Hair cortisol and inhaled corticosteroid use in asthmatic children

Associations between maternal stress and infant resting brain activity among families residing in poverty in the U.S

Growing evidence suggests that maternal experiences of stress shape children's functional brain activity in the first years of life. Individuals living in poverty are more likely to experience stress from a variety of sources. However, it is unclear how stress is related to resting brain activity among children born into poverty. The present study examines whether infants born into households experiencing poverty show differences in brain activity associated with maternal reports of experiencing stress. The analytic sample comprised 247 mother-infant dyads who completed maternal questionnaires characterizing stress, and for whom recordings of infant resting brain activity were obtained at 1 year of age (M=12.93 months, SD=1.66; 50% female). Mothers (40% Black, non-Hispanic, 40% Hispanic, 12% White, non-Hispanic) who reported higher stress had infants who showed more resting brain activity in the lower end of the frequency spectrum (relative theta power) and less resting brain activity in the middle range of the frequency spectrum (relative alpha power). While statistically detectable at the whole-brain level, follow-up exploratory analyses revealed that these effects were most apparent in electrodes over frontal and parietal regions of the brain. These findings held after adjusting for a variety of potentially confounding variables. Altogether, the present study suggests that, among families experiencing low economic resources, maternal reports of stress are associated with differences in patterns of infant resting brain activity during the first year of life.

Investigation of the optic disc and retinal microvasculature by optical coherence tomography angiography in children with asthma

PURPOSE

To assess the optic disc and retinal microvasculature by optical coherence tomography angiography (OCTA) in asthmatic children.

MATERIALS AND METHODS

Thirty asthmatic children (asthma group) and 30 control age- and sex-matched healthy controls (control group) were included in this cross-sectional study. The asthma group was then divided into two subgroups according to the presence of inhaled steroid use. Demographic findings were noted. Retinal nerve fiber layer (RNFL) thickness and vessel density in different sections of the retina and optic nerve head were analyzed by OCTA.

RESULTS

RNFL thickness for temporal quadrants and flow area for outer retina levels were significantly lower in the asthma group than the control group (72.58 ± 10.99 μm vs 77.73 ± 9.73μm, P = 0.015, and 0.60 ± 0.31mm2 vs. 0.72 ± 0.31mm2, P = 0.047, respectively). However, inside disc vascular densities were significantly higher in the asthma group when compared to controls (55.16% ± 3.71% vs. 52.08% ± 3.79%, P < 0.001). Inside disc vascular densities were also significantly higher, and RNFL thickness for temporal quadrants was significantly lower in the asthmatic patients without steroid use subgroup when compared to others (P < 0.001, P = 0.012, respectively).

CONCLUSION

Lower values of temporal quadrant RNFL, and flow area for outer retina, but higher levels of inside disc vascular density seem to be associated with asthmatic children. OCTA findings in asthmatic children appear to be regardless of inhaled steroid use.

Associations Between Different Cortisol Measures and Adiposity in Children: A Systematic Review and Meta-Analysis

This study examined associations between hair, salivary, serum, and urinary cortisol concentration with adiposity-related indicators in children, and explored their potential effects modification by age, sex, cortisol measurement method, and country developmental context. We systematically searched PubMed, Web of Science, and Embase for studies examining at least one of the four aforementioned cortisol with objectively measured adiposity-related outcomes in children. Meta-analyses of cross-sectional studies revealed that hair cortisol concentration was associated with fat mass index (FMI)-standard deviation score (SDS)/FMI z-score (pooled-β = 0.04, 95% CI: 0.01, 0.08) and BMI/BMI z-score (pooled-β = 0.15, 95% CI: 0.06, 0.25), and these associations were significant among children aged ≤ 12 years (pooled-β = 0.15, 95% CI: 0.05, 0.26) and >12 years (pooled-β = 0.13, 95% CI: 0.04, 0.22), children from developed countries (pooled β = 0.12, 95% CI: 0.03, 0.21) and developing countries (pooled-β = 0.193, 95% CI: 0.188, 0.198), and in studies extracting cortisol via LC-MS/MS (pooled-β = 0.18, 95% CI: 0.06, 0.29) but not ELISA (pooled-β = 0.08, 95% CI: −0.06, 0.22). Meta-analyses of both cohort and cross-sectional studies revealed non-significant associations of morning salivary cortisol concentration and total daily cortisol output with BMI/BMI z-score. Serum cortisol concentration was not associated with BMI or waist circumference. Meta-analysis of urinary cortisol concentration and adiposity was hindered by insufficient data. These findings further corroborate understanding of chronic stress’ physiological contribution to increased pediatric obesity risk.

Pediatric Pulmonology 2020 year in review: Asthma

Pediatric asthma is a heterogeneous and common chronic condition with significant morbidity and burden on the healthcare system. Despite advances in the field, the disease has proven to be increasingly complex to diagnose and management strategies are constantly evolving. Studies from 2020 have advanced the field even further, particularly with regard to new methods of diagnosis and monitoring, treatment of severe asthma, modifiable risk factors like exercise and obesity, aerosol delivery, and viral respiratory infections contributing to the development of asthma. Continued studies are needed to improve our care for children with asthma and we look forward to future advances. This article is part of our 2020 "Year in Review" series, in which we summarize publications in major topic areas, in the context of selected literature from other journals relevant to our discipline.

Curcumol Ameliorates Lung Inflammation and Airway Remodeling via Inhibiting the Abnormal Activation of the Wnt/β-Catenin Pathway in Chronic Asthmatic Mice

Background

Curcumol exhibits anti-inflammatory effect, but its effect on chronic asthma lacked research. Therefore, this study explored the role of curcumol in asthma.

Methods

A chronic asthmatic mice model was established by ovalbumin induction. After treatment with curcumol, airway resistance in mice was detected by forced oscillation technique. The histopathological features of airway tissues, pulmonary inflammation, and inflammation cell recruitment in the bronchoalveolar lavage fluid (BALF) of mice were detected by hematoxylin-eosin staining. Collagen deposition in the airways of mice was examined by Masson staining. The secretion of ovalbumin-IgE, IL-4, IL-5, IL-13 in mouse serum and VEGFA secretion in BALF were analyzed by ELISA. Finally, the expressions of β-catenin, Wnt5a, VEGFA, TGF-β1, Fibronectin, and MMP-9 in mice lung tissues were determined by Western blot or immunohistochemical.

Results

Curcumol attenuated airway hyperresponsiveness, airway remodeling, and pulmonary inflammation in chronic asthmatic mice. Curcumol relieved collagen deposition in airway tissues, inflammation cell recruitment in BALF, and reduced the up-regulation of serum ovalbumin-IgE, IL-4, IL-5, and IL-13 and BALF VEGFA in chronic asthmatic mice. In addition, curcumol attenuated the up-regulated expressions of β-catenin, Wnt5a, VEGFA, TGF-β1, Fibronectin, and MMP-9 in the lung tissues of chronic asthmatic mice, but curcumol treatment did not show such effects on healthy mice.

Conclusion

Our findings revealed that curcumol could ameliorate lung inflammation and airway remodeling by inhibiting the abnormal activation of the Wnt/β-catenin pathway in chronic asthmatic mice, indicating that curcumol could be used as a novel anti-asthma drug for basic and clinical research.

Cumulative cortisol concentrations in hair of patients with atopy are lower than in healthy subjects and are not related to their perceived stress experience

Patients with atopy were found to exhibit blunted cortisol responses to acute stress stimuli. The aim of this study was to test the hypothesis that cumulative cortisol concentrations in the hair of patients with atopy are lower than in healthy subjects when related to their perceived stress experience. The sample consisted of 31 participants. The most proximal 3 cm of hair (as close to the scalp as possible), reflecting the cumulative cortisol secretion during the previous 3 months, was used for the analysis. Only in 20 subjects (9 patients with atopy and 11 healthy controls), there was a sufficient amount of hair for precise analysis using a new methodology. The results showed lower hair cortisol concentrations in patients with atopy compared to those in controls. The perceived stress scores in patients with atopy and healthy controls were not statistically different. The cortisol concentration/perceived stress score ratios were lower in patients with atopy compared to those in controls. No statistically significant correlation between hair cortisol and long-term experienced stress assessed via perceived stress scale was observed. In conclusion, the cumulative cortisol secretion in the hair of atopic patients is lower than would be expected according to their subjective scores of perceived stress. Most importantly, the previously lower stress hormone increase found in acute stress situations and in children now was confirmed in adult patients with chronic stress load.

Hair cortisol and inhaled corticosteroid use in asthmatic children

BACKGROUND

Adrenal suppression is a side effect of long-term use of inhaled corticosteroids (ICS). Hair cortisol concentration (HCC) measurement is a noninvasive tool for measuring adrenal function that may be useful for asthmatic patients who are on long-term ICS treatment. The aim of this study was to compare HCC between children with and without asthma and to explore the association between HCC and ICS dose in asthmatic children.

METHODS

A cross-sectional observational study in subjects with or without asthma (n = 72 and 226, respectively, age 6-21 years). Hair samples were obtained from the posterior vertex for each subject and data on medication use were collected using questionnaires. HCC was analyzed by liquid chromatography-mass spectrometry in the most proximal 3 cm of hair.

RESULTS

Median HCC was significantly lower in subjects with asthma than in subjects without asthma: 1.83 pg/mg and 2.39 pg/mg, respectively (P value after adjustment for age, sex, and body mass index: .036). Median HCC was 1.98 pg/mg in asthmatics using no ICS, 1.84 pg/mg in those using a low dose, 1.75 pg/mg in those on a medium dose, and 1.46 in those using a high ICS dose (P = .54).

CONCLUSION

We observed a significantly lower HCC in asthmatics than in healthy controls and a nonsignificant trend of lower HCC with increasing ICS dose. Whether HCC measurement may be used to detect individuals at risk for hypocortisolism and may be useful to monitor adrenal function in asthmatic children using ICS needs to be further investigated.