Fungal sensitization and positive fungal culture from sputum in children with asthma are associated with reduced lung function and acute asthma attacks respectively

2020 ◽  
Author(s):  
Kathryn G. Welsh ◽  
Karl A. Holden ◽  
Andrew J. Wardlaw ◽  
Jack Satchwell ◽  
William Monteiro ◽  
...  
Keyword(s):  
Lung Function ◽  
Acute Asthma ◽  
Fungal Culture ◽  
Children With Asthma ◽  
Fungal Sensitization

Effects of Dingchuan Decoction on Lung Function and Clinical Effectiveness Rate in Children with Asthma: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-12
Author(s):  
Sheng-Nan Wang ◽  
Jia-Li Yan ◽  
Shao-Xing Wu ◽  
Lei Wu ◽  
Yan-Chan Zheng ◽  
...  
Keyword(s):  
Lung Function ◽  
Randomized Controlled Trials ◽  
Large Scale ◽  
Clinical Effectiveness ◽  
Controlled Trials ◽  
Improvement Rate ◽  
Randomized Controlled ◽  
Conventional Medication ◽  
Effectiveness Rate ◽  
Children With Asthma

Dingchuan decoction (DCD) is a traditional Chinese prescription for asthma that remains popular today. To systematically evaluate the effect of DCD on lung function, clinical effectiveness rate, and safety in children with asthma, significant databases were searched for randomized controlled trials from their inception to September 9, 2019. Randomized controlled trials assessing the effect of DCD on lung function and clinical effectiveness rate in children with asthma were included in this meta-analysis. The methodological quality of the included trials was assessed using the Cochrane risk of bias tool. RevMan 5.3 was used for data analysis. Fourteen studies with 1,384 children were reviewed. FEV<sub>1</sub> improvement rate (mean difference [MD] 12.50, 95% confidence interval [CI] 8.72–16.29), PEF improvement rate (MD 14.28, 95% CI 11.08–17.49), and clinical effectiveness rate (relative risk 1.19, 95% CI 1.14–1.25) significantly increased in the DCD group when compared to simple conventional medication. Four trials suggest that DCD is safe for children. In conclusion, the use of DCD combined with conventional medication improves lung function and clinical effectiveness rate better than simple conventional medication. However, the selected trials lack blinding and large-scale studies. Therefore, to better manage DCD in clinical practice, more randomized controlled trials and large-scale studies are required for further evaluation.

Questioning Asthma Treatment Study

PEDIATRICS ◽  
1991 ◽  
Vol 88 (1) ◽  
pp. 186-186
Author(s):  
ASHER TAL ◽  
NISSIM LEVY ◽  
Jacob E. Bearman
Keyword(s):  
Emergency Department ◽  
Lung Function ◽  
Young Children ◽  
Respiratory Rate ◽  
Peak Expiratory Flow ◽  
Flow Rate ◽  
Peak Expiratory Flow Rate ◽  
Acute Asthma ◽  
Asthma Treatment ◽  
Function Measure

In Reply.— We thank Drs McJunkin and Stallo for their interest in our paper. Their suggestion of using objective lung function measurements in young children and infants with acute asthma in the emergency department is impractical. The pulmonary index score we used includes at least one important lung function measure, namely, respiratory rate; this score also has been shown to be very reliable in children.1 Although we routinely use the peak expiratory flow rate in children in the emergency department, most of our patients were younger than 3 years of age and could not cooperate with this objective measurement.

Persistent airflow obstruction in inner-city children with asthma

2021 ◽  
Vol 42 (4) ◽  
pp. 310-316
Author(s):  
Kenny Y. Kwong ◽  
Yang Z. Lu ◽  
Emilio Jauregui ◽  
Lyne Scott
Keyword(s):  
Lung Function ◽  
Inner City ◽  
Airway Remodeling ◽  
Airflow Obstruction ◽  
Later Life ◽  
Forced Expiratory Volume ◽  
Initial Visit ◽  
Asthma Care ◽  
Increased Risk ◽  
Children With Asthma

Background: Airway remodeling has been shown to be persistent in patients with asthma despite treatment with controller medications. Patients with early airflow obstruction may continue to experience poor lung function despite treatment. Objectives: To determine whether early airflow obstruction in inner-city children with asthma persists despite guideline-based asthma care. Methods: In a retrospective study that used a cohort of inner-city children with asthma treated by using an asthma-specific disease management system, the patients were stratified into “low” or “high” lung function groups at the time of the initial visit (high, forced expiratory volume in the first second of expiration [FEV1] % predicted and FEV1/forced vital capacity [FVC] ≥ 80%; and low, FEV1% predicted and FEV1/FVC < 80%). These patients then received National Heart, Lung, and Blood Institute guideline‐based asthma treatment at regular follow-up intervals with spirometry performed at these visits as part of regular care. FEV1% predicted and FEV1/FVC were followed up for up to 10 years for both the high and low cohorts. Results: Over 10 years, the patients initially in the “high” group maintained FEV1% predicted and FEV1/FVC at values similar to the initial visit (94 to 96% and 87 to 89%, respectively), whereas those in the low group had only slight increases of FEV1% predicted and FEV1/FVC over the same time (77 to 82% and 78 to 82%, respectively). Low FEV1% predicted and FEV1/FVC at the time of the first visit was significantly associated with an increased risk of low values of these lung functions over the next 3‐5 years despite treatment. African American ethnicity and male gender were also associated with lower lung function over time. Conclusion: Early airflow obstruction in inner city children asthma is associated with poor lung function in later life despite guideline-based asthma care. Current asthma therapy may not affect pathways and leads to airway remodeling in children with asthma.

scholarly journals Effects of exercise training on physical and psychosocial health in children with chronic respiratory disease: a systematic review and meta-analysis

2018 ◽  
Vol 4 (1) ◽  
pp. e000409 ◽  
Author(s):  
Barbara Joschtel ◽  
Sjaan R Gomersall ◽  
Sean Tweedy ◽  
Helen Petsky ◽  
Anne B Chang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lung Function ◽  
Exercise Training ◽  
Respiratory Disease ◽  
Effect Size ◽  
Meta Analysis ◽  
Chronic Respiratory Disease ◽  
Cardiovascular Fitness ◽  
Standard Mean Difference ◽  
Children With Asthma

IntroductionChronic disease in children is increasing, including the prevalence of chronic respiratory diseases such as asthma, cystic fibrosis (CF), bronchiectasis and bronchopulmonary dysplasia (BPD). The aim of this systematic review and meta-analysis was to evaluate the effects of exercise training on health outcomes in children with chronic respiratory disease.MethodFive databases were searched for randomised controlled trials investigating the effects of exercise training on children with chronic respiratory disease. Following the PRISMA guidelines, eligible studies were identified and data were extracted. A meta-analysis was conducted for the outcomes cardiovascular fitness, lung function and quality of life (QoL).ResultsThe initial search returned 3688 papers. Twenty-seven (17 in children with asthma, 10 in children with CF) were included in the systematic review and 24 of these were included in the meta-analysis. No studies were identified in children with bronchiectasis or BPD. Included papers had a total of 1009 participants aged 8–20 years. In addition to cardiovascular fitness, lung function and QoL, studies also assessed pulmonary function, respiratory muscle strength, muscular strength and inflammation. Meta-analysis showed a large significant effect size in favour of exercise for cardiovascular fitness (peak VO2) (standard mean difference (SMD)=1.16, 95%  CI 0.61 to 1.70) and QoL (SMD=1.27, 95% CI 0.72 to 1.82) as well as a small, non-significant effect size for lung function (FEV1) (SMD=0.02, 95% CI -0.38 to 0.42).ConclusionExercise training significantly improves cardiovascular fitness and QoL in children with asthma and CF. Further research is needed, particularly in children with bronchiectasis and BPD.

scholarly journals Respiratory function declines in children with asthma associated with chemical species of fine particulate matter (PM2.5) in Nagasaki, Japan

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yoonhee Kim ◽  
Eun Ha Park ◽  
Chris Fook Sheng Ng ◽  
Yeonseung Chung ◽  
Kunio Hashimoto ◽  
...  
Keyword(s):  
Air Pollution ◽  
Lung Function ◽  
Urban Areas ◽  
Chemical Species ◽  
Mixed Effects ◽  
Linear Mixed Effects Model ◽  
Linear Mixed Effects ◽  
Asthmatic Children ◽  
Transboundary Air Pollution ◽  
Children With Asthma

Abstract Background The differential effects of PM2.5 fractions on children’s lung function remain inconclusive. This study aimed to examine whether lung function in asthmatic children was associated with increased PM2.5 fractions in urban areas in Nagasaki prefecture, Japan, where the air pollution level is relatively low but influenced by transboundary air pollution. Methods We conducted a multiyear panel study of 73 asthmatic children (boys, 60.3%; mean age, 8.2 years) spanning spring 2014–2016 in two cities. We collected self-measured peak expiratory flow (PEF) twice a day and daily time-series data for PM2.5 total mass and its chemical species. We fitted a linear mixed effects model to examine short-term associations between PEF and PM2.5, adjusting for individual and time-varying confounders. A generalized linear mixed effects model was also used to estimate the association for worsening asthma defined by severe PEF decline. Back-trajectory and cluster analyses were used to investigate the long-range transboundary PM2.5 in the study areas. Results We found that morning PEFs were adversely associated with higher levels of sulfate (− 1.61 L/min; 95% CI: − 3.07, − 0.15) in Nagasaki city and organic carbon (OC) (− 1.02 L/min; 95% CI: − 1.94, − 0.09) in Isahaya city, per interquartile range (IQR) increase at lag1. In addition, we observed consistent findings for worsening asthma, with higher odds of severe PEF decline in the morning for sulfate (odds ratio (OR) = 2.31; 95% CI: 1.12, 4.77) and ammonium (OR = 1.73; 95% CI: 1.06, 2.84) in Nagasaki city and OC (OR = 1.51; 95% CI: 1.06, 2.15) in Isahaya city, per IQR increase at lag1. The significant chemical species were higher on days that could be largely attributed to the path of Northeast China origin (for sulfate and ammonium) or both the same path and local sources (for OC) than by other clusters. Conclusions This study provides evidence of the differential effects of PM2.5 fractions on lung function among asthmatic children in urban areas, where the Japanese national standards of air quality have been nearly met. Continuous efforts to promote mitigation actions and public awareness of hazardous transboundary air pollution are needed to protect susceptible children with asthma.

scholarly journals Novel KITLG/SCF regulatory variants are associated with lung function in African American children with asthma

2020 ◽  
Author(s):  
Angel CY Mak ◽  
Satria Sajuthi ◽  
Jaehyun Joo ◽  
Shujie Xiao ◽  
Patrick M Sleiman ◽  
...  
Keyword(s):  
African American ◽  
Lung Function ◽  
Genetic Association ◽  
Interaction Analysis ◽  
Whole Genome Sequencing Data ◽  
African American Children ◽  
Eqtl Analysis ◽  
Sequencing Data ◽  
Children With Asthma ◽  
American Children

ABSTRACTBaseline lung function, quantified as forced expiratory volume in the first second of exhalation (FEV1), is a standard diagnostic criterion used by clinicians to identify and classify lung diseases. Using whole genome sequencing data from the National Heart, Lung, and Blood Institute TOPMed project, we identified a novel genetic association with FEV1 on chromosome 12 in 867 African American children with asthma (p = 1.26 × 10−8, β = 0.302). Conditional analysis within 1 Mb of the tag signal (rs73429450) yielded one major and two other weaker independent signals within this peak. We explored statistical and functional evidence for all variants in linkage disequilibrium with the three independent signals and yielded 9 variants as the most likely candidates responsible for the association with FEV1. Hi-C data and eQTL analysis demonstrated that these variants physically interacted with KITLG (aka SCF) and their minor alleles were associated with increased expression of KITLG gene in nasal epithelial cells. Gene-by-air-pollution interaction analysis found that the candidate variant rs58475486 interacted with past-year SO2 exposure (p = 0.003, β = 0.32). This study identified a novel protective genetic association with FEV1, possibly mediated through KITLG, in African American children with asthma.

scholarly journals Changes in circulating microRNA-126 levels are associated with immune imbalance in children with acute asthma

2018 ◽  
Vol 32 ◽  
pp. 205873841877924 ◽  
Author(s):  
Man Tian ◽  
Yong Ji ◽  
Tingting Wang ◽  
Wenxin Zhang ◽  
Ying Zhou ◽  
...  
Keyword(s):  
Treg Cell ◽  
Peripheral Blood ◽  
Th17 Cell ◽  
Acute Asthma ◽  
Control Group ◽  
Relative Level ◽  
Cell Percentage ◽  
Children With Asthma ◽  
Ifn Γ ◽  
Immune Imbalance

Regulation of the immune response in asthma is complex. MicroRNA-126 (miR-126) expression has been implicated in this response, so we sought to determine the clinical significance of miR-126 measured in the peripheral blood. A total of 80 children with acute asthma were selected to participate in the study and were compared to 80 healthy children. The relative circulating miR-126 levels, interleukin (IL)-4 levels, and the Th17 cell percentage in the peripheral blood of children in the case group were significantly higher than those in the control group, while the interferon (IFN)-γ levels and the CD4+CD25+Treg cell percentage were significantly lower than those in the control group. Along with the aggravation of the disease, the relative levels of miR-126 and IL-4 and the percentage of Th17 cells increased gradually, while the IFN-γ levels and the CD4+CD25+Treg cell percentage decreased. The relative level of miR-126 in the peripheral blood of children with asthma was positively correlated with IL-4 and the Th17 cell percentage and was negatively correlated with IFN-γ levels, CD4+CD25+Treg cell percentage and lung function indicators. The relative level of miR-126 was correlated with the Th17 cell percentage in the peripheral blood, forced vital capacity (FVC), and forced expiratory flow (FEF)75% of the children with asthma. The relative levels of miR-126 and IL-4 and the Th17 cell percentage were positively correlated with the severity of the asthma, while IFN-γ levels and the CD4+CD25+Treg cell percentage were negatively correlated with the severity of the asthma. CD4+CD25+Treg cell percentage and relative miR-126 levels were of the most predictive value in the diagnosis of asthma. Our findings show that the overexpression of miR-126 in acute asthma is correlated with signs of immune imbalance and is predictive of the severity of the disease, suggesting that it could be used as a potential serological marker for asthma diagnosis and evaluation.

Smoking and Asthma

PEDIATRICS ◽  
1985 ◽  
Vol 76 (4) ◽  
pp. 655-655
Author(s):  
FRANK PEDREIRA
Keyword(s):  
Lung Function ◽  
Cigarette Smoking ◽  
Cigarette Smoke ◽  
Tobacco Smoke ◽  
Clinical Impression ◽  
Children With Asthma

In Reply.— We thank Dr Berkowitz for his thoughtful response to our paper in the March 1985 issue of Pediatrics. Our study was not designed to address the problem of smoking effect on asthma. However, a number of investigations have shown that atopic individuals may develop wheezing after exposure to tobacco smoke.1-4 Moreover, several studies have demonstrated that cigarette smoke can cause bronchoconstriction and associated decrease in lung function.5-7 These studies support the clinical impression of Dr Berkowitz that children with asthma will "have less problems if their parents stop or decrease their amount of cigarette smoking."

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