Sleep Duration and Exhaled Nitric Oxide in Asthma and Health Adults

MedicalResearch.com Interview with:
Rauno Joks, MD

Associate Professor of Clinical Medicine
Chief, Division of Allergy & Immunology
Program Director, Allergy &Immunology Fellowship
SUNY Downstate Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are circadian and circannular patterns to many diseases, including allergy and asthma. Humans spend roughly one-third of their lifetimes asleep. Your immune system never sleeps, but shifts its activity when you sleep.

It is known that asthma disease activity can be worse at night – the reasons for this are complex, and may involve changes in allergic responses.

We found, in a preliminary study of both adults with and without asthma, that longer duration of nighttime sleep was associated with lower levels of exhaled nitric oxide, a biomarker which is elevated in exhaled breath of those with allergic asthma. This may carry over into the afternoon as well, but the sample size was too small to fully conclude that.

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Pediatric Asthma Costs Over $5 Billion Per Year In Health Care Expenses

MedicalResearch.com Interview with:

Patrick W. Sullivan, Ph.D. Professor Regis University School of Pharmacy Denver, CO 80221

Dr. Sullivan

Patrick W. Sullivan, Ph.D.
Professor
Regis University School of Pharmacy
Denver, CO 80221

MedicalResearch.com: What is the background for this study?

Response: Asthma is one of the most common chronic disorders among children. It affects 7.1 million children in the U.S. Of these, 4.1 million children suffered an asthma attack in 2011. An asthma attack is an acute period of extreme difficulty breathing. It can be life threatening and is always very frightening for children. Because asthma can be dangerous and frightening, it ends up costing a lot because patients need to go the doctor, hospital or take medications to try to control it.

Asthma also has a negative effect on the patient’s health and outlook about their health – both mentally and physically. Previous studies have focused on adults with asthma and have found that it is very expensive – it costs $18 billion in the U.S. to manage adults with asthma. Those studies also showed that adults with asthma have lower quality of life. However, there is not a lot of good evidence on the burden of asthma in children. This study was designed to quantify the cost and mental and physical health of children with asthma in the U.S.

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Asthma Risk Varies Among Hispanic Groups After Relocation to the U.S.

MedicalResearch.com Interview with:

Elina Jerschow, M.D., M.Sc., FAAAAI, FACAAI Associate Professor of Medicine, Allergy/ Immunology Division Director, Drug Allergy Center Montefiore Medical Center The University Hospital for Albert Einstein College of Medicine Bronx, New York 10461

Dr. Elina Jerschow

Elina Jerschow, M.D., M.Sc., FAAAAI, FACAAI
Associate Professor of Medicine, Allergy/ Immunology Division
Director, Drug Allergy Center
Montefiore Medical Center
The University Hospital for Albert Einstein College of Medicine
Bronx, New York 10461

MedicalResearch.com: What is the background for this study?

Response: Asthma prevalence varies across and within countries, and markedly increased rates of asthma have been observed in recent decades. Recent time-trends may be attributed to increased urbanization and dissemination of a Western lifestyle.

In the US, asthma disproportionally affects African-Americans and Hispanics/Latinos living in urban areas. Among Hispanics/Latinos, asthma prevalence varies from 5.7 % for Mexicans/Mexican-Americans to 16.5% for Puerto Ricans. Besides national background, US nativity, longer duration of US residence, and having one or two parents born in the US have been previously reported as acculturation-related risk factors for asthma in foreign born children. Asthma prevalence was also higher in foreign-born Latinos who relocated to the US as children.

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Palivizumab Prophylaxis in Preterm Infants and Subsequent Recurrent Wheezing

MedicalResearch.com Interview with:
Hiroyuki Mochizuki, M.D., Ph.D
.
Professor & Chairman
Department of Pediatrics
Tokai University School of Medicine
Japan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: My major is allergy and respiratory health of children. By this examination, we wanted to know the true influence of respiratory syncytial virus infection on childhood atopic asthma. We have confirmed that infantile asthma is heterogenic, and at least two kinds of phenotypes are present.

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Fish Oil Fatty Acids in Pregnancy May Reduce Wheeze and Asthma in Offspring

MedicalResearch.com Interview with:

Hans Bisgaard, M.D., D.M.Sc. COPSAC, Herlev and Gentofte Hospital University of Copenhagen Copenhagen, Denmark

Dr. Hans Bisgaard

Hans Bisgaard, M.D., D.M.Sc.
COPSAC, Herlev and Gentofte Hospital
University of Copenhagen
Copenhagen, Denmark

MedicalResearch.com: What is the background for this study?

Response: Asthma and lower respiratory infections are leading causes of morbidity and mortality in pediatric populations. Thus, having low cost, effective, safe options for prevention could have important implications for both clinical practice and public health.

The increased use of vegetable oils in cooking and of grain in the feeding of livestock has resulted in an increase in the intake of n−6 polyunsaturated fatty acids and a decrease in the intake of n−3 polyunsaturated fatty acids, especially the long-chain poly-unsaturated fatty acids (LCPUFAs) — eicosapentaenoic acid (20:5n–3, EPA) and docosahexaenoic acid (22:6n–3, DHA) — found in cold-water fish. N3-LCPUFAs are known to have immune-modulatory effects, and observational studies have suggested an association between a diet that is deficient in n−3 LCPUFA during pregnancy and an increased risk of asthma and wheezing disorders in offspring. Only a few randomized, controlled trials of n−3 LCPUFA supplementation during pregnancy have been performed and these have generally been underpowered and produced ambiguous results.

Therefore, we conducted a double-blind, randomized, controlled trial of n−3 LCPUFA supplementation during the third trimester of pregnancy in a total of 736 Danish women to assess the effect on the risk of persistent wheeze and asthma in offspring.

The clinical follow-up rate among children was 96% (N=664) by the end of the 3 years double-blind period and 93% (N=647) after an additional follow-up to age 5 years.
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Trajectory To Childhood Asthma Begins At Birth

MedicalResearch.com Interview with:

Donata Vercelli, MD Professor of Cellular and Molecular Medicine, University of Arizona Director, Arizona Center for the Biology of Complex Diseases Associate Director, Asthma and Airway Disease Research Center The BIO5 Institute, Rm. 339 Tucson, AZ 85721

Dr. Donata Vercelli

Donata Vercelli, MD
Professor of Cellular and Molecular Medicine
Director, Arizona Center for the Biology of Complex Diseases
Director, Molecular Genomics, Asthma and Airway Disease Research Center
The University of Arizona The BIO5 Institute
Tucson, AZ 85721

MedicalResearch.com: What is the background for this study?

Response: Asthma is the most prevalent chronic disease of childhood. Epidemiological evidence suggests that the disease often begins during the pre-school years even when chronic symptoms appear much later in life. However, firm criteria to pinpoint how early a child’s trajectory to asthma truly begins are currently lacking. The mechanisms underlying asthma inception also remain largely unknown. Although epigenetic mechanisms likely contribute to asthma pathogenesis, little is known about their role in asthma inception.

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Cured Meat Linked To Worsening of Asthma Symptoms

MedicalResearch.com Interview with:
Zhen LI, MD, MPH, PhD Candidate

INSERM UMR-S 1168 (ex-Equipe 5 du CESP)
(VIMA : Aging and chronic diseases. Epidemiological and public health approaches.), Hôpital Paul Brousse
France

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: -Cured meat, which is rich in nitrite, has been known as a probable carcinogen. However, although some studies have suggested a potential deleterious role of cured meat intake in lung health, its role in asthma remained unknown.

This study was conducted using data from the French Epidemiological study on the Genetics and Environment of Asthma (EGEA). Using data from 971 participants with seven years’ follow-up, we found that participants who ate frequently cured meat, including ham, sausages, and dried sausages, had a high likelihood of having worsening asthma symptoms. The highest likelihood (76% more) was observed among participants who ate cured meats four or more servings per week, compared with those who ate less than one serving per week. Moreover, as previous studies suggested that obesity is linked to worsening asthma, we used a newly developed method to estimate if this effect was mediated by Body Mass Index (BMI), and we found that overweight/obesity only partly explained the association (14%).

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Asthma Medications in Schools Prevents Children From Being Sent Home or to the ED

MedicalResearch.com Interview with:

Manoj Warrier, M.D. Allergy, Asthma & Sinus Care Center Adjunct Associate Professor of Pediatrics Saint Louis University and Cardinal Glennon Children's Medical Center St. Louis, MO 63127

Dr. Manoj Warrier

Manoj Warrier, M.D.
Allergy, Asthma & Sinus Care Center
Adjunct Associate Professor of Pediatrics
Saint Louis University and Cardinal Glennon Children’s Medical Center
St. Louis, MO 63127

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In 2012, Missouri House Bill 1188 was passed, which allowed trained employees in Missouri schools to administer asthma related rescue medications at their discretion to students experiencing an asthma exacerbation, even if the individual student did not have their own supply of the medication.

The Asthma and Allergy Foundation of America St. Louis Chapter (AAFA-STL) was instrumental in facilitating passage of this bill and also created the RESCUE (Resources for Every School Confronting Unexpected Emergencies) program, which provides equipment and access to free medications to treat acute asthma symptoms, mainly supporting schools with lower income populations. AAFA-STL tracked how often RESCUE supplies were used and found that equipment was used 1357 individual times in 2013-2014 school year, with students going back to class 86.07%, sent home 10.83%, and sent to emergency department (ED) only 1.33% of the time. In the 2014-2015, they found similar results with equipment used 1720 individual times, with students going back to class 84.48%, sent home 10.81%, and sent to ED 3.14% of the time.

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Many Children With Asthma Still Not Receiving Flu Vaccine

MedicalResearch.com Interview with:

Deepa Patadia, MD Wexner Medical Center The Ohio State University

Dr. Deepa Patadia

Deepa Patadia, MD
Wexner Medical Center
The Ohio State University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Influenza vaccination is recommended every autumn for all children 6 months of age and older. It is particularly important for children with asthma, who are at high risk of hospitalization or severe illness if they contract influenza infection. The rates of influenza vaccination in children with asthma have not previously been well studied, but Healthy People 2020 has set a target goal to vaccinate 70% of all children for influenza. We found that rates of vaccination in our large primary care population was much lower than the target rate, with less than 50% of all children receiving the vaccine each year over a 5 year period; however rates were higher in children with asthma, albeit still only at 55%.

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Breastfeeding May Protect Against Genetic Tendency Toward Pediatric Asthma

MedicalResearch.com Interview with:
Olga Gorlanova
Wissenschaftliche Assistenzärztin
Paediatric Pneumology Research Group
Universitäts-Kinderspital beider Base

MedicalResearch.com: What is the background for this study?

Response: Previous research has investigated how childhood asthma and early wheeze can develop as the result of a complex interaction between environmental exposures, such as tobacco exposure, older siblings and an individual’s genetic profile. Genes associated with childhood asthma risk are located on chromosome 17, called 17q21. Our study asked the question: could the effect of 17q21 on respiratory symptoms in infants be modified by breastfeeding? Continue reading

Overweight Girls, Underweight Boys May Be At Greater Risk of Adult Asthma

MedicalResearch.com Interview with:
Professor Charlotte Suppli Ulrik MD DMSc et al.
Dept. of Respiratory Medicine
Hvidovre Hospital
Copenhagen, Denmark

MedicalResearch.com: What is the background for this study?

Response: Obesity is a risk factor for new-onset asthma, but the association is incompletely understood. Our aim was, therefore, to investigate the association between body mass index (BMI) BMI in childhood and asthma admissions in early adulthood (until age 45 years).

We used data on BMI measured annually (age 7-13 years) in 321,830 children enrolled in the Copenhagen School Health Records Registry. During the 36-years of follow-up, a total of 2,059 first-time ever hospital admissions for asthma were observed.

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Origins of Childhood Asthma Can Be Traced To Very Early in Pregnancy

MedicalResearch.com Interview with:

Dr Steve Turner MD MBBS Lead investigator of the study team and Respiratory paediatrician Royal Aberdeen Children’s Hospital

Dr. Stephen Turner

Dr Steve Turner MD MBBS
Lead investigator of the study team and
Respiratory paediatrician
Royal Aberdeen Children’s Hospital

MedicalResearch.com: What is the background for this study?

Response: For almost thirty years there has been evidence that we are all born with a certain predisposition to what are called non communicable diseases (NCD) such as high blood pressure, type II diabetes and heart disease.

The evidence comes from studies which have linked reduced birth weight with increased risk for these NCDs in later life. The question which arises, and which has been more difficult to answer, is “when during pregnancy is the predisposition to for NCDs first seen?”

This is important to any attempt to reduce the unborn baby’s risk for NCD. We and other researchers have used fetal ultrasound data to link size before birth to non communicable diseases outcomes. In childhood, NCDs include asthma.

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Most Childhood Asthma Responds To Evidenced Based Therapy

MedicalResearch.com Interview with:

Francine M. Ducharme, MD, FRCPC Professor, Departments of Paediatrics and Social and Preventive Medicine University of Montreal Associate Director of Clinical Research and Knowledge Transfer, Research Centre, CHU Ste-Justine

Prof. Francine Ducharme

Francine M. Ducharme, MD, FRCPC
Professor, Departments of Paediatrics and Social and Preventive Medicine
University of Montreal
Associate Director of Clinical Research and Knowledge Transfer, Research Centre, CHU Ste-Justine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The management of asthma attacks in preschoolers has been the subject of much recent debate. The results of a study published in 2009 had shaken the pediatric world. The study reported that preschool children with viral-triggered flare-ups did not respond to standard treatment and, suggesting that this was due to their young age. Such finding was particularly worrisome as the majority of asthma-related emergency room visits and hospitalizations involve preschool children.

We conducted this large cohort study in which children aged 1 to 17 years with a moderate or severe asthma attack were treated using the established evidence-based therapy adjusted to the severity of exacerbation assessed by the Pediatric Respiratory Assessment Measure (PRAM), administered rapidly. We explored the determinants of the failure of emergency therapy. Age was not a factor. Instead, in addition to attack severity and symptoms between attacks, it was rather the presence of respiratory viral infection or fever triggering the attack that was more often associated with treatment failure, i.e., higher hospitalization rates, more returns to the emergency room, and reduced speed of recovery over the 10 days after discharge. Viral detection occurred more frequently in preschoolers (67%) than in older children (46%) with asthma.
Nevertheless, the results confirm the overall effectiveness of standard treatment, adjusted to the severity of the attack and administered early, in the vast majority of children, regardless of age and viral detection. Indeed, although a failure rate of nearly 40% was expected in this group of children with moderate to severe attack, only 17% of the participants did not respond to standard treatment. This rate was significantly higher (19%) in children with viral infection compared to uninfected children (13%).

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Long-Acting Beta-Agonists-Steroid Combination in Pediatric Asthma

MedicalResearch.com Interview with:
David A Stempel, MD
Medical Affairs Lead
US Medical Affairs
GlaxoSmithKline

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Long-acting beta-agonists (LABAs) have been shown to increase the risk of asthma-related death among adults and the risk of asthma-related hospitalization among children.

It is unknown whether the concomitant use of inhaled glucocorticoids
with LABAs mitigates those risks. This trial prospectively evaluated the safety of the LABA salmeterol, added to fluticasone propionate, in a fixed-dose combination in children.

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Children With Food Allergies More Likely To Develop Asthma and Allergic Rhinitis

MedicalResearch.com Interview with:
David A. Hill, M.D., Ph.D.
Fellow Physician
Division of Allergy and Immunology
The Children’s Hospital of Philadelphia
Philadelphia, PA 19104-3375

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Eczema, asthma, allergic rhinitis, and food allergies are among the most common childhood medical conditions in the United States. Importantly, disease rates for these conditions are thought to be changing, prompting the need for continued surveillance.

In our study, we examined electronic medical record data of over 1 million children to measure incidence and prevalence rates of these conditions in our community. We found that 1 in 5 children seen in our network are diagnosed with asthma, a rate that is among the highest in the nation. Additionally, the large size of our study allowed us to measure the extent to which food allergies are associated with asthma or allergic rhinitis. In this analysis, we found that children with food allergies are 2 to 3 times more likely to develop asthma or allergic rhinitis, as compared with children without food allergy.

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No Difference In Asthma Exacerbations Between Acetaminophen and Ibuprofen in Young Children

MedicalResearch.com Interview with:

Wanda Phipatanakul, MD, MS Associate Professor of Pediatrics Harvard Medical School Director, Asthma Clinical Research Center Boston Children's Hospital Asthma, Allergy and Immunology Boston, MA 02115

Dr. Wanda Phipatanakul

Wanda Phipatanakul, MD, MS
Associate Professor of Pediatrics
Harvard Medical School
Director, Asthma Clinical Research Center
Boston Children’s Hospital
Asthma, Allergy and Immunology
Boston, MA 02115

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:  Acetaminophen (e.g., Tylenol, Panadol) and ibuprofen (e.g., Advil, Motrin) are the only available treatments for pain and fever in toddlers and the most commonly utilized medications worldwide. Recently there has been controversy and even alarm with suggestive observational data that acetaminophen makes asthma worse. This has led some experts to recommend the avoidance of acetaminophen in children with asthma. We sought to find the answer to this burning question through the first prospective, double-blind, randomized clinical trial comparing acetaminophen versus ibuprofen head to head for use when clinically indicated for fever or pain. Is there a difference in asthma morbidity (exacerbations) in young children between the age of 12-59 months, who have asthma?

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Innate Immune Activation Protects Amish Children From Asthma

MedicalResearch.com Interview with:

Donata Vercelli, MD Professor of Cellular and Molecular Medicine, University of Arizona Director, Arizona Center for the Biology of Complex Diseases Associate Director, Asthma and Airway Disease Research Center The BIO5 Institute, Rm. 339 Tucson, AZ 85721

Dr. Donata Vercelli

Donata Vercelli, MD
Professor of Cellular and Molecular Medicine, University of Arizona
Director, Arizona Center for the Biology of Complex Diseases
Associate Director, Asthma and Airway Disease Research Center
The BIO5 Institute
Tucson, AZ 85721

MedicalResearch.com: What is the background for this study?

Response: By probing the differences between two farming communities—the Amish of Indiana and the Hutterites of South Dakota—our interdisciplinary team (which included, among others, Erika von Mutius from Ludwig-Maximilians University in Munich, Carole Ober and Anne Sperling from the University of Chicago, and myself) found that substances in the house dust from Amish, but not Hutterite, homes shape the innate immune system in ways that may prevent the development of allergic asthma.

Growing up in a microbe-rich farm environment has been known to protect against asthma. Our current study extends these findings by showing that in both humans and mice protection requires engagement of the innate immune system.

The Amish and Hutterite farming communities in the United States, founded by immigrants from Central Europe in the 18th and 19th centuries, provide textbook opportunities for comparative studies. The Amish and the Hutterites have similar genetic ancestry and share lifestyles (e.g., family size, diet, lack of exposure to indoor pets) known to affect asthma risk. However, their farming practices differ. The Amish have retained traditional methods, live on single-family dairy farms and rely on horses for fieldwork and transportation. In contrast, the Hutterites live on large communal farms and use modern, industrialized farm machinery. This distances young Hutterite children from the constant daily exposure to farm animals.

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Loss of ADAM33 suppresses features of asthma, suggesting targeting ADAM33 as a potential new asthma therapy

MedicalResearch.com Interview with:

Hans Michael Haitchi, MD, MMed (INT), PhD, PD, FHEA, PGcert Associate Professor in Respiratory Medicine Clinical and Experimental Sciences Faculty of Medicine, University of Southampton United Kingdom

Dr. Hans Michael Haitchi

Hans Michael Haitchi, MD, MMed (INT)
PhD, PD, FHEA, PGcert

Associate Professor in Respiratory Medicine
Clinical and Experimental Sciences
Faculty of Medicine, University of Southampton
United Kingdom

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is estimated that 300 million people worldwide suffer from asthma with 1 in 10/11 (USA/UK) children and 1 in 12 (USA & UK) adults suffering from the disorder. In children asthma is the most common long-term medical condition.
ADAM33 is an asthma gene. Small changes in the gene have been associated with increased twitchiness of the airways (bronchial hyperresponsiveness), loss of lung function in children and decline in lung function in the general population.
ADAM33 makes an enzyme, which is attached to cells in the airway muscles. When the enzyme loses its anchor to the cell surface, it is prone to going rogue around the lung causing poorer lung function in people who have asthma.

Our research, published in The Journal of Clinical Investigation (JCI) Insight, analysed human tissue samples and mice. Our experiments suggest that the human rogue ADAM33 protein is increased and enzymatically active in asthma. Furthermore, ADAM33 protein initiates airway remodelling (more muscle and blood vessels around the airways) without causing any inflammation in early life. However, when we switch off ADAM33 or prevent it from going rouge, the features of asthma – airway remodelling (more muscle and blood vessels around the airways), twitchiness and inflammation – will be reversed or reduced.

These findings identify ADAM33 as a novel target for disease modifying therapy in asthma.
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Increased Asthma Hospitalizations Associated With Living Near Fracking Sites

MedicalResearch.com Interview with:

Sara Rasmussen PhD Student Johns Hopkins School of Public Health Department of Environmental Health Sciences Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland

Sara Rasmussen

Sara Rasmussen PhD Student
Johns Hopkins School of Public Health
Department of Environmental Health Sciences
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Residents of communities undergoing unconventional natural gas development (the “fracking” industry) and those nearby can be exposed to noise, light, vibration, heavy truck traffic, air pollution, social disruption, and anxiety related to rapid industrial development of one’s community. In Pennsylvania, development began in the mid-2000s and by 2012, 6,253 wells were drilled.

In our study, we found increased odds of asthma hospitalizations, asthma emergency department visits, and asthma oral corticosteroid medication orders (a medication used for asthma exacerbations) among asthma patients residing near bigger or larger numbers of active unconventional natural gas wells compared to those residing farther away.

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The 1952 London Smog Event Still Impacts Health Of Those Exposed Today

MedicalResearch.com Interview with:

Jamie T Mullins PhD Environmental Economics and Applied Microeconomic Department of Resource Economics University of Massachusetts Amherst Amherst, MA 01003

Dr. Jamie Mullins

Jamie T Mullins PhD
Environmental Economics and Applied Microeconomic
Department of Resource Economics
University of Massachusetts Amherst
Amherst, MA 01003

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Episodic triggers of asthma are widely known, but the root causes of the condition still aren’t well understood. There is also very limited evidence on the long-term impacts of exposure to air pollution. Speaking to both issues, we find evidence linking the development of asthma to exposure to a significant air pollution event early in life.

The 1952 London Smog provides a natural experiment for studying the underlying cause of asthma and the long-term effects of air pollution exposure, while limiting threats from statistical confounding. The London Smog (also called the “Great Smog”) dramatically increased concentrations of air pollution across the city in December of 1952. We compare the incidence of asthma among those exposed to the Great Smog in utero or the first year of life to those in relevant comparison groups, including those conceived after the incident and those residing outside the affected area at the time of the Smog.

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Persistent Childhood Asthma Linked to Long-Term Lung Function Deficits

MedicalResearch.com Interview with:

Dr. James P. Kiley Ph.D National Institutes of Health Bethesda Maryland

Dr. James Kiley

Dr. James P. Kiley Ph.D
National Institutes of Health Bethesda
Maryland 

MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Kiley: While a higher proportion of children have asthma compared to adults, the disease is limited to childhood for many individuals who appear to be unaffected as adults. Regardless of whether asthma continues into adulthood or reoccurs during adulthood, the impact of childhood asthma on lung function later in life is unclear. This study demonstrated that in children with chronic persistent asthma at the age of 5-12 years who continued to be followed through their early twenties, 75% of them had some abnormality in the pattern of their lung growth. The study examined the trajectory of lung growth, and the decline from maximum growth, in a large cohort of persons who had persistent, mild-to-moderate asthma in childhood and determined the demographic and clinical factors associated with abnormal patterns of lung growth and decline.
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Children With Persistent Asthma At Risk For Future Lung Disease

MedicalResearch.com Interview with:

Michael McGeachie, PhD Instructor in Medicine Harvard Medical School Channing Division of Network Medicine Brigham and Women's Hospital

Dr. Michael McGeachie

Michael McGeachie, PhD
Instructor in Medicine
Harvard Medical School
Channing Division of Network Medicine
Brigham and Women’s Hospital

MedicalResearch.com: What is the background for this study?

Dr. McGeachie: In asthma, and in general but particularly in asthma, a person’s level of lung function has a big impact on his or her quality of life, level of respiratory symptoms and complications, and general morbidity. In asthma, low lung function leads to greater severity and frequency of asthma symptoms. Asthma is a common childhood illness, affecting 9-10% of children. Many children grow out of asthma as they become adults, but other asthmatics remain effected through adulthood, which can lead to a lifetime of respiratory symptoms and chronic airway obstruction, including chronic obstructive pulmonary disease (COPD).

If you consider lung function longitudinally, throughout development, plateau, and decline, different people and different asthmatics tend to exhibit different patterns of lung function. Healthy, non-asthmatic people tend to have a period of rapid lung function increase in adolescence, a plateau of lung function level in their late teens and early 20s, and starting around 25 or so a slow, gradual decline of lung function that continues throughout old age. We call this Normal Growth of lung function. However, some people exhibit Reduced Growth, where they don’t reach their expected maximum lung function for a person of the same age, sex, height, and race. Others can show Early Decline, who might reach a normal maximum but then begin to decline immediately without a plateau or with a truncated plateau. We hypothesized that these patterns, Reduced Growth and Early Decline, might have different baseline indicators, precursors, outcomes, and risk of developing COPD.

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Can Oral Dust Mite Immunotherapy Asthma Exacerabtions?

MedicalResearch.com Interview with:

Prof Dr. med. J. Christian Virchow, FRCP, FCCP, FAAAA University of Rostock, Germany

Prof. Christian Virchow

Prof Dr. med. J. Christian Virchow, FRCP, FCCP, FAAAA
University of Rostock, Germany

What is the background for this study? What are the main findings?

Dr. Virchow: House Dust mite related allergic asthma is a very frequent chronic disease. Allergen Immunotherapy (AIT) for this condition in asthma has not been well studied and subcutaneous treatment has been associated with (systemic, potentially serious) side effects. Aim of the study was to investigate, if sublingual AIT can improve a patient relevant endpoint, namely reduce the frequency of exacerbations (primary endpoint: time to first exacerbation compared to placebo) .

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First Trimester Use of Rhinocort Linked To Respiratory Defects in Newborns

MedicalResearch.com Interview with:
Anick Bérard PhD FISPE
Research chair FRQ-S on Medications and Pregnancy and
Director Réseau Québécois de recherche sur le médicament (RQRM) and
Professor, Research Chair on Medications, Pregnancy and Lactation
Faculty of Pharmacy,University of Montreal
and Director, Research Unit on Medications and Pregnancy
Research Center
CHU Ste-Justine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Intranasal corticosteroid (Nasacort) use during pregnancy for the treatment of seasonal allergies has increased over the past decade. Nasacort is now available over the counter since October 2013 in the US and January 2015 in Canada. Given that seasonal allergies are prevalent during pregnancy and that a medication available over-the-counter is likely to be used frequently, we aimed to study the risk of using Nasacort during gestation. Furthermore, given the potential public health impact, the objectives of our study were to assess the safety of intranasal triamcinolone exposure during pregnancy on the occurrence of major congenital malformations, small-for-gestational-age (SGA) newborn, and spontaneous abortions.

Use of intranasal triamcinolone during the first trimester of pregnancy was not significantly associated with the risk of overall congenital malformations (OR 0.88, 95%CI 0.60-1.28; 31 exposed cases) compared to non-exposure; it was however associated with the risk of respiratory defects (OR 2.71, 95%CI 1.11-6.64; 5 exposed cases). This is important given that a medication given for the treatment of respiratory diseases is associated with respiratory defects in newborns.

Pregnancy exposure to intranasal triamcinolone was not significantly associated with the risk of spontaneous abortions (OR 1.04, 95%CI 0.76-1.43; 50 exposed cases). No association was found between 2nd or 3rd trimester exposure to intranasal triamcinolone and the risk of SGA (OR 1.06, 95%CI 0.79-1.43; 50 exposed cases).

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PCOS Associated With Greater Risk of Asthma

MedicalResearch.com Interview with:
Dr Anju Joham (MBBS (Hons), FRACP, PhD)
Endocrinologist, Monash Health
Post doctoral Research Fellow
Monash Centre for Health Research and Implementation – MCHRI
School of Public Health and Preventive Medicine
Monash University – in partnership with Monash Healtj

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Johan: Polycystic Ovary Syndrome (PCOS) is a common condition affecting reproductive-aged women. Recent research suggests that asthma may be more commonly seen in women with PCOS; however, there are very limited studies that have examined this relationship. It will be helpful to understand if there is a relationship with PCOS and asthma.

Women were randomly selected from the national health insurance database (Medicare) in Australia. Data was available for 8612 women. We found that in women aged 28 to 33 years, PCOS prevalence was 5.8% (95% CI: 5.3%-6.4%). The prevalence of asthma was 15.2% in women reporting PCOS and 10.6% in women not reporting PCOS respectively. PCOS was associated with 34% increased odds of asthma after adjusting for weight. In addition, weight in the overweight and obese range were associated with increased odds of asthma.

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