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Wheezing phenotypes

Elysia M Hollams, Shu Mei Teo, Merci Kusel, Barbara J Holt, Kathryn E Holt, Michael Inouye, Nicholas H De Klerk, Guicheng Zhang, Peter D Sly, Prue H Hart, Patrick G Holt
BACKGROUND: Vitamin D (25(OH)D) deficiency has been implicated as a possible risk factor for asthma development, but studies at selected time points measuring 25(OH)D levels during childhood have yielded conflicting findings. Prospective studies tracking 25(OH)D levels during the initiation phase of asthma in early childhood have not been reported. OBJECTIVE: We sought to elucidate relationships between 25(OH)D levels from birth to age 10 years and susceptibility to allergic sensitization, respiratory tract infections, and asthma...
October 7, 2016: Journal of Allergy and Clinical Immunology
Elisa Adele Colombo, Luigina Spaccini, Ludovica Volpi, Gloria Negri, Davide Cittaro, Dejan Lazarevic, Salvatore Zirpoli, Andrea Farolfi, Cristina Gervasini, Maria Vittoria Cubellis, Lidia Larizza
BACKGROUND: Integrin α3 (ITGA3) gene mutations are associated with Interstitial Lung disease, Nephrotic syndrome and Epidermolysis bullosa (ILNEB syndrome). To date only six patients are reported: all carried homozygous ITGA3 mutations and presented a dramatically severe phenotype leading to death before age 2 years, from multi-organ failure due to interstitial lung disease and congenital nephrotic syndrome. The involvement of skin and cutaneous adnexa was variable with sparse hair and nail dysplasia combined or not to skin lesions ranging from skin fragility to epidermolysis bullosa-like blistering...
October 7, 2016: Orphanet Journal of Rare Diseases
Alexander J Adami, Sonali J Bracken
Asthma is a highly heterogeneous disease characterized by inflammation of the airways, which invokes symptoms such as wheeze, dyspnea, and chest tightness. Asthma is the product of multiple interconnected immunological processes and represents a constellation of related, but distinct, disease phenotypes. The prevalence of asthma has more than doubled since the 1980s, and efforts to understand this increase have inspired consideration of the microbiome as a key player in the pathophysiology and regulation of this disease...
September 2016: Yale Journal of Biology and Medicine
Mingyuan Han, Jun Young Hong, Suraj Jaipalli, Charu Rajput, Jing Lei, Joanna L Hinde, Qiang Chen, Natalie M Hershenson, J Kelley Bentley, Marc B Hershenson
Early-life wheezing-associated infections with rhinovirus (RV) have been associated with asthma development in children. We have shown that RV infection of six day-old mice induces mucous metaplasia and airways hyperresponsiveness which is dependent on IL-13, IL-25 and type 2 innate lymphoid cells (ILC2s). Infection of immature mice fails to induce lung IFN-γ expression, in contrast to mature 8 week-old mice with a robust IFN-γ response, consistent with the notion that deficient IFN-γ production in immature mice permits RV-induced type 2 immune responses...
September 28, 2016: American Journal of Respiratory Cell and Molecular Biology
Jenna MacNeil, Robyn H Loves, Shawn D Aaron
Asthma is diagnosed based on patients' respiratory symptoms of wheeze, cough, chest tightness and/or dyspnea together with physiologic evidence of variable and reversible expiratory airflow limitation. A high prevalence of overdiagnosis, underdiagnosis and misdiagnosis of adult asthma has been reported in the literature. Areas covered: Misdiagnosis of asthma in adults can occur in the community due to physicians' failure to confirm airflow limitation using spirometry, the relatively poor sensitivity of spirometry to absolutely rule in asthma, the complexity of multiple asthma phenotypes and endotypes, and the inherent day to day variability of asthma symptoms and airflow limitation...
October 8, 2016: Expert Review of Respiratory Medicine
P Ning, Y F Guo, T Y Sun, H S Zhang, D Chai, X M Li
OBJECTIVE: To study the distinct clinical phenotype of chronic airway diseases by hierarchical cluster analysis and two-step cluster analysis. METHODS: A population sample of adult patients in Donghuamen community, Dongcheng district and Qinghe community, Haidian district, Beijing from April 2012 to January 2015, who had wheeze within the last 12 months, underwent detailed investigation, including a clinical questionnaire, pulmonary function tests, total serum IgE levels, blood eosinophil level and a peak flow diary...
September 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Maia P Smith, Dietrich Berdel, Carl-Peter Bauer, Sibylle Koletzko, Dennis Nowak, Joachim Heinrich, Holger Schulz
INTRODUCTION: Physical activity (PA) protects against most noncommunicable diseases and has been associated with decreased risk of allergic phenotype, which is increasing worldwide. However, the association is not always present; furthermore it is not clear whether it is strongest for asthma, rhinitis, symptoms of these, or atopic sensitization; which sex is most affected; or whether it can be explained by either avoidance of sport or exacerbation of symptoms by exercise. Interventions are thus difficult to target...
2016: PloS One
Steven McVea, Thomas Bourke
One third of all preschool children will have an episode of wheeze and many of these present to primary care. Most will fall within a spectrum of diagnosis ranging from episodic viral wheeze to multiple trigger wheeze or early onset asthma. A small proportion will have other rare, but important, diagnoses such as foreign body aspiration, anaphylaxis, gastro-oesophageal reflux, congenital anatomical abnormalities or other chronic lung diseases. Clinical assessment should try to classify children into either episodic viral wheeze or multiple trigger wheeze phenotypes...
June 2016: Practitioner
Annette Kainu, Paula Pallasaho, Anne Pietinalho
BACKGROUND: The age-dependent increase of chronic obstructive pulmonary disease (COPD) prevalence caused by smoking and other inhalational exposures in the general population is well-known worldwide. However, time trends are poorly known, due to lower number of high-quality studies especially following nationwide efforts on diminishing exposure levels. This study aimed to compare the prevalence of COPD symptoms and their major determinants in Finnish adults in 1996 and 2006. METHODS: Two identical postal surveys were conducted among two random population samples from Helsinki using identical methodologies in 1996 and 2006, with 6,062 (76%) and 2,449 (62%) participants, respectively...
2016: European Clinical Respiratory Journal
Bo Lund Krogsgaard Chawes
Asthma and allergies are today the most common chronic diseases in children and the leading causes of school absences, chronic medication usage, emergency department visits and hospitalizations, which affect all members of the family and represent a significant societal and scientific challenge. These highly prevalent disorders are thought to originate from immune distortion in early childhood, but the etiology and heterogeneity of the disease mechanisms are not understood, which hampers preventive initiatives and makes treatment inadequate...
August 2016: Danish Medical Journal
Katja Landgraf-Rauf, Bettina Anselm, Bianca Schaub
Asthma represents the most common chronic childhood disease worldwide. Whereas preschool children present with wheezing triggered by different factors (multitrigger and viral wheeze), clinical asthma manifestation in school children has previously been classified as allergic and non-allergic asthma. For both, the underlying immunological mechanisms are not yet understood in depth in children. Treatment is still prescribed regardless of underlying mechanisms, and children are not always treated successfully...
December 2016: Molecular and Cellular Pediatrics
Ali Ozdemir, Dilek Dogruel, Ozlem Yilmaz
OBJECTIVE: To investigate vitamin D levels in patients with recurrent wheeze at early ages of childhood. METHODS: In the present cross-sectional study, serum 25-hydroxy vitamin D [25 (OH)D], levels which is known as an indicator of vitamin D adequacy, was examined in infants with three or more wheezing attacks. RESULTS: A total of 186 infants with recurrent wheezing were included in the study along with 118 healthy control peers. The recurrent wheezing study participants were classified into two groups according to Asthma Predictive Index (API) positivity and compared to control subjects regarding their serum vitamin D status...
June 27, 2016: Indian Journal of Pediatrics
Sze Man Tse, Sheryl L Rifas-Shiman, Brent A Coull, Augusto A Litonjua, Emily Oken, Diane R Gold
BACKGROUND: Although sexual dimorphism in wheeze and asthma prevalence are well documented, sex-specific risk factors for wheeze and longitudinal wheeze phenotypes have not been well elucidated. OBJECTIVE: By using a large prebirth cohort, this study aimed to identify sex-specific risk factors for wheeze from birth through midchildhood and identify distinct longitudinal wheeze phenotypes and the sex-specific risk factors associated with these phenotypes. METHODS: Mothers reported child wheeze symptoms over the past year approximately yearly on 9 occasions starting at age 1 year...
April 27, 2016: Journal of Allergy and Clinical Immunology
Suzanne Schuh, Judy Sweeney, Stephen B Freedman, Allan L Coates, David W Johnson, Graham Thompson, Jocelyn Gravel, Francine M Ducharme, Roger Zemek, Amy C Plint, Darcy Beer, Terry Klassen, Sarah Curtis, Karen Black, Darcy Nicksy, Andrew R Willan
BACKGROUND: Up to 30 % of children with acute asthma are refractory to initial therapy, and 84 % of this subpopulation needs hospitalization. Finding safe, noninvasive, and effective strategies to treat this high-risk group would substantially decrease hospitalizations, healthcare costs, and the psycho-social burden of the disease. Whereas intravenous magnesium (Mg) is effective in severe refractory asthma, its use is sporadic due to safety concerns, with the main treatment goal being to prevent intensive care unit admission...
May 24, 2016: Trials
Raquel Granell, A John Henderson, Jonathan A Sterne
BACKGROUND: Variable patterns of childhood wheezing might indicate differences in the cause and prognosis of respiratory illnesses. Better understanding of these patterns could facilitate identification of modifiable factors related to development of asthma. OBJECTIVES: We characterized childhood wheezing phenotypes from infancy to adolescence and their associations with asthma outcomes. METHODS: Latent class analysis was used to derive phenotypes based on patterns of wheezing recorded at up to 14 time points from birth to 16½ years among 12,303 participants from the Avon Longitudinal Study of Parents and Children...
April 19, 2016: Journal of Allergy and Clinical Immunology
Márcia B Silva, Ana L M Amor, Leonardo N Santos, Alana A Galvão, Aida V Oviedo Vera, Eduardo S Silva, Cynara Gomes Barbosa, Marilda S Gonçalves, Philip J Cooper, Camila A Figueiredo, Rita de Cassia Ribeiro, Neuza Maria Alcântara-Neves
Toxocara canis, Toxocara cati, are roundworms that live in the intestines of dogs and cats, respectively, and are predominantly agents of human toxocariasis. Studies have suggested that Toxocara spp. seroprevalence increases levels of total and aeroallergen-specific IgE (sIgE), asthma prevalence and asthma morbidity. Nevertheless, other work reported a negative association between Toxocara spp. seropositivity with skin hypersensititity and a positive association with sIgE. The objective of the present study was to evaluate risk factors for acquiring Toxocara spp...
April 11, 2016: Acta Tropica
Helena Pité, Ângela Gaspar, Mário Morais-Almeida
BACKGROUND: Predicting long-term outcomes in individuals with childhood wheezing is of major clinical relevance. OBJECTIVE: To identify and characterize childhood wheezing phenotypes related to asthma persistence in adolescence with a multidimensional statistical model, independent of predefined hypotheses. METHODS: This prospective cohort study included 308 children, ages < 7 years, with recurrent wheezing. We systematically evaluated asthma prevalence in children at 3, 8, and 13 years of follow-ups...
May 2016: Allergy and Asthma Proceedings:
Santosh Prasad, Rishabh Kumar Rana, Ronak Sheth, Anupama V Mauskar
INTRODUCTION: Early childhood wheezing is a heterogeneous condition, which has several phenotypic expressions and a complex relationship with the development of asthma later in life. New studies indicate the prevalence of recurrent wheeze to be associated with Vitamin D deficiency. This has not been explored in Indian settings widely, mandating this exploration. AIM: To determine the severity of Vitamin D deficiency and its association with recurrent wheeze in children less than 3 years of age...
February 2016: Journal of Clinical and Diagnostic Research: JCDR
Larissa Bouwman Sayão, Murilo Carlos Amorim de Britto, Edjane Burity, Catarina Rattes, Cyda Maria Albuquerque Reinaux, James Fink, Armèle Dornelas de Andrade
BACKGROUND: Airways inflammation may precede pulmonary dysfunction in wheezing individuals. The fraction of exhaled nitric oxide (FENO) has been described as a useful method for wheezing diagnosis in children, however, its application requires evidence. This study aimed to determine the accuracy of FENO in identifying wheezing in preschoolers. METHODS: A cross-sectional study was carried out with children from 3 to 5 years old, from Brazilian day care centers and public schools...
April 2016: Respiratory Medicine
James Fingleton, Irene Braithwaite, Justin Travers, Darren Bowles, Rianne Strik, Rob Siebers, Cecile Holweg, John Matthews, Mark Weatherall, Richard Beasley
Serum periostin is a potential biomarker of response to therapies that target type 2 inflammation in asthma. The objectives of this study were to describe: 1) the distribution of serum periostin levels in adults with symptomatic airflow obstruction; 2) its relationship with other variables, including type 2 biomarkers; and 3) the effect of inhaled corticosteroids on periostin levels.Serum periostin levels were measured in a cross-sectional study exploring phenotypes and biomarkers in 386 patients aged 18-75 years who reported wheeze and breathlessness in the past 12 months...
May 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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