Lung Function Tracking - Does It Wobble during Adolescence?
Am J Respir Crit Care Med. 2018 Jul 18;:
Authors: Turner S
PMID: 30020806 [PubMed - as supplied by publisher]
Does allergy explain why some children have severe asthma?
Clin Exp Allergy. 2018 Jul 17;:
Authors: Bonner K, Roberts G
Asthma is a common disease in childhood with a minority of affected children having severe asthma. Children with severe asthma can be differentiated from those with mild-moderate disease by greater allergic sensitisation and increased airway inflammation. Many children with asthma have co-existing allergic disease. Increasing severity of allergic rhinitis is associated with increasing severity of asthma, even after adjustment for atopy. Food allergy seems to be a particularly strong marker of severe asthma. Mould allergy, pollen allergy and pet allergy have also all been associated with severe asthma. Identifying allergens that are driving asthma symptoms in children with severe asthma may provide additional strategies for improving their disease control. Avoidance strategies may be possible. Alternative, monoclonal antibody therapy with Omalizumab or Mepoluzumab may be helpful in children with clinically important polysensitisation. This article is protected by copyright. All rights reserved.
PMID: 30019503 [PubMed - as supplied by publisher]
How molecular diagnosis may modify immunotherapy prescription in multi-sensitized pollen-allergic children.
Allergol Immunopathol (Madr). 2018 Jul 12;:
Authors: Camacho GD, Arjona AMM, Padial JF, Jesús RC
INTRODUCTION: Specific immunotherapy (SIT) is used to treat asthma and allergic rhinitis, and a dose-response relationship has been found for SIT efficacy, creating a need to accurately select the allergen used in therapy. This need is especially pronounced in poly-sensitized children living in areas where different pollen allergen sources coexist in the same season, as this circumstance complicates diagnostic efforts. In such cases, component-resolved diagnosis (CRD) can increase diagnostic accuracy and aid in SIT prescription.
MATERIALS AND METHODS: We hypothesized that CRD results would lead to modifications in classical immunotherapy prescription based on sources such as medical history, season of symptom presentation, and skin testing. We studied a sample of children indicated for immunotherapy in whom classical methods had not pointed out the most relevant allergen due to sensitization to more than two pollens. We used a small panel of recombinant allergens, analyzing the percentage of changes to prescription considering the findings of molecular studies.
RESULTS: Of the 70 children included, CRD led to modified immunotherapy prescription in 54.3%. Indications of single-allergen therapy increased from 18% to 51% when CRD was included. The decision to prescribe immunotherapy was reversed following CRD in 9.3% of cases.
DISCUSSION: CRD use alters the choice of specific immunotherapy in poly-sensitized children. A wide panel of recombinant allergens may not be necessary to improve immunotherapy indication using molecular techniques; rather, a smaller panel adapted to include those allergens prevalent in the geographical area in question appears to be sufficient for more effective immunotherapy, also leading to an improved cost-benefit ratio.
PMID: 30017214 [PubMed - as supplied by publisher]
Air pollution and airway resistance at age 8 years - the PIAMA birth cohort study.
Environ Health. 2018 Jul 17;17(1):61
Authors: Finke I, de Jongste JC, Smit HA, Wijga AH, Koppelman GH, Vonk J, Brunekreef B, Gehring U
BACKGROUND: Air pollution has been found to adversely affect children's lung function. Forced expiratory volume in 1 s and forced vital capacity from spirometry have been studied most frequently, but measurements of airway resistance may provide additional information. We assessed associations of long-term air pollution exposure with airway resistance.
METHODS: We measured airway resistance at age 8 with the interrupter resistance technique (Rint) in participants of the Dutch PIAMA birth cohort study. We linked Rint with estimated annual average air pollution concentrations [nitrogen oxides (NO2, NOx), PM2.5 absorbance ("soot"), and particulate matter < 2.5 μm (PM2.5), < 10 μm (PM10) and 2.5-10 μm (PMcoarse)] at the birth address and current home address (n = 983). Associations between air pollution exposure and interrupter resistance (Rint) were assessed using multiple linear regression adjusting for potential confounders.
RESULTS: We found that higher levels of NO2 at the current address were associated with higher Rint [adj. mean difference (95% confidence interval) per interquartile range increase in NO2: 0.018 (0.001, 0.035) kPa·s·L- 1]. Similar trends were observed for the other pollutants, except, PM10. No association was found between Rint and exposure at the birth address.
CONCLUSIONS: Our results support the hypothesis that air pollution exposure is associated with a lower lung function in schoolchildren.
PMID: 30016982 [PubMed - in process]
Sex-specific impact of asthma during pregnancy on infant gut microbiota.
Eur Respir J. 2017 Nov;50(5):
Authors: Koleva PT, Tun HM, Konya T, Guttman DS, Becker AB, Mandhane PJ, Turvey SE, Subbarao P, Sears MR, Scott JA, Kozyrskyj AL, CHILD Study Investigators
Asthma during pregnancy is associated with retardation of fetal growth in a sex-specific manner. Lactobacilli microbes influence infant growth. This study aimed to determine whether lactobacilli and other microbes are reduced in the gut of infants born to an asthmatic mother, and whether this differs by the sex of the infant.Mother-infant pairs (N=1021) from the Canadian Healthy Infant Longitudinal Development full-term cohort were studied. The abundance of infant faecal microbiota at 3-4 months, profiled by gene sequencing, was compared between both women with and without asthma treatment during pregnancy. Infant sex, maternal ethnicity, pre-pregnancy overweight and atopy status, birth mode, breastfeeding status and intrapartum antibiotic treatment were tested as covariates.Independent of birth mode and other covariates, male, Caucasian infants born to women with prenatal asthma harboured fewer lactobacilli in the gut at 3-4 months of age. If asthmatic mothers had pre-pregnancy overweight, the abundance of Lactobacillus in males was further reduced in the infant gut, whereas the microbiota of female infants was enriched with Bacteroidaceae Similar differences in infant gut microbial composition according to maternal prenatal asthma status were also more evident among women with food or environmental allergies.Gut lactobacilli were less abundant in male infants, but Bacteroidaceae were more abundant in female infants at 3-4 months of age, following maternal asthma during pregnancy.
PMID: 29167295 [PubMed - indexed for MEDLINE]