MedicalResearch.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.
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MedicalResearch.com Interview with: Brian H. Rowe, MD, MSc, CCFP(EM), FCCP
Tier I Canada Research Chair in Evidence-based Emergency Medicine
Scientific Director, Emergency Strategic Clinical Network
Professor, Department of Emergency Medicine
University of Alberta
Medical Research: What is the background for this study? What are the main findings?Dr. Rowe:The study was designed to evaluate non-pharmacological issues associated with relapse following discharge from the emergency department with acute asthma. Many years of high-quality research have shown that systemic and inhaled corticosteroids (ICS) in combination are required to reduce relapse. In this study all patients received systemic corticosteroids and the majority received inhaled corticosteroids (either as mono-therapy or in combination with long-acting beta-agonists {LABA}).
This study design permitted us to evaluate other factors associated with relapse as a guide for clinicians to use in planning discharge.
The main findings include identifying the key factors independently associated with relapse: female sex (OR = 1.9; 95% confidence interval [CI]: 1.2, 3.0), symptom duration of > 24 hours prior to emergency department visit (OR = 1.7; 95% CI: 1.3, 2.3), ever using oral corticosteroids (OR = 1.5; 95% CI: 1.1, 2.0), current use of an ICS/LABA combination product (OR = 1.9; 95% CI: 1.1, 3.2), and owning a spacer device (OR = 1.6; 95% CI: 1.3, 1.9). (more…)
MedicalResearch.com Interview with: Nandita Bhan, ScD MSc MA
Research Scientist & Adjunct Assistant Professor
Public Health Foundation of India (PHFI)
Medical Research: What are the main findings of the study?Dr. Bhan: We found that the last decade in the US has seen a rise in racial/ethnic disparities in asthma. Compared to Non-Hispanic White populations, greater rates of asthma were seen among African Americans and lower rates among Hispanic populations. But more importantly, we found that it is not just a question of who you are, but where you live. Results showed heterogeneity by region and place of origin - highlighting that it will be simplistic to assume that asthma rates for Hispanic populations are the same across all states in the US.
While data is unable to explore further granularity by ethnicity, our results add to the developing evidence that state policies and politics have impacts on socioeconomic and racial/ethnic inequalities manifesting in health disparities in the US.
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MedicalResearch.com Interview with: Andrea Gershon MD, MSc, FRCP(C)
Scientist, Institute for Clinical Evaluative Sciences
Respirologist, Division of Respirology, Sunnybrook Health Sciences Centre
Assistant Professor of Medicine, University of Toronto
ICES Central Bayview Avenue, Toronto, Ontario
Medical Research: What are the main findings of the study?Dr. Gershon: Within a large real world population of people with COPD, those who initiated combination long-acting beta-agonists (LABA) and inhaled corticosteroids (ICS) were less likely to die or be hospitalized for COPD than those who initiated LABA alone. Further those who initiated LABA/ICS combination therapy did not appear to have more pneumonia or osteoporotic fractures – side effects that have been associated with ICS use—than those initiating LABA alone.
A second interesting finding was that people with a co-diagnosis of asthma experienced a greater incremental benefit of LABA/ICS over LABA than people without a co-diagnosis of asthma.
Finally, we found that people who were not also taking an inhaled long-acting anticholinergic medication experienced a greater incremental benefit of LABA/ICS over LABA than people who were.
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Medical Research Interview with:
Lara J. Akinbami, MD
Infant, Child and Women's Health Statistics Branch
National Center for Health Statistics
Centers for Disease...
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.
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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.
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MedicalResearch.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.
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MedicalResearch.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.
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MedicalResearch.com Interview Invitation
Klaus Bønnelykke MD, PhD
The Faculty of Health Sciences University of Copenhagen
The Danish Pediatric Asthma Center Copenhagen University Hospital
Gentofte Ledreborg Alle...
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.
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MedicalResearch.com Interview with:Daniel Belsky, PhDNIA 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 studyMedicalResearch.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.
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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.
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Poorly controlled asthma more than doubles healthcare costs associated with the disease and threatens educational achievement through a dramatic increase...
Discovers new asthma gene in African-Americans, replicates 4 others
A new national collaboration of asthma genetics researchers has revealed a novel...
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