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Wheezing phenotypes

Paraskevi Xepapadaki, Claus Bachert, Susetta Finotto, Tuomas Jartti, George N Konstantinou, Alexander Kiefer, Marek Kowalski, Anna Lewandowska-Polak, Heikki Lukkarinen, Eirini Roumpedaki, Anna Sobanska, Ina Sintobin, Tytti Vuorinen, Nan Zhang, Theodor Zimmermann, Nikolaos G Papadopoulos
BACKGROUND: The PreDicta cohort was designed to prospectively evaluate wheeze/asthma persistence in preschoolers in association to viral/microbial exposures and immunological responses. We present the cohort design, demographic/disease characteristics and evaluate unsupervised and predefined phenotypic subgroups at inclusion. METHODS: PreDicta is a 2-year prospective study conducted in five European regions, including children 4-6 years with a diagnosis of asthma as cases and healthy age-matched controls...
March 7, 2018: Pediatric Allergy and Immunology
Irfan Ismail Ayub, Abdul Majeed Arshad, Prathipa Sekar, Natraj Manimaran, Dhanasekar Thangaswamy, Chandrasekar Chockalingam
Background: There is dearth of literature on asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS) in India. The aim was to compare clinical characteristics between patients with ACOS and non-ACOS COPD and to identify clinical predictors of ACOS in patients with COPD. Methods: We conducted a retrospective study by reviewing data collected from patients performing spirometry at our hospital. Those with postbronchodilator FEV1 /FVC <70% were included in the study...
March 2018: Lung India: Official Organ of Indian Chest Society
Beatriz Villafuerte, Daniel Natera-de Benito, Aidy González, María A Mori, María Palomares, Julián Nevado, Sixto García-Miñaur, Pablo Lapunzina, Luis I González-Granado, Luis M Allende, José C Moreno
Genetic defects of NKX2-1 are classically associated with hypothyroidism, benign chorea and neonatal respiratory distress. The purpose of this study was to identify the genetic pathogenesis of the "NKX2-1 triad" in a 10 year-old female presenting additional features barely described in the disorder. In the neonatal period, she presented with generalized hypotonia and respiratory distress, with later episodes of frequent wheezing. At 3 month-age developmental dysplasia of the hip was diagnosed and at 10 months, primary hypothyroidism was detected and treated...
February 22, 2018: European Journal of Medical Genetics
Maria José Rosa, Alison G Lee, Rosalind J Wright
PURPOSE OF REVIEW: The objective of this review is to provide an update on our evolving understanding of the effects of stress in pregnancy and during early development on the onset of asthma-related phenotypes across childhood, adolescence, and into early adulthood. RECENT FINDINGS: Accumulating evidence over the past 2 decades has established that prenatal and early-life psychological stress and stress correlates (e.g., maternal anxiety or depression) increase the risk for childhood respiratory disorders...
January 23, 2018: Current Opinion in Allergy and Clinical Immunology
Chinedu Nwokoro, Jonathan Grigg
Preschool wheeze is a common but poorly understood cause of respiratory morbidity that is both distinct from and overlaps with infantile bronchiolitis and school age asthma. Attempts at classification by epidemiology, pathophysiology, therapeutic response and clinical phenotype are imperfect and yet fundamental to both treatment choice and research design. The four main therapeutic classes for preschool wheeze, namely beta2 agonists, anticholinergics, corticosteroids and leukotriene modifiers are employed with variable and often scanty evidence base, with evidence for a genetic influence on response variations...
December 5, 2017: Paediatric Respiratory Reviews
Nikos Stratakis, Marij Gielen, Katerina Margetaki, Renate H M de Groot, Maria Apostolaki, Georgia Chalkiadaki, Marina Vafeiadi, Vasiliki Leventakou, Roger W Godschalk, Manolis Kogevinas, Euripides G Stephanou, Maurice P Zeegers, Leda Chatzi
Lower prenatal exposure to n-3 PUFA relative to n-6 PUFA has been hypothesised to influence allergy development, but evidence remains largely inconsistent. In the Dutch Maastricht Essential Fatty Acid Birth (MEFAB) (n 293) and Greek RHEA Mother-Child (n 213) cohorts, we investigated whether cord blood phospholipid PUFA concentrations are associated with symptoms of wheeze, asthma, rhinitis and eczema at the age of 6-7 years. Information on allergy-related phenotypes was collected using validated questionnaires...
January 2018: British Journal of Nutrition
Lucy J Griffiths, Ronan A Lyons, Amrita Bandyopadhyay, Karen S Tingay, Suzanne Walton, Mario Cortina-Borja, Ashley Akbari, Helen Bedford, Carol Dezateux
Introduction: Electronic health records (EHRs) are increasingly used to estimate the prevalence of childhood asthma. The relation of these estimates to those obtained from parent-reported wheezing suggestive of asthma is unclear. We hypothesised that parent-reported wheezing would be more prevalent than general practitioner (GP)-recorded asthma diagnoses in preschool-aged children. Methods: 1529 of 1840 (83%) Millennium Cohort Study children registered with GPs in the Welsh Secure Anonymised Information Linkage databank were linked...
2018: BMJ Open Respiratory Research
Susanne Kutzora, Alisa Weber, Stefanie Heinze, Lana Hendrowarsito, Uta Nennstiel-Ratzel, Erika von Mutius, Nina Fuchs, Caroline Herr
BACKGROUND: Different wheezing and asthmatic phenotypes turned out to indicate differences in etiology, risk factors and health care. We examined influential factors and urban-rural differences for different phenotypes. METHODS: Parents of 4732 children filled out a questionnaire concerning children's health and environmental factors administered within the Health Monitoring Units (GME) in a cross-sectional study in Bavaria, Germany (2014/2015). To classify respiratory symptoms, five phenotype groups were built: episodic, unremitting and frequent wheeze, ISAAC (International Study of Asthma and Allergies in Children) - asthma and physician-diagnosed asthma (neither of the groups are mutually exclusive)...
December 24, 2017: International Journal of Hygiene and Environmental Health
Prem Parkash Gupta, Manjunath B Govidagoudar, Rohtas Yadav, Dipti Agarwal
PURPOSE: The present study aimed at clinical and pulmonary functions profiling of patients with chronic obstructive pulmonary disease (COPD) to anticipate future exacerbations. METHODS: The study included 80 COPD patients; 40 patients had ≥2 acute exacerbations during preceding 1 year (frequent exacerbation [FECOPD] group) and 40 patients had <2 acute exacerbations during preceding 1 year (infrequent exacerbation [I-FECOPD] group). Clinical profile, sputum microbiology, blood gas analysis, spirometric indices, and diffusion capacity (transfer test) variables were assessed...
January 2018: Lung India: Official Organ of Indian Chest Society
Sara Nilsson, Maria Ödling, Niklas Andersson, Anna Bergström, Inger Kull
BACKGROUND: Asthma is common among schoolchildren and may influence quality of life and school attendance. However, it is unclear if asthma affects school performance. The aim of this study was to examine if different phenotypes of asthma affect school performance during adolescence. METHODS: The study population consisted of 1,715 adolescents from a population-based birth cohort, followed to age 16 with questionnaires and clinical examinations. Asthma was defined as at least 4 wheeze episodes or at least 1 wheeze episode in combination with inhaled steroids in the last 12 months...
January 4, 2018: Pediatric Allergy and Immunology
Katarina Stenberg Hammar, Katarzyna Niespodziana, Marianne van Hage, Juha Kere, Rudolf Valenta, Gunilla Hedlin, Cilla Söderhäll
BACKGROUND: Rhinovirus induced wheezing in young children has been associated with increased asthma risk at school age. Recently, the transmembrane protein cadherin related family member 3 (CDHR3) was identified as the RV-C receptor and the genetic variant rs6967330 (p.Cys529Tyr) was reported to be associated with enhanced RV-C binding and increased replication in vitro. The aim of this study was to examine rs6967330 genotypes and mRNA expression of CDHR3 in relation to presence of rhinovirus and clinical symptoms in children with acute wheezing and compare to a group of age-matched healthy children...
January 4, 2018: Pediatric Allergy and Immunology
Hengameh Raissy, Kathryn Blake
A growing body of literature has investigated optimizing asthma management by identifying phenotypes and biomarkers to guide the treatment. In particular, management of asthma in preschool children remains challenging due to different phenotype presentation in early life. The focus of this review is to summarize the recent data on personalized medicine in management of preschool children with wheezing.
December 1, 2017: Pediatric Allergy, Immunology, and Pulmonology
M Dogru, L P Seren
Background. Recurrent wheezing may be related to various reasons. There is a lack of knowledge about the effect of vitamin D status in the children with recurrent wheezing. The aim of this study is to compare the level of vitamin D between recurrent wheezing children and healthy controls, and to investigate the relationship between vitamin D status and the clinical parameters of recurrent wheezing in preschool children. Methods. One hundred-ten children followed up in our hospital with recurrent wheezing were included in the study...
November 2017: European Annals of Allergy and Clinical Immunology
Jaymin B Morjaria, Alan S Rigby, Alyn H Morice
Little is known of the long-term symptom profile in uncontrolled asthma and whether symptoms can predict distinct phenotypes. The primary objective of these analyses was to assess diurnal profile of cough and wheeze in an uncontrolled asthma population. Secondary outcomes were to examine how these symptom profiles influence response to treatment.Twice-daily electronically recorded data from 1701 patients were examined in relation to the population demographics. Reliever treatment with salbutamol was then compared with extra-fine beclometasone/formoterol maintenance and reliever therapy (MART)...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
James Fingleton, Kewu Huang, Mark Weatherall, Yanfei Guo, Stefan Ivanov, Piet Bruijnzeel, Hong Zhang, Wei Wang, Richard Beasley, Chen Wang
It is uncertain whether phenotypes of asthma and chronic obstructive pulmonary disease (COPD) vary between populations with different genetic and environmental characteristics. Here, our objective was to compare the phenotypes of airways disease in two separate populations.This was a cross-sectional observational study in adult populations from New Zealand and China. Participants aged 40-75 years who reported wheeze and breathlessness in the last 12 months were randomly selected from the general population and underwent detailed characterisation...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Annette T Hastie, Fernando J Martinez, Jeffrey L Curtis, Claire M Doerschuk, Nadia N Hansel, Stephanie Christenson, Nirupama Putcha, Victor E Ortega, Xingnan Li, R Graham Barr, Elizabeth E Carretta, David J Couper, Christopher B Cooper, Eric A Hoffman, Richard E Kanner, Eric Kleerup, Wanda K O'Neal, Richard Paine, Stephen P Peters, Neil E Alexis, Prescott G Woodruff, MeiLan K Han, Deborah A Meyers, Eugene R Bleecker
BACKGROUND: Increased concentrations of eosinophils in blood and sputum in chronic obstructive pulmonary disease (COPD) have been associated with increased frequency of exacerbations, reduced lung function, and corticosteroid responsiveness. We aimed to assess whether high eosinophil concentrations in either sputum or blood are associated with a severe COPD phenotype, including greater exacerbation frequency, and whether blood eosinophils are predictive of sputum eosinophils. METHODS: We did a multicentre observational study analysing comprehensive baseline data from SPIROMICS in patients with COPD aged 40-80 years who had a smoking history of at least 20 pack-years, recruited from six clinical sites and additional subsites in the USA between Nov 12, 2010, and April 21, 2015...
December 2017: Lancet Respiratory Medicine
Hui Wu, Chunwei Zhang, Yongqing Wang, Yanlin Li
Asthma is a heterogeneous disease with multiple phenotypes. Epidemiologic studies suggest a close relationship between vitamin E and the occurrence of asthma, wheezing and atopic conditions during childhood. Previous results on its effects have been conflicting. The aim of this meta-analysis was to critically examine the current evidence on the association of vitamin E with childhood asthma and wheezing. We searched electronic databases for observational studies in English-language journals published from 2000 to 2016...
October 16, 2017: Paediatric Respiratory Reviews
Ben D Spycher, Cara Cochrane, Raquel Granell, Jonathan A C Sterne, Michael Silverman, Eva Pedersen, Erol A Gaillard, John Henderson, Claudia E Kuehni
The distinction between episodic viral wheeze (EVW) and multitrigger wheeze (MTW) is used to guide management of preschool wheeze. It has been questioned whether these phenotypes are stable over time. We examined the temporal stability of MTW and EVW in two large population-based cohorts.We classified children from the Avon Longitudinal Study of Parents and Children (n=10 970) and the Leicester Respiratory Cohorts ((LRCs), n=3263) into EVW, MTW and no wheeze at ages 2, 4 and 6 years based on parent-reported symptoms...
November 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Felix Zamora, Roy Cho, Madhuri Rao, Heidi Gibson, H Erhan Dincer
Asthma is an incurable chronic disease affecting approximately 24 million people in the United States. The hallmark features of asthma are reversible airflow obstruction, airway hyperresponsiveness, airway inflammation, bronchoconstriction, and excessive mucus secretion. Clinical symptoms include episodic or persistent breathlessness, wheezing, cough, or chest tightness/pressure. Forty-five percent of asthmatics continue to have yearly exacerbations and the disease is responsible for approximately 3,600 annual deaths...
2017: Journal of visualized surgery
Fernando D Martinez, Stefano Guerra
Asthma is a developmental disease that affects airway growth and is characterized by inappropriate responses to a variety of environmental stimuli. Recent advances point to two altered early life pathways as major determinants of asthma risk. In the "microbial" pathway, pre- and post-natal exposures to microbiota-loaded farm environments block gene-virus interactions (e.g., interactions between risk alleles in chromosome 17q21 and lower respiratory illnesses [LRI] by rhinovirus) that are associated with asthma development...
October 19, 2017: American Journal of Respiratory and Critical Care Medicine
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