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primary prevention asthma

Matthew Morten, Adam Collison, Vanessa E Murphy, Daniel Barker, Christopher Oldmeadow, John Attia, Joseph Meredith, Heather Powell, Paul D Robinson, Peter D Sly, Peter G Gibson, Joerg Mattes
BACKGROUND: The single-centre double-blind, randomised controlled Managing Asthma in Pregnancy (MAP) trial in Newcastle, Australia, compared a treatment algorithm using the fraction of exhaled nitric oxide (FeNO) in combination with asthma symptoms (FeNO group) against a treatment algorithm using clinical symptoms only (clinical group) in pregnant asthmatic women (ANZ Clinical Trials Registry, number 12607000561482). The primary outcome was a 50% reduction in asthma exacerbations during pregnancy in the FeNO group...
March 7, 2018: Journal of Allergy and Clinical Immunology
Katharine C Pike, Melika Akhbari, Dylan Kneale, Katherine M Harris
BACKGROUND: Asthma exacerbations in school-aged children peak in autumn, shortly after children return to school following the summer holiday. This might reflect a combination of risk factors, including poor treatment adherence, increased allergen and viral exposure, and altered immune tolerance. Since this peak is predictable, interventions targeting modifiable risk factors might reduce exacerbation-associated morbidity and strain upon health resources. The peak occurs in September in the Northern Hemisphere and in February in the Southern Hemisphere...
March 8, 2018: Cochrane Database of Systematic Reviews
Daniel J Jackson, Leonard B Bacharier, David T Mauger, Susan Boehmer, Avraham Beigelman, James F Chmiel, Anne M Fitzpatrick, Jonathan M Gaffin, Wayne J Morgan, Stephen P Peters, Wanda Phipatanakul, William J Sheehan, Michael D Cabana, Fernando Holguin, Fernando D Martinez, Jacqueline A Pongracic, Sachin N Baxi, Mindy Benson, Kathryn Blake, Ronina Covar, Deborah A Gentile, Elliot Israel, Jerry A Krishnan, Harsha V Kumar, Jason E Lang, Stephen C Lazarus, John J Lima, Dayna Long, Ngoc Ly, Jyothi Marbin, James N Moy, Ross E Myers, J Tod Olin, Hengameh H Raissy, Rachel G Robison, Kristie Ross, Christine A Sorkness, Robert F Lemanske
Background Asthma exacerbations occur frequently despite the regular use of asthma-controller therapies, such as inhaled glucocorticoids. Clinicians commonly increase the doses of inhaled glucocorticoids at early signs of loss of asthma control. However, data on the safety and efficacy of this strategy in children are limited. Methods We studied 254 children, 5 to 11 years of age, who had mild-to-moderate persistent asthma and had had at least one asthma exacerbation treated with systemic glucocorticoids in the previous year...
March 3, 2018: New England Journal of Medicine
Nienke M Scheltema, Elisabeth E Nibbelke, Juliëtte Pouw, Maarten O Blanken, Maroeska M Rovers, Christiana A Naaktgeboren, Natalie I Mazur, Joanne G Wildenbeest, Cornelis K van der Ent, Louis J Bont
BACKGROUND: Respiratory syncytial virus (RSV) infection is associated with subsequent wheeze and asthma. We previously reported on the causal relationship between prevention of RSV infection during infancy and reduced frequency of subsequent wheeze using a double-blind, randomised, placebo-controlled trial (MAKI). We continued follow-up and analysed the effect of RSV prevention during infancy on asthma and lung function at age 6 years. METHODS: We studied 429 infants born at 32-35 weeks of gestation between 2008-10 who had randomly received either palivizumab for RSV immunoprophylaxis or placebo during the RSV season of their first year of life...
February 27, 2018: Lancet Respiratory Medicine
Hamid Tavakoli, J Mark FitzGerald, Larry D Lynd, Mohsen Sadatsafavi
BACKGROUND: Understanding factors associated with the inappropriate or excessive use of short-acting beta agonists (SABA) can help develop better policies. METHODS: We used British Columbian (BC)'s administrative health data (1997-2014) to create a retrospective cohort of asthma patients aged between 14 and 55 years. The primary and secondary outcomes were, respectively, inappropriate and excessive use of SABA based on a previously validated definition. Exposures were categorised into groups comprising socio-demographic variables, indicators of type and quality of asthma care, and burden of comorbid conditions...
February 12, 2018: BMC Pulmonary Medicine
Zhi-Hui Yao, Hao-Jun Xie, Ya-Lu Yuan, Ya-Ting Huo, Jing Cao, Wen-Yan Lai, Rui-Jun Cai, Yuan-Xiong Cheng
AIMS: Thrombin is a serine proteinase that is not only involved in coagulation cascade, but also mediates a number of biological responses relevant to tissues repair, and induces bronchoconstriction. TGF-β plays a pivotal role in airway remodeling due to its effects on airway smooth muscle proliferation and extracellular matrix (ECM) deposition. Recently, bronchoconstriction itself is found to constitute a form of strain and is highly relevant to asthmatic airway remodeling. However, the underlying mechanisms remain unknown...
March 15, 2018: Life Sciences
Gayan Bowatte, Caroline J Lodge, Luke D Knibbs, Bircan Erbas, Jennifer L Perret, Bin Jalaludin, Geoffrey G Morgan, Dinh S Bui, Graham G Giles, Garun S Hamilton, Richard Wood-Baker, Paul Thomas, Bruce R Thompson, Melanie C Matheson, Michael J Abramson, E Haydn Walters, Shyamali C Dharmage
BACKGROUND AND AIMS: Traffic Related Air Pollution (TRAP) exposure is known to exacerbate existing respiratory diseases. We investigated longer term effects of TRAP exposure for individuals with or without existing asthma, and with or without lower lung function. METHODS: Associations between TRAP exposure and asthma (n = 689) and lung function (n = 599) were investigated in the prospective Tasmanian Longitudinal Health Study (TAHS). TRAP exposure at age 45 years was measured using two methods based on residential address: mean annual NO2 exposure; and distance to nearest major road...
February 7, 2018: Environment International
So-Hee Lee, Woo-Jung Song, Heung-Woo Park, Min-Gyu Kang, Sae-Hoon Kim, Hye-Kyung Park, Sang-Heon Kim, Yong-Eun Kwon, Tae-Bum Kim, Byung-Jae Lee, Young-Koo Jee, Byung-Whui Choi, Sang-Heon Cho, Sun-Sin Kim
Background: Although many risk factors are known to be associated with poor asthma outcomes in the elderly, the literature on the effect of risk factor control on asthma outcomes in the elderly is very sparse. Objective: To evaluate the role of multifaceted interventions in reducing acute exacerbations in elderly asthmatics. Methods: A total of 100 subjects were randomly selected from our prospective cohort of elderly asthmatics aged 65 years or older and were provided multifaceted intervention for 1 year...
January 2018: Asia Pacific Allergy
Osemeke U Osokogu, Javeed Khan, Swabra Nakato, Daniel Weibel, Maria de Ridder, Miriam C J M Sturkenboom, Katia Verhamme
PURPOSE: To control for confounding by indication in comparative (drug) effectiveness studies, propensity scores (PS) methods may be utilized. Since childhood diseases or outcomes often present as acute events, we compared the effect of using different look back periods in electronic health care data, to construct PSs. This was applied in our research on the effect of a combination of inhaled corticosteroids/long-acting beta-2-agonists (ICS+LABA), either as fixed combination or used as loose combination (2 separate inhaler devices) in the prevention of severe asthma exacerbations...
January 26, 2018: Journal of Clinical Epidemiology
Jennifer Mammen, Hyekyun Rhee, Sally A Norton, Arlene M Butz, Jill S Halterman, Kimberly Arcoleo
OBJECTIVES: A previous definition of adolescent asthma self-management was derived from interviews with clinicians/researchers and published literature; however, it did not incorporate perspectives of teens or parents. Therefore, we conducted in-depth interviews with teens and parents and synthesized present findings with the prior analysis to develop a more encompassing definition and model. METHODS: Focal concepts were qualitatively extracted from 14-day self-management voice-diaries (n = 14) and 1-hour interviews (n = 42) with teens and parents (28 individuals) along with concepts found in the previous clinical/research oriented analysis...
January 19, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Béatrice Duxbury, Émilie Chappuis-Gisin, Salim Chucri, Jean-Paul Janssens
Among the novelties described in the management of pulmonary disorders during the year 2017, we chose to describe three. First, the indication for inhaled glucocorticosteroids (ICS) in COPD has been revisited, because of their relationship with an increased occurence of pneumonia : ICS are now recommended only in severe COPD (GOLD D) with frequent exacerbations as second line treatment. Secondly, azithromycine has shown very promising results in poorly controlled severe asthma, with a significant impact on symptoms and exacerbations...
January 10, 2018: Revue Médicale Suisse
Ruby Biezen, Danilla Grando, Danielle Mazza, Bianca Brijnath
INTRODUCTION: Influenza vaccination has been shown to be safe and effective against influenza and in the prevention of complicating secondary respiratory illnesses. However, its uptake in young children remains low. This study explored the views, attitudes and practices of parents and primary care providers (PCPs) on their knowledge and acceptance of influenza vaccination in children under 5. METHODS: Using a cross-sectional qualitative research design, we conducted 30 in-depth interviews with PCPs (i...
January 5, 2018: Vaccine
Julie Deckers, Nadia Bougarne, Viacheslav Mylka, Sofie Desmet, Astrid Luypaert, Michael Devos, Giel Tanghe, Justine Van Moorleghem, Manon Vanheerswynghels, Lode De Cauwer, Jonathan Thommis, Marnik Vuylsteke, Jan Tavernier, Bart Lambrecht, Hamida Hammad, Karolien De Bosscher
Children with atopic dermatitis (AD) show an increased risk to develop asthma later in life, a phenomenon referred to as 'atopic march', which emphasizes the need for secondary prevention therapies. This study aimed to investigate whether relief of skin inflammation by glucocorticoids and PPARγ-agonists might influence the subsequent development of asthma in a murine model for the atopic march in which mice were repeatedly exposed to house dust mite (HDM) via the skin, followed by exposure to HDM in lungs...
December 27, 2017: Journal of Investigative Dermatology
D E S Larenas Linnemann, B E Del Río Navarro, J A Luna Pech, J Romero Lombard, J Villaverde Rosas, M C Cano Salas, M Fernández Vega, J A Ortega Martell, E C López Estrada, J L Mayorga Butrón, J Salas Hernández, J C Vázquez García, I Ortiz Aldana, M H Vargas Becerra, M Bedolla Barajas, N Rodríguez Pérez, A Aguilar Aranda, C A Jiménez González, C García Bolaños, C Garrido Galindo, D A Mendoza Hernández, E Mendoza López, G López Pérez, G H Wakida Kuzonoki, H H Ruiz Gutiérrez, H León Molina, H Martínez de la Lanza, H Stone Aguilar, J Gómez Vera, J Olvera Salinas, J J Oyoqui Flores, J L Gálvez Romero, J S Lozano Saenz, J I Salgado Gama, M A Jiménez Chobillon, M A García Avilés, M P Guinto Balanzar, M A Medina Ávalos, R Camargo Angeles, R García Torrentera, S Toral Freyre, G Montes Narvaez, H Solorio Gómez, J Rosas Peña, S J Romero Tapia, A Reyes Herrera, F Cuevas Schacht, J Esquer Flores, J A Sacre Hazouri, L Compean Martínez, P J Medina Sánchez, S Garza Salinas, C Baez Loyola, I Romero Alvarado, J L Miguel Reyes, L E Huerta Espinosa, M Á Correa Flores, R Castro Martínez
BACKGROUND: With the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma. METHODS: The guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-II to select three mother guidelines...
December 26, 2017: Allergologia et Immunopathologia
Dimitra E Zazara, Clara V Perani, María E Solano, Petra C Arck
Allergic asthma is an increasing health problem worldwide. Interestingly, prenatal challenges such as stress have been associated with an increased risk for asthma during childhood. The underlying pathogenesis of how prenatal stress increases the risk for asthma still remains unclear. Potential targets could be that the fetal immune ontogeny or fetal lung development are compromised by prenatal challenges. Here, we aimed to identify whether prenatal stress challenge affects fetal lung development in mice. C57BL/6 pregnant mice were challenged with sound stress and fetal lung development was assessed histologically...
February 2018: Journal of Reproductive Immunology
Marie-Claire Arrieta, Andrea Arévalo, Leah Stiemsma, Pedro Dimitriu, Martha E Chico, Sofia Loor, Maritza Vaca, Rozlyn C T Boutin, Evan Morien, Mingliang Jin, Stuart E Turvey, Jens Walter, Laura Wegener Parfrey, Philip J Cooper, Brett Finlay
BACKGROUND: Asthma is the most prevalent chronic disease of childhood. Recently, we identified a critical window early in the life of both mice and Canadian infants during which gut microbial changes (dysbiosis) affect asthma development. Given geographic differences in human gut microbiota worldwide, we studied the effects of gut microbial dysbiosis on atopic wheeze in a population living in a distinct developing world environment. OBJECTIVE: We sought to determine whether microbial alterations in early infancy are associated with the development of atopic wheeze in a nonindustrialized setting...
November 30, 2017: Journal of Allergy and Clinical Immunology
Sara C Sebag, Olha M Koval, John D Paschke, Christopher J Winters, Alejandro P Comellas, Isabella M Grumbach
Mitochondria are increasingly recognized as key mediators of acute cellular stress responses in asthma. However, the distinct roles of regulators of mitochondrial physiology on allergic asthma phenotypes are currently unknown. The mitochondrial Ca2+ uniporter (MCU) resides in the inner mitochondrial membrane and controls mitochondrial Ca2+ uptake into the mitochondrial matrix. To understand the function of MCU in models of allergic asthma, in vitro and in vivo studies were performed using models of functional deficiency or knockout of MCU...
January 15, 2018: Experimental Cell Research
Aki Mafune Hamada, Izumi Yamamoto, Yasuyuki Nakada, Akimitsu Kobayashi, Yusuke Koike, Jun Miki, Hiroki Yamada, Yudo Tanno, Ichiro Ohkido, Nobuo Tsuboi, Hiroyasu Yamamoto, Mitsuyoshi Urashima, Takashi Yokoo
BACKGROUND/AIMS: Post-transplant hypertension is highly prevalent in renal transplant recipients and is a risk factor for graft loss, cardiovascular disease and death. Glucocorticoid is used to prevent rejection, but simultaneously increases the risk of post-transplant hypertension. The glucocorticoid-induced transcript 1 (GLCCI1) promoter polymorphism (rs37972) has been reported to be associated with response to glucocorticoid therapy in asthma. We therefore examined the association between GLCCI1 promoter polymorphism and post-transplant hypertension in renal transplant recipients...
2017: Kidney & Blood Pressure Research
Hye Ju Yeo, Dohyung Kim, Doosoo Jeon, Yun Seong Kim, Peter Rycus, Woo Hyun Cho
BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) in cases of near-fatal asthma (NFA) has increased, but the benefits and potential complications of this therapy have yet to be fully investigated. METHODS: Cases were extracted from the Extracorporeal Life Support Organization Registry between March 1992 and March 2016. All patients with a diagnosis of asthma (according to the International Classification of Diseases 9th edition), who also received ECMO, were extracted...
December 6, 2017: Critical Care: the Official Journal of the Critical Care Forum
Michelle Trivedi, Janki Patel, Darleen Lessard, Ted Kremer, Nancy Byatt, Wanda Phipatanakul, Lori Pbert, Robert Goldberg
OBJECTIVE: We examined the impact of a novel, school nurse-supervised asthma therapy program on healthcare utilization. METHODS: We retrospectively reviewed charts of 84 children enrolled in this program in central Massachusetts between 2012 and 2015. Physicians identified children with persistent asthma and poor medication adherence. These children were enrolled in the program to receive daily-inhaled corticosteroid at school, supervised by their school nurse, with ongoing communication between physician's office and school nurse through the school year...
December 5, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
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