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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Dust Mite Allergen Proteins More Abundant Than Non-Allergen Dust Mite Proteins

MedicalResearch.com Interview with:

Geoffrey Mueller, Ph.D. Staff Scientist Genome Integrity and Structural Biology Laboratory National Institute of Environmental Health Sciences National Institutes of Health Research Triangle Park, NC 27709

Dr. Geoffrey Mueller

Geoffrey Mueller, Ph.D.
Staff Scientist
Genome Integrity and Structural Biology Laboratory
National Institute of Environmental Health Sciences
National Institutes of Health
Research Triangle Park, NC 27709

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

Response: While allergic disease is a wide spread problem, it is actually a select few proteins, called allergens, that initiate allergy symptoms. This study was focused on looking for fundamental biochemical differences between allergens and non-allergens derived from the house dust mite.

We found that the mite allergens, as a group, are distinctly different from the non-allergens in that they are more highly produced, and more stable. Previous anecdotal evidence suggested that these properties would lead to more allergens surviving the journey from the source (either mites or pollens) to a person. In addition, the greater stability of allergens may influence the decision making of the immune system to target these proteins as dangerous instead of harmless.

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Early Immune Intervention May Prevent Atopic March of Eczema and Allergies

MedicalResearch.com Interview with:
Emma Guttman-Yassky, MD, PhD

Professor of Dermatology and Immunology
Vice Chair of the Department of Dermatology at the Icahn School of Medicine and
Amy S. Paller, MD
Walter J. Hamlin Professor
Chair of the Department of Dermatology at Northwestern

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

Response: Researchers for the first time have identified the skin phenotype of pediatric eczema or atopic dermatitis (AD) in infants, opening the door for personalized treatment approaches for young children with eczema. The study, led by researchers at the Icahn School of Medicine at Mount Sinai and Northwestern University’s Feinberg School of Medicine, was published online today in the Journal of Allergy and Clinical Immunology.

Emma Guttman-Yassky, MD, PhD, Professor of Dermatology and Immunology, and Vice Chair of the Department of Dermatology at the Icahn School of Medicine, and Amy S. Paller, MD, Walter J. Hamlin Professor and Chair of the Department of Dermatology at Northwestern, investigated lesional and non-lesional skin biopsies from 19 AD infants under the age of five, and compared them to age-matched pediatric controls, in addition to adult AD biopsies. The researchers found that the non-lesional, or normal-appearing, skin of young children with early eczema is already highly abnormal with significant immune activation, simulating that of lesional skin of adults with many years of active disease.

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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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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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Minority Kids With Asthma Likely To Miss Days of School

MedicalResearch.com Interview with:

Joy Hsu, MD, MS Air Pollution and Respiratory Health Branch Division of Environmental Hazards and Health Effects National Center for Environmental Health CDC Atlanta GA 30341

Dr. Joy Hsu

Joy Hsu, MD, MS
Air Pollution and Respiratory Health Branch
Division of Environmental Hazards and Health Effects
National Center for Environmental Health
CDC Atlanta GA 30341

Medical Research: What is the background for this study?

Dr. Hsu: Asthma is a leading cause of missed school days related to chronic illness.

This study is based on survey data from 2006 to 2010 on children aged 17 years and younger with asthma from 35 states and the District of Columbia.  Continue reading

Asthma May Raise Risk of Abdominal Aortic Aneurysm Rupture

MedicalResearch.com Interview with:

Guo-Ping Shi, DSc and Dr. Cong-Lin Liu Cardiovascular Medicine Brigham and Women’s Hospital Boston, MA

Guo-Ping Shi, DSc and Dr. Cong-Lin Liu
Cardiovascular Medicine
Brigham and Women’s Hospital
Boston, MA

Guo-Ping Shi, DSc and Dr. Cong-Lin Liu
Cardiovascular Medicine
Brigham and Women’s Hospital
Boston, MA

Medical Research: What is the background for this study? What are the main findings?

Response: Abdominal aortic aneurysm (commonly called AAA) is an aortic disease that affects 1~5% men above 50, depending on the countries and regions. There is currently no effective medication or prevention besides surgical repair. Fast growth or unstable AAA often leads to aortic rupture and sudden death. Although ultrasound can be used to monitor the size and growth of AAA, our current annual health examination system in the US does not include this service.

We report that mast cells are essential to AAA (J Clin Invest. 2007;117:3359-68). These cells are predominant immune cells in allergic asthmatic lungs from humans and experimental animals. Plasma immunoglobulin E (IgE) level elevation is also a signature of allergic asthma. We report that IgE contributes to experimental AAA by activating mast cells, as well as other immune cells such as macrophages and T cells (EMBO Mol Med. 2014;6:952-69). Direct evidence from our recent study demonstrates that production of allergic asthma in mice doubles the AAA sizes in experimental mice (Arterioscler Thromb Vasc Biol. 2016;36:69-77). All these prior studies suggest a role of allergic asthma to the pathogenesis of AAA.

In this human population-based nationwide case-control study (Arterioscler Thromb Vasc Biol. 2016 Feb 11. [Epub ahead of print]), we reported two major findings: First, among 15,942 Danish AAA patients selected from 1996 to 2012, compared to those who did not have asthma, patients who had hospital-diagnosed asthma within the past 12 months had 60% more risk to experience aortic rupture, and those who had hospital-diagnosed asthma within the past 6 months had greater than 100% more risk to experience aortic rupture. Further, patients who received anti-asthmatic treatment, as evidence of asthma, also had 20~50% more risk of experiencing aortic rupture than those who did not have record of anti-asthmatic treatment, depending on how recent the patients received the treatments.

Second, among a general men population aged from 65 to 74, patients who used bronchodilating drugs to treat asthma or reversible obstructive pulmonary disease had 45% more risk to have AAA compared with those who never used bronchodilators. This risk was not affected by smoking or other major AAA risk factors.

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Acetaminophen During Pregnancy Linked To Childhood Asthma

MedicalResearch.com Interview with:

Maria C. Magnus Norwegian Institute of Public Health Oslo Norway

Maria C. Magnus

Maria C. Magnus
Norwegian Institute of Public Health
Oslo Norway 

Medical Research: What is the background for this study? What are the main findings?

Response:  Researchers have found that developing asthma can be linked to pregnant women and infants being exposed to paracetamol, (acetaminophen) by testing that the association was not simply linked to the complaint for which the person is taking paracetamol. The findings were published in the International Journal of Epidemiology

Using data from the Norwegian Mother and Child Cohort Study, researchers in Norway compared associations between several conditions during pregnancy (with and without the use of paracetamol) and asthma developing in the 114,500 children in the study. They examined asthma outcomes at ages three and seven and evaluated the likelihood of the association being as a result of the three most common uses of paracetamol in pregnancy: pain, fever, and influenza.

The results showed that 5.7 per cent of the children had current asthma at age three, and 5.1 per cent had asthma at age seven. The research found that there was a strong link between children who had asthma at age three who had been exposed to paracetamol as during pregnancy or infancy. The strongest association was seen if the mother used paracetamol during pregnancy for more than one complaint with a child having asthma at three years old.
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Wheezing in Early Childhood Linked to Reduced Lung Function By Adolescence

MedicalResearch.com Interview with:

Dr. Meghan B. Azad PhD Assistant Professor Department of Pediatrics & Child Health and Community Health Sciences University of Manitoba Associate Investigator, Canadian Healthy Infant Longitudinal Development (CHILD

Dr. Meghan Azad

Dr. Meghan B. Azad PhD
Assistant Professor Department of Pediatrics & Child Health and Community Health Sciences University of Manitoba and
Children’s Hospital Research Institute of Manitoba
Associate Investigator, Canadian Healthy Infant Longitudinal Development (CHILD) Study

Medical Research: What is the background for this study?

Dr. Azad: Asthma is the most common reason for children to miss school or be admitted to hospital, and accounts for over 30% of Canadian healthcare billings for children. Although many treatments exist to manage asthma symptoms, it is a lifelong disease and there is no cure.  Prevention is the best approach to reduce the global burden of asthma, and our study provides important new information to inform asthma prevention strategies.  

Medical Research: What are the main findings?

Dr. Azad: Wheezing is common in babies and young children.  Our study looked at the long-term implications of wheezing in early life, using data from the Canadian Asthma Primary Prevention Study (CAPPS).

We followed 320 children from Winnipeg and Vancouver from before birth until adolescence, and found that specific patterns of early wheezing (from age 0 to 7) were associated with decreased lung function and increased risk for asthma by age 15.

By age 15, children who wheezed consistently through infancy and early childhood had the worst lung function (9% lower compared to non-wheezers) and the highest asthma risk (11 times higher). Even children with “transient early wheeze” (those who wheezed as babies but not as young children) had reduced lung function (5% lower) and increased asthma risk (4 times higher) as teenagers.

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Trial Tests Effect of Vitamin D Supplementation During Pregnancy On Wheezing in Children

More on Asthma on MedicalResearch.com

Professor of Pediatrics Hans Bisgaard, MD, DMSc Copenhagen Prospective Studies on Asthma in Childhood Herlev and Gentofte Hospital, University of Copenhagen, Denmark.

Prof. Bisgaard

MedicalResearch.com Interview with:
Hans Bisgaard, MD, DMSc
Professor of Pediatrics
The Faculty of Health Sciences
University of Copenhagen
Head of the Copenhagen Prospective Studies on Asthma in Childhood
University  of Copenhagen and Naestved Hospital

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

Dr. Bisgaard: Vitamin D deficiency has become a common health problem in westernized societies, possibly caused by a more sedentary indoor lifestyle and decreased intake of vitamin D containing foods. Vitamin D possesses a range of immune regulatory properties, and it has been speculated that vitamin D deficiency during pregnancy may affect fetal immune programming and contribute to asthma pathogenesis. Asthma often begins in early childhood and is the most common chronic childhood disorder. Observational studies have suggested that increased dietary vitamin D intake during pregnancy may protect against wheezing in the offspring, but the preventive effect of vitamin D supplementation to pregnant women is unknown. In our double-blind, single-center, randomized clinical trial conducted within the Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort we supplemented 2800 IU/d of vitamin D3 during the third trimester of pregnancy compared with 400 IU/d in the control group. Although the maternal supplementation did not result in a statistically significant reduction of risk of persistent wheeze in the offspring through age 3 years, the interpretation of the study is limited by a wide confidence interval that includes a clinically important protective effect.

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Does Prenatal Supplementation With Vitamin D Affect Childhood Asthma?

Augusto A. Litonjua, MD, MPH Associate Professor Channing Division of Network Medicine and Division of Pulmonary and Critical Care Medicine Department of Medicine Brigham and Women's Hospital Harvard Medical School Boston, MA 02115 USA

Dr. Augusto Litonjua

MedicalResearch.com Interview with:
Augusto A. Litonjua, MD, MPH
Associate Professor
Channing Division of Network Medicine
and Division of Pulmonary and Critical Care Medicine
Department of Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA 02115 USA 

Medical Research: What is the background for this study? What are the main findings?

Response: Vitamin D deficiency has been hypothesized to contribute to the asthma and allergy epidemic.  Vitamin D has been shown to affect lung development in utero. However, observational studies have shown mixed results when studying asthma development in young children. Since most asthma cases start out as wheezing illnesses in very young children, we hypothesized that vitamin D supplementation in pregnant mothers might prevent the development of asthma and wheezing illnesses in their offspring.  We randomly assigned 881 pregnant women at 10 to 18 weeks’ gestation and at high risk of having children with asthma to receive daily 4,000 IU vitamin D plus a prenatal vitamin containing 400 IU vitamin D (n = 440), or a placebo plus a prenatal vitamin containing 400 IU vitamin D (n = 436). Eight hundred ten infants were born during the study period, and 806 were included in the analyses for the 3-year outcomes. The children born to mothers in the 4,400 IU group had a 20% reduction in the development of asthma or recurrent wheeze compared to the children born to mothers in the 400 IU group (24% vs 30%, respectively; an absolute reduction of 6%).  However, this reduction did not reach statistical significance (p=0.051).

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Azithromycin Shortens Asthma Symptoms in Children

Professor of Pediatrics Hans Bisgaard, MD, DMSc Copenhagen Prospective Studies on Asthma in Childhood Herlev and Gentofte Hospital, University of Copenhagen, Denmark.

Prof. Bisgaard

More on Asthma on MedicalResearch.com
MedicalResearch.com Interview with:
Hans Bisgaard, MD, DMSc
Professor of Pediatrics
The Faculty of Health Sciences
University of Copenhagen
Head of the Copenhagen Prospective Studies on Asthma in Childhood
University  of Copenhagen and Naestved Hospital

Medical Research: What is the background for this study?

Dr. Bisgaard: Childhood asthma is often preceded by recurrent asthma-like symptoms in relation to airway infections in the first years of life. Bacteria and viruses are equally associated with the risk of episodes of asthma-like symptoms in these children, suggesting antibiotics as a potential treatment for such episodes.

Medical Research: What are the main findings?

Dr. Bisgaard: Our study demonstrates a clinically significant shortening of symptom duration by 63% after intervention. The effect size increased with early initiation of treatment, showing a reduction in episode duration of 83% if treatment was initiated before day 6 of the episode. Azithromycin was effective in shortening the episodes even though no pathogenic bacteria was detected. This study is, to our knowledge, the first randomized trial of azithromycin treatment of acute episodes of asthma-like symptoms in young children with a history of recurrent episodes.

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C-sections Linked To Small Increase in Childhood Asthma

Dr Mairead Black MBChB, MRCOG, MSc Research Fellow, Wellcome Trust Clinical Lecturer, Obstetrics and Gynaecology School of Medicine and Dentistry, Division of Applied Health Sciences University of Aberdeen Aberdeen Maternity Hospital, Cornhill Road Aberdeen AB25 2ZD

Dr. Mairead Black

MedicalResearch.com Interview with:
Dr Mairead Black MBChB, MRCOG, MSc

Research Fellow, Wellcome Trust
Clinical Lecturer, Obstetrics and Gynaecology
School of Medicine and Dentistry, Division of Applied Health Sciences
University of Aberdeen
Aberdeen Maternity Hospital, Cornhill Road
Aberdeen AB25 2ZD 

Medical Research: What is the background for this study?
Dr. Black: The current thinking is, if a baby is exposed to labour, then it is also exposed to ‘good bacteria’ that mothers pass on during the birth, and they are also exposed to a degree of natural stress at the time of birth that might make them more resistant to developing future illnesses.

The World Health Organisation formerly recommended that no more than 15 percent of deliveries should be C-sections. However rates in some countries have soared – China and Brazil have rates in excess of 50%, whilst in the UK the figure is 26% with almost half of these being planned in advance.

The main purpose of this study was to explore whether health outcomes in children up to very early adulthood differ according to how they are delivered and whether avoiding labour entirely, i.e. via a planned C-section, could put children at a disadvantage compared to those delivered vaginally or by emergency C-section, where most will have been exposed to labour. The study analysed data from over 300,000 births between 1993 and 2007 across Scotland, using routinely collected data from seven linked databases.

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Study Evaluates Non-Steroidal LTRAs For Asthma

MedicalResearch.com Interview with:
Michael Miligkos, MD, MS
Laboratory of Biomathematics,
University of Thessaly School of Medicine
Larissa, Greece

Medical Research: What is the background for this study? What are the main findings?

Dr. Miligkos: Asthma is one of the most common chronic diseases with and has
considerable social and economic burdens. Although inhaled
corticosteroids constitute the current gold standard of maintenance
treatment, leukotriene-receptor antagonists (LTRAs) have the
advantages of oral once- or twice- daily dosing and, apparent
avoidance of the adverse effects associated with long-term
corticosteroid therapy. In addition, their mechanisms of action
theoretically predicts a good response in patients with specific
asthma “phenotypes”. This systematic review investigated the use of
all marketed LTRAs in usual licensed doses as asthma controller
medications compared with placebo and found that administration of a
LTRA to adults and adolescents with asthma significantly reduced the
risk for an exacerbation. In trials of LTRA monotherapy, LTRAs
significantly improved asthma control compared with placebo, whereas
only some measures of asthma control were significantly improved in
trials of LTRAs used as add-on use therapy to ICSs.

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