scholarly journals Urinary Eosinophil Protein X in Childhood Asthma: Relation with Changes in Disease Control and Eosinophilic Airway Inflammation

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Marianne Nuijsink ◽  
Wim C. J. Hop ◽  
Peter J. Sterk ◽  
Eric J. Duiverman ◽  
Johan C. De Jongste
Keyword(s):  
Airway Inflammation ◽  
Asthma Control ◽  
Forced Expiratory Volume ◽  
Atopic Asthma ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Protein X ◽  
Symptom Scores ◽  
Within Subjects ◽  
The Individual

The aim of this study was to assess cross-sectional and longitudinal correlations between uEPX and other markers of asthma control and eosinophilic airway inflammation.Methods. We measured uEPX at baseline, after 1 year and after 2 years in 205 atopic asthmatic children using inhaled fluticasone. At the same time points, we assessed symptom scores (2 weeks diary card), lung function (forced expiratory volume in one second (FEV1)), airway hyperresponsiveness (AHR), and percentage eosinophils in induced sputum (% eos).Results. We found negative correlations between uEPX and FEV1at baseline (r=-0.18,P=0.01), after 1 year (r=-0.25,P<0.01) and after 2 years (r=-0.21,P=0.02). Within-patient changes of uEPX showed a negative association with FEV1changes (at 1 year:r=-0.24,P=0.01; at 2 years:r=-0.21,P=0.03). Within-patient changes from baseline of uEPX correlated with changes in % eos. No relations were found between uEPX and symptoms.Conclusion. In this population of children with atopic asthma, uEPX correlated with FEV1and % eos, and within-subjects changes in uEPX correlated with changes in FEV1and % eos. As the associations were weak and the scatter of uEPX wide, it seems unlikely that uEPX will be useful as a biomarker for monitoring asthma control in the individual child.

scholarly journals Urinary Eosinophil Protein X in Children with Atopic Asthma

2007 ◽  
Vol 2007 ◽  
pp. 1-6 ◽  
Author(s):  
M. Nuijsink ◽  
W. C. J. Hop ◽  
P. J. Sterk ◽  
E. J. Duiverman ◽  
P. S. Hiemstra ◽  
...  
Keyword(s):  
Airway Inflammation ◽  
Inverse Correlation ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Atopic Asthma ◽  
Sputum Induction ◽  
Creatinine Concentration ◽  
Cross Sectional ◽  
Steroid Dependent ◽  
Protein X

The aim of this study was to investigate the relationship between urinary eosinophil protein X (uEPX) and asthma symptoms, lung function, and other markers of eosinophilic airway inflammation in asthmatic school children.Methods. A cross-sectional study was performed in 180 steroid dependent atopic children with stable moderately severe asthma, who were stable on 200 or 500μg of fluticasone per day. uEPX was measured in a single sample of urine and was normalized for creatinine concentration (uEPX/c). Symptom scores were kept on a diary card.FEV1andPD20methacholine were measured. Sputum induction was performed in 49 andFENOlevels measured in 24 children.Results. We found an inverse correlation between uEPX/c andFEV1(r=−.20,P=.01) and a borderline significant correlation between uEPX/c andPD20methacholine (r=−.15,P=.06). Symptom score,%eosinophils and ECP in induced sputum andFENOlevels did not correlate with uEPX/c.Conclusion. uEPX/c levels did not correlate with established markers of asthma severity and eosinophilic airway inflammation in atopic asthmatic children.

scholarly journals The Asthma Quiz for Kidz: A Validated Tool to Appreciate the Level of Asthma Control in Children

2004 ◽  
Vol 11 (8) ◽  
pp. 541-546 ◽  
Author(s):  
Francine M Ducharme ◽  
G Michael Davis ◽  
Francisco Noya ◽  
Harold Rich ◽  
Pierre Ernst
Keyword(s):  
Asthma Control ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Medical Visit ◽  
Poor Control ◽  
Cross Sectional ◽  
Response Options ◽  
Clinical Criteria ◽  
Quiz Score

BACKGROUND:There is an urgent need to bridge the large gap between optimal and observed asthma control among Canadian children.OBJECTIVES:To adapt the criteria of asthma control proposed in the 1999 Asthma Consensus Statement for children and validate the proposed cut-offs in children with asthma.METHODS:Six clinical criteria of asthma control were phrased as questions and response options, and pretested for clarity. A cross-sectional study was conducted in children one to 17 years of age presenting to the hospital's asthma clinics. Children nine years of age or older and their parents were asked to complete The Asthma Quiz for Kidz separately, and then together, before the medical visit. Parents of younger children completed the questionnaire with their child. Physicians were not informed of the results of the quiz.RESULTS:The mean age of the 343 participants was 8.0±4.4 (SD) years with a mean baseline forced expiratory volume in 1 s of 96±15% of predicted values. Asthma severity was rated as mild (67%), moderate (29%) or severe (4%). Overall, 57% of subjects endorsed at least two of the six criteria of poor control. The median (interquartile range) Asthma Quiz score was significantly higher when the physician's assessment of asthma control was poor than when the physician's assessment of asthma control was good (3 [1, 5] versus 1 [0, 2], P<0.001), but it did not correlate with the spirometry. A score of at least 2 out of 6 had 73% sensitivity and 59% specificity for identifying poor control.INTERPRETATION:The Asthma Quiz score provides complementary information to, but does not replace, lung function testing. A score of 2 or more out of 6 suggests poor asthma control and should prompt patients to consult their physician for reassessment.

scholarly journals EVALUATION OF INDUCED SPUTUM CYTOLOGY IN ASTHMATIC CHILDREN

2021 ◽  
Author(s):  
Debora Carla Chong-Silva ◽  
Adriana Nascimento ◽  
Roberta Cunha ◽  
Elessandra Bitencourt ◽  
Leticia Botelho ◽  
...  
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Pulmonary Function Tests ◽  
Sputum Cytology ◽  
Asthma Control Test ◽  
Sputum Induction ◽  
Hypertonic Saline Solution ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Children With Asthma

Objective: To evaluate the viability of sputum cytology in asthmatic children, recognizing inflammatory patterns and correlating them with clinical, epidemiological and functional variables of the disease. Methods: This was a cross-sectional and observational study of children with asthma who underwent sputum induction through increasing concentrations of nebulized hypertonic saline solution from 3% to 7%. The samples were processed according to the technique developed by Pizzichini et al. and the cytological pattern classified as pauci-granulocytic, neutrophilic, eosinophilic and mixed. Samples with cell viability> 50% were considered adequate. Asthma control was assessed using the asthma control test (ACT). Results: Seventy-nine children performed sputum induction. Thirty-three samples were excluded because they were not viable for analysis, resulting in 46 samples. The children’s average age was 9.4 (± 3) years. There was a predominance of eosinophilic (25/46, 54.3%), followed by mixed (13/46, 28.3%), pauci-granulocytic (7/46, 15.2%) and neutrophilic (1/46, 2.2%) pattern. Sixty-three percent of the children had severe asthma and 84.7% were treated with inhaled corticosteroids. The ACT showed that 25 (56.8%) patients had the disease under control. Forty-five children (97.8%) underwent pulmonary function tests (spirometry) and in 13 cases (28.9%) an obstructive ventilatory defect was found. Conclusions: The eosinophilic profile was predominant in the assessed asthmatic children. Non-eosinophilic phenotypes were found, but less frequently. There was no difference between the clinical variables and the sputum profile in this study group. Sputum induction in children with asthma is feasible and safe and can contribute to a specific and personalized approach to the disease.

scholarly journals Assessment of Asthma Control and Severity among Children According to Global Initiative for Asthma Guidelines in Sulaimani City-Iraq

2016 ◽  
Vol 12 (3) ◽  
pp. 160
Author(s):  
Adnan M. H. Hamawandi ◽  
Kosar M Ali ◽  
Ali Z. Naji
Keyword(s):  
Asthma Control ◽  
Objective Assessment ◽  
Asthma Management ◽  
Persistent Asthma ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Global Initiative For Asthma ◽  
Severe Persistent Asthma ◽  
Global Initiative ◽  
Gina Guidelines

Background: Asthma is a common and potentially serious chronic disease that imposes a substantial burden on patients, their families and the community. Objective: Assessment of the level of asthma control and severity in asthmatic children in Sulaimani city according to the global initiative for asthma (GINA) guidelines. Methods: A cross-sectional study of 82 patients who are known cases of asthma, aged 5 – 15 years , from 1st of March 2014 to 1st of August 2014. Results: Out of 82 patients in our study, 20.8%were classified as having intermittent asthma all of them have well controlled asthma, 42.7% of those classified as having mild persistent asthma 65.7% of them have well controlled asthma, 26.8% of those classified as having moderate persistent asthma 54.5% of them have partly controlled asthma, and 9.8%of those classified as having severe persistent asthma the majority of them 87.5% have uncontrolled asthma and none of them reached to the controlled asthma level according to GINA guidelines. Regarding the peak expiratory flow (PFT) we notice that 58.8% of asthmatic children who were classified as having intermittent severity, their PEF measurements ranged between 160- 250 l/min while those with severe persistent asthma 75% of them have readings between 50-150 l/min. Conclusion: Current levels of asthma control in the Sulaimani city fall far short of the goals specified in the GINA guidelines for asthma management. Also there is a strong correlation between PEF measurements and the level of asthma severity,

scholarly journals Assessment of asthma control and lung function in asthmatic children in Sokoto, North Western Nigeria

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Fatima Abubakar Ishaq ◽  
Bilkisu Ilah Garba ◽  
Nma Mohammad Jiya ◽  
Ahmed Hamidu
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Children With Asthma ◽  
Global Initiative ◽  
Gina Guidelines ◽  
Study Participants

Objectives: This study aimed at assessing asthma control using Global Initiative for Asthma (GINA) asthma assessment, and determining its relationship with lung function parameters among asthmatic children in Usmanu Danfodiyo University Teaching hospital, Sokoto. Materials and Methods: This was a cross-sectional study among 60 children with asthma diagnosed based on GINA guidelines. It was conducted over a period of 4 months. The GINA asthma control assessment was administered to assess asthma control. Lung function was done using a portable spirometer. Results: Males accounted for 58.3% of the study population with M: F of 1.4:1 and median age of 9.47 years, with majority from urban domicile (91.7%). Well-controlled asthma accounted for 50.0% while 35.0% had partly controlled asthma and 15.0% had poorly controlled asthma. The median FEV1/FVC among the study participants was 0.856 (IQR: 0.170). There was no relationship between asthma control and LF parameters (FEV1: r = 0.044, P = 0.736, FVC: r = 0.010, P = 0.941, FEV1/FVC: r = 0.122, P = 0.352, and PEFR: r = 0.015, P = 0.911). Conclusion: Majority of the study participants had well-controlled asthma and no relationship was found between asthma control and lung function. Thus, serial monitoring of LF in addition to uniformly agreed standardized assessment of asthma control is required to objectively evaluate asthma control in children.

scholarly journals Childhood obesity in relation to poor asthma control and exacerbation: a meta-analysis

2016 ◽  
Vol 48 (4) ◽  
pp. 1063-1073 ◽  
Author(s):  
Fariba Ahmadizar ◽  
Susanne J.H. Vijverberg ◽  
Hubertus G.M. Arets ◽  
Anthonius de Boer ◽  
Jason E. Lang ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Asthma Control ◽  
Meta Analysis ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Random Effects Models ◽  
Asthmatic Children ◽  
Asthma Exacerbations ◽  
Increased Risk ◽  
A Minor

To estimate the association between obesity and poor asthma control or risk of exacerbations in asthmatic children and adolescents, and to assess whether these associations are different by sex.A meta-analysis was performed on unpublished data from three North-European paediatric asthma cohorts (BREATHE, PACMAN (Pharmacogenetics of Asthma medication in Children: Medication with Anti-inflammatory effects) and PAGES (Pediatric Asthma Gene Environment Study)) and 11 previously published studies (cross-sectional and longitudinal studies). Outcomes were poor asthma control (based on asthma symptoms) and exacerbations rates (asthma-related visits to the emergency department, asthma-related hospitalisations or use of oral corticosteroids). Overall pooled estimates of the odds ratios were obtained using fixed- or random-effects models.In a meta-analysis of 46 070 asthmatic children and adolescents, obese children (body mass index ≥95th percentile) compared with non-obese peers had a small but significant increased risk of asthma exacerbations (OR 1.17, 95% CI 1.03–1.34; I2: 54.7%). However, there was no statistically significant association between obesity and poor asthma control (n=4973, OR 1.23, 95% CI 0.99–1.53; I2: 0.0%). After stratification for sex, the differences in odds ratios for girls and boys were similar, yet no longer statistically significant.In asthmatic children, obesity is associated with a minor increased risk of asthma exacerbations but not with poor asthma control. Sex does not appear to modify this risk.

scholarly journals The Role of FENO in Comparison to Spirometry and ACT in Control of Children Asthma Symptoms

2019 ◽  
Author(s):  
Abbas Dabbaghzadeh ◽  
Marzieh Tavakol ◽  
Mohammad Gharagozlou
Keyword(s):  
Asthma Control ◽  
Medical Center ◽  
Lung Function Test ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Asthma Control Test ◽  
Cross Sectional ◽  
Before And After ◽  
The Mean ◽  
Act Score

  Fractional exhaled nitric oxide (FeNO) is a noninvasive marker of inflammation, used for monitoring asthma. The aim of this study was to compare FeNO, asthma control test (ACT), and lung function test (spirometry) in children aged 8-15 years. This observational, cross-sectional study was performed on76 asthmatic children (age, 8-15 years), who were referred to the Department of Immunology and Allergy, Children's Medical Center, Tehran, Iran during 2012-2013. Patients were matched for sex and age. The recruited patients were selected via consecutive sampling. FeNO was measured with a portable electrochemical analyzer and forced spirometry was performed according to the American Thoracic Society (ATS) guidelines. The ACT questionnaire was used and completed for all the patients.  The mean FeNO was 28.5±29.1 ppb, and the mean ACT score was 19.8±3.6. FeNO was significantly correlated with forced expiratory volume (FEV1) (r, 0.232; p=0.049) or 25-75% maximum expiratory flow (MEF 25-75) (r, -0.304; p=0.009). FeNO showed no significant correlation with ACT score or FEV1/forced vital capacity (FVC) (p>0.05). Additionally, there was no significant correlation between FeNO and changes in FEV1 and MEF 25-75% before and after the administration of bronchodilators (p>0.05). To improve asthma control, childhood ACT, FeNO, and spirometric tests can be used as complementary tools in clinical practice to detect children with poorly controlled asthma.

scholarly journals Is there an association between the value of forced expiratory volume in the 1st second, the Asthma Control Test and a Control Framework by Global Initiative for asthma in asthmatic children and adolescents treated with inhaled corticosteroids?

2019 ◽  
Vol 29 (3) ◽  
pp. 346-353
Author(s):  
Karla Delevedove Taglia-Ferre ◽  
Sandra Lisboa ◽  
Luanda Dias da S. Salviano ◽  
Ana Carolina Carioca da Costa ◽  
Shandra Lisboa Monteiro ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Asthma Control ◽  
Control Method ◽  
Inhaled Corticosteroids ◽  
Forced Expiratory Volume ◽  
Control Test ◽  
Asthma Control Test ◽  
Asthmatic Children ◽  
Global Initiative For Asthma ◽  
Global Initiative

Objective: Evaluate the presence of association between the classification of the level of asthma control, using the method proposed by the Global Initiative for Asthma (GINA), the Asthma Control Test (ACT)/Childhood-ACT and the forced expiratory volume in the 1st second (FEV1), in asthmatic children and adolescents treated with inhaled corticosteroids, followed up at the National Institute of Women's, Children's and Adolescents' Health FernandesFigueira of the Oswaldo Cruz Foundation (IFF / FIOCRUZ). Method: A cross-sectional study was carried out with a review of the medical records of all children between 7 and 17 years of age followed up at the Asthma Outpatient Clinic and referred to the Respiratory Insertion Test (PFR) sector between March 2013 and September 2014. In the same day were applied the C-ACT/ACT questionnaires, an asthma control method proposed by the GINA and the FEV1 value in a spirometrictest. Results: From the total number of records evaluated (72), 16 children were excluded because they did not meet the required criteria for performing spirometry. The sample studied (56 children) was predominantly male (58.9%) and median age was 12 (7-17) years. It was observed an association between FEV1 and GINA values ??(p <0.01). Conclusion: The results found in this study indicate that FEV1 measurement is a useful component among the instruments for assessing clinical control of asthma by GINA.

scholarly journals Exercise Limitation in Children and Adolescents With Severe Refractory Asthma: A Lack of Asthma Control?

2021 ◽  
Vol 11 ◽  
Author(s):  
Rita C. Faleiro ◽  
Eliane V. Mancuzo ◽  
Fernanda C. Lanza ◽  
Mônica V. N. P. Queiroz ◽  
Luciano F. L. de Oliveira ◽  
...  
Keyword(s):  
Asthma Control ◽  
Cardiopulmonary Exercise Testing ◽  
Forced Expiratory Volume ◽  
Peak Exercise ◽  
Cross Sectional ◽  
Exercise Limitation ◽  
Significant Difference ◽  
Exercise Induced ◽  
Physical Deconditioning ◽  
Refractory Asthma

BackgroundPatients with severe refractory asthma (SRA), even when using high doses of multiple controller medications in a regular and appropriate way, can have persistent complaints of exercise limitation.MethodsThis was a cross-sectional study involving patients with SRA (treated with ≥ 800 μg of budesonide or equivalent, with ≥ 80% adherence, appropriate inhaler technique, and comorbidities treated), who presented no signs of a lack of asthma control other than exercise limitation. We also evaluated healthy controls, matched to the patients for sex, age, and body mass index. All participants underwent cardiopulmonary exercise testing (CPET) on a cycle ergometer, maximum exertion being defined as ≥ 85% of the predicted heart rate, with a respiratory exchange ratio ≥ 1.0 for children and ≥ 1.1 for adolescents. Physical deconditioning was defined as oxygen uptake (VO2) &lt; 80% of predicted at peak exercise, without cardiac impairment or ventilatory limitation. Exercise-induced bronchoconstriction (EIB) was defined as a forced expiratory volume in one second ≥ 10% lower than the baseline value at 5, 10, 20, and 30 minutes after CPET.ResultsWe evaluated 20 patients with SRA and 19 controls. In the sample as a whole, the mean age was 12.9 ± 0.4 years. The CPET was considered maximal in all participants. In terms of the peak VO2 (VO2peak), there was no significant difference between the patients and controls, (P = 0.10). Among the patients, we observed isolated EIB in 30%, isolated physical deconditioning in 25%, physical deconditioning accompanied by EIB in 25%, and exercise-induced symptoms not supported by the CPET data in 15%.Conclusion and Clinical RelevancePhysical deconditioning, alone or accompanied by EIB, was the determining factor in reducing exercise tolerance in patients with SRA and was not therefore found to be associated with a lack of asthma control.

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