e141-e144. [PMID: 38241663 PMCID: PMC10919270 DOI: 10.1097/inf.0000000000004221] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/21/2024]
Abstract
We assessed human metapneumovirus infections in children hospitalized between 2011 and 2023 and compared the strongest pre- and postpandemic seasons. After the COVID-19 pandemic, we observed offseason cases and loss of the alternating pattern of the human metapneumovirus season magnitude. Incidence rate ratio of 0- to 11-month-old versus 12- to 23-month-old children was 2.1 (95% CI: 1.0-4.8) before and 1.3 (95% CI: 0.6-2.9) after the pandemic.
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Affiliation(s)
- Ruth Steinberg
- From the Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Véronique Marty
- From the Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital
| | - Insa Korten
- From the Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital
| | - Christoph Aebi
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- From the Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital
| | - Philipp KA Agyeman
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Oestreich MA, Wyler F, Buess C, Etter B, Ramsey KA, Latzin P. Signal-correction errors in the EasyOne Pro LAB multiple-breath washout device significantly impact outcomes in children and adults. J Appl Physiol (1985) 2024; 136:460-471. [PMID: 38269412 DOI: 10.1152/japplphysiol.00096.2022] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 01/16/2024] [Indexed: 01/26/2024] Open
Abstract
Multiple-breath washout (MBW) is an established technique to assess functional residual capacity (FRC) and ventilation inhomogeneity in the lung. Indirect calculation of nitrogen concentration requires accurate measurement of gas concentrations. To investigate the accuracy of the CO2 concentration and molar mass (MM) values used for the indirect calculation of nitrogen concentration in a commercial MBW device [EasyOne Pro LAB (EOPL), ndd Medizintechnik AG, Switzerland] and its impact on outcomes. We used high-precision gas mixtures to evaluate CO2 and MM sensor output in vivo and in vitro. We developed updated algorithms to correct observed errors and assessed the impact on MBW outcomes and FRC measurement accuracy compared with body plethysmography. The respiratory exchange ratio (RER)-based adjustment of the measured CO2 signal used in the EOPL led to an overestimated CO2 signal (range -0.1% to 1.0%). In addition, an uncorrected dependence on humidity was identified. These combined effects resulted in an overestimation of expired nitrogen concentrations (range -0.7% to 2.6%), and consequently MBW outcomes. Corrected algorithms reduced the mean (SD) cumulative expired volume by 15.8% (9.7%), FRC by 6.6% (3.0%), and lung clearance index by 9.9% (7.6%). Differences in FRC between the EOPL and body plethysmography further increased. Inadequate signal correction causes RER- and humidity-dependent expired nitrogen concentration errors and overestimation of test outcomes. Updated algorithms reduce average signal error, however, RER values far from the population average still cause measurement errors. Despite improved signal accuracy, the updated algorithm increased the difference in FRC between the EOPL and body plethysmography.NEW & NOTEWORTHY We investigated the accuracy of the molar mass (MM) and CO2 sensors of a commercial multiple-breath washout device (ndd Medizintechnik AG, Switzerland). We identified humidity and respiratory exchange ratio-dependent errors that in most measurements resulted in an overestimation of expired nitrogen concentrations, and consequently, MBW results. Functional residual capacity and lung clearance index decreased by 6.6% and 9.9%, respectively. Despite improved signal accuracy, the difference in FRC between the EOPL and body plethysmography increased.
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Affiliation(s)
- Marc-Alexander Oestreich
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Florian Wyler
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Blaise Etter
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kathryn A Ramsey
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Otth M, Kasteler R, Mulder RL, Agrusa J, Armenian SH, Barnea D, Bergeron A, Bhatt NS, Bourke SJ, Constine LS, Goutaki M, Green DM, Hennewig U, Houdouin V, Hudson MM, Kremer L, Latzin P, Ng A, Oeffinger KC, Schindera C, Skinner R, Sommer G, Srinivasan S, Stokes DC, Versluys B, Waespe N, Weiner DJ, Dietz AC, Kuehni CE. Recommendations for surveillance of pulmonary dysfunction among childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. EClinicalMedicine 2024; 69:102487. [PMID: 38420219 PMCID: PMC10900250 DOI: 10.1016/j.eclinm.2024.102487] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
Childhood, adolescent, and young adult (CAYA) cancer survivors are at risk of pulmonary dysfunction. Current follow-up care guidelines are discordant. Therefore, the International Late Effects of Childhood Cancer Guideline Harmonization Group established and convened a panel of 33 experts to develop evidence-based surveillance guidelines. We critically reviewed available evidence regarding risk factors for pulmonary dysfunction, types of pulmonary function testing, and timings of surveillance, then we formulated our recommendations. We recommend that CAYA cancer survivors and healthcare providers are aware of reduced pulmonary function risks and pay vigilant attention to potential symptoms of pulmonary dysfunction, especially among survivors treated with allogeneic haematopoietic stem cell transplantation, thoracic radiotherapy, and thoracic surgery. Based on existing limited evidence and current lack of interventions, our panel recommends pulmonary function testing only for symptomatic survivors. Since scarce existing evidence informs our recommendation, we highlight the need for prospective collaborative studies to address pulmonary function knowledge gaps among CAYA cancer survivors.
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Affiliation(s)
- Maria Otth
- Department of Oncology, Haematology, Immunology, Stem Cell Transplantation and Somatic Gene Therapy, University Children's Hospital Zurich, Zurich, Switzerland
- Pediatric Hematology-Oncology Center, Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Rahel Kasteler
- Department of Oncology, Haematology, Immunology, Stem Cell Transplantation and Somatic Gene Therapy, University Children's Hospital Zurich, Zurich, Switzerland
- Pediatric Hematology-Oncology Center, Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
| | - Renée L. Mulder
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Jennifer Agrusa
- Department of Pediatric Hematology Oncology, C.S. Mott Children's Hospital, University of Michigan, Michigan, USA
| | | | - Dana Barnea
- Department of Hematology and Department of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Anne Bergeron
- Hôpitaux Universitaires de Genève, Université de Genève, Genève, Switzerland
| | - Neel S. Bhatt
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Stephen J. Bourke
- Department of Respiratory Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Louis S. Constine
- Departments of Radiation Oncology and Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel M. Green
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Ulrike Hennewig
- University Hospital of Giessen and Marburg, Pediatric Hematology and Oncology, Giessen, Germany
| | | | - Melissa M. Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Leontien Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Antony Ng
- Department of Paediatric Oncology, Royal Hospital for Children, Bristol, UK
| | - Kevin C. Oeffinger
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Christina Schindera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Division of Pediatric Oncology/Haematology, University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | - Roderick Skinner
- Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital and Newcastle University Centre for Cancer, Newcastle upon Tyne, UK
| | - Grit Sommer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Saumini Srinivasan
- Division of Pulmonology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Dennis C. Stokes
- Division of Pulmonology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Birgitta Versluys
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Nicolas Waespe
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Pediatric Hematology and Oncology, University Children's Hospital Bern, University of Bern, Bern, Switzerland
- CANSEARCH Research Platform for Paediatric Oncology and Haematology, Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Daniel J. Weiner
- Division of Pediatric Pulmonology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Claudia E. Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Pediatric Hematology and Oncology, University Children's Hospital Bern, University of Bern, Bern, Switzerland
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6
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Oestreich MA, Hänni R, Wyler F, Kentgens AC, Yammine S, Obrist D, Latzin P, Ramsey KA. Comparison of functional residual capacity between updated infant SF 6 multiple-breath washout setups. Pediatr Pulmonol 2024; 59:518-520. [PMID: 38010843 DOI: 10.1002/ppul.26770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023]
Affiliation(s)
- Marc-Alexander Oestreich
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Robin Hänni
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Florian Wyler
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Anne-Christianne Kentgens
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Dominik Obrist
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Kathryn A Ramsey
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
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Salem Y, Jakob J, Steinberg R, Gorlanova O, Fuchs O, Müller L, Usemann J, Frey U, Latzin P, Yammine S. Cohort Profile Update: The Bern Basel Infant Lung Development Cohort. Int J Epidemiol 2024; 53:dyad164. [PMID: 38061036 DOI: 10.1093/ije/dyad164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/05/2023] [Indexed: 02/12/2024] Open
Affiliation(s)
- Yasmin Salem
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Julian Jakob
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Ruth Steinberg
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Biomedical Science, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Oliver Fuchs
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Allergology, Department of Medicine, Lucerne Cantonal Hospital and University of Lucerne, Lucerne, Switzerland
| | - Loretta Müller
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Urs Frey
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Philipp Latzin
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Kentgens AC, Kurz JM, Mozun R, Usemann J, Pedersen ESL, Kuehni CE, Latzin P, Moeller A, Singer F. Evaluation of the Double-Tracer Gas Single-Breath Washout Test in a Pediatric Field Study. Chest 2024; 165:396-404. [PMID: 37716474 PMCID: PMC10851274 DOI: 10.1016/j.chest.2023.09.006] [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: 03/28/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND The early life origins of chronic pulmonary diseases are thought to arise in peripheral small airways. Predictors of ventilation inhomogeneity, a proxy of peripheral airway function, are understudied in schoolchildren. RESEARCH QUESTION Is the double-tracer gas single-breath washout (DTG-SBW) measurement feasible in a pediatric field study setting? What are the predictors of the DTG-SBW-derived ventilation inhomogeneity estimate in unselected schoolchildren? STUDY DESIGN AND METHODS In this prospective cross-sectional field study, a mobile lung function testing unit visited participating schools in Switzerland. We applied DTG-SBW, fraction of exhaled nitric oxide (Feno), and spirometry measurements. The DTG-SBW is based on tidal inhalation of helium and sulfur-hexafluoride, and the phase III slope (SIIIHe-SF6) is derived. We assessed feasibility, repeatability, and associations of SIIIHe-SF6 with the potential predictors of anthropometrics, presence of wheeze (ie, parental report of one or more episode of wheeze in the prior year), Feno, FEV1, and FEV1/FVC. RESULTS In 1,782 children, 5,223 DTG-SBW trials were obtained. The DTG-SBW was acceptable in 1,449 children (81.3%); the coefficient of variation was 39.8%. SIIIHe-SF6 was independently but weakly positively associated with age and BMI. In 276 children (21.2%), wheeze was reported. SIIIHe-SF6 was higher by 0.049 g.mol.L-1 in children with wheeze compared with those without and remained associated with wheeze after adjusting for age and BMI in a multivariable linear regression model. SIIIHe-SF6 was not associated with Feno, FEV1, and FEV1/FVC. INTERPRETATION The DTG-SBW is feasible in a pediatric field study setting. On the population level, age, body composition, and wheeze are independent predictors of peripheral airway function in unselected schoolchildren. The variation of the DTG-SBW possibly constrains its current applicability on the individual level. TRIAL REGISTRATION ClinicalTrials.gov; No.: NCT03659838; URL: www. CLINICALTRIALS gov.
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Affiliation(s)
- Anne-Christianne Kentgens
- Division of Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Johanna M Kurz
- Division of Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Rebeca Mozun
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Intensive Care and Neonatology and Children's Research Center, University Children`s Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jakob Usemann
- Division of Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Respiratory Medicine, University Children`s Hospital Zurich, University of Zurich, Zurich, Switzerland; University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Eva S L Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Claudia E Kuehni
- Division of Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexander Moeller
- Department of Respiratory Medicine, University Children`s Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Florian Singer
- Division of Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Respiratory Medicine, University Children`s Hospital Zurich, University of Zurich, Zurich, Switzerland; Division of Pediatric Pulmonology and Allergology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
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Mostacci N, Wüthrich TM, Siegwald L, Kieser S, Steinberg R, Sakwinska O, Latzin P, Korten I, Hilty M. Informed interpretation of metagenomic data by StrainPhlAn enables strain retention analyses of the upper airway microbiome. mSystems 2023; 8:e0072423. [PMID: 37916972 PMCID: PMC10734448 DOI: 10.1128/msystems.00724-23] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
IMPORTANCE The usage of 16S rRNA gene sequencing has become the state-of-the-art method for the characterization of the microbiota in health and respiratory disease. The method is reliable for low biomass samples due to prior amplification of the 16S rRNA gene but has limitations as species and certainly strain identification is not possible. However, the usage of metagenomic tools for the analyses of microbiome data from low biomass samples is not straight forward, and careful optimization is needed. In this work, we show that by validating StrainPhlAn 3 results with the data from bacterial cultures, the strain-level tracking of the respiratory microbiome is feasible despite the high content of host DNA being present when parameters are carefully optimized to fit low biomass microbiomes. This work further proposes that strain retention analyses are feasible, at least for more abundant species. This will help to better understand the longitudinal dynamics of the upper respiratory microbiome during health and disease.
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Affiliation(s)
- Nadja Mostacci
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Tsering Monika Wüthrich
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
- Graduate School for Biomedical Science, University of Bern, Bern, Switzerland
| | - Léa Siegwald
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Silas Kieser
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Ruth Steinberg
- Graduate School for Biomedical Science, University of Bern, Bern, Switzerland
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Olga Sakwinska
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Philipp Latzin
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Insa Korten
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
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10
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Mallet MC, Pedersen ESL, Makhoul R, Blanchon S, Hoyler K, Jochmann A, Latzin P, Moeller A, Regamey N, Goutaki M, Spycher BD, Kuehni CE. Phenotypes of cough in children: A latent class analysis. Clin Exp Allergy 2023; 53:1279-1290. [PMID: 37997173 DOI: 10.1111/cea.14416] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/29/2023] [Accepted: 10/19/2023] [Indexed: 11/25/2023]
Abstract
INTRODUCTION Distinguishing phenotypes among children with cough helps understand underlying causes. Using a statistical data-driven approach, we aimed to identify and validate cough phenotypes based on measurable traits, physician diagnoses, and prognosis. METHODS We used data from the Swiss Paediatric Airway Cohort and included 531 children aged 5-16 years seen in outpatient clinics since 2017. We included children with any parent-reported cough (i.e. cough without a cold, cough at night, cough more than other children, or cough longer than 4 weeks) without current wheeze. We applied latent class analysis to identify phenotypes using nine symptoms and characteristics and selected the best model using the Akaike information criterion. We assigned children to the most likely phenotype and compared the resulting groups for parental atopy history, comorbidities, spirometry, fractional exhaled nitric oxide (FeNO), skin prick tests and specific IgE, physician diagnoses, and 1-year prognosis. RESULTS We identified four cough phenotypes: non-specific cough (26%); non-allergic infectious and night cough with snoring and otitis (4%); chronic allergic dry night cough with snoring (9%); and allergic non-infectious cough with rhino-conjunctivitis (61%). Children with the allergic phenotype often had family or personal history of atopy and asthma diagnosis. FeNO was highest for the allergic phenotype [median 17.9 parts per billion (ppb)] and lowest for the non-allergic infectious phenotype [median 7.0 parts per billion (ppb)]. Positive allergy test results differed across phenotypes (p < .001) and were most common among the allergic (70%) and least common among the non-specific cough (31%) phenotypes. Subsequent wheeze was more common among the allergic than the non-specific phenotype. CONCLUSION We identified four clinically relevant cough phenotypes with different prognoses. Although we excluded children with current wheeze, most children with cough belonged to allergy-related phenotypes.
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Affiliation(s)
- Maria Christina Mallet
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Eva S L Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Ronny Makhoul
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Sylvain Blanchon
- Pediatric Pulmonology and Cystic Fibrosis Unit, Service of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Karin Hoyler
- Kinderpneumologie Horgen, Private Practice for Pediatric Pneumology, Horgen, Switzerland
| | - Anja Jochmann
- Department of Paediatric Pulmonology, University Children's Hospital Basel, Basel, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexander Moeller
- Department of Respiratory Medicine, University Children's Hospital Zurich and Children's Research Centre, University of Zurich, Zurich, Switzerland
| | - Nicolas Regamey
- Division of Paediatric Pulmonology, Children's Hospital, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ben D Spycher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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11
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Wolf L, Usemann J, Collaud E, Derkenne MF, Fischer R, Hensen M, Hitzler M, Hofer M, Inci D, Irani S, Jahn K, Koutsokera A, Kusche R, Kurowski T, Latzin P, Lin D, Mioranza L, Moeller A, Mornand A, Mueller-Suter D, Murer C, Naehrlich L, Plojoux J, Regamey N, Rodriguez R, Rochat I, Sauty A, Schuurmans M, Semmler M, Trachsel D, Walter AL, Jung A. Data accuracy, consistency and completeness of the national Swiss cystic fibrosis patient registry: Lessons from an ECFSPR data quality project. J Cyst Fibros 2023:S1569-1993(23)00904-9. [PMID: 37996316 DOI: 10.1016/j.jcf.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/03/2023] [Accepted: 08/31/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Good data quality is essential when rare disease registries are used as a data source for pharmacovigilance studies. This study investigated data quality of the Swiss cystic fibrosis (CF) registry in the frame of a European Cystic Fibrosis Society Patient Registry (ECFSPR) project aiming to implement measures to increase data reliability for registry-based research. METHODS All 20 pediatric and adult Swiss CF centers participated in a data quality audit between 2018 and 2020, and in a re-audit in 2022. Accuracy, consistency and completeness of variables and definitions were evaluated, and missing source data and informed consents (ICs) were assessed. RESULTS The first audit included 601 out of 997 Swiss people with CF (60.3 %). Data quality, as defined by data correctness ≥95 %, was high for most of the variables. Inconsistencies of specific variables were observed because of an incorrect application of the variable definition. The proportion of missing data was low with <5 % for almost all variables. A considerable number of missing source data occurred for CFTR variants. Availability of ICs varied largely between centers (10 centers had >5 % of missing documents). After providing feedback to the centers, availability of genetic source data and ICs improved. CONCLUSIONS Data audits demonstrated an overall good data quality in the Swiss CF registry. Specific measures such as support of the participating sites, training of data managers and centralized data collection should be implemented in rare disease registries to optimize data quality and provide robust data for registry-based scientific research.
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Affiliation(s)
- Lara Wolf
- Department of Respiratory Medicine, University Children's Hospital Zurich, Switzerland; Departments of Pulmonology and Paediatric Pulmonology, Cantonal Hospital Winterthur, Switzerland
| | - Jakob Usemann
- Department of Respiratory Medicine, University Children's Hospital Zurich, Switzerland; Department of Pulmonology, University Children's Hospital Basel, Switzerland
| | - Eugénie Collaud
- Department of Respiratory Medicine, University Children's Hospital Zurich, Switzerland
| | | | - Reta Fischer
- Quartier Bleu, Pulmonology Outpatient Clinic, Berne, Switzerland
| | - Maxime Hensen
- Department of Paediatrics, Cantonal Hospital Fribourg, Switzerland
| | - Michael Hitzler
- Department of Paediatric Pulmonology, Cantonal Hospital Lucerne, Switzerland
| | - Markus Hofer
- Departments of Pulmonology and Paediatric Pulmonology, Cantonal Hospital Winterthur, Switzerland
| | - Demet Inci
- Department of Respiratory Medicine, University Children's Hospital Zurich, Switzerland
| | - Sarosh Irani
- Department of Pulmonology, Cantonal Hospital Aarau, Switzerland
| | - Kathleen Jahn
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Switzerland
| | - Angela Koutsokera
- Department of Pulmonology, Lausanne University Hospital, Switzerland
| | - Rachel Kusche
- Department of Pulmonology, Cantonal Hospital Aarau, Switzerland; Department of Paediatric Pulmonology, Cantonal Hospital Aarau, Switzerland
| | - Thomas Kurowski
- Department of Pulmonology, University Hospital Zurich, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital Berne University Hospital, Switzerland
| | - Dagmar Lin
- Department of Pulmonology, Inselspital Berne University Hospital, Switzerland
| | - Laurence Mioranza
- Paediatric Pulmonology and Cystic Fibrosis Unit, Division of Paediatrics, Department Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - Alexander Moeller
- Department of Respiratory Medicine, University Children's Hospital Zurich, Switzerland
| | - Anne Mornand
- Department of Paediatric Pulmonology, Geneva University Hospital, Switzerland
| | | | - Christian Murer
- Department of Pulmonology, Cantonal Hospital Lucerne, Switzerland
| | - Lutz Naehrlich
- Department of Paediatrics, Justus-Liebig-University Giessen, Germany; European Cystic Fibrosis Society Patient Registry, Karup, Denmark
| | - Jérôme Plojoux
- Deparment of Pulmonology, Geneva University Hospital, Switzerland
| | - Nicolas Regamey
- Department of Paediatric Pulmonology, Cantonal Hospital Lucerne, Switzerland
| | - Romy Rodriguez
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital Berne University Hospital, Switzerland
| | - Isabelle Rochat
- Paediatric Pulmonology and Cystic Fibrosis Unit, Division of Paediatrics, Department Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - Alain Sauty
- Department of Pulmonology, Réseau Hospitalier Neuchâtelois, Switzerland
| | - Macé Schuurmans
- Department of Pulmonology, University Hospital Zurich, Switzerland
| | - Michaela Semmler
- Department of Pulmonology, Inselspital Berne University Hospital, Switzerland
| | - Daniel Trachsel
- Department of Pulmonology, University Children's Hospital Basel, Switzerland
| | - Anna-Lena Walter
- Department of Pulmonology, Cantonal Hospital St. Gallen, Switzerland
| | - Andreas Jung
- Department of Respiratory Medicine, University Children's Hospital Zurich, Switzerland; Departments of Pulmonology and Paediatric Pulmonology, Cantonal Hospital Winterthur, Switzerland; European Cystic Fibrosis Society Patient Registry, Karup, Denmark.
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12
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Streibel C, Willers CC, Bauman G, Pusterla O, Bieri O, Curdy M, Horn M, Casaulta C, Berger S, Dekany GM, Kieninger E, Bartenstein A, Latzin P. Long-term pulmonary outcome of children with congenital diaphragmatic hernia: functional lung MRI using matrix-pencil decomposition enables side-specific assessment of lung function. Eur Radiol 2023:10.1007/s00330-023-10395-8. [PMID: 37982833 DOI: 10.1007/s00330-023-10395-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/23/2023] [Accepted: 08/30/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES In patients with congenital diaphragmatic hernia (CDH) the exact functional outcome of the affected lung side is still unknown, mainly due to the lack of spatially resolved diagnostic tools. Functional matrix-pencil decomposition (MP-) lung MRI fills this gap as it measures side-specific ventilation and perfusion. We aimed to assess the overall and side-specific pulmonary long-term outcomes of patients with CDH using lung function tests and MP-MRI. METHODS Thirteen school-aged children with CDH (seven with small and six with large defect-sized CDH, defined as > 50% of the chest wall circumference being devoid of diaphragm tissue) and thirteen healthy matched controls underwent spirometry, multiple-breath washout, and MP-MRI. The main outcomes were forced expiratory volume in 1 second (FEV1), lung clearance index (LCI2.5), ventilation defect percentage (VDP), and perfusion defect percentage (QDP). RESULTS Patients with a large CDH showed significantly reduced overall lung function compared to healthy controls (mean difference [95%-CIadjusted]: FEV1 (z-score) -4.26 [-5.61, -2.92], FVC (z-score) -3.97 [-5.68, -2.26], LCI2.5 (TO) 1.12 [0.47, 1.76], VDP (%) 8.59 [3.58, 13.60], QDP (%) 17.22 [13.16, 21.27]) and to patients with a small CDH. Side-specific examination by MP-MRI revealed particularly reduced ipsilateral ventilation and perfusion in patients with a large CDH (mean difference to contralateral side [95%-CIadjusted]: VDP (%) 14.80 [10.50, 19.00], QDP (%) 23.50 [1.75, 45.20]). CONCLUSIONS Data indicate impaired overall lung function with particular limitation of the ipsilateral side in patients with a large CDH. MP-MRI is a promising tool to provide valuable side-specific functional information in the follow-up of patients with CDH. CLINICAL RELEVANCE STATEMENT In patients with congenital diaphragmatic hernia, easily applicable MP-MRI allows specific examination of the lung side affected by the hernia and provides valuable information on ventilation and perfusion with implications for clinical practice, making it a promising tool for routine follow-up. KEY POINTS • Functional matrix pencil decomposition (MP) MRI data from a small sample indicate reduced ipsilateral pulmonary ventilation and perfusion in children with large congenital diaphragmatic hernia (CDH). • Easily applicable pencil decomposition MRI provides valuable side-specific diagnostic information on lung ventilation and perfusion. This is a clear advantage over conventional lung function tests, helping to comprehensively follow up patients with congenital diaphragmatic hernia and monitor therapy effects.
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Affiliation(s)
- Carmen Streibel
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - C Corin Willers
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Department of Paediatrics, Kantonsspital Aarau, Aarau, Switzerland
| | - Grzegorz Bauman
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Orso Pusterla
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Oliver Bieri
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Marion Curdy
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matthias Horn
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carmen Casaulta
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Steffen Berger
- Department of Paediatric Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Gabriela Marta Dekany
- Department of Paediatric Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Elisabeth Kieninger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Bartenstein
- Department of Paediatric Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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13
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Mallet MC, Mozun R, Ardura-Garcia C, Pedersen ESL, Jurca M, Latzin P, Moeller A, Kuehni CE. Phenotypic characteristics, healthcare use, and treatment in children with night cough compared with children with wheeze. Pediatr Pulmonol 2023; 58:3083-3094. [PMID: 37606206 DOI: 10.1002/ppul.26626] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 06/09/2023] [Accepted: 07/19/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVES Population-based studies of children with dry night cough alone compared with those who also wheeze are few and inconclusive. We compared how children with dry night cough differ from those who wheeze. METHODS LuftiBus in the school is a population-based study of schoolchildren conducted between 2013 and 2016 in Zurich, Switzerland. We divided children into four mutually exclusive groups based on reported dry night cough (henceforth referred as "cough") and wheeze and compared parent-reported symptoms, comorbidities, exposures, FeNO, spirometry, and healthcare use and treatment. RESULTS Among 3457 schoolchildren aged 6-17 years, 294 (9%) reported "cough," 181 (5%) reported "wheeze," 100 (3%) reported "wheeze and cough," and 2882 (83%) were "asymptomatic." Adjusting for confounders in a multinomial regression, children with "cough" reported more frequent colds, rhinitis, and snoring than "asymptomatic" children; children with "wheeze" or "wheeze and cough" more often reported hay fever, eczema, and parental histories of asthma. FeNO and spirometry were similar among "asymptomatic" and children with "cough," while children with "wheeze" or "wheeze and cough" had higher FeNO and evidence of bronchial obstruction. Children with "cough" used healthcare less often than those with "wheeze," and they attended mainly primary care. Twenty-two children (7% of those with "cough") reported a physician diagnosis of asthma and used inhalers. These had similar characteristics as children with wheeze. CONCLUSION Our representative population-based study confirms that children with dry night cough without wheeze clearly differed from those with wheeze. This suggests asthma is unlikely, and they should be investigated for alternative aetiologies, particularly upper airway disease.
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Affiliation(s)
- Maria C Mallet
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Rebeca Mozun
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Intensive Care and Neonatology, Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Eva S L Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Maja Jurca
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- The University Children's Hospital Basel, Basel, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexander Moeller
- Department of Respiratory Medicine, University Children's Hospital Zurich and Children's Research Center, University of Zurich, Zurich, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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14
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Escher A, Kieninger E, Groof SD, Savas ST, Schneiter M, Tschanz SA, Frenz M, Latzin P, Casaulta C, Müller L. In Vitro Effect of Combined Hypertonic Saline and Salbutamol on Ciliary Beating Frequency and Mucociliary Transport in Human Nasal Epithelial Cells of Healthy Volunteers and Patients with Cystic Fibrosis. J Aerosol Med Pulm Drug Deliv 2023; 36:171-180. [PMID: 37196208 DOI: 10.1089/jamp.2022.0026] [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] [Indexed: 05/19/2023] Open
Abstract
Background: Inhalation of hypertonic saline (HS) is standard of care in patients with cystic fibrosis (CF). However, it is unclear if adding salbutamol has-besides bronchodilation-further benefits, for example, on the mucociliary clearance. We assessed this in vitro by measuring the ciliary beating frequency (CBF) and the mucociliary transport rate (MCT) in nasal epithelial cells (NECs) of healthy volunteers and patients with CF. Aims: To investigate the effect of HS, salbutamol, and its combination on (muco)ciliary activity of NECs in vitro, and to assess potential differences between healthy controls and patients with CF. Methods: NECs obtained from 10 healthy volunteers and 5 patients with CF were differentiated at the air-liquid interface and aerosolized with 0.9% isotonic saline ([IS] control), 6% HS, 0.06% salbutamol, or combined HS and salbutamol. CBF and MCT were monitored over 48-72 hours. Results: In NECs of healthy controls, the absolute CBF increase was comparable for all substances, but CBF dynamics were different: HS increased CBF slowly and its effect lasted for an extended period, salbutamol and IS increased CBF rapidly and the effect subsided similarly fast, and HS and salbutamol resulted in a rapid and long-lasting CBF increase. Results for CF cells were comparable, but less pronounced. Similar to CBF, MCT increased after the application of all the tested substances. Conclusion: CBF and MCT of NECs of healthy participants and CBF of patients with CF increased upon treatment with aerosolized IS, HS, salbutamol, or HS and salbutamol, showing a relevant effect for all tested substances. The difference in the CBF dynamics can be explained by the fact that the properties of the mucus are changed differently by different saline concentrations.
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Affiliation(s)
- Anaïs Escher
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Elisabeth Kieninger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Susan De Groof
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Sibel T Savas
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Martin Schneiter
- Institute of Applied Physics, University of Bern, Bern, Switzerland
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | | | - Martin Frenz
- Institute of Applied Physics, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Carmen Casaulta
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Loretta Müller
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
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15
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Rüttimann C, Nissen-Kratzert A, Mostacci N, Künstle N, Marten A, Gisler A, Bacher K, Yammine S, Steinberg R, Schulzke S, Röösli M, Latzin P, Hilty M, Frey U, Gorlanova O. Antibiotics in pregnancy influence nasal microbiome and respiratory morbidity in infancy. ERJ Open Res 2023; 9:00225-2023. [PMID: 37650088 PMCID: PMC10463034 DOI: 10.1183/23120541.00225-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/06/2023] [Indexed: 09/01/2023] Open
Abstract
Background The effects of prenatal antibiotic exposure on respiratory morbidity in infancy and the involved mechanisms are still poorly understood. We aimed to examine whether prenatal antibiotic exposure in the third trimester is associated with nasal microbiome and respiratory morbidity in infancy and at school age, and whether this association with respiratory morbidity is mediated by the nasal microbiome. Methods We performed 16S ribosomal RNA gene sequencing (regions V3-V4) on nasal swabs obtained from 296 healthy term infants from the prospective Basel-Bern birth cohort (BILD) at age 4-6 weeks. Information about antibiotic exposure was derived from birth records and standardised interviews. Respiratory symptoms were assessed by weekly telephone interviews in the first year of life and a clinical visit at age 6 years. Structural equation modelling was used to test direct and indirect associations accounting for known risk factors. Results α-Diversity indices were lower in infants with antibiotic exposure compared to nonexposed infants (e.g. Shannon index p-value 0.006). Prenatal antibiotic exposure was also associated with a higher risk of any, as well as severe, respiratory symptoms in the first year of life (risk ratio 1.38, 95% CI 1.03-1.84; adjusted p-value (padj)=0.032 and risk ratio 1.75, 95% CI 1.02-2.97; padj=0.041, respectively), but not with wheeze or atopy in childhood. However, we found no indirect mediating effect of nasal microbiome explaining these clinical symptoms. Conclusion Prenatal antibiotic exposure was associated with lower diversity of nasal microbiome in infancy and, independently of microbiome, with respiratory morbidity in infancy, but not with symptoms later in life.
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Affiliation(s)
- Céline Rüttimann
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Annika Nissen-Kratzert
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nadja Mostacci
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Noëmi Künstle
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrea Marten
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Amanda Gisler
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Katharina Bacher
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ruth Steinberg
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Sven Schulzke
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland and University of Basel, Basel, Switzerland
| | - Philipp Latzin
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Urs Frey
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Shared senior authorship
| | - Olga Gorlanova
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Shared senior authorship
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16
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Streibel C, Willers CC, Pusterla O, Bauman G, Stranzinger E, Brabandt B, Bieri O, Curdy M, Bullo M, Frauchiger BS, Korten I, Krüger L, Casaulta C, Ratjen F, Latzin P, Kieninger E. Effects of elexacaftor/tezacaftor/ivacaftor therapy in children with cystic fibrosis - a comprehensive assessment using lung clearance index, spirometry, and functional and structural lung MRI. J Cyst Fibros 2023; 22:615-622. [PMID: 36635199 DOI: 10.1016/j.jcf.2022.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [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: 08/03/2022] [Revised: 12/07/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND With improvement in supportive therapies and the introduction of cystic fibrosis transmembrane conductance regulator (CFTR)-modulator treatment in patients with cystic fibrosis (CF), milder disease courses are expected. Therefore, sensitive parameters are needed to monitor disease course and effects of CFTR-modulators. Functional lung MRI using matrix-pencil decomposition (MP-MRI) is a promising tool for assessing ventilation and perfusion quantitatively. This study aimed to assess the treatment effect of elexacaftor/tezacaftor/ivacaftor combination regimen (ELX/TEZ/IVA) on measures of structural and functional lung abnormalities. METHODS 24 children with CF underwent lung function tests (multiple breath washout, spirometry), functional and structural MRI twice (one year apart) before and once after at least two weeks (mean 4.7 ± 2.6 months) on ELX/TEZ/IVA. Main outcomes were changes (Δ) upon ELX/TEZ/IVA in lung function, defect percentage of ventilation (VDP) and perfusion (QDP), defect distribution index of ventilation and perfusion (DDIV, DDIQ), and Eichinger score. Statistical analyses were performed using paired t-tests and multilevel regression models with bootstrapping. RESULTS We observed a significant improvement in lung function, structural and functional MRI parameters upon ELX/TEZ/IVA treatment (mean; 95%-CI): ΔLCI2.5 (TO) -0.84 (-1.62 to -0.06); ΔFEV1 (z-score) 1.05 (0.56 to 1.55); ΔVDP (% of impairment) -6.00 (-8.44 to -3.55); ΔQDP (% of impairment) -3.90 (-5.90 to -1.90); ΔDDIV -1.38 (-2.22 to -0.53); ΔDDIQ -0.31 (-0.73 to 0.12); ΔEichinger score -3.89 (-5.05 to -2.72). CONCLUSIONS Besides lung function tests, functional and structural MRI is a suitable tool to monitor treatment response of ELX/TEZ/IVA therapy, and seems promising as outcome marker in the future.
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Affiliation(s)
- Carmen Streibel
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Corin C Willers
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland; Departement of Paediatrics, Kantonsspital Aarau, Aarau, Switzerland
| | - Orso Pusterla
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Grzegorz Bauman
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Enno Stranzinger
- Department of Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Ben Brabandt
- Department of Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Oliver Bieri
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Marion Curdy
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Marina Bullo
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Bettina Sarah Frauchiger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Insa Korten
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Linn Krüger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Carmen Casaulta
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Felix Ratjen
- Division of Respiratory Medicine, Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Elisabeth Kieninger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland; Division of Respiratory Medicine, Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Canada.
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17
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Lam YT, Papon JF, Alexandru M, Anagiotos A, Armengot M, Boon M, Burgess A, Crowley S, Dheyauldeen SAD, Emiralioglu N, Erdem Eralp E, van Gogh C, Gokdemir Y, Gunaydın O, Haarman EG, Harris A, Hayn I, Ismail-Koch H, Karadag B, Kempeneers C, Kim S, Latzin P, Lorent N, Ozcelik U, Pioch C, Poirrier ALM, Reula A, Roehmel J, Yiallouros P, Goutaki M. Sinonasal disease among patients with primary ciliary dyskinesia: an international study. ERJ Open Res 2023; 9:00701-2022. [PMID: 37228283 PMCID: PMC10204851 DOI: 10.1183/23120541.00701-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/21/2023] [Indexed: 05/27/2023] Open
Abstract
Background Sinonasal symptoms are a common feature of primary ciliary dyskinesia (PCD); however, literature about their severity and frequency, particularly during the life course, is scarce. Using baseline data from the Ear, nose and throat (ENT) Prospective International Cohort of PCD patients, we describe sinonasal disease in PCD. Methods We included participants who had a routine sinonasal examination during which they completed a symptoms questionnaire. We compared frequency of reported symptoms and examination findings among children and adults, and identified characteristics potentially associated with higher risk of sinonasal disease using ordinal regression. Results 12 centres contributed 384 participants; median age was 16 years (IQR 9-22), and 54% were male. Chronic nasal problems were the most common feature, reported by 341 (89%). More adults (33; 24%) than children (10; 4%) described hyposmia. Quality of life was moderately affected by rhinosinusitis among 136 participants with completed SNOT-22 questionnaires (median score 31; IQR 23-45). Examinations revealed nasal polyps among 51 of 345 participants (15%) and hypertrophic inferior nasal turbinates among 127 of 341 participants (37%). Facial pain was detected in 50 of 342 participants (15%). Nasal polyps, hypertrophic turbinates, deviated septum and facial pain were found more commonly in adults than children. The only characteristic associated with higher risk of sinonasal disease was age 10 years and older. Conclusions Based on our findings, regular sinonasal examinations are relevant for patients with PCD of all ages. There is a need for improved management of sinonasal disease supported by evidence-based guidelines.
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Affiliation(s)
- Yin Ting Lam
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Jean-François Papon
- Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Hôpital Bicêtre, Service d'ORL, Le Kremlin-Bicêtre, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Mihaela Alexandru
- Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Hôpital Bicêtre, Service d'ORL, Le Kremlin-Bicêtre, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Andreas Anagiotos
- Department of Otorhinolaryngology, Nicosia General Hospital, Nicosia, Cyprus
| | - Miguel Armengot
- Department of Otorhinolaryngology, and Primary Ciliary Dyskinesia Unit, La Fe University and Polytechnic Hospital, Valencia, Spain
- Medical School, Valencia University, Valencia, Spain
| | - Mieke Boon
- Department of Paediatrics, University Hospital, Leuven, Belgium
| | - Andrea Burgess
- Primary Ciliary Dyskinesia Centre, Southampton Children's Hospital, Southampton NHS Foundation Trust, Southampton, UK
| | - Suzanne Crowley
- Paediatric Department of Allergy and Lung Diseases, Oslo University Hospital, Oslo, Norway
| | - Sinan Ahmed D. Dheyauldeen
- Department of Otorhinolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nagehan Emiralioglu
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Ela Erdem Eralp
- Department of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Christine van Gogh
- Department of Otorhinolaryngology – Head and Neck Surgery, Amsterdam UMC, Amsterdam, The Netherlands
| | - Yasemin Gokdemir
- Department of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Onder Gunaydın
- Department of Otorhinolaryngology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Eric G. Haarman
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Amanda Harris
- Southampton Children's Hospital, University of Southampton, Southampton, UK
- Primary Ciliary Dyskinesia Centre, NIHR Respiratory Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Isolde Hayn
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Hasnaa Ismail-Koch
- Primary Ciliary Dyskinesia Centre, Southampton Children's Hospital, Southampton NHS Foundation Trust, Southampton, UK
| | - Bülent Karadag
- Department of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Céline Kempeneers
- Division of Respirology, Department of Pediatrics, University Hospital Liège, Liège, Belgium
| | - Sookyung Kim
- Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Hôpital Bicêtre, Service d'ORL, Le Kremlin-Bicêtre, France
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Natalie Lorent
- Department of Respiratory Diseases, University Hospital, Leuven, Belgium
| | - Ugur Ozcelik
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Charlotte Pioch
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Ana Reula
- Biomedical Sciences Department, CEU-Cardenal Herrera University, Castellón, Spain
- Molecular, Cellular and Genomic Biomedicine Group, IIS La Fe, Valencia, Spain
| | - Jobst Roehmel
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Panayiotis Yiallouros
- Medical School, University of Cyprus, Nicosia, Cyprus
- Pediatric Pulmonology Unit, Hospital “Archbishop Makarios III”, Nicosia, Cyprus
| | | | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, University Hospital, University of Bern, Bern, Switzerland
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18
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Mallet MC, Mozun R, Pedersen ESL, Ardura-Garcia C, Gaillard EA, Latzin P, Moelller A, Kuehni CE. Prevalence of childhood cough in epidemiological studies depends on the question used: findings from two population-based studies. Swiss Med Wkly 2023; 153:40044. [PMID: 36912371 DOI: 10.57187/smw.2023.40044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Epidemiological studies use different questions to assess recurrent cough in children. In two independent population-based studies, we assessed how prevalence estimates of cough vary depending on the questions parents are asked about their child's cough and how answers to the different questions overlap. METHODS We analysed cross-sectional data from two population-based studies on respiratory health: LuftiBus in the School (LUIS), conducted in 2013-2016 among 6- to 17-year-school children in the Canton of Zurich, Switzerland, and the 1998 Leicester Respiratory Cohort (LRC) study, UK where we used data from 6- to 8-year-old children from the 2003 follow-up survey. Both studies used parental questionnaires that included the same three questions on the child's cough, namely cough without a cold, dry cough at night and coughing more than others. We assessed how the prevalence of cough varied depending on the question and how answers to the different questions on cough overlapped. We also assessed how results were influenced by age, sex, presence of wheeze and parental education. RESULTS We included 3457 children aged 6-17 years from LUIS and 2100 children aged 6-8 years from LRC. All respiratory outcomes - cough, wheeze and physician-diagnosed asthma - were reported twice as often in the LRC as in LUIS. We found large differences in the prevalence of parent-reported cough between the three cough questions. In LUIS, 880 (25%) parents reported cough without a cold, 394 (11%) dry night cough, and 159 (5%) reported that their child coughed more than other children. In the LRC, these numbers were 1003 (48%), 527 (25%) and 227 (11%). There was only partial overlap of answers, with 89 (3%) answering yes to all questions in LUIS and 168 (8%) in LRC. Prevalence of all types of cough and overlap between the cough questions was higher in children with current wheeze. CONCLUSION In both population-based studies prevalence estimates of cough depended strongly on the question used to assess cough with only partial overlap of responses to different questions. Epidemiological studies on cough can only be compared if they used exactly the same questions for cough.
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Affiliation(s)
- Maria Christina Mallet
- Institute of Social and Preventive Medicine, University of Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Switzerland
| | - Rebeca Mozun
- Institute of Social and Preventive Medicine, University of Bern, Switzerland.,Department of Intensive Care and Neonatology, and Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Switzerland
| | - Eva S L Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Switzerland
| | | | - Erol A Gaillard
- Institute for Lung Health, Department of Respiratory Sciences, College of Life Sciences, Department of Paediatrics, NIHR Biomedical Research Centre: Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Alexander Moelller
- Department of Respiratory Medicine, University Children's Hospital Zurich and Children's Research Centre, University of Zurich, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Switzerland.,Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
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19
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Beydon N, Kouis P, Marthin JK, Latzin P, Colas M, Davis SD, Haarman E, Harris AL, Hogg C, Kilbride E, Kuehni CE, Marangu D, Nielsen KG, Pendergrast C, Robinson P, Rumman N, Rutter M, Walker WT, Ferkol T, Lucas JS. Nasal nitric oxide measurement in children for the diagnosis of primary ciliary dyskinesia: European Respiratory Society technical standard. Eur Respir J 2023; 61:13993003.02031-2022. [PMID: 36822632 DOI: 10.1183/13993003.02031-2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/11/2023] [Indexed: 02/25/2023]
Abstract
Nasal nitric oxide (nNO) is extremely low in most people with primary ciliary dyskinesia (PCD) and its measurement is an important contributor to making the diagnosis. Existing guidelines and technical standards focus on nNO measurements in older, cooperative children using chemiluminescent analysers. However, measurements of nNO in pre-school children (2-5 years) may facilitate early diagnosis, and electrochemical rather than chemiluminescence analysers are widely used. Pre-schoolers often need different methods to be employed when measuring nNO. Hence a European Respiratory Society Task Force has developed this technical standard as the first step towards standardising sampling, analysis, and reporting of nNO measured as part of the diagnostic testing for PCD in all age groups including preschool-age children. Furthermore, we considered both chemiluminescence and electrochemical analysers that are in use worldwide. There was paucity of quality evidence for electrochemical analysers and sampling methods used in young children, and this manuscript proposes future research priorities to allow updates of this technical standard.
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Affiliation(s)
- Nicole Beydon
- AP-HP.Sorbonne Université, Unité Fonctionnelle de Physiologie - Explorations Fonctionnelles Respiratoires et du Sommeil, Hôpital Armand Trousseau.,Sorbonne Université, INSERM U938, Centre de Recherche Saint Antoine, Hôpital Saint-Antoine, Paris, France.,Nicole Beydon and Jane SA Lucas co-chaired the task force and contributed equally
| | - Panayotis Kouis
- Respiratory Physiology Laboratory, Medical School, University of Cyprus
| | - June K Marthin
- Danish PCD Centre Copenhagen, Paediatric Pulmonary Service, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Philipp Latzin
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | | | - Stephanie D Davis
- Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, UNC Children's, Chapel Hill, NC, USA
| | - Eric Haarman
- Dept of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Amanda Lea Harris
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Primary Ciliary Dyskinesia Centre, NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton
| | - Claire Hogg
- Department Paediatric Respiratory Medicine and Primary Ciliary Dyskinesia Centre, Royal Brompton Hospital, London, Imperial College London
| | - Emma Kilbride
- Paediatric Respiratory Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Claudia E Kuehni
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Diana Marangu
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Kim G Nielsen
- Danish PCD Centre Copenhagen, Paediatric Pulmonary Service, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Catherine Pendergrast
- Lung Function Laboratory, Dept Respiratory & Sleep Medicine, Women's & Children's Hospital, Adelaide, Australia.,Innovation, Implementation and Clinical Translation in Health (IIMPACT) Research Concentration, University of South Australia, Adelaide, Australia
| | - Phil Robinson
- Dept of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Australia.,Dept of Paediatrics, University of Melbourne, Parkville, Australia.,Murdoch Children's Research Institute, Parkville, Australia
| | - Nisreen Rumman
- Department of Pediatrics, Makassed Hospital, East Jerusalem, Palestine.,Caritas Baby Hospital, Bethlehem, Palestine
| | - Matthew Rutter
- Lung Function Department, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Woolf T Walker
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Primary Ciliary Dyskinesia Centre, NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton
| | - Thomas Ferkol
- Departments of Pediatrics, Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK .,Primary Ciliary Dyskinesia Centre, NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton.,Nicole Beydon and Jane SA Lucas co-chaired the task force and contributed equally
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20
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Gorlanova O, Oller H, Marten A, Müller L, Laine-Carmelli J, Decrue F, Salem Y, Vienneau D, Hoogh KD, Gisler A, Usemann J, Korten I, Yammine S, Nahum U, Künstle N, Sinues P, Schulzke S, Latzin P, Fuchs O, Röösli M, Schaub B, Frey U. Ambient prenatal air pollution exposure is associated with low cord blood IL-17a in infants. Pediatr Allergy Immunol 2023; 34:e13902. [PMID: 36705042 DOI: 10.1111/pai.13902] [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] [Received: 06/21/2022] [Revised: 11/24/2022] [Accepted: 12/05/2022] [Indexed: 01/03/2023]
Affiliation(s)
- Olga Gorlanova
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Heide Oller
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Andrea Marten
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Loretta Müller
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Fabienne Decrue
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Yasmin Salem
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Amanda Gisler
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Insa Korten
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Uri Nahum
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Noemi Künstle
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Pablo Sinues
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Sven Schulzke
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Philipp Latzin
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Oliver Fuchs
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Bianca Schaub
- Department of Pulmonary and Allergy, Dr. von Hauner Children's Hospital, LMU, University of Munich, Munich, Germany
| | - Urs Frey
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | -
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.,Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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21
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Postma AV, Rapp CK, Knoflach K, Volk AE, Lemke JR, Ackermann M, Regamey N, Latzin P, Celant L, Jansen SM, Bogaard HJ, Ilgun A, Alders M, van Spaendonck-Zwarts KY, Jonigk D, Klein C, Gräf S, Kubisch C, Houweling AC, Griese M. Biallelic variants in the calpain regulatory subunit CAPNS1 cause pulmonary arterial hypertension. Genet Med Open 2023; 1:100811. [PMID: 38230350 PMCID: PMC10790724 DOI: 10.1016/j.gimo.2023.100811] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 01/18/2024]
Abstract
Purpose The aim of this study was to identify the monogenic cause of pulmonary arterial hypertension (PAH), a multifactorial and often fatal disease, in 2 unrelated consanguine families. Methods We performed exome sequencing and validated variant pathogenicity by whole-blood RNA and protein expression analysis in both families. Further RNA sequencing of preserved lung tissue was performed to investigate the consequences on selected genes that are involved in angiogenesis, proliferation, and apoptosis. Results We identified 2 rare biallelic variants in CAPNS1, encoding the regulatory subunit of calpain. The variants cosegregated with PAH in the families. Both variants lead to loss of function (LoF), which is demonstrated by aberrant splicing resulting in the complete absence of the CAPNS1 protein in affected patients. No other LoF CAPNS1 variant was identified in the genome data of more than 1000 patients with unresolved PAH. Conclusion The calpain holoenzyme was previously linked to pulmonary vascular development and progression of PAH in patients. We demonstrated that biallelic LoF variants in CAPNS1 can cause idiopathic PAH by the complete absence of CAPNS1 protein. Screening of this gene in patients who are affected by PAH, especially with suspected autosomal recessive inheritance, should be considered.
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Affiliation(s)
- Alex V. Postma
- Department of Medical Biology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
- Department of Human Genetics, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Christina K. Rapp
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, LMU Klinikum, Ludwig Maximilians University of Munich, German Center for Lung Research (DZL), Munich, Germany
| | - Katrin Knoflach
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, LMU Klinikum, Ludwig Maximilians University of Munich, German Center for Lung Research (DZL), Munich, Germany
| | - Alexander E. Volk
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes R. Lemke
- Institute of Human Genetics, Leipzig University Medical Center, Leipzig, Germany
- Center for Rare Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Nicolas Regamey
- Division of Paediatric Pulmonology, Children’s Hospital, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Lucas Celant
- Department of Pulmonary Medicine, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Samara M.A. Jansen
- Department of Pulmonary Medicine, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Harm J. Bogaard
- Department of Pulmonary Medicine, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Aho Ilgun
- Department of Human Genetics, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Mariëlle Alders
- Department of Human Genetics, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | | | - Danny Jonigk
- Institute of Pathology, Medizinische Hochschule Hannover, Hanover, Germany
| | - Christoph Klein
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, LMU Klinikum, Ludwig Maximilians University of Munich, German Center for Lung Research (DZL), Munich, Germany
| | - Stefan Gräf
- Department of Medicine, University of Cambridge, Heart and Lung Research Institute, Cambridge, United Kingdom
- NIHR BioResource for Translational Research–Rare Diseases, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Christian Kubisch
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Arjan C. Houweling
- Department of Human Genetics, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Matthias Griese
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, LMU Klinikum, Ludwig Maximilians University of Munich, German Center for Lung Research (DZL), Munich, Germany
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22
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Kentgens AC, Pusterla O, Bauman G, Santini F, Wyler F, Curdy MS, Willers CC, Bieri O, Latzin P, Ramsey KA. SIMULTANEOUS MULTIPLE BREATH WASHOUT AND OXYGEN-ENHANCED MAGNETIC RESONANCE IMAGING IN HEALTHY ADULTS. Respir Med Res 2023; 83:100993. [PMID: 37058881 DOI: 10.1016/j.resmer.2023.100993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/23/2022] [Accepted: 12/26/2022] [Indexed: 01/11/2023]
Abstract
Lung function testing and lung imaging are commonly used techniques to monitor respiratory diseases, such as cystic fibrosis (CF). The nitrogen (N2) multiple-breath washout technique (MBW) has been shown to detect ventilation inhomogeneity in CF, but the underlying pathophysiological processes that are altered are often unclear. Dynamic oxygen-enhanced magnetic resonance imaging (OE-MRI) could potentially be performed simultaneously with MBW because both techniques require breathing of 100% oxygen (O2) and may allow for visualisation of alterations underlying impaired MBW outcomes. However, simultaneous MBW and OE-MRI has never been assessed, potentially as it requires a magnetic resonance (MR) compatible MBW equipment. In this pilot study, we assessed whether MBW and OE-MRI can be performed simultaneously using a commercial MBW device that has been modified to be MR-compatible. We performed simultaneous measurements in five healthy volunteers aged 25-35 years. We obtained O2 and N2 concentrations from both techniques, and generated O2 wash-in time constant and N2 washout maps from OE-MRI data. We obtained good quality simultaneous measurements in two healthy volunteers due to technical challenges related to the MBW equipment and poor tolerance. Oxygen and N2 concentrations from both techniques, as well as O2 wash-in time constant maps and N2 washout maps could be obtained, suggesting that simultaneous measurements may have the potential to allow for comparison and visualization of regional differences in ventilation underlying impaired MBW outcomes. Simultaneous MBW and OE-MRI measurements can be performed with a modified MBW device and may help to understand MBW outcomes, but the measurements are challenging and have poor feasibility.
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23
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Frauchiger BS, Ramsey KA, Usemann J, Kieninger E, Casaulta C, Sirtes D, Yammine S, Spycher B, Moeller A, Latzin P. Variability of clinically measured lung clearance index in children with cystic fibrosis. Pediatr Pulmonol 2023; 58:197-205. [PMID: 36251441 DOI: 10.1002/ppul.26180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/29/2022] [Accepted: 09/28/2022] [Indexed: 01/11/2023]
Abstract
RATIONALE The lung clearance index (LCI) is increasingly being used in the clinical surveillance of patients with cystic fibrosis (CF). However, there are limited data on long-term variability and physiologically relevant changes in LCI during routine clinical surveillance. OBJECTIVES To evaluate the long-term variability of LCI and propose a threshold for a physiologically relevant change. METHODS In children aged 4-18 years with CF, LCI was measured every 3 months as part of routine clinical surveillance during 2011-2020 in two centers. The variability of LCI during periods of clinical stability was assessed using mixed-effects models and was used to identify thresholds for physiologically relevant changes. RESULTS Repeated LCI measurements of acceptable quality (N = 858) were available in 100 patients with CF; for 74 patients, 399 visits at clinical stability were available. The variability of repeated LCI measurements over time expressed as the coefficient of variation (CV%) was 7.4%. The upper limit of normal (ULN) for relative changes in LCI between visits was 19%. CONCLUSION We report the variability of LCI in children and adolescents with CF during routine clinical surveillance. According to our data, a change in LCI beyond 19% may be considered physiologically relevant. These findings will help guide clinical decisions according to LCI changes.
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Affiliation(s)
- Bettina S Frauchiger
- Department of Pediatrics, Division of Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kathryn A Ramsey
- Department of Pediatrics, Division of Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jakob Usemann
- Division of Respiratory Medicine and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Elisabeth Kieninger
- Department of Pediatrics, Division of Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carmen Casaulta
- Department of Pediatrics, Division of Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel Sirtes
- Department of Pediatrics, Division of Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Department of Pediatrics, Division of Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ben Spycher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Alexander Moeller
- Division of Respiratory Medicine and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Philipp Latzin
- Department of Pediatrics, Division of Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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24
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Gisler A, Eeftens M, de Hoogh K, Vienneau D, Salem Y, Yammine S, Jakob J, Gorlanova O, Decrue F, Gehrig R, Frey U, Latzin P, Fuchs O, Usemann J, Decrue F, Frey U, Fuchs O, Gisler A, Gorlanova O, Kentgens A, Korten I, Kurz J, Latzin P, Nissen A, Oestreich M, Röösli M, Salem Y, Usemann J, Vienneau D. Pollen exposure is associated with risk of respiratory symptoms during the first year of life. Allergy 2022; 77:3606-3616. [PMID: 35302662 PMCID: PMC10078730 DOI: 10.1111/all.15284] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/12/2022] [Accepted: 02/14/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Pollen exposure is associated with respiratory symptoms in children and adults. However, the association of pollen exposure with respiratory symptoms during infancy, a particularly vulnerable period, remains unclear. We examined whether pollen exposure is associated with respiratory symptoms in infants and whether maternal atopy, infant's sex or air pollution modifies this association. METHODS We investigated 14,874 observations from 401 healthy infants of a prospective birth cohort. The association between pollen exposure and respiratory symptoms, assessed in weekly telephone interviews, was evaluated using generalized additive mixed models (GAMMs). Effect modification by maternal atopy, infant's sex, and air pollution (NO2 , PM2.5 ) was assessed with interaction terms. RESULTS Per infant, 37 ± 2 (mean ± SD) respiratory symptom scores were assessed during the analysis period (January through September). Pollen exposure was associated with increased respiratory symptoms during the daytime (RR [95% CI] per 10% pollen/m3 : combined 1.006 [1.002, 1.009]; tree 1.005 [1.002, 1.008]; grass 1.009 [1.000, 1.23]) and nighttime (combined 1.003 [0.999, 1.007]; tree 1.003 [0.999, 1.007]; grass 1.014 [1.004, 1.024]). While there was no effect modification by maternal atopy and infant's sex, a complex crossover interaction between combined pollen and PM2.5 was found (p-value 0.003). CONCLUSION Even as early as during the first year of life, pollen exposure was associated with an increased risk of respiratory symptoms, independent of maternal atopy and infant's sex. Because infancy is a particularly vulnerable period for lung development, the identified adverse effect of pollen exposure may be relevant for the evolvement of chronic childhood asthma.
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Affiliation(s)
- Amanda Gisler
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marloes Eeftens
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Yasmin Salem
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Julian Jakob
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Primary Health Care (BIHAM), Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fabienne Decrue
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Regula Gehrig
- Federal Office of Meteorology and Climatology MeteoSwiss, Zurich, Switzerland
| | - Urs Frey
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Oliver Fuchs
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Respiratory Medicine, University Children's Hospital of Zurich, Zurich, Switzerland
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25
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Oestreich MA, Wyler F, Frauchiger BS, Latzin P, Ramsey KA. Breath detection algorithms affect multiple-breath washout outcomes in pre-school and school age children. PLoS One 2022; 17:e0275866. [PMID: 36240198 PMCID: PMC9565421 DOI: 10.1371/journal.pone.0275866] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Background Accurate breath detection is essential for the computation of outcomes in the multiple-breath washout (MBW) technique. This is particularly important in young children, where irregular breathing is common, and the designation of inspirations and expirations can be challenging. Aim To investigate differences between a commercial and a novel breath-detection algorithm and to characterize effects on MBW outcomes in children. Methods We replicated the signal processing and algorithms used in Spiroware software (v3.3.1, Eco Medics AG). We developed a novel breath detection algorithm (custom) and compared it to Spiroware using 2,455 nitrogen (N2) and 325 sulfur hexafluoride (SF6) trials collected in infants, children, and adolescents. Results In 83% of N2 and 32% of SF6 trials, the Spiroware breath detection algorithm rejected breaths and did not use them for the calculation of MBW outcomes. Our custom breath detection algorithm determines inspirations and expirations based on flow reversal and corresponding CO2 elevations, and uses all breaths for data analysis. In trials with regular tidal breathing, there were no differences in outcomes between algorithms. However, in 10% of pre-school children tests the number of breaths detected differed by more than 10% and the commercial algorithm underestimated the lung clearance index by up to 21%. Conclusion Accurate breath detection is challenging in young children. As the MBW technique relies on the cumulative analysis of all washout breaths, the rejection of breaths should be limited. We provide an improved algorithm that accurately detects breaths based on both flow reversal and CO2 concentration.
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Affiliation(s)
- Marc-Alexander Oestreich
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Florian Wyler
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Bettina S. Frauchiger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kathryn A. Ramsey
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- * E-mail:
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26
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Willers CC, Frauchiger BS, Stranzinger E, Bauman G, Moeller A, Jung A, Hector A, Regamey N, Zanolari M, Mueller-Suter D, Lioba Kuhn A, Blanchon S, Rochat I, Latzin P, Ramsey KA. Feasibility of unsedated lung MRI in young children with cystic fibrosis. Eur Respir J 2022; 60:13993003.03112-2021. [PMID: 36137591 DOI: 10.1183/13993003.03112-2021] [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] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 08/30/2022] [Indexed: 11/05/2022]
Affiliation(s)
- C Corin Willers
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Bettina S Frauchiger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Enno Stranzinger
- Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Grzegorz Bauman
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Alexander Moeller
- Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research center, University of Zurich, Zurich, Switzerland
| | - Andreas Jung
- Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research center, University of Zurich, Zurich, Switzerland
| | - Andreas Hector
- Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research center, University of Zurich, Zurich, Switzerland
| | - Nicolas Regamey
- Division of Paediatric Pulmonology, Children's Hospital, Cantonal Hospital Lucerne, Switzerland
| | - Maura Zanolari
- Department of Paediatrics, Hospital of Bellinzona, Bellinzona, Switzerland
| | | | - Alena Lioba Kuhn
- Department of Paediatrics, Kantonsspital Aarau, Aarau, Switzerland
| | - Sylvain Blanchon
- Paediatric Pulmonology Unit, Department of Paediatrics, CHUV Lausanne, University Hospital of Lausanne, Lausanne, Switzerland
| | - Isabelle Rochat
- Paediatric Pulmonology Unit, Department of Paediatrics, CHUV Lausanne, University Hospital of Lausanne, Lausanne, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Kathryn A Ramsey
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland .,Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia
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27
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Oyewole ORA, Latzin P, Brugger SD, Hilty M. Strain-level resolution and pneumococcal carriage dynamics by single-molecule real-time (SMRT) sequencing of the plyNCR marker: a longitudinal study in Swiss infants. Microbiome 2022; 10:152. [PMID: 36138483 PMCID: PMC9502908 DOI: 10.1186/s40168-022-01344-6] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Pneumococcal carriage has often been studied from a serotype perspective; however, little is known about the strain-specific carriage and inter-strain interactions. Here, we examined the strain-level carriage and co-colonization dynamics of Streptococcus pneumoniae in a Swiss birth cohort by PacBio single-molecule real-time (SMRT) sequencing of the plyNCR marker. METHODS A total of 872 nasal swab (NS) samples were included from 47 healthy infants during the first year of life. Pneumococcal carriage was determined based on the quantitative real-time polymerase chain reaction (qPCR) targeting the lytA gene. The plyNCR marker was amplified from 214 samples having lytA-based carriage for pneumococcal strain resolution. Amplicons were sequenced using SMRT technology, and sequences were analyzed with the DADA2 pipeline. In addition, pneumococcal serotypes were determined using conventional, multiplex PCR (cPCR). RESULTS PCR-based plyNCR amplification demonstrated a 94.2% sensitivity and 100% specificity for Streptococcus pneumoniae if compared to lytA qPCR. The overall carriage prevalence was 63.8%, and pneumococcal co-colonization (≥ 2 plyNCR amplicon sequence variants (ASVs)) was detected in 38/213 (17.8%) sequenced samples with the relative proportion of the least abundant strain(s) ranging from 1.1 to 48.8% (median, 17.2%; IQR, 5.8-33.4%). The median age to first acquisition was 147 days, and having ≥ 2 siblings increased the risk of acquisition. CONCLUSION The plyNCR amplicon sequencing is species-specific and enables pneumococcal strain resolution. We therefore recommend its application for longitudinal strain-level carriage studies of Streptococcus pneumoniae. Video Abstract.
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Affiliation(s)
- Oluwaseun Rume-Abiola Oyewole
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3001, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Silvio D Brugger
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3001, Bern, Switzerland.
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28
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Peng S, Stojkov D, Gao J, Oberson K, Latzin P, Casaulta C, Yousefi S, Simon HU. Nascent RHOH acts as a molecular brake on actomyosin-mediated effector functions of inflammatory neutrophils. PLoS Biol 2022; 20:e3001794. [PMID: 36108062 PMCID: PMC9514642 DOI: 10.1371/journal.pbio.3001794] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 09/27/2022] [Accepted: 08/11/2022] [Indexed: 12/22/2022] Open
Abstract
In contrast to molecular changes associated with increased inflammatory responses, little is known about intracellular counter-regulatory mechanisms that control signaling cascades associated with functional responses of neutrophils. Active RHO GTPases are typically considered as effector proteins that elicit cellular responses. Strikingly, we show here that RHOH, although being constitutively GTP-bound, limits neutrophil degranulation and the formation of neutrophil extracellular traps (NETs). Mechanistically, RHOH is induced under inflammatory conditions and binds to non-muscle myosin heavy chain IIA (NMHC IIA) in activated neutrophils in order to inhibit the transport of mitochondria and granules along actin filaments, which is partially reverted upon disruption of the interaction with NMHC IIA by introducing a mutation in RhoH at lysine 34 (RhoHK34A). In parallel, RHOH inhibits actin polymerization presumably by modulating RAC1 activity. In vivo studies using Rhoh-/- mice, demonstrate an increased antibacterial defense capability against Escherichia coli (E. coli). Collectively, our data reveal a previously undefined role of RHOH as a molecular brake for actomyosin-mediated neutrophil effector functions, which represents an intracellular regulatory axis involved in controlling the strength of an antibacterial inflammatory response.
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Affiliation(s)
- Shuang Peng
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Darko Stojkov
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Jian Gao
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Biotechnology and Pharmaceutical Sciences, School of Life Sciences, Nanjing University, Nanjing, China
| | - Kevin Oberson
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Respiratory Medicine, Department of Pediatrics, University Children’s Hospital of Bern, University of Bern, Bern, Switzerland
| | - Carmen Casaulta
- Division of Respiratory Medicine, Department of Pediatrics, University Children’s Hospital of Bern, University of Bern, Bern, Switzerland
| | - Shida Yousefi
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Hans-Uwe Simon
- Institute of Pharmacology, University of Bern, Bern, Switzerland
- Department of Clinical Immunology and Allergology, Sechenov University, Moscow, Russia
- Laboratory of Molecular Immunology, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
- Institute of Biochemistry, Brandenburg Medical School, Neuruppin, Germany
- * E-mail:
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29
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Latzin P. Liebe Freundinnen und Freunde, liebe Kolleginnen und Kollegen,. Klin Padiatr 2022. [DOI: 10.1055/a-1901-3655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Nach der virtuellen Jahrestagung 2021 in Hamburg und der kurzfristigen Verschiebung
des Termins für die Jahrestagung 2022 ist es jetzt hoffentlich bald wieder
soweit: wir treffen uns persönlich auf einer echten Jahrestagung und
können uns austauschen und gemeinsam diskutieren (vielleicht sogar ohne
Maske). Ich freue mich sehr darauf und hoffe, dass viele von Euch nach Bern kommen
können!
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30
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Usemann J, Mozún R, Kuehni CE, de Hoogh K, Flückiger B, Singer F, Moeller A, Latzin P. Air pollution exposure during pregnancy and lung development during
childhood: the LUIS study. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754477] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- J Usemann
- University Children’s Hospital Zurich and Childhood Research
Center, Zurich, Switzerland, Department of Respiratory Medicine, Zurich,
Switzerland
| | - R Mozún
- University of Bern, Switzerland, Institute of Social and Preventive
Medicine, Bern, Switzerland
| | - CE Kuehni
- University of Bern, Switzerland, Institute of Social and Preventive
Medicine, Bern, Switzerland
| | - K de Hoogh
- Basel, Switzerland, Swiss Tropical and Public Health Institute, Basel,
Switzerland
| | - B Flückiger
- Basel, Switzerland, Swiss Tropical and Public Health Institute, Basel,
Switzerland
| | - F Singer
- University Children’s Hospital Zurich and Childhood Research
Center, Zurich, Switzerland, Department of Respiratory Medicine, Zurich,
Switzerland
| | - A Moeller
- University Children’s Hospital Zurich and Childhood Research
Center, Zurich, Switzerland, Department of Respiratory Medicine, Zurich,
Switzerland
| | - P Latzin
- University of Bern, Switzerland, Institute of Social and Preventive
Medicine, Bern, Switzerland
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31
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Kentgens AC, Pusterla O, Bauman G, Santini F, Wyler F, Willers CC, Bieri O, Latzin P, Ramsey K. Simultaneous nitrogen multiple-breath washout and oxygen-enhanced
lung MRI. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754480] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- A-C Kentgens
- Inselspital, Bern University Hospital, University of Bern, Division of
Respiratory Medicine and Allergology, Department of Paediatrics, Bern,
Switzerland
- Graduate School for Health Sciences, University of Bern, Bern,
Switzerland
| | - O Pusterla
- University Hospital Basel, Division of Radiological Physics, Department
of Radiology, Basel, Switzerland
- University of Basel, Department of Biomedical Engineering, Basel,
Switzerland
| | - G Bauman
- University Hospital Basel, Division of Radiological Physics, Department
of Radiology, Basel, Switzerland
- University of Basel, Department of Biomedical Engineering, Basel,
Switzerland
| | - F Santini
- University Hospital Basel, Division of Radiological Physics, Department
of Radiology, Basel, Switzerland
- University of Basel, Department of Biomedical Engineering, Basel,
Switzerland
| | - F Wyler
- Inselspital, Bern University Hospital, University of Bern, Division of
Respiratory Medicine and Allergology, Department of Paediatrics, Bern,
Switzerland
| | - CC Willers
- Inselspital, Bern University Hospital, University of Bern, Division of
Respiratory Medicine and Allergology, Department of Paediatrics, Bern,
Switzerland
| | - O Bieri
- University Hospital Basel, Division of Radiological Physics, Department
of Radiology, Basel, Switzerland
- University of Basel, Department of Biomedical Engineering, Basel,
Switzerland
| | - P Latzin
- Inselspital, Bern University Hospital, University of Bern, Division of
Respiratory Medicine and Allergology, Department of Paediatrics, Bern,
Switzerland
| | - K Ramsey
- Inselspital, Bern University Hospital, University of Bern, Division of
Respiratory Medicine and Allergology, Department of Paediatrics, Bern,
Switzerland
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32
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Mallet MC, Pedersen ESL, Makhoul R, Blanchon S, Hoyler K, Jochmann A, Latzin P, Moeller A, Regamey N, Sutter O, Goutaki M, Spycher BD, Kuehni CE. Cough phenotypes in children: findings from the Swiss Paediatric
Airway Cohort. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754456] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- MC Mallet
- Institute of Social and Preventive Medicine, University of Bern, Bern,
Switzerland
| | - ESL Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Bern,
Switzerland
| | - R Makhoul
- Institute of Social and Preventive Medicine, University of Bern, Bern,
Switzerland
| | - S Blanchon
- Unité de pneumologie et de mucoviscidose pédiatrique,
Département Femme-Mère-Enfant, CHUV et Université de
Lausanne, Lausanne, Switzerland
| | - K Hoyler
- Kinderpneumologie Horgen, Private Practice for Paediatric Pneumology,
Horgen, Switzerland
| | - A Jochmann
- Department of Paediatric Pulmonology, University Children’s
Hospital Basel, Basel, Switzerland
| | - P Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department
of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern,
Switzerland
| | - A Moeller
- Department of Respiratory Medicine, University Children’s
Hospital Zurich and Children’s Research Centre, University of Zurich,
Zurich, Switzerland
| | - N Regamey
- Division of Paediatric Pulmonology, Children's Hospital,
Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - O Sutter
- Paediatric Practice, Worb, Switzerland
| | - M Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern,
Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department
of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern,
Switzerland
| | - BD Spycher
- Institute of Social and Preventive Medicine, University of Bern, Bern,
Switzerland
| | - CE Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern,
Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department
of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern,
Switzerland
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Kentgens AC, Latzin P, Anagnostopoulou P, Jensen R, Stahl M, Harper A, Yammine S, Foong RE, Hall GL, Singer F, Stanojevic S, Mall MA, Ratjen F, Ramsey KA. Normative multiple breath washout data in school-aged children corrected for sensor error. Eur Respir J 2022; 60:13993003.02398-2021. [PMID: 35710262 DOI: 10.1183/13993003.02398-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 06/07/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Anne-Christianne Kentgens
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Pinelopi Anagnostopoulou
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland.,Insitute of Anatomy, University of Bern, Bern, Switzerland.,Medical School, University of Cyprus, Nicosia, Cyprus
| | - Renee Jensen
- Division of Respiratory Medicine, The Hospital for Sick Children and Translational Medicine, SickKids Research Institute, University of Toronto, Toronto, ON, Canada
| | - Mirjam Stahl
- Dept of Translational Pulmonology, Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.,Division of Pediatric Pulmonology and Allergy and Cystic Fibrosis Center, Dept of Pediatrics, University of Heidelberg, Heidelberg, Germany.,Department of Pediatric Respiratory Medicine, Immunology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health at Charité, Universitätsmedizin Berlin, Berlin, Germany.,German Center for Lung Research (DZL), associated partner, Berlin, Germany
| | - Alana Harper
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, Australia
| | - Sophie Yammine
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Rachel E Foong
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, Australia.,School of Allied Health, Curtin University, Perth, Australia
| | - Graham L Hall
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, Australia.,School of Allied Health, Curtin University, Perth, Australia
| | - Florian Singer
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Sanja Stanojevic
- Division of Respiratory Medicine, The Hospital for Sick Children and Translational Medicine, SickKids Research Institute, University of Toronto, Toronto, ON, Canada
| | - Marcus A Mall
- Department of Pediatric Respiratory Medicine, Immunology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health at Charité, Universitätsmedizin Berlin, Berlin, Germany.,German Center for Lung Research (DZL), associated partner, Berlin, Germany
| | - Felix Ratjen
- Division of Respiratory Medicine, The Hospital for Sick Children and Translational Medicine, SickKids Research Institute, University of Toronto, Toronto, ON, Canada
| | - Kathryn A Ramsey
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland .,Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, Australia.,School of Child Health Research, University of Western Australia, Perth, Australia
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Frauchiger BS, Oestreich MA, Wyler F, Monney N, Willers C, Yammine S, Latzin P. Do clinimetric properties of LCI change after correction of signal processing? Pediatr Pulmonol 2022; 57:1180-1187. [PMID: 35182057 PMCID: PMC9314934 DOI: 10.1002/ppul.25865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/31/2022] [Accepted: 02/12/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The recently described sensor-crosstalk error in the multiple-breath washout (MBW) device Exhalyzer D (Eco Medics AG) could highly influence clinimetric properties and the current interpretation of MBW results. This study reanalyzes MBW data from clinical routine in the corrected software version Spiroware® 3.3.1 and evaluates the effect on outcomes. METHODS We included nitrogen-MBW data from healthy children and children with cystic fibrosis (CF) from previously published trials and ongoing cohort studies. We specifically compared lung clearance index (LCI) analyzed in Spiroware 3.2.1 and 3.3.1 with regard to (i) feasibility, (ii) repeatability, and (iii) validity as outcome parameters in children with CF. RESULTS (i) All previously collected measurements could be reanalyzed and resulted in unchanged feasibility in Spiroware 3.3.1. (ii) Short- and midterm repeatability of LCI was similar in both software versions. (iii) Clinical validity of LCI remained similar in Spiroware 3.3.1; however, this resulted in lower values. Discrimination between health and disease was comparable between both software versions. The increase in LCI over time was less pronounced with 0.16 LCI units/year (95% confidence interval [CI] 0.08; 0.24) versus 0.30 LCI units/year (95% CI 0.21; 0.38) in 3.2.1. Response to intervention in children receiving CF transmembrane conductance-modulator therapy resulted in a comparable improvement in LCI, in both Spiroware versions. CONCLUSION Our study confirms that clinimetric properties of LCI remain unaffected after correction for the cross-sensitivity error in Spiroware software.
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Affiliation(s)
- Bettina S Frauchiger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marc-Alexander Oestreich
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Florian Wyler
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nathalie Monney
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Corin Willers
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Pusterla O, Heule R, Santini F, Weikert T, Willers C, Andermatt S, Sandkühler R, Nyilas S, Latzin P, Bieri O, Bauman G. MRI lung lobe segmentation in pediatric cystic fibrosis patients using a recurrent neural network trained with publicly accessible CT datasets. Magn Reson Med 2022; 88:391-405. [PMID: 35348244 PMCID: PMC9314108 DOI: 10.1002/mrm.29184] [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: 08/30/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 11/30/2022]
Abstract
Purpose To introduce a widely applicable workflow for pulmonary lobe segmentation of MR images using a recurrent neural network (RNN) trained with chest CT datasets. The feasibility is demonstrated for 2D coronal ultrafast balanced SSFP (ufSSFP) MRI. Methods Lung lobes of 250 publicly accessible CT datasets of adults were segmented with an open‐source CT‐specific algorithm. To match 2D ufSSFP MRI data of pediatric patients, both CT data and segmentations were translated into pseudo‐MR images that were masked to suppress anatomy outside the lung. Network‐1 was trained with pseudo‐MR images and lobe segmentations and then applied to 1000 masked ufSSFP images to predict lobe segmentations. These outputs were directly used as targets to train Network‐2 and Network‐3 with non‐masked ufSSFP data as inputs, as well as an additional whole‐lung mask as input for Network‐2. Network predictions were compared to reference manual lobe segmentations of ufSSFP data in 20 pediatric cystic fibrosis patients. Manual lobe segmentations were performed by splitting available whole‐lung segmentations into lobes. Results Network‐1 was able to segment the lobes of ufSSFP images, and Network‐2 and Network‐3 further increased segmentation accuracy and robustness. The average all‐lobe Dice similarity coefficients were 95.0 ± 2.8 (mean ± pooled SD [%]) and 96.4 ± 2.5, 93.0 ± 2.0; and the average median Hausdorff distances were 6.1 ± 0.9 (mean ± SD [mm]), 5.3 ± 1.1, 7.1 ± 1.3 for Network‐1, Network‐2, and Network‐3, respectively. Conclusion Recurrent neural network lung lobe segmentation of 2D ufSSFP imaging is feasible, in good agreement with manual segmentations. The proposed workflow might provide access to automated lobe segmentations for various lung MRI examinations and quantitative analyses.
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Affiliation(s)
- Orso Pusterla
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland.,Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Rahel Heule
- High Field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Francesco Santini
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Thomas Weikert
- Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Corin Willers
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Simon Andermatt
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Robin Sandkühler
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Sylvia Nyilas
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Philipp Latzin
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Oliver Bieri
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Grzegorz Bauman
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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Halbeisen FS, Pedersen ESL, Goutaki M, Spycher BD, Amirav I, Boon M, Malena CC, Crowley S, Emiralioglu N, Haarman EG, Karadag B, Koerner-Rettberg C, Latzin P, Loebinger MR, Lucas JS, Mazurek H, Morgan L, Marthin J, Pohunek P, Santamaria F, Schwerk N, Thouvenin G, Yiallouros P, Nielsen KG, Kuehni CE. Lung function from school age to adulthood in primary ciliary dyskinesia. Eur Respir J 2022; 60:13993003.01918-2021. [PMID: 35301251 DOI: 10.1183/13993003.01918-2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 02/26/2022] [Indexed: 11/05/2022]
Abstract
Primary ciliary dyskinesia (PCD) presents with symptoms early in life and the disease course may be progressive, but longitudinal data on lung function are scarce. This multinational cohort study describes lung function trajectories in children, adolescents, and young adults with PCD. We analysed data from 486 patients with repeated lung function measurements obtained between the age of 6 and 24 years from the international PCD Cohort (iPCD) and calculated z-scores for forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio using the Global Lung Function Initiative 2012 references. We described baseline lung function and change of lung function over time and described their associations with possible determinants in mixed-effects linear regression models. Overall, FEV1, FVC, and FEV1/FVC z-scores declined over time (average crude annual FEV1 decline was -0.07 z-scores) but not at the same rate for all patients. FEV1 z-scores improved over time in 21% of patients, remained stable in 40% and declined in 39%. Low BMI was associated with poor baseline lung function and with further decline. Results differed by country and ultrastructural defect, but we found no evidence of differences by sex, calendar year of diagnosis, age at diagnosis, diagnostic certainty, or laterality defect. Our study shows that on average lung function in PCD declines throughout the entire period of lung growth, from childhood to young adult age, even among patients treated in specialised centres. It is essential to develop strategies to reverse this tendency and improve prognosis.
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Affiliation(s)
- Florian S Halbeisen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.,These authors contributed equally to the manuscript
| | - Eva S L Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,These authors contributed equally to the manuscript
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Bern, Switzerland
| | - Ben D Spycher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Israel Amirav
- The PCD Israeli Consortium.,Department of Pediatrics, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Mieke Boon
- Department of Paediatrics, University Hospital Gasthuisberg, Leuven, Belgium
| | - Cohen-Cymberknoh Malena
- Pediatric Pulmonology Unit and Cystic fibrosis Center, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Suzanne Crowley
- Paediatric Department of Allergy and Lung Diseases, Oslo University Hospital, Oslo, Norway
| | - Nagehan Emiralioglu
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Eric G Haarman
- Department of Pediatric Pulmonology, Emma Children's Hospital, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bulent Karadag
- Department of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Cordula Koerner-Rettberg
- Department of Paediatric Pneumology, University Children's Hospital of Ruhr University Bochum, Bochum, Germany
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Bern, Switzerland.,on behalf of the Swiss PCD Group
| | - Michael R Loebinger
- Host Defence Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, London, UK
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, NIHR Respiratory Biomedical Research Centre, University of Southampton and University Hospital, Southampton, UK
| | - Henryk Mazurek
- Department of Pneumonology and Cystic Fibrosis, Institute of Tuberculosis and Lung Disorders, ul.Prof.Rudnika 3b, Rabka - Zdrój, Poland
| | - Lucy Morgan
- Department of Respiratory Medicine, Concord Hospital Clinical School, University of Sydney, Sydney, Australia
| | - June Marthin
- Department of Respiratory Medicine, Concord Hospital Clinical School, University of Sydney, Sydney, Australia
| | - Petr Pohunek
- Paediatric Department, 2nd Faculty of Medicine, Charles University Prague and University Hospital Motol, Prague, Czech Republic
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Napoli, Italy
| | - Nicolaus Schwerk
- Clinic for paediatric pneumology, allergology and neonatology, Hannover Medical School, Hannover, Germany
| | - Guillaume Thouvenin
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, Paris, France.,on behalf of the French Reference Centre for Rare Lung Diseases RespiRare®
| | | | - Kim G Nielsen
- Danish PCD Centre Copenhagen, Paediatric Pulmonary Service, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland .,Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Bern, Switzerland
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Mozun R, Ardura-Garcia C, Pedersen ESL, Usemann J, Singer F, Latzin P, Moeller A, Kuehni CE. Age and body mass index affect fit of spirometry GLI references in schoolchildren. ERJ Open Res 2022; 8:00618-2021. [PMID: 35449761 PMCID: PMC9016172 DOI: 10.1183/23120541.00618-2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/17/2022] [Indexed: 11/27/2022] Open
Abstract
Background References from the Global Lung Function Initiative (GLI) are widely used to interpret children's spirometry results. We assessed fit for healthy schoolchildren. Methods LuftiBus in the School was a population-based cross-sectional study undertaken in 2013–2016 in the canton of Zurich, Switzerland. Parents and their children aged 6–17 years answered questionnaires about respiratory symptoms and lifestyle. Children underwent spirometry in a mobile lung function lab. We calculated GLI-based z-scores for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC and forced expiratory flow for 25–75% of FVC (FEF25–75) for healthy White participants. We defined appropriate fit to GLI references by mean values between +0.5 and −0.5 z-scores. We assessed whether fit varied by age, body mass index, height and sex using linear regression models. Results We analysed data from 2036 children with valid FEV1 measurements, of whom 1762 also had valid FVC measurements. The median age was 12.2 years. Fit was appropriate for children aged 6–11 years for all indices. In adolescents aged 12–17 years, fit was appropriate for FEV1/FVC z-scores (mean±sd −0.09±1.02), but not for FEV1 (−0.62±0.98), FVC (−0.60±0.98) and FEF25–75 (−0.54±1.02). Mean FEV1, FVC and FEF25–75 z-scores fitted better in children considered overweight (−0.25, −0.13 and −0.38, respectively) than normal weight (−0.55, −0.50 and −0.55, respectively; p-trend <0.001, 0.014 and <0.001, respectively). FEV1, FVC and FEF25–75 z-scores depended on both age and height (p-interaction 0.033, 0.019 and <0.001, respectively). Conclusion GLI-based FEV1, FVC, and FEF25–75 z-scores do not fit White Swiss adolescents well. This should be considered when using reference equations for clinical decision-making, research and international comparison. This study suggests GLI-based FEV1, FVC and FEF25–75% z-scores over-detect abnormal lung function in Swiss adolescents, and more so among slimmer adolescents, which has important implications for clinical care, research and international comparisonshttps://bit.ly/3sbGtAS
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Beydon N, Ferkol T, Harris AL, Colas M, Davis SD, Haarman E, Hogg C, Kilbride E, Kouis P, Kuehni CE, Latzin P, Marangu D, Marthin J, Nielsen KG, Robinson P, Rumman N, Rutter M, Walker W, Lucas JS. An international survey on nasal nitric oxide measurement practices for the diagnosis of primary ciliary dyskinesia. ERJ Open Res 2022; 8:00708-2021. [PMID: 35386825 PMCID: PMC8977594 DOI: 10.1183/23120541.00708-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/14/2022] [Indexed: 11/05/2022] Open
Abstract
Nasal nitric oxide (nNO) measurements are routinely used in the assessment of patients suspected to have primary ciliary dyskinesia (PCD), but recommendations for performing such measurements have not focused on children and do not include all current practices. To guide the development of a European Respiratory Society-supported technical standard for nNO measurements in children, an international online survey was conducted to better understand current practices for measuring nNO among providers involved in PCD diagnostics.Seventy-eight professionals responded, representing 65 centres across 18 countries, mainly located in Europe and North America. Nearly all centres measured nNO in children and more than half of them performed measurements before 5-years of age. The test was often postponed in children with signs of acute airway infection. In Europe, the electrochemical technique was more frequently used than chemiluminescence. A similar proportion of centres performed measurements during exhalation against a resistance (49/65) or during tidal breathing (50/65) with 15 centres using only exhalation against a resistance and 15 centres using only tidal breathing. The cut-off values used to discriminate PCD was consistent across centres using chemiluminescence analyzers and these centres reported results as an output (nL.min−1). However, cut-off values were highly variable across centres using electrochemical devices, and nNO concentrations were typically reported as ppb.This survey represents the first to determine real-world use of nNO measurements worldwide and revealed remarkable variability in methodology, equipment, and interpretation. These findings will be useful to standardise methods and training.
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Salem Y, Oestreich MA, Fuchs O, Usemann J, Frey U, Surbek D, Amylidi-Mohr S, Latzin P, Ramsey K, Yammine S. Are children born by cesarean delivery at higher risk for respiratory sequelae? Am J Obstet Gynecol 2022; 226:257.e1-257.e11. [PMID: 34364843 DOI: 10.1016/j.ajog.2021.07.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/19/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Globally, the number of children born by cesarean delivery is constantly increasing. However, hormonal and physiological changes associated with labor and vaginal delivery are considered necessary for lung maturation. OBJECTIVE We aimed to assess whether the mode of delivery is associated with changes in respiratory and atopic outcomes during infancy and at school age. STUDY DESIGN We included 578 children, born at ≥37 weeks of gestation, from a prospective birth cohort study. We compared weekly respiratory symptoms throughout the first year of life and infant lung function (tidal breathing and multiple-breath washout) at 5 weeks of age between children born by cesarean delivery (N=114) and those born by vaginal delivery (N=464) after term pregnancy in healthy women. At a follow-up visit conducted at 6 years of age (N=371, of which 65 were delivered by cesarean delivery), we assessed respiratory, atopic, and lung function outcomes (spirometry, body plethysmography, and multiple-breath washout). We performed adjusted regression analyses to examine the association between cesarean delivery and respiratory and atopic outcomes. To account for multiple testing, we used the Bonferroni correction, which led to an adapted significance level of P<.002. RESULTS During infancy, children born by cesarean delivery did not have more respiratory symptoms than those born by vaginal delivery (median, 4 weeks; interquartile range, 7 weeks vs median, 5 weeks; interquartile range, 7 weeks; adjusted incidence rate ratio, 0.8; 95% confidence interval, 0.6-1.0; P=.02). Infant lung function was similar between the groups. Children born by cesarean delivery did not have a higher incidence of "ever wheezing" (adjusted odds ratio, 0.9; 95% confidence interval, 0.5-1.8; P=.78) or current asthma (adjusted odds ratio, 0.4; 95% confidence interval, 0.0-3.5; P=.42) at school age than those born by vaginal delivery. There was no difference in the lung function parameters between the groups. CONCLUSION Cesarean delivery was not associated with respiratory symptoms in the first year of life, nor with different respiratory or atopic outcomes at school age, when compared with vaginal delivery. Our results indicate that there are no long-term consequences on the respiratory health of the child associated with cesarean delivery.
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Oestreich MA, Wyler F, Latzin P, Ramsey KA. Impact of Spiroware re-analysis method on multiple-breath washout outcomes in children with cystic fibrosis. J Cyst Fibros 2022; 21:e208-e209. [DOI: 10.1016/j.jcf.2022.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/22/2022] [Indexed: 11/24/2022]
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Fouzas S, Kentgens AC, Lagiou O, Frauchiger BS, Wyler F, Theodorakopoulos I, Yammine S, Latzin P. Novel volumetric capnography indices measure ventilation inhomogeneity in cystic fibrosis. ERJ Open Res 2022; 8:00440-2021. [PMID: 35295235 PMCID: PMC8918935 DOI: 10.1183/23120541.00440-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/14/2021] [Indexed: 11/05/2022] Open
Abstract
BackgroundVolumetric capnography (VCap) is a simpler alternative of multiple-breath washout (MBW) to detect ventilation inhomogeneity (VI) in patients with cystic fibrosis (CF). However, its diagnostic performance is influenced by breathing dynamics. We introduce two novel VCap indices, the Capnographic Inhomogeneity Indices (CIIs) that may overcome this limitation and explore their diagnostic characteristics in a cohort of CF patients.MethodsWe analysed 320 N2-MBW trials from 50 CF patients and 65 controls (age 4-18 years) and calculated classical VCap indices, such as slope III (SIII) and the capnographic index (KPIv). We introduced novel CIIs based on a theoretical lung model, and assessed their diagnostic performance compared to classical VCap indices and the lung clearance index (LCI).ResultsBoth CIIs were significantly higher in CF patients compared with controls (mean±SD CII1 5.9±1.4% versus 5.1±1.0%, p=0.002; CII2 7.7±1.8% versus 6.8±1.4%, p=0.002) and presented strong correlation with LCI (CII1 R2=0.47 and CII2 R2=0.44 in CF patients). Classical VCap indices showed inferior discriminative ability (SIII 2.3±1.0%/L versus 1.9±0.7%/L, P=0.013; KPIv 3.9±1.3% versus 3.5±1.2%, P=0.071), while the correlation with LCI was weak (SIII R2=0.03; KPIv R2=0.08 in CF patients). CIIs showed lower intra-subject inter-trial variability, calculated as coefficient of variation for three and relative difference for two trials, than classical VCap indices, but higher than LCI (CII1 11.1±8.2% and CII2 11.0±8.0% versus SIII 16.3±13.5%; KPIv 15.9±12.8%; LCI 5.9%±4.2%).ConclusionCIIs detect VI better than classical VCap indices and correlate well with LCI. However, further studies on their diagnostic performance and clinical utility are required.
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Korten I, Kieninger E, Krueger L, Bullo M, Flück CE, Latzin P, Casaulta C, Boettcher C. Short-Term Effects of Elexacaftor/Tezacaftor/Ivacaftor Combination on Glucose Tolerance in Young People With Cystic Fibrosis-An Observational Pilot Study. Front Pediatr 2022; 10:852551. [PMID: 35529332 PMCID: PMC9070552 DOI: 10.3389/fped.2022.852551] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The effect of elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) on glucose tolerance and/or cystic-fibrosis-related diabetes (CFRD) is not well understood. We performed an observational study on the short-term effects of ELX/TEZ/IVA on glucose tolerance. METHODS Sixteen adolescents with CF performed oral glucose tolerance tests (OGTT) before and 4-6 weeks after initiating ELX/TEZ/IVA therapy. A continuous glucose monitoring (CGM) system was used 3 days before until 7 days after starting ELX/TEZ/IVA treatment. RESULTS OGTT categories improved after initiating ELX/TEZ/IVA therapy (p = 0.02). Glucose levels of OGTT improved at 60, 90, and 120 min (p < 0.05), whereas fasting glucose and CGM measures did not change. CONCLUSION Shortly after initiating ELX/TEZ/IVA therapy, glucose tolerance measured by OGTT improved in people with CF. This pilot study indicates that ELX/TEZ/IVA treatment has beneficial effects on the endocrine pancreatic function and might prevent or at least postpone future CFRD.
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Affiliation(s)
- Insa Korten
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Elisabeth Kieninger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Linn Krueger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marina Bullo
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christa E Flück
- Department of Paediatric Endocrinology, Diabetology and Metabolism, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of BioMedical Research, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carmen Casaulta
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudia Boettcher
- Department of Paediatric Endocrinology, Diabetology and Metabolism, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of BioMedical Research, Bern University Hospital, University of Bern, Bern, Switzerland
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Decrue F, Gorlanova O, Salem Y, Vienneau D, de Hoogh K, Gisler A, Usemann J, Korten I, Nahum U, Sinues P, Schulzke S, Fuchs O, Latzin P, Röösli M, Frey U. Increased Impact of Air Pollution on Lung Function in Preterm versus Term Infants: The BILD Study. Am J Respir Crit Care Med 2022; 205:99-107. [PMID: 34587471 DOI: 10.1164/rccm.202102-0272oc] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Rationale: Infants born prematurely have impaired capacity to deal with oxidative stress shortly after birth. Objectives: We hypothesize that the relative impact of exposure to air pollution on lung function is higher in preterm than in term infants. Methods: In the prospective BILD (Basel-Bern Infant Lung Development) birth cohort of 254 preterm and 517 term infants, we investigated associations of particulate matter ⩽10 μm in aerodynamic diameter (PM10) and nitrogen dioxide with lung function at 44 weeks' postconceptional age and exhaled markers of inflammation and oxidative stress response (fractional exhaled nitric oxide [FeNO]) in an explorative hypothesis-driven study design. Multilevel mixed-effects models were used and adjusted for known confounders. Measurements and Main Results: Significant associations of PM10 during the second trimester of pregnancy with lung function and FeNO were found in term and preterm infants. Importantly, we observed stronger positive associations in preterm infants (born 32-36 wk), with an increase of 184.9 (95% confidence interval [CI], 79.1-290.7) ml/min [Formula: see text]e per 10-μg/m3 increase in PM10, than in term infants (75.3; 95% CI, 19.7-130.8 ml/min) (pprematurity × PM10 interaction = 0.04, after multiple comparison adjustment padj = 0.09). Associations of PM10 and FeNO differed between moderate to late preterm (3.4; 95% CI, -0.1 to 6.8 ppb) and term (-0.3; 95% CI, -1.5 to 0.9 ppb) infants, and the interaction with prematurity was significant (pprematurity × PM10 interaction = 0.006, padj = 0.036). Conclusions: Preterm infants showed significantly higher susceptibility even to low to moderate prenatal air pollution exposure than term infants, leading to increased impairment of postnatal lung function. FeNO results further elucidate differences in inflammatory/oxidative stress response when comparing preterm infants with term infants.
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Affiliation(s)
- Fabienne Decrue
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yasmin Salem
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Danielle Vienneau
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute Basel, Basel, Switzerland
| | - Kees de Hoogh
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute Basel, Basel, Switzerland
| | | | - Jakob Usemann
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Respiratory Medicine, University Children's Hospital of Zürich, Zürich, Switzerland; and
| | - Insa Korten
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Uri Nahum
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Pablo Sinues
- University Children's Hospital Basel UKBB.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | | | - Oliver Fuchs
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin Röösli
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute Basel, Basel, Switzerland
| | - Urs Frey
- University Children's Hospital Basel UKBB.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Willers C, Maager L, Bauman G, Cholewa D, Stranzinger E, Raio L, Casaulta C, Latzin P. School-age structural and functional MRI and lung function in children following lung resection for congenital lung malformation in infancy. Pediatr Radiol 2022; 52:1255-1265. [PMID: 35305121 PMCID: PMC9192451 DOI: 10.1007/s00247-022-05317-7] [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: 04/23/2021] [Revised: 10/21/2021] [Accepted: 02/03/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND The management of asymptomatic congenital lung malformations is debated. Particularly, there is a lack of information regarding long-term growth and development of the remaining lung in children following lung resection for congenital lung malformations. In addition to conventional pulmonary function tests, we used novel functional magnetic resonance imaging (MRI) methods to measure perfusion and ventilation. OBJECTIVE To assess functionality of the remaining lung expanded into the thoracic cavity after resection of congenital lung malformations. MATERIALS AND METHODS A prospective, cross-sectional pilot study in five children who had surgery for congenital lung malformations during infancy. Participants had structural and functional MRI as well as spirometry, body plethysmography and multiple breath washout at school age. RESULTS Structural MRI showed an expansion of the remaining lung in all cases. Fractional ventilation and relative perfusion of the expanded lung were locally decreased in functional MRI. In all other parts of the lungs, fractional ventilation and relative perfusion were normal in all children. There was an association between overall impairment of perfusion and elevated lung clearance index. The results of spirometry and body plethysmography varied between patients, including normal lung function, restriction and obstruction. CONCLUSION Fractional ventilation and relative perfusion maps from functional MRI specifically locate impairment of the remaining lung after lung resection. These changes are not captured by conventional measures such as structural MRI and standard pulmonary function tests. Therefore, following lung resection for congenital lung malformation, children should be investigated more systematically with functional lung MRI.
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Affiliation(s)
- Corin Willers
- grid.5734.50000 0001 0726 5157Division of Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 8, 3010 Bern, Switzerland
| | - Lukas Maager
- grid.5734.50000 0001 0726 5157Division of Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 8, 3010 Bern, Switzerland
| | - Grzegorz Bauman
- grid.410567.1Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Dietmar Cholewa
- grid.5734.50000 0001 0726 5157Department of Pediatric Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Enno Stranzinger
- grid.5734.50000 0001 0726 5157Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Luigi Raio
- grid.5734.50000 0001 0726 5157Department of Obstetrics and Gynecology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carmen Casaulta
- grid.5734.50000 0001 0726 5157Division of Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 8, 3010 Bern, Switzerland
| | - Philipp Latzin
- Division of Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 8, 3010, Bern, Switzerland.
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Gahleitner F, Thompson J, Jackson CL, Hueppe JF, Behan L, Dehlink E, Goutaki M, Halbeisen F, Queiroz APL, Thouvenin G, Kuehni CE, Latzin P, Lucas JS, Rubbo B. Lower airway clinical outcome measures for use in primary ciliary dyskinesia research: a scoping review. ERJ Open Res 2021; 7:00320-2021. [PMID: 34853782 PMCID: PMC8628193 DOI: 10.1183/23120541.00320-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/31/2021] [Indexed: 11/05/2022] Open
Abstract
Objectives Disease-specific, well-defined and validated clinical outcome measures are essential in designing research studies. Poorly defined outcome measures hamper pooling of data and comparisons between studies. We aimed to identify and describe pulmonary outcome measures that could be used for follow-up of patients with primary ciliary dyskinesia (PCD). Methods We conducted a scoping review by systematically searching MEDLINE, Embase and the Cochrane Database of Systematic Reviews online databases for studies published from 1996 to 2020 that included ≥10 PCD adult and/or paediatric patients. Results We included 102 studies (7289 patients). 83 studies reported on spirometry, 11 on body plethysmography, 15 on multiple-breath washout, 36 on high-resolution computed tomography (HRCT), 57 on microbiology and 17 on health-related quality of life. Measurement and reporting of outcomes varied considerably between studies (e.g. different scoring systems for chest HRCT scans). Additionally, definitions of outcome measures varied (e.g. definition of chronic colonisation by respiratory pathogen), impeding direct comparisons of results. Conclusions This review highlights the need for standardisation of measurements and reporting of outcome measures to enable comparisons between studies. Defining a core set of clinical outcome measures is necessary to ensure reproducibility of results and for use in future trials and prospective cohorts.
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Affiliation(s)
- Florian Gahleitner
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Paediatric Respiratory Medicine, Royal Hospital for Children and Young People, Edinburgh, UK
| | - James Thompson
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,School of Clinical and Experimental Science, University of Southampton, Faculty of Medicine, Southampton, UK
| | - Claire L Jackson
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,School of Clinical and Experimental Science, University of Southampton, Faculty of Medicine, Southampton, UK
| | - Jana F Hueppe
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,School of Clinical and Experimental Science, University of Southampton, Faculty of Medicine, Southampton, UK
| | - Laura Behan
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,School of Clinical and Experimental Science, University of Southampton, Faculty of Medicine, Southampton, UK
| | - Eleonora Dehlink
- Division of Pediatric Pulmonology, Allergy and Endocrinology, Dept of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Florian Halbeisen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland.,Basel Institute for Clinical Epidemiology and Biostatistics, Dept of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ana Paula L Queiroz
- School of Clinical and Experimental Science, University of Southampton, Faculty of Medicine, Southampton, UK
| | - Guillaume Thouvenin
- AP-HP, Pneumologic Unit, Trousseau Hospital, Sorbonne Universités, INSERM, Centre de Recherche Saint-Antoine, Paris, France
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,School of Clinical and Experimental Science, University of Southampton, Faculty of Medicine, Southampton, UK
| | - Bruna Rubbo
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,School of Clinical and Experimental Science, University of Southampton, Faculty of Medicine, Southampton, UK.,School of Health Sciences, University of Southampton, Faculty of Environmental and Life Sciences, Southampton, UK
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Mozun R, Ardura-Garcia C, Pedersen ESL, Goutaki M, Usemann J, Singer F, Latzin P, Moeller A, Kuehni CE. Agreement of parent- and child-reported wheeze and its association with measurable asthma traits. Pediatr Pulmonol 2021; 56:3813-3821. [PMID: 34597475 PMCID: PMC9293286 DOI: 10.1002/ppul.25690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/13/2021] [Accepted: 09/18/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES In epidemiological studies, childhood asthma is usually assessed with questionnaires directed at parents or children, and these may give different answers. We studied how well parents and children agreed when asked to report symptoms of wheeze and investigated whose answers were closer to measurable traits of asthma. METHODS LuftiBus in the school is a cross-sectional survey of respiratory health among Swiss schoolchildren aged 6-17 years. We applied questionnaires to parents and children asking about wheeze and exertional wheeze in the past year. We assessed agreement between parent-child answers with Cohen's kappa (k), and associations of answers from children and parents with fractional exhaled nitric oxide (FeNO) and forced expiratory volume in 1 s over forced vital capacity (FEV1 /FVC), using quantile regression. RESULTS We received questionnaires from 3079 children and their parents. Agreement was poor for reported wheeze (k = 0.37) and exertional wheeze (k = 0.36). Median FeNO varied when wheeze was reported by children (19 ppb, interquartile range [IQR]: 9-44), parents (22 ppb, IQR: 12-46), both (31 ppb, IQR: 16-55), or neither (11 ppb, IQR: 7-19). Median absolute FEV1 /FVC was the same when wheeze was reported by children (84%, IQR: 78-89) and by parents (84%, IQR: 78-89), lower when reported by both (82%, IQR: 78-87), and higher when reported by neither (87%, IQR: 82-91). For exertional wheeze findings were similar. Results did not differ by age or sex. CONCLUSION Our findings suggest that surveying both parents and children and combining their responses can help us to better identify children with measurable asthma traits.
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Affiliation(s)
- Rebeca Mozun
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | | | - Eva S L Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jakob Usemann
- Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research center, University of Zurich, Zurich, Switzerland.,University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Florian Singer
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,PEDNET, Paediatric Clinical Trial Unit, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexander Moeller
- Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research center, University of Zurich, Zurich, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Kieninger E, Willers C, Röthlisberger K, Yammine S, Pusterla O, Bauman G, Stranzinger E, Bieri O, Latzin P, Casaulta C. Effect of Salbutamol on Lung Ventilation in Children with Cystic Fibrosis: Comprehensive Assessment Using Spirometry, Multiple-Breath Washout, and Functional Lung Magnetic Resonance Imaging. Respiration 2021; 101:281-290. [PMID: 34808631 DOI: 10.1159/000519751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/20/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Inhalation therapy is one of the cornerstones of the daily treatment regimen in patients with cystic fibrosis (CF). Recommendations regarding the addition of bronchodilators, especially salbutamol are conflicting due to the lack of evidence. New diagnostic measures such as multiple-breath washout (<underline>MBW)</underline> and functional magnetic resonance imaging (MRI) have the potential to reveal new insights into bronchodilator effects in patients with CF. OBJECTIVE The objective of the study was to comprehensively assess the functional response to nebulized inhalation with salbutamol in children with CF. METHODS Thirty children aged 6-18 years with stable CF performed pulmonary function tests, MBW, and matrix pencil-MRI before and after standardized nebulized inhalation of salbutamol. RESULTS Lung clearance index decreased (improved) by -0.24 turnover (95% confidence interval [CI]: -0.53 to 0.06; p = 0.111). Percentage of the lung volume with impaired fractional ventilation and relative perfusion decreased (improved) by -0.79% (CI: -1.99 to 0.42; p = 0.194) and -1.31% (CI: -2.28 to -0.35; p = 0.009), respectively. Forced expiratory volume (FEV1) increased (improved) by 0.41 z-score (CI: 0.24-0.58; p < 0.0001). We could not identify specific clinical factors associated with a more pronounced effect of salbutamol. CONCLUSIONS There is a positive short-term effect of bronchodilator inhalation on FEV1 in patients with CF, which is independent of ventilation inhomogeneity. Heterogeneous response between patients suggests that for prediction of a therapeutic effect this should be tested by spirometry in every patient individually.
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Affiliation(s)
- Elisabeth Kieninger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Corin Willers
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland,
| | - Katrin Röthlisberger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Physiotherapy, University Hospital of Bern, Bern, Switzerland
| | - Sophie Yammine
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Orso Pusterla
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Grzegorz Bauman
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Enno Stranzinger
- Department of Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Oliver Bieri
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carmen Casaulta
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Nussbaumer M, Kieninger E, Tschanz SA, Savas ST, Casaulta C, Goutaki M, Blanchon S, Jung A, Regamey N, Kuehni CE, Latzin P, Müller L. Diagnosis of primary ciliary dyskinesia: discrepancy according to different algorithms. ERJ Open Res 2021; 7:00353-2021. [PMID: 34729370 PMCID: PMC8558472 DOI: 10.1183/23120541.00353-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/26/2021] [Indexed: 11/08/2022] Open
Abstract
Background Diagnosis of primary ciliary dyskinesia (PCD) is challenging since there is no gold standard test. The European Respiratory (ERS) and American Thoracic (ATS) Societies developed evidence-based diagnostic guidelines with considerable differences. Objective We aimed to compare the algorithms published by the ERS and the ATS with each other and with our own PCD-UNIBE algorithm in a clinical setting. Our algorithm is similar to the ERS algorithm with additional immunofluorescence staining. Agreement (Cohen's κ) and concordance between the three algorithms were assessed in patients with suspicion of PCD referred to our diagnostic centre. Results In 46 out of 54 patients (85%) the final diagnosis was concordant between all three algorithms (30 PCD negative, 16 PCD positive). In eight patients (15%) PCD diagnosis differed between the algorithms. Five patients (9%) were diagnosed as PCD only by the ATS, one (2%) only by the ERS and PCD-UNIBE, one (2%) only by the ATS and PCD-UNIBE, and one (2%) only by the PCD-UNIBE algorithm. Agreement was substantial between the ERS and the ATS (κ=0.72, 95% CI 0.53–0.92) and the ATS and the PCD-UNIBE (κ=0.73, 95% CI 0.53–0.92) and almost perfect between the ERS and the PCD-UNIBE algorithms (κ=0.92, 95% CI 0.80–1.00). Conclusion The different diagnostic algorithms lead to a contradictory diagnosis in a considerable proportion of patients. Thus, an updated, internationally harmonised and standardised PCD diagnostic algorithm is needed to improve diagnostics for these discordant cases. There is no gold standard test for diagnosing PCD. The use of existing diagnostic algorithms leads to contradicting results in many patients (15% in this study). Thus, an updated and internationally harmonised diagnostic guideline is needed.https://bit.ly/2U19Vvq
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Affiliation(s)
- Mirjam Nussbaumer
- Division of Paediatric Respiratory Medicine and Allergology, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Dept of BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Elisabeth Kieninger
- Division of Paediatric Respiratory Medicine and Allergology, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Dept of BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | | | - Sibel T Savas
- Division of Paediatric Respiratory Medicine and Allergology, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Dept of BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Carmen Casaulta
- Division of Paediatric Respiratory Medicine and Allergology, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Dept of BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Myrofora Goutaki
- Division of Paediatric Respiratory Medicine and Allergology, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sylvain Blanchon
- Dept Woman-Mother-Child, Service of Pediatrics, Pediatric Pulmonology and Cystic Fibrosis Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Andreas Jung
- Division of Respiratory Medicine, University Children's Hospital Zurich, Zurich, Switzerland
| | - Nicolas Regamey
- Division of Paediatric Pulmonology, Children's Hospital Lucerne, Lucerne, Switzerland
| | - Claudia E Kuehni
- Division of Paediatric Respiratory Medicine and Allergology, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Dept of BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Loretta Müller
- Division of Paediatric Respiratory Medicine and Allergology, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Dept of BioMedical Research (DBMR), University of Bern, Bern, Switzerland
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Gisler A, Korten I, de Hoogh K, Vienneau D, Frey U, Decrue F, Gorlanova O, Soti A, Hilty M, Latzin P, Usemann J. Associations of air pollution and greenness with the nasal microbiota of healthy infants: A longitudinal study. Environ Res 2021; 202:111633. [PMID: 34256075 DOI: 10.1016/j.envres.2021.111633] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Air pollution and greenness are associated with short- and long-term respiratory health in children but the underlying mechanisms are only scarcely investigated. The nasal microbiota during the first year of life has been shown to be associated with respiratory tract infections and asthma development. Thus, an interplay between greenness, air pollution and the early nasal microbiota may contribute to short- and long-term respiratory health. We aimed to examine associations between fine particulate matter (PM2.5), nitrogen dioxide (NO2) and greenness with the nasal microbiota of healthy infants during the first year of life in a European context with low-to-moderate air pollution levels. METHODS Microbiota characterization was performed using 16 S rRNA pyrosequencing of 846 nasal swabs collected fortnightly from 47 healthy infants of the prospective Basel-Bern Infant Lung Development (BILD) cohort. We investigated the association of satellite-based greenness and an 8-day-average exposure to air pollution (PM2.5, NO2) with the nasal microbiota during the first year of life. Exposures were individually estimated with novel spatial-temporal models incorporating satellite data. Generalized additive mixed models adjusted for known confounders and considering the autoregressive correlation structure of the data were used for analysis. RESULTS Mean (SD) PM2.5 level was 17.1 (3.8 μg/m3) and mean (SD) NO2 level was 19.7 (7.9 μg/m3). Increased PM2.5 and increased NO2 were associated with reduced within-subject Ružička dissimilarity (PM2.5: per 1 μg/m3 -0.004, 95% CI -0.008, -0.001; NO2: per 1 μg/m3 -0.004, 95% CI -0.007, -0.001). Whole microbial community comparison with nonmetric multidimensional scaling revealed distinct microbiota profiles for different PM2.5 exposure levels. Increased NO2 was additionally associated with reduced abundance of Corynebacteriaceae (per 1 μg/m3: -0.027, 95% CI -0.053, -0.001). No associations were found between greenness and the nasal microbiota. CONCLUSION Air pollution was associated with Ružička dissimilarity and relative abundance of Corynebacteriaceae. This suggests that even low-to-moderate exposure to air pollution may impact the nasal microbiota during the first year of life. Our results will be useful for future studies assessing the clinical relevance of air-pollution-induced alterations of the nasal microbiota with subsequent respiratory disease development.
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Affiliation(s)
- Amanda Gisler
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Insa Korten
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Urs Frey
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fabienne Decrue
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andras Soti
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel, University of Basel, Basel, Switzerland; Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Division of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, University of Zurich, Zurich, Switzerland.
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50
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Goutaki M, Lam YT, Alexandru M, Anagiotos A, Armengot M, Bequignon E, Boon M, Burgess A, Coste A, Emiralioglu N, Erdem E, Haarman EG, Harris A, Hool SL, Karadag B, Kim S, Latzin P, Lorent N, Ozcelik U, Reula A, Roehmel J, van Gogh C, Yiallouros P, Zappe SM, Papon JF. Study protocol: the ear-nose-throat (ENT) prospective international cohort of patients with primary ciliary dyskinesia (EPIC-PCD). BMJ Open 2021; 11:e051433. [PMID: 34635525 PMCID: PMC8506890 DOI: 10.1136/bmjopen-2021-051433] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Primary ciliary dyskinesia (PCD) is a rare, genetic, multiorgan disease with an estimated prevalence of 1 in 10 000. It affects mainly the upper and lower airways due to impaired mucociliary clearance. Almost all patients have sinonasal or otologic (ear-nose-throat, ENT) problems, although the ENT clinical phenotype may present great variability. Despite that, data on PCD ENT manifestations are scarce and based on small single-centre studies. To date, we know little about the spectrum and severity of PCD ENT disease, its association with lung disease, its course over life and its determinants of prognosis.This study protocol describes the aims and methods of the first prospective, observational, multinational cohort study focusing on ENT disease in patients with PCD. METHODS AND ANALYSIS The ENT prospective international cohort of patients with PCD (EPIC-PCD) is a prospective standardised observational clinical cohort set up as a multinational multicentre study, embedded into routine patient care. It aims to longitudinally characterise ENT disease in patients with PCD and its association with lung disease, and to identify determinants of its prognosis. Patients of all ages, diagnosed with PCD who undergo an ENT clinical assessment at least once a year at one of the participating centres will be invited to participate. Collected data include diagnostic test results, results of ENT examinations, lung function measurements, information on management of ENT disease and patient-reported data on clinical symptoms and health-related quality of life (QoL). Data are collected using the standardised PCD-specific FOLLOW-PCD form and the validated QoL-PCD questionnaire. ETHICS AND DISSEMINATION The study has been reviewed and approved by the Human Research Ethics Committees at all participating centres, based on local legislation. The results of the study will be published in scientific journals, presented at scientific conferences and disseminated to participants and national patient organisations. TRIAL REGISTRATION NCT04611516.
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Affiliation(s)
- Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Yin Ting Lam
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Mihaela Alexandru
- Hôpital Kremlin-Bicetre, Service d'ORL et de Chirurgie Cervico-Faciale, AP-HP, Paris, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, Paris, France
| | - Andreas Anagiotos
- Department of Otorhinolaryngology, Nicosia General Hospital, Nicosia, Cyprus
| | - Miguel Armengot
- Department of Otorhinolaryngology, and Primary Ciliary Dyskinesia Unit, La Fe University and Polytechnic Hospital, Valencia, Spain
- Medical School, University of Valencia, Valencia, Spain
| | - Emilie Bequignon
- Hôpital Henri Mondor et Centre Hospitalier Intercommunal de Créteil, Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, AP-HP, Creteil, France
| | - Mieke Boon
- Department of Paediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Andrea Burgess
- Primary Ciliary Dyskinesia Centre, Southampton Children's Hospital, Southampton NHS Foundation Trust, Southampton, UK
| | - Andre Coste
- Hôpital Henri Mondor et Centre Hospitalier Intercommunal de Créteil, Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, AP-HP, Creteil, France
- Faculté de médecine, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Hôpital Henri Mondor, Université Paris-Est Créteil Val de Marne, Creteil, France
| | - Nagehan Emiralioglu
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ela Erdem
- Department of Pediatric Pulmonology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Eric G Haarman
- Department of Paediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Amanda Harris
- Primary Ciliary Dyskinesia Centre, NIHR Respiratory Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Sara-Lynn Hool
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Bulent Karadag
- Department of Pediatric Pulmonology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Sookyung Kim
- Hôpital Kremlin-Bicetre, Service d'ORL et de Chirurgie Cervico-Faciale, AP-HP, Paris, France
| | - Philipp Latzin
- Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Natalie Lorent
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Ugur Ozcelik
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ana Reula
- Biomedical Sciences Department, CEU Cardenal Herrera University, Castellón, Spain
- Molecular, Cellular and Genomic Biomedicine Group, IIS La Fe, Valencia, Spain
| | - Jobst Roehmel
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christine van Gogh
- Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Panayiotis Yiallouros
- Medical School, University of Cyprus, Nicosia, Cyprus
- Pediatric Pulmonology Unit, Hospital 'Archbishop Makarios III', Nicosia, Cyprus
| | - Soeren Marian Zappe
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jean Francois Papon
- Hôpital Kremlin-Bicetre, Service d'ORL et de Chirurgie Cervico-Faciale, AP-HP, Paris, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, Paris, France
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