Paediatric asthma and allergy最新文献_第9页

Adherence, airway inflammation and adrenal suppression in children with asthma 哮喘患儿的依从性、气道炎症和肾上腺抑制

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa5428

L. Selby, A. Jamalzadeh, P. Hall, A. Bush, Sammy Ndlovu-Dawika, S. Saglani, L. Fleming

{"title":"Adherence, airway inflammation and adrenal suppression in children with asthma","authors":"L. Selby, A. Jamalzadeh, P. Hall, A. Bush, Sammy Ndlovu-Dawika, S. Saglani, L. Fleming","doi":"10.1183/13993003.congress-2019.pa5428","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5428","url":null,"abstract":"Introduction: Systemic absorption of inhaled corticosteroids (ICS) is greater in normal adults than asthmatics [Lancet 2000;356:556-61]. In children, ICS unpredictably cause adrenal suppression. We hypothesized that adrenal suppression for a given ICS dose is less in asthmatic children with worse airway obstruction and inflammation. Methods: Single centre prospective cohort study of children aged 4-16 years prescribed ≥400µg/day beclomethasone (BDP) equivalent. Adherence was measured with an electronic monitoring device (EMD) for 12 weeks. Adrenal function was assessed using the low dose Synacthen test (LDSST) (300 nanograms/m2, serum cortisol taken before then 15, 20, 25, 30 and 35 minutes post administration). Results: 33 children were recruited, 14 (42%) had abnormal LDSST. Those with normal LDSST had significantly higher blood eosinophils and significantly higher FeNO. There was a trend for FEV1% predicted to be lower in those with normal LDSST with a trend to higher cumulative ICS exposure in the week prior to testing. Conclusion: Despite a higher cumulative dose of ICS in the week prior to testing, children with elevated blood eosinophil count and FeNO had normal adrenal function. There was a trend to lower FEV1 in those with normal adrenal function. We speculate that in children with asthma, adrenal suppression relates to the appropriateness of ICS dosage for the level of airway inflammation, rather than absolute dose.","PeriodicalId":114886,"journal":{"name":"Paediatric asthma and allergy","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115241931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gut microbiota in wheezing preschool children and the development of childhood asthma 学龄前喘息儿童肠道菌群与儿童哮喘的发展

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4507

M. Bannier, L. Bervoets, N. Best, Q. Jöbsis, E. Dompeling, J. Penders

{"title":"Gut microbiota in wheezing preschool children and the development of childhood asthma","authors":"M. Bannier, L. Bervoets, N. Best, Q. Jöbsis, E. Dompeling, J. Penders","doi":"10.1183/13993003.congress-2019.pa4507","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa4507","url":null,"abstract":"Background: We currently lack reliable biomarkers to predict whether wheezing, a common symptom in preschool children, will eventually progress into asthma. In this study, we profiled the gut microbiota in wheezing and healthy preschool children, and examined whether the gut microbiota composition in wheezing preschool children could predict asthma at the age of 6 years. Methods: In the Asthma DEetection and Monitoring study (ADEM), 202 preschool wheezing children aged 2-3 years and 50 healthy controls were followed until the age of 6 years, when a diagnosis of asthma was made. At preschool age, faecal samples were collected. The faecal microbial composition was analysed by sequencing of the 16S rRNA V4 hypervariable gene region. Results: Overall microbial community structure and diversity were neither significantly different in wheezing preschool children compared to healthy controls, nor could these indices at preschool age predict future asthma. However, the relative abundance of genera Collinsella and Dorea was significantly lower in wheezing children compared to healthy controls (pfor trend= 0.024; pfor trend= 0.034, respectively), whereas Gemmiger and Escherichia were significantly higher in preschool wheezers that developed asthma (pfor trend= 0.044; pfor trend= 0.015, respectively). Conclusion: Some specific microbial taxa differed between preschool wheezers who developed asthma and transient wheezers. However, overall gut microbiota composition at preschool age did not predict future asthma. It might be that gut microbiota earlier in life has a stronger association with asthma.","PeriodicalId":114886,"journal":{"name":"Paediatric asthma and allergy","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115417391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EBC periostin concentration in children with mild-to moderate asthma 轻中度哮喘患儿EBC骨膜素浓度变化

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4514

P. Nejman-Gryz, K. Górska, K. Krenke, J. Peradzyńska, M. Paplińska-Goryca, M. Kulus, R. Krenke

引用次数: 0

Are there differences in the level of physical activity and functional capacity between healthy and asthmatic children and adolescents? 健康儿童和青少年与哮喘儿童和青少年在身体活动水平和功能能力方面是否存在差异?

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa938

Lívea Gianfrancesco, N. Y. Matsunaga, A. P. Malheiro, Maria Cristina Ribeiro dos Santos Simões, M. D. C. Toro, M. A. Ribeiro, J. Ribeiro, A. Morcillo, A. A. Toro

引用次数: 0

Risk factors for PICU admission in children with severe acute asthma: a multicenter prospective study 重症急性哮喘患儿PICU入院的危险因素:一项多中心前瞻性研究

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa946

S. Boeschoten, A. Boehmer, P. Merkus, J. Rosmalen, C. Buysse, M. Hoog

引用次数: 0

Infants with severe preschool wheeze: results of a 3 year survey of 138 patients 严重学龄前喘息患儿:138例3年调查结果

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa957

H. Petat, C. Marguet, J. Raghani, Aline Chabbat

引用次数: 0

Oral steroids for preschool children with acute wheeze: a systematic review and meta-analysis 口服类固醇治疗学龄前儿童急性喘息:一项系统回顾和荟萃分析

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa4941

J. Murphy, C. King, B. Kapitein, R. Fernandes, A. Lilley, S. Messahel, D. Hawcutt, I. Sinha

{"title":"Oral steroids for preschool children with acute wheeze: a systematic review and meta-analysis","authors":"J. Murphy, C. King, B. Kapitein, R. Fernandes, A. Lilley, S. Messahel, D. Hawcutt, I. Sinha","doi":"10.1183/13993003.congress-2019.oa4941","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa4941","url":null,"abstract":"Background: Benefits of oral corticosteroids (OCS) for acute preschool wheeze are unclear. Aim: Systematically review evidence for OCS in preschool children presenting to the emergency department (ED) or hospitalised with acute wheeze. Methods: We included randomised controlled trials of OCS vs placebo for children Results: Four studies were eligible. Risk of bias was generally low except for selective outcome reporting. OCS did not reduce risk of hospitalisation (Risk ratio 0.94,95%CI 0.80,1.12; Figure 1). Of 3 studies reporting LOS, 2 showed statistically but not clinically significant reduction (placebo 9 hours [IQR 2-16] vs OCS 6.2 [2–11.8] p0.04; and placebo 7.7 hours[5.0-22.9] versus OCS 6.8[4–14] p0.03). Atopic history, and interval symptoms were not consistently associated with better response to OCS. Severity and prior diagnosis of asthma were associated with response in one study. Conclusion: High quality evidence suggests OCS should not be used in the ED in acute preschool wheeze. Effects on those with known asthma or hospitalised with severe illness are uncertain.","PeriodicalId":114886,"journal":{"name":"Paediatric asthma and allergy","volume":"144 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121337050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Late Breaking Abstract - A symptom-based algorithm to improve asthma diagnosis in early childhood:the CHILD Cohort Study 一种基于症状的算法改善儿童早期哮喘诊断:儿童队列研究

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa5418

P. Subbarao, M. Tran, R. Dai, W. Lou, M. Emmerson, C. Dharma, D. Lefebvre, T. Moraes, A. Becker, E. Simons, P. Mandhane, S. Turvey, M. Sears

{"title":"Late Breaking Abstract - A symptom-based algorithm to improve asthma diagnosis in early childhood:the CHILD Cohort Study","authors":"P. Subbarao, M. Tran, R. Dai, W. Lou, M. Emmerson, C. Dharma, D. Lefebvre, T. Moraes, A. Becker, E. Simons, P. Mandhane, S. Turvey, M. Sears","doi":"10.1183/13993003.congress-2019.pa5418","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5418","url":null,"abstract":"Background: Our objective was to develop a short, symptom-based algorithm to screen symptomatic 3-year old children to detect those at risk of persistent wheeze at 5 years. Methods: Parents of children participating in the CHILD Cohort study completed health questionnaires at multiple time points. Children underwent structured clinical assessments at ages 1, 3 and 5 years. Diagnoses of asthma by a study pediatrician were documented at 3 and 5 years. Results: At age 3 years, four operational definitions of asthma were compared: (a) clinical assessment by an expert asthma clinician, (b) parental report of physician-diagnosed asthma, (c) modified Asthma Predictive Index (Castro-Rodriguez et al ARJCCM 2000; Guilbert et al JACI 2004) and (d) a symptom-based algorithm using questionnaire data. Among 2354 children, a classification of “definite asthma by algorithm,” compared to “no asthma by algorithm,” had the strongest associations with study physician-diagnosed asthma at age 5 years (OR 50.4, 95% CI 29.7-89.3) and persistent wheeze to age 5 years (OR 239, 95% CI 114-583). The algorithm identified more cases of definite asthma and more unique cases not identified by the other definitions. Notably, of 79 children with persistent wheeze to age 5 years, the algorithm identified 72 (91.1%), whereas in-person clinical assessment identified 49 (62.0%), and parental report of physician-diagnosed asthma only 33 (41.8%). Conclusions: A short, simple symptom-based algorithm identified most children at age 3 years with likely asthma and at higher risk for persistence to age 5 years. The algorithm could be incorporated in electronic medical records to earlier alert physicians to asthma diagnosis.","PeriodicalId":114886,"journal":{"name":"Paediatric asthma and allergy","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121989779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

PICU admission in children with severe acute asthma: a multicenter prospective study 重症急性哮喘患儿PICU住院:一项多中心前瞻性研究

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa948

S. Boeschoten, C. Buysse, P. Merkus, J. Rosmalen, A. Boehmer, M. Hoog

引用次数: 0

Late Breaking Abstract - Maternal asthma, weight gain in early life and infant lung function 摘要-母亲哮喘，早期体重增加和婴儿肺功能

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa4937

Patricia de Gouveia Belinelo, K. Jesson, Rhea Appenzeller, O. Gorlanova, A. Collison, C. Oldmeadow, V. Murphy, P. Robinson, P. Latzin, P. Gibson, U. Frey, J. Mattes

引用次数: 1