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) < 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.

scholarly journals Metabolic Response to Submaximal and Maximal Exercise in People with Severe Obesity, Prediabetes, and Diabetes

Obesity Facts ◽  
2021 ◽  
pp. 1-10
Author(s):  
Francesca Battista ◽  
Anna Belligoli ◽  
Daniel Neunhaeuserer ◽  
Andrea Gasperetti ◽  
Silvia Bettini ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Maximal Exercise ◽  
Metabolic Response ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiopulmonary Exercise Test ◽  
Peak Exercise ◽  
Cross Sectional ◽  
Cardiopulmonary Exercise ◽  
Significant Difference ◽  
Metabolic Inflexibility

<b><i>Introduction:</i></b> Metabolic adaptations to maximal physical exercise in people with obesity (PwO) are scarcely described. This cross-sectional study evaluates the metabolic response to exercise via the respiratory exchange ratio (RER) in PwO and different degrees of glycemic control. <b><i>Methods:</i></b> Eighty-five PwO (body mass index 46.0 [39.0–54.0] kg/m<sup>2</sup>), that is, 32 normoglycemic (Ob-N), 25 prediabetic (Ob-preDM), and 28 diabetic (Ob-T2DM) subjects and 18 healthy subjects performed an incremental, maximal cardiopulmonary exercise test. The RER was measured at rest (RERrest) and at peak exercise (RERpeak). <b><i>Results:</i></b> RERpeak was significantly higher in healthy subjects than that in PwO. Among those, RERpeak was significantly higher in Ob-N than that in Ob-preDM and Ob-T2DM (1.20 [1.15–1.27] vs. 1.18 [1.10–1.22] <i>p</i> = 0.04 and vs. 1.14 [1.10–1.18] <i>p</i> &#x3c; 0.001, respectively). Accordingly, ΔRER (RERpeak-RERrest) was lower in Ob-preDM and Ob-T2DM than that in Ob-N (0.32 [0.26–0.39] <i>p</i> = 0.04 and 0.29 [0.24–0.36] <i>p</i> &#x3c; 0.001 vs. 0.38 [0.32–0.43], respectively), while no significant difference was found in ΔRER between Ob-preDM and Ob-T2DM and not even between Ob-N and healthy subjects. Moreover, ΔRER in PwO correlated with glucose area under curve (<i>p</i> = 0.002). <b><i>Conclusions:</i></b> PwO demonstrate restricted metabolic response during maximal exercise. Particularly, those with prediabetes already show metabolic inflexibility during exercise, similarly to those with type 2 diabetes. These findings also suggest a potential role of cardiopulmonary exercise testing in detecting early metabolic alterations in PwO.

scholarly journals High prevalence of exercise-induced stridor during Parkrun: a cross-sectional field-based evaluation

2020 ◽  
Vol 7 (1) ◽  
pp. e000618
Author(s):  
Joe Sails ◽  
James H Hull ◽  
Hayden Allen ◽  
Liam Darville ◽  
Emil S Walsted ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Phase 1 ◽  
Upper Airway ◽  
Peak Exercise ◽  
Inspiratory Stridor ◽  
Cross Sectional ◽  
Respiratory Dysfunction ◽  
Objective Evidence ◽  
Abnormal Breathing ◽  
Exercise Induced

Background and objectiveThe differential diagnosis for exercise-associated breathlessness is broad, however, when a young athletic individual presents with respiratory symptoms, they are most often prescribed inhaler therapy for presumed exercise-induced asthma (EIA). The purpose of this study was therefore to use a novel sound-based approach to assessment to evaluate the prevalence of exertional respiratory symptoms and characterise abnormal breathing sounds in a large cohort of recreationally active individuals.MethodsCross-sectional field-based evaluation of individuals completing Parkrun.Phase 1Prerace, clinical assessment and baseline spirometry were conducted. At peak exercise and immediately postrace, breathing was monitored continuously using a smartphone. Recordings were analysed retrospectively and coded for signs of the predominant respiratory noise.Phase 2A subpopulation that reported symptoms with at least one audible sign of respiratory dysfunction was randomly selected and invited to attend the laboratory on a separate occasion to undergo objective clinical workup to confirm or refute EIA.ResultsForty-eight participants (22.6%) had at least one audible sign of respiratory dysfunction; inspiratory stridor (9.9%), expiratory wheeze (3.3%), combined stridor+wheeze (3.3%), cough (6.1%). Over one-third of the cohort (38.2%) were classified as symptomatic. Ten individuals attended a follow-up appointment, however, only one had objective evidence of EIA.ConclusionsThe most common audible sign, detected in approximately 1 in 10 individuals, was inspiratory stridor, a characteristic feature of upper airway closure occurring during exercise. Further work is now required to further validate the precision and feasibility of this diagnostic approach in cohorts reporting exertional breathing difficulty.

scholarly journals Airways Hyperresponsiveness and Atopy: A Comparison of Inuit and Montreal Schoolchildren

1995 ◽  
Vol 2 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Brenda Hemmelgarn ◽  
Esther Loozen ◽  
Sheila Saralegui ◽  
Susan Chatwood ◽  
Pierre Ernst
Keyword(s):  
Skin Testing ◽  
Challenge Test ◽  
Bronchial Hyperresponsiveness ◽  
Forced Expiratory Volume ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
History Of ◽  
Exercise Induced ◽  
Allergy Skin Testing ◽  
Airways Hyperresponsiveness

OBJECTIVE: To compare the prevalence ol exercise induced bronchial hyperresponsiveness in Inuit children with that or children in Montreal, and to identify possible genetic and environmental determinants of the differences observed.DESIGN: Cross-sectional survey.SETTING: Salluit, an isolated Inuit community in northern Quebec, and Montreal.POPULATION STUDIED: All children attending school in Salluit in grades 2 to 6 were eligible to participate. For the Montreal study, 18 schools were selected and from each of these one class from each of grades 1, 3 and 5 were chosen.MEASUREMENTS: Data collection for both locations included an exercise challenge test to assess exercise induced bronchial hyperresponsiveness (EIBH), allergy skin testing, a questionnaire for parents regarding details or the home environment as well as the child’s history of respiratory symptoms, and collection of dust samples from the bedroom floor and mattress for the presence of house dust mite.RESULTS: The prevalence or EIBH (defincd as a decline of 15% or more between pre-exercise forced expiratory volume in 1 s [FEV1] and that at 5 or 10 mins postexercise) was 19.5% (23 of 118) among the Inuit children, compared with 8.8% (87 of 989) among the Montreal children. In contrast. only 8.6% of the Inuit children had a positive allergy skin test compared with 34% in Montreal.CONCLUSIONS: A higher prevalence of EIBH was found in Inuit schoolchildren compared with children of similar age in Montreal, although the prevalence of atopy was considerably lower.

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 Effect of obesity on lung function test among adults

2020 ◽  
Vol 7 (12) ◽  
pp. 1795
Author(s):  
Dhairya Salvi ◽  
Dhanvi Moradia
Keyword(s):  
Vital Capacity ◽  
Lung Function Test ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Function Test

Background: Obesity is a chronic disease characterized by excessive body fat that causes damage to the individual’s health and is associated with comorbidities such as diabetes and hypertension and vascular dysfunction. This cross-sectional study was carried out with the objective of evaluating the effect of obesity on lung function test in obese but otherwise healthy adults.Methods: It was a cross-sectional study carried out at tertiary care institute of Gujarat, India. It was conducted over a period of 5 months. A total of 240 adult healthy subjects of both sexes were selected randomly belonging to varying socio-economic status. The study subjects were divided into 3 categories (normal body mass index i.e. BMI, overweight, obese). BMI were calculated for the randomly selected subjects from each list till the desired number in each BMI group were attained. Four respiratory parameters viz. forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory volume in 3 seconds (FEV3), and maximum voluntary ventilation (MVV) were used to assess their lung functions.Results: Two hundred and forty subjects (each group having n=80). The mean age of group I, group II and group III were 27.45±6.37, 28.18±6.42 and 28.98±6.74 respectively. Lung volumes showed significant difference in relation to the BMI. FVC and FEV1 show significant decrease. Group III verses group I (p˂0.001 and p˂0.017 respectively) FEV3 showed significant difference between group I and group III and between group II and group III (p˂0.001). MVV was significantly lower in group III when compared to group I.Conclusions: There is decline in pulmonary function in obese as compared to normal weight adults. These findings suggest deleterious effects on ventilatory mechanics caused by obesity, due to probable lung compression (reduction in the expiratory reserve volume i.e. ERV), leading to a compensatory increase in the inspiratory reserve volume (IRV) in an attempt to maintain a constant vital capacity (VC).

scholarly journals Pulmonary Arterial Pressure Response During Exercise in COPD: A Correlation with C-Reactive Protein (hsCRP)

2016 ◽  
Vol 10 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Janos Varga ◽  
Attila Palinkas ◽  
Imre Lajko ◽  
Ildikó Horváth ◽  
Krisztina Boda ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
Cardiopulmonary Exercise Testing ◽  
Systolic Pressure ◽  
Forced Expiratory Volume ◽  
Pulmonary Vasculature ◽  
Peak Exercise ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Copd Patients ◽  
Pulmonary Arterial

Background: The non-invasive assessment of pulmonary haemodynamics during exercise provides complementary data for the evaluation of exercise tolerance in patients with COPD. Methods: Exercise echocardiography in the semi-supine position was performed in 27 patients with COPD (C) with a forced expiratory volume in one second (FEV1) of 36±12% predicted and 13 age and gender-matched non-COPD subjects (NC). COPD patients also underwent cardiopulmonary exercise testing with gas exchange detection (CPET). Furthermore, serum high sensitive C-reactive protein (hsCRP), a marker of systemic inflammation, was also measured. Results: The maximal work rate (WRmax) and aerobic capacity (VO2peak) were significantly reduced (WRmax: 77±33 Watt, VO2peak: 50±14 %pred) in COPD. Pulmonary arterial systolic pressure (PAPs) was higher in COPD versus controls both at rest (39±5 vs. 31±2 mmHg, p<0.001), and at peak exercise (72±12 vs. 52±8 mmHg, p<0.001). In 19 (70%) COPD patients, the increase in PAPs was above 22 mmHg. The change in pressure (dPAPs) correlated with hsCRP (r2=0.53, p<0.0001) and forced vital capacity (FVC) (r2=0.18, p<0.001). Conclusion: PAPs at rest and during exercise were significantly higher in COPD patients and correlated with higher hsCRP. This may indicate a role for systemic inflammation and hyperinflation in the pulmonary vasculature in COPD. The study was registered at ClinicalTrials.gov webpage with NCT00949195 registration number.

scholarly journals Sputum and plasma adiponectin levels in clinically stable adult cystic fibrosis patients with CFTR I1234V mutation

2019 ◽  
Author(s):  
Atqah AbdulWahab ◽  
Mona Allangawi ◽  
Merlin Thomas ◽  
Ilham Bettahi ◽  
Siveen K. Sivaraman ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Adiponectin Level ◽  
Pancreatic Insufficiency ◽  
Forced Expiratory Volume ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Plasma Adiponectin ◽  
Inflammatory Status ◽  
Significant Difference ◽  
The Mean

Abstract Background: Cystic fibrosis (CF) lung disease is associated with chronic inflammation leading to progress in lung function. Adiponectin is a predominantly anti-inflammatory adipokine that may have a role in CF lung. This study aims to determine total sputum and total plasma adiponectin levels in clinically stable adults CF patients with CFTR I1234V mutation, compared to plasma adiponectin levels in healthy controls and to investigate their correlations with body mass index (BMI) and spirometry in patients with CF. Methods: A cross-sectional study comprises 17 CF patients and 18 healthy controls. Adiponectin levels were measured by magnetic bead-based multiplex assay. Results: The mean age of adult CF patients was 22.9 years± 3.8 (18-30) and 76.5% CF patients had pancreatic sufficiency. The mean BMI in healthy controls was slightly higher than CF patients. The mean sputum adiponectin level was significantly lower than plasma adiponectin levels in CF patients and healthy controls (p<0.001), whereas no significant difference in plasma adiponectin levels between CF patients and healthy controls. The mean sputum adiponectin level was observed to be higher in CF patients with pancreatic insufficiency. Sputum adiponectin level was correlated positively with plasma adiponectin level in CF patients (r= 0.47, p=0.06). Sputum and plasma adiponectin levels in CF patients were correlated negatively with BMI and percentage predicted forced expiratory volume in 1 second (FEV1) and Forced vital capacity (FVC). Conclusions: Sputum adiponectin may provide a minimally invasive tool in the assessment of an inflammatory status in CF patients. Further larger study to address any difference in sputum and plasma adiponectin levels among CF patients with pancreatic sufficiency versus pancreatic insufficiency.

scholarly journals Pulmonary haemodynamic response to exercise in highlanders versus lowlanders

2021 ◽  
Vol 7 (2) ◽  
pp. 00937-2020
Author(s):  
Silvia Ulrich ◽  
Stéphanie Saxer ◽  
Michael Furian ◽  
Patrick R. Bader ◽  
Paula Appenzeller ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Index ◽  
Cross Sectional Study ◽  
Haemodynamic Response ◽  
Cross Sectional ◽  
Pressure Flow ◽  
Central Asian ◽  
Significant Difference ◽  
Exercise Induced ◽  
Response To Exercise

The aim of the study was to investigate the pulmonary haemodynamic response to exercise in Central Asian high- and lowlanders.This was a cross-sectional study in Central Asian highlanders (living >2500 m) compared with lowlanders (living <800 m), assessing cardiac function, including tricuspid regurgitation pressure gradient (TRPG), cardiac index and tricuspid annular plane systolic excursion (TAPSE) by echocardiography combined with heart rate and oxygen saturation measured by pulse oximetry (SpO2) during submaximal stepwise cycle exercise (10 W increase per 3 min) at their altitude of residence (at 760 m or 3250 m, respectively).52 highlanders (26 females; aged 47.9±10.7 years; body mass index (BMI) 26.7±4.6 kg·m−2; heart rate 75±11 beats·min−1; SpO2 91±5%;) and 22 lowlanders (eight females; age 42.3±8.0 years; BMI 26.9±4.1 kg·m−2; heart rate 68±7 beats·min−1; SpO2 96±1%) were studied. Highlanders had a lower resting SpO2 compared to lowlanders but change during exercise was similar between groups (highlanders versus lowlanders −1.4±2.9% versus −0.4±1.1%, respectively, p=0.133). Highlanders had a significantly elevated TRPG and exercise-induced increase was significantly higher (13.6±10.5 mmHg versus 6.1±4.8 mmHg, difference 7.5 (2.8 to 12.2) mmHg; p=0.002), whereas cardiac index increase was slightly lower in highlanders (2.02±0.89 L·min−1versus 1.78±0.61 L·min−1, difference 0.24 (−0.13 to 0.61) L·min−1; p=0.206) resulting in a significantly steeper pressure–flow ratio (ΔTRPG/Δcardiac index) in highlanders 9.4±11.4 WU and lowlanders 3.0±2.4 WU (difference 6.4 (1.4 to 11.3) WU; p=0.012). Right ventricular-arterial coupling (TAPSE/TRPG) was significantly lower in highlanders but no significant difference in change with exercise in between groups was detected (−0.01 (−0.20 to 0.18); p=0.901).In highlanders, chronic exposure to hypoxia leads to higher pulmonary artery pressure and a steeper pressure–flow relation during exercise.

scholarly journals Pulmonary Involvement in the Antisynthetase Syndrome: A Comparative Cross-sectional Study

2016 ◽  
Vol 43 (6) ◽  
pp. 1107-1113 ◽  
Author(s):  
Helena Andersson ◽  
Trond Mogens Aaløkken ◽  
Anne Günther ◽  
Georg Karl Mynarek ◽  
Torhild Garen ◽  
...  
Keyword(s):  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Pulmonary Involvement ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Walking Distance ◽  
Antisynthetase Syndrome ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Significant Difference

Objective.Interstitial lung disease (ILD) is a major component of the antisynthetase syndrome, but quantitative data on longterm pulmonary outcome in antisynthetase syndrome are limited. In this study, the main aims were to compare pulmonary function tests (PFT) and the 6-min walking distance (6MWD) between patients with antisynthetase syndrome and healthy sex- and age-matched controls, to evaluate the extent of ILD by lung high-resolution computed tomography (HRCT), and to assess correlations between PFT measures and ILD extent.Methods.Concurrent PFT and 6MWD were performed in 68 patients with antisynthetase syndrome and their individually matched controls. Additionally, in the patients, the extent of ILD was determined in 10 HRCT sections, expressed as percentage of total lung volumes.Results.Median disease duration in the antisynthetase syndrome cohort was 71 months. Compared with the matched controls, the patients with antisynthetase syndrome had mean 28%, 27%, and 53% lower absolute values of forced vital capacity (FVC), forced expiratory volume in 1 s, and DLCO (p < 0.001). Mean difference in 6MWD between patients and controls was 116 m (p < 0.001). Median extent of ILD by HRCT was 20% (range 0–73) and correlated with FVC and DLCO. Pulmonary outcome did not differ between Jo1 and non-Jo1 subsets.Conclusion.To our knowledge, this study is the first to demonstrate a highly significant difference in PFT between patients with antisynthetase syndrome with 6 years of followup and healthy controls. DLCO displayed the highest difference with mean 53% lower value in the patients. FVC and DLCO correlated significantly with ILD extent, indicating these variables as appropriate outcome measures in antisynthetase syndrome–associated ILD.

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.

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