Asthma, Author Interviews, Compliance, Lancet, Technology / 30.01.2015

Amy Chan BPharm(Hons) RegPharmNZ MPS ANZCP Pharmacist / PhD candidate Department of Paediatrics Auckland Hospital Faculty of Medical & Health Sciences University of Auckland Auckland, New ZealandMedicalResearch.com Interview with: Amy Chan   BPharm(Hons) RegPharmNZ  MPS  ANZCP Pharmacist / PhD candidate Department of Paediatrics Auckland Hospital Faculty of Medical & Health Sciences University of Auckland  Auckland, New Zealand Medical Research: What is the background for this study? What are the main findings? Response: Asthma is one of the most common childhood conditions, affecting 1 in 4 children in New Zealand.  Although there are many effective medications available for asthma, of which the most important are inhaled corticosteroids, asthma control remains suboptimal due to poor adherence.  In children, adherence to regular preventive asthma therapy is about 50%, and can be as low as 30%.  Our randomised controlled trial looked at use of an electronic monitoring device with an in-built audiovisual reminder to see if it improved adherence and asthma control.  We recruited 220 children aged between 6-15yrs, who presented to the emergency department with asthma and randomised them to receive the device either with the audiovisual function enabled or disabled.  It found that those who received the audiovisual reminder (the intervention arm) took a median of 84% of their inhaled corticosteroids compared to just 30% in those who did not receive the reminder (control arm).  This equates to a 180% improvement in adherence.  We found significant improvements also in asthma control (including reduced asthma symptoms and increased participation in daily activities) and a reduction in reliever use from 17.4% to 9.5% in those who received the reminder. (more…)
Asthma, Author Interviews, CHEST, Omega-3 Fatty Acids / 23.01.2015

John Brannan PhD Firestone Institute for Respiratory Health at St Joseph’s Healthcare & McMaster University, Hamilton, Ontario, CanadaMedicalResearch.com Interview with: John Brannan PhD Firestone Institute for Respiratory Health at St Joseph’s Healthcare & McMaster University, Hamilton, Ontario, Canada Medical Research: What is the background for this study? Response: The use of omega-3 acid supplements as treatments for allergic diseases including asthma is controversial. Studies by investigators from Indiana University in the USA have repeatedly demonstrated a beneficial effect of high dose omega-3 fatty acid supplements over 3 weeks in attenuating exercise-induced bronchoconstriction (EIB) similar or possibly better in potency to what may be expected with a regular inhaled corticosteroids. The study by Brannan et al. attempted to validate these findings by using inhaled mannitol, a bronchial provocation test that was derived from the understanding of exercise-induced bronchoconstriction and which has demonstrated experimentally to be a useful model for exercise-induced bronchoconstriction. All pharmacotherapies that modify exercise-induced bronchoconstriction can modify the airway sensitivity to inhaled mannitol in persons with asthma, thus it was of interest to see if an 'alternative' treatment that demonstrated efficacy in exercise-induced bronchoconstriction could too modify the airway response to mannitol. Medical Research: What are the main findings? Response: The main findings were, to our surprise, there was no benefit of high dose omega-3 fatty acid supplements on bronchial hyperresponsiveness to mannitol over 3 weeks. This was associated with no changes in airway inflammation (sputum eosinophils), lung function or asthma symptom control. We also found no benefit on resting urinary mast cell metabolites, in contrast to the findings in studies showing a benefit of omega-3 fatty acids on EIB. Our findings suggest that omega-3 supplements in tissues may not be able to penetrate tissue and/or modify the substrate flow of eicosanoids in tissue such as the airways of the asthmatic. We did observed the expected reductions in blood triglycerides which suggests that these doses of omega-3s can modify metabolism in the blood or to some extent tissues that are highly perfused. (more…)
Asthma, Author Interviews / 05.12.2014

MedicalResearch.com Interview with: Katarzyna Niespodziana, PhD and Rudolf Valenta, MD Division of Immunopathology, Department of Pathophysiology and Allergy Research,Medical University of Vienna, Austria MedicalResearch: What is the background for this study? What are the main findings? Response: Infections with the common cold virus (Rhinovirus, RV) are in fact a major trigger factor for acute exacerbations of asthma and COPD (chronic obstructive pulmonary disease). An attack can also lead to the worsening of the underlying disease. In previous studies we have found that although the human body produces antibodies against rhinoviruses, these are not directed against the surface structures on the virus which the virus uses to infect host cells and therefore do not protect against infection. In the framework of the EU project "Predicta”, we have collaborated with investigators from London and published in EBioMedicine a novel study which shows for the first time that increases of antibodies against a portion of the rhinovirus coat protein VP1 might be strain-specific surrogate markers for the severity of rhinovirus-induced respiratory symptoms. In this work, asthma patients and healthy subjects were infected with the rhinovirus under controlled conditions. Results of the subsequent antibody tests with recombinant virus antigens showed that the asthmatics that experienced the most severe respiratory symptoms upon infections produced significantly higher antibodies to a part of the structure protein VP1, than any of the subjects with mild or no symptoms. (more…)
Asthma, Author Interviews / 04.11.2014

Robert H. Schiestl, Ph.D. Professor of Pathology, Environmental Health and Radiation Oncology UCLA Schools of Medicine and Public Health Los Angeles, CA 90095MedicalResearch.com Interview with: Robert H. Schiestl, Ph.D. Professor of Pathology, Environmental Health and Radiation Oncology UCLA Schools of Medicine and Public Health Los Angeles, CA 90095 Medical Research: What is the background for this study? What are the main findings? Dr. Schiesti: We studies whether asthma has any effect on peripheral blood and we found that it significantly increased DNA double strand breaks, single strand breaks, oxidative DNA damage, inflammation and oxidative protein damage. (more…)
Asthma, Author Interviews, Exercise - Fitness / 05.06.2014

Holger Cramer, PhD Director of Yoga Research University of Duisburg-Essen | Faculty of Medicine Department of Internal and Integrative Medicine | Kliniken Essen-Mitte Essen Germany MedicalResearch.com Interview with: Holger Cramer, PhD Director of Yoga Research University of Duisburg-Essen | Faculty of Medicine Department of Internal and Integrative Medicine Essen  Germany MedicalResearch: What are the main findings of the study? Dr. Cramer: There is a number of randomized trials available on yoga for asthma. Based on those trials, there is evidence that yoga can improve asthma symptoms, asthma control, and pulmonary function in patients with asthma. However, yoga does not seem to be superior to sham procedures or breathing exercises and generally the evidence was quite weak. Yoga seems to be relatively safe in this patient population. (more…)
Asthma, Author Interviews, Cost of Health Care / 21.05.2014

dr_vicki_fung MedicalResearch.com Interview with: Vicki Fung, Ph.D. Assistant Professor Department of Medicine, Harvard Medical School Mongan Institute for Health Policy, Massachusetts General Hospital   MedicalResearch: What are the main findings of the study? Dr. Fung: We found that lower income parents of children with asthma were more likely to delay or avoid taking their children to a doctor's office visit or to the emergency room if they had to pay higher out-of-pocket costs for care; they were also more likely to report borrowing money to pay for asthma care. (more…)
Asthma, Author Interviews, Lancet, Pediatrics / 20.05.2014

Adnan Custovic DM MD PhD FRCP Professor of Allergy Institute of Inflammation and Repair University of Manchester University Hospital of South Manchester Manchester M23 9LT, UKMedicalResearch.com Interview with: Adnan Custovic DM MD PhD FRCP Professor of Allergy Institute of Inflammation and Repair University of Manchester University Hospital of South Manchester Manchester M23 9LT, UK MedicalResearch: What are the main findings of the study? Dr. Custovic: In a longitudinal analysis of the data from our birth cohort study collected from birth to age eleven years, we demonstrated an association between early-life antibiotic prescription and development of wheezing, but not atopy. Furthermore, amongst children with wheezing, antibiotic prescription in infancy increases the risk of subsequent severe wheeze/asthma exacerbations and hospital admissions. This is the first demonstration that children who receive antibiotics in infancy have impaired antiviral immunity later in life, and that early-life antibiotic prescription is associated with variants on chromosome 17q21 locus (which is an asthma susceptibility locus). Our findings suggest that the association between antibiotics and childhood asthma reported in previous studies arises through a complex confounding by indication, in which hidden factors which increase the likelihood of both antibiotic prescription in early life and subsequent asthma development are increased susceptibility to virus infections consequent to impaired antiviral immunity, and genetic variants on 17q21. Our results raises an important issue that effects which are often attributed to environmental exposures may be a reflection of genetic predisposition. (more…)
Allergies, Asthma, Author Interviews, Dermatology / 05.02.2014

Sabina Illi, Dipl.-Stat., MPH University Children's Hospital Lindwurmstr. 4 80337 Munich GermanyMedicalResearch.com Interview with: Dr. Sabina Illi, Dipl.-Stat., MPH University Children's Hospital Lindwurmstr. 4 80337 Munich Germany MedicalResearch.com: What are the main findings of the study? Answer: We observed that the offspring of atopic pregnant women that showed symptoms of atopy during pregnancy, i.e. atopic dermatitis or hay fever, had a higher risk of having the respective atopic disorder themselves. However, we do not know whether this is due to timing, i.e. pregnancy, or whether it merely mirrors the severity of maternal disease. Furthermore, in our study pregnant mothers with repeated colds during pregnancy were at increased risk of having a child that wheezed at pre-school age, this was statistically independent of the intake of medication. (more…)
Allergies, Asthma, Author Interviews, Lancet / 15.01.2014

Mariona Pinart, PhD CREAL-Centre for Research in Environmental Epidemiology ISGlobal alliance Parc de Recerca Biomèdica de Barcelona Doctor Aiguader, 88 | 08003 BarcelonaMedicalResearch.com Interveiw with: Mariona Pinart, PhD CREAL-Centre for Research in Environmental Epidemiology ISGlobal alliance Doctor Aiguader, 88 | 08003 Barcelona MedicalResearch.com: What are the main findings of the study? Answer: The study examined 23.434 children at 4 and 8 years from 12 ongoing European population-based birth cohort studies that recorded information on current eczema, rhinitis, and asthma from questionnaires and serum-specific IgE to six allergens. We wanted to assess how often eczema, rhinitis and asthma coexist in the same children (comorbidity) and whether the occurrence of comorbidities was due to causality or casualty and finally we wanted to examine whether the occurrence of comorbidity was modified by IgE sensitization. We found that comorbidity affects about 4% of children aged 4–8 years and that about 50% of this comorbidity is due to causality, suggesting that these diseases share common pathophysiological mechanisms. In addition, we found that children comorbidity at age 4 are 30 to 60 times more likely to have comorbidity at age 8 years, suggesting that the presence of comorbidity at age 4 years is a strong determinant of comorbidity at age 8 years. Even children with one single disease are also at high risk of developing comorbidity by age 8 years. Interestingly, we found that not only comorbidity is present in children both sensitized and not sensitized to IgE but also that only 38% of incident comorbidity at age 8 years is explained by the presence of IgE sensitization at age 4 years. (more…)
Asthma, Author Interviews, Biomarkers, CHEST / 10.01.2014

Dr. Lawrence M. Lewis, MD Professor, Emergency Medicine and Medicine Washington University School of Medicine in St. LouisMedicalResearch.com Interview with: Dr. Lawrence M. Lewis, MD Professor, Emergency Medicine and Medicine Washington University School of Medicine in St. Louis MedicalResearch.com: What are the main findings of the study? Dr. Lewis: The main finding of the study is that there is a dose-dependent increase in serum lactate concentration with increasing amounts of nebulized albuterol administered. This hyperlactatemia did not portend a worse prognosis, and was not associated with worse FEV1 or dyspnea scores. (more…)
Asthma, Author Interviews, BMJ, Pediatrics / 06.12.2013

Dr. Meghan Azad, PhD Banting Postdoctoral Fellow Department of Pediatrics University of AlbertaMedicalResearch.com Interview with: Dr. Meghan Azad, PhD Banting Postdoctoral Fellow Department of Pediatrics University of Alberta MedicalResearch.com: What are the main findings of the study? Dr. Azad: In this study, our goal was to evaluate the clinical evidence for using probiotics (live "healthy bacteria") to prevent childhood asthma.  We reviewed the results of 20 clinical trials involving over 4000 infants, where probiotics were administered during pregnancy or the first year of life, and found no evidence to support the use of probiotics for asthma prevention.  Children receiving probiotics were just as likely to develop asthma as children receiving placebo.  Similarly, there was no effect of probiotic supplementation on the development of wheezing. (more…)
Asthma, Author Interviews, Genetic Research, Smoking, UCLA / 06.08.2013

MedicalResearch.com Interview with: Virender Rehan, MD Professor of Pediatrics Chief, Division of Neonatology Director, Neonatal Intensive Care Unit Director, Neonatal-Perinatal Fellowship Training Program Co-Director Perinatal Research Center Harbor UCLA Medical Center, David Geffen School of Medicine at UCLA Torrance, CA, 90502 MedicalResearch.com: What are the main findings of the study? Dr. Rehan: The main findings of the study include the likelihood of transmission of asthma to third generation offspring following maternal smoking during pregnancy even when child’s mother didn’t smoke. And these effects seem to be more profound in the upper airways of males compared to that in females. (more…)
Asthma, Author Interviews, Duke, Genetic Research, Lancet, NEJM / 10.07.2013

Daniel Belsky, PhD NIA Postdoctoral Fellow Center for the Study of Aging and Human Development Duke UniversityMedicalResearch.com Interview with: Daniel Belsky, PhD NIA Postdoctoral Fellow Center for the Study of Aging and Human Development Duke University Polygenic risk and the development and course of asthma: an analysis of data from a four-decade longitudinal study MedicalResearch.com: What are the main findings of the study? Dr. Belsky : We looked to the largest-ever genome-wide association study of asthma (that study by the GABRIEL Consortium included more than 26,000 individuals) to identify genetic variants that could be used to construct a genetic profile of asthma risk. We then turned to The Dunedin Multidisciplinary Health and Development Study, a unique cohort of 1,000 individuals who have been followed from birth through their fourth decade of life with extensive measurements of asthma and related traits. We computed a “genetic risk score” for each person based on the variants identified in GWAS.  Then, we looked at who developed asthma, when they developed asthma, and what that asthma looked like in terms of allergic response and impaired lung function. What we found: (1) People with higher genetic risk scores were more likely to develop asthma and they developed asthma earlier in life. (2) Among children who developed asthma, the ones at higher genetic risk were more likely to have persistent asthma through midlife. (3) Genetic risk was specifically associated with allergic asthma that resulted in chronic symptoms of impaired lung function. (4) People with higher genetic risk score developed more severe cases of asthma. As compared to people with a lower genetic risk, they were more often absent from school and work because of asthma and they were more likely to be hospitalized for asthma. (5) The genetic risk score provided new information about asthma risk that could not be obtained from a family history. (more…)
Asthma, Author Interviews / 26.05.2013

MedicalResearch.com eInterview with: Stefan Worgall Ph.D., M.D
Department of Genetic Medicine and 4Department of Pediatrics Weill Cornell Medical College, New York, NY 10021, USA.
MedicalResearch.com: What are the main findings of the study? Dr. Worgall: Asthma is a common disease and large genome-wide association studies  found variation in the gene for ORMDL3, in to up to 30 percent of asthma cases. The over-production ORMDL3 was connected to childhood asthma. ORMDL3 protein inhibits the new production of sphingolipids. Our study connects sphingolipid metabolism mechanistically to human asthma for the first time. We found that inhibition of the enzyme that is critical to sphingolipid synthesis, serine palmitoyl-CoA transferase (SPT),  produced asthmatic lungs in mice and in human bronchi, as it did in mice that had a genetic defect in SPT. When these mice were given methacholine their airways constricted further. We further determined that the airway hyperactivity seen in the mice was not linked to increased inflammation, which is a target for most asthma therapies. (more…)