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Alyami MA, Alyami MM, Alasimi AH, Alqahtani JS, Alqarni AA, Aldhahir AM. The utility of the necessity-concerns framework (NCF) in explaining adherence and parental beliefs about controller medication in Saudi Arabian children with asthma. J Asthma 2024; 61:436-443. [PMID: 37997759 DOI: 10.1080/02770903.2023.2288320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/19/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE This study aims to assess beliefs about asthma controller medications among parents of Saudi Arabian children with asthma and the association between these beliefs and medication adherence using the Necessity-Concerns Framework. METHODS A cross-sectional survey was provided to parents of children with asthma when they brought their children to routine appointments at local public clinics between May 16 and July 10, 2018. Participants electronically filled out validated Arabic versions of the Medication Adherence Reported Scale (MARS) and Beliefs About Medications Questionnaire (BMQ). Descriptive statistics were used to characterize the study participants, while hierarchical linear regression analysis assessed associations between parental beliefs about controller medications and medication adherence. RESULTS A total of 381 parents of children with asthma completed the study survey. The vast majority (89%) of study participants were non-adherent to their children's prescribed medications while only 11% were adherent. Additionally, our study revealed a significantly positive association between adherence and parents' beliefs in the necessity of the medication (p < .001), with concerns about the adverse effects of medication being negatively associated with parental adherence. A higher mean score for medication adherence was reported among the ambivalent groups compared to the accepting, indifferent, and skeptical groups. CONCLUSIONS Medication adherence among parents of children with asthma was relatively low. In addition, necessity beliefs were significantly associated with parental adherence to controller medications for their children with asthma. Further studies are warranted to investigate potential factors contributing to poor parental adherence and develop tailored interventions that support parental medication adherence for their asthmatic children.
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Affiliation(s)
- Marja A Alyami
- Dhahran Long Term Hospital, Eastern Health Cluster, Ministry of Health, Dhahran, Saudi Arabia
| | - Mohammed M Alyami
- Respiratory Therapy Department, Batterjee Medical College, Khamis Mushait, Saudi Arabia
| | - Ahmed H Alasimi
- Department of Respiratory Therapy, GA State University, Atlanta, GA, USA
| | - Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Abdullah A Alqarni
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulelah M Aldhahir
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
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Li Y, Wang P, Shao X, Peng F, Lv D, Du H, Wang Y, Wang X, Wu F, Chen C. Asthma prevalence based on the Baidu index and China's Health Statistical Yearbook from 2011 to 2020 in China. Front Public Health 2023; 11:1221852. [PMID: 37869190 PMCID: PMC10586501 DOI: 10.3389/fpubh.2023.1221852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 09/04/2023] [Indexed: 10/24/2023] Open
Abstract
Background Due to environmental pollution, changes in lifestyle, and advancements in diagnostic technology, the prevalence of asthma has been increasing over the years. Although China has made early efforts in asthma epidemiology and prevention, there is still a lack of unified and comprehensive epidemiological research within the country. The objective of the study is to determine the nationwide prevalence distribution of asthma using the Baidu Index and China's Health Statistical Yearbook. Methods Based on China's Health Statistical Yearbook, we analyzed the gender and age distribution of asthma in China from 2011 to 2020, as well as the length of hospitalization and associated costs. By utilizing the Baidu Index and setting the covering all 31 provinces and autonomous regions in China, we obtained the Baidu Index for the keyword 'asthma'. Heatmaps and growth ratios described the prevalence and growth of asthma in mainland China. Results The average expenditure for discharged asthma (standard deviation) patients was ¥5,870 (808). The average length of stay (standard deviation) was 7.9 (0.38) days. During the period of 2011 to 2020, hospitalization expenses for asthma increased while the length of hospital stay decreased. The proportion of discharged patients who were children under the age of 5 were 25.3% (2011), 19.4% (2012), 16% (2013), 17.9% (2014), 13.9% (2015), 11.3% (2016), 10.2% (2017), 9.4% (2018), 8.1% (2019), and 7.2% (2020), respectively. The prevalence of asthma among boys was higher than girls before the age of 14. In contrast, the proportion of women with asthma was larger than men after the age of 14. During the period from 2011 to 2020, the median [The first quartile (Q1)-the third quartile (Q3)] daily asthma Baidu index in Guangdong, Beijing, Jiangsu, Sichuan, and Zhejiang were 419 (279-476), 328 (258-376), 315 (227-365), 272 (166-313), and 312 (233-362) respectively. Coastal regions showed higher levels of attention toward asthma, indicating a higher incidence rate. Since 2014, there has been a rapid increase in the level of attention toward asthma, with the provinces of Qinghai, Sichuan, and Guangdong experiencing the fastest growth. Conclusion There are regional variations in the prevalence of asthma among different provinces in China, and the overall prevalence of asthma is increasing.
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Affiliation(s)
- Yahui Li
- First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ping Wang
- Shandong Academy of Chinese Medicine, Jinan, China
| | - Xuekun Shao
- College of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Fulai Peng
- Shandong Institute of Advanced Technology, Chinese Academy of Sciences, Jinan, China
| | - Danyang Lv
- Shandong Institute of Advanced Technology, Chinese Academy of Sciences, Jinan, China
| | - Haitao Du
- Shandong Academy of Chinese Medicine, Jinan, China
| | - Yi Wang
- Shandong Academy of Chinese Medicine, Jinan, China
| | - Xingchen Wang
- First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Fengxia Wu
- School of Basic Medical Sciences, Shandong University, Jinan, China
| | - Cai Chen
- Shandong Institute of Advanced Technology, Chinese Academy of Sciences, Jinan, China
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Zhou Y, Kuai S, Pan R, Li Q, Zhang J, Gu X, Ren H, Cui Y. Quantitative proteomics profiling of plasma from children with asthma. Int Immunopharmacol 2023; 119:110249. [PMID: 37146352 DOI: 10.1016/j.intimp.2023.110249] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/07/2023]
Abstract
A lack of validated blood diagnostic markers presents an obstacle to asthma control. The present study sought to profile the plasma proteins of children with asthma and to determine potential biomarkers. Plasma samples from children in acute exacerbation (n = 4), in clinical remission (n = 4), and from healthy children (n = 4, control) were analyzed using a tandem mass tag (TMT)-labeling quantitative proteomics and the candidate biomarkers were validated using liquid chromatography-parallel reaction monitoring (PRM)/mass spectrometry (MS) with enzyme-linked immunosorbent assay (ELISA). We identified 347 proteins with differential expression between groups: 125 (50 upregulated, 75 downregulated) between acute exacerbation and control, 142 (72 upregulated, 70 downregulated) between clinical remission and control, and 55 (22 upregulated, 33 downregulated) between acute and remission groups (all between-group fold changes > 1.2; P < 0.05 by Student's t-test). Gene ontology analysis implicated differentially expressed proteins among children with asthma in immune response, the extracellular region, and protein binding. Further, KEGG pathway analysis of differentially expressed proteins identified complement and coagulation cascades and Staphylococcus aureus infection pathways as having the highest protein aggregation. Our analyses of protein interactions identified important node proteins, particularly KRT10. Among 11 differentially expressed proteins, seven proteins (IgHD, IgHG4, AACT, IgHA1, SAA, HBB, and HBA1) were verified through PRM/MS. Protein levels of AACT, IgA, SAA, and HBB were verified through ELISA and may be useful as biomarkers to identify individuals with asthma. In conclusion, our study presents a novel comprehensive analysis of changes in plasma proteins in children with asthma and identifies a panel for accessory diagnosis of pediatric asthma.
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Affiliation(s)
- Ying Zhou
- Department of Pediatrics Laboratory, The Affiliated Wuxi Children's Hospital of Jiangnan University, Wuxi 214023, Jiangsu Province, China
| | - Shougang Kuai
- Department of Clinical Laboratory, Huishan District Hospital, Wuxi 214187, Jiangsu Province, China
| | - Ruilin Pan
- Clinical Research Center, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Qingqing Li
- Clinical Research Center, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Jian Zhang
- Department of Clinical Laboratory, The Affiliated Wuxi Children's Hospital of Jiangnan University, Wuxi 214023, Jiangsu Province, China
| | - Xiaohong Gu
- Department of Respiratory, The Affiliated Wuxi Children's Hospital of Jiangnan University, Wuxi 214023, Jiangsu Province, China
| | - Huali Ren
- Department of Allergy, State Grid Beijing Electric Power Hospital, Capital Medical University Electric Power Teaching Hospital, Beijing 100073, China.
| | - Yubao Cui
- Department of Clinical Laboratory, Huishan District Hospital, Wuxi 214187, Jiangsu Province, China.
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López JF, Bel Imam M, Satitsuksanoa P, Lems S, Yang M, Hwang YK, Losol P, Choi JP, Kim SH, Chang YS, Akdis M, Akdis CA, van de Veen W. Mechanisms and biomarkers of successful allergen-specific immunotherapy. Asia Pac Allergy 2022; 12:e45. [PMID: 36452016 PMCID: PMC9669467 DOI: 10.5415/apallergy.2022.12.e45] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 10/30/2022] [Indexed: 11/22/2023] Open
Abstract
Allergen-specific immunotherapy (AIT) is considered the only curative treatment for allergic diseases mediated by immunoglobulin E (IgE). Currently, the route of administration depends both on the different types of causal allergens and on its effectiveness and safety profile. Several studies have reported the mechanisms and changes in humoral and cellular response underlying AIT; however, the full picture remains unknown. Knowledge of who can benefit from this type of treatment is urgently needed due to the patient safety risks and costs of AIT. In vivo or in vitro biomarkers have become a strategy to predict clinical outcomes in precision medicine. There are currently no standardized biomarkers that allow determining successful responses to AIT, however, some studies have found differences between responders and nonresponders. In addition, different candidates have been postulated that may have the potential to become biomarkers. In this review, we aim to summarize the findings to date related to biomarkers in different IgE-mediated allergic diseases (respiratory, food, and venom allergy) with the potential to define who will benefit from AIT.
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Affiliation(s)
- Juan-Felipe López
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Manal Bel Imam
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | | | - Sophieke Lems
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Minglin Yang
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Yu-Kyoung Hwang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Purevsuren Losol
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University, Seoul, Korea
| | - Jun-Pyo Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University, Seoul, Korea
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University, Seoul, Korea
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
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Maritano S, Moirano G, Popovic M, D'Errico A, Rusconi F, Maule M, Richiardi L. Maternal pesticides exposure in pregnancy and the risk of wheezing in infancy: A prospective cohort study. ENVIRONMENT INTERNATIONAL 2022; 163:107229. [PMID: 35405505 DOI: 10.1016/j.envint.2022.107229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/08/2022] [Accepted: 04/03/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Pesticide exposure in pregnancy may have health effects in the offspring. We studied whether maternal pesticides exposure during pregnancy is associated with infant wheezing. METHODS The study involved 5997 children from the Italian NINFEA birth cohort, whose mothers were recruited during pregnancy between 2005 and 2016. We used questionnaires completed during pregnancy and 6 months after delivery to derive the following indirect measures of exposure: i) Self-reported pesticide use during the first and the third trimester of pregnancy; (ii) Agricultural activities during the same trimesters. We also evaluated the exposure to agricultural pesticides applied near home using the Corine Land Cover inventory to derive the proportion of a 200-metre buffer area around maternal home address covered by agricultural crops and specific crop types (arable land, fruit trees, heterogeneous cultivations). Questionnaires completed when the child turned 18 months reported information on wheezing between 6 and 18 months of age. We estimated the odds ratios of wheezing adjusting for the following maternal characteristics: age, education, parity, asthma, atopy, smoking in pregnancy, region and area of residence, pet ownership during pregnancy. Crops proximity analyses were restricted to residents in rural areas (N = 1674). RESULTS Agricultural activities during pregnancy were not associated with infant wheezing. Compared to no pesticide use, there was a weak positive association for self-reported use in the third trimester (POR: 1.30; 95 %CI 0.95-1.78) and a stronger association for use in both trimesters (POR: 1.72; 95 %CI 1.11-2.65). The relationship between the proportion of crops around the home address and the risk of infant wheezing, was J-shaped, in particular for fruit trees with the lowest risk for mid values and elevated risk for higher values. CONCLUSION We found some evidence of association for maternal pesticide use in pregnancy and residential proximity to fruit trees cultivations with infant wheezing.
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Affiliation(s)
- Silvia Maritano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Via Santena 7, 10126 Turin, Italy.
| | - Giovenale Moirano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Via Santena 7, 10126 Turin, Italy.
| | - Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Via Santena 7, 10126 Turin, Italy.
| | - Antonio D'Errico
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Via Santena 7, 10126 Turin, Italy.
| | - Franca Rusconi
- Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, Via Cocchi 7/9, 56121 Pisa, Italy.
| | - Milena Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Via Santena 7, 10126 Turin, Italy.
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Via Santena 7, 10126 Turin, Italy.
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Grant TL, Wood RA. The influence of urban exposures and residence on childhood asthma. Pediatr Allergy Immunol 2022; 33:e13784. [PMID: 35616896 PMCID: PMC9288815 DOI: 10.1111/pai.13784] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 12/19/2022]
Abstract
Children with asthma who live in urban neighborhoods experience a disproportionately high asthma burden, with increased incident asthma and increased asthma symptoms, exacerbations, and acute visits and hospitalizations for asthma. There are multiple urban exposures that contribute to pediatric asthma morbidity, including exposure to pest allergens, mold, endotoxin, and indoor and outdoor air pollution. Children living in urban neighborhoods also experience inequities in social determinants of health, such as increased poverty, substandard housing quality, increased rates of obesity, and increased chronic stress. These disparities then in turn can increase the risk of urban exposures and compound asthma morbidity as poor housing repair is a risk factor for pest infestation and mold exposure and poverty is a risk factor for exposure to air pollution. Environmental interventions to reduce in-home allergen concentrations have yielded inconsistent results. Population-level interventions including smoking bans in public places and legislation to decrease traffic-related air pollution have been successful at reducing asthma morbidity and improving lung function growth. Given the interface and synergy between urban exposures and social determinants of health, it is likely population and community-level changes will be needed to decrease the excess asthma burden in children living in urban neighborhoods.
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Affiliation(s)
- Torie L Grant
- Division of Pediatric Allergy, Immunology, and Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert A Wood
- Division of Pediatric Allergy, Immunology, and Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Zhu Z, Wang H, Xie Y, An J, Li J, Zheng J. Two-minute tidal breathing methacholine bronchial challenge: Comparison of two jet nebulisers. CLINICAL RESPIRATORY JOURNAL 2021; 15:863-869. [PMID: 33840150 DOI: 10.1111/crj.13374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 04/06/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The American Thoracic Society (ATS) guideline for methacholine challenge testing (MCT) recommended using the English Wright (EW) nebuliser. However, other brands of nebulisers are also indicated to be acceptable for this technique, but further validation of nebuliser performance is recommended. OBJECTIVE To compare the methacholine provocation concentration causing a 20% fall in forced expiratory volume in 1 second (PC20 -FEV1 ) measured by using EW nebuliser and DV 646 nebuliser. METHODS Subjects were randomly assigned to undergo 2-min tidal breathing methacholine challenge with either EW or DV 646 nebuliser on two separate days, which were at least 24 hours but not more than 7 days apart. The above procedure was repeated for each subject in 1 month, but the nebulisers were selected in a reverse order. RESULTS The study includes 15 mild and stable asthmatic patients. The geometric means (SD) of methacholine PC20 measured with using EW and DV 646 nebulisers were 1.82 (6.38) mg/mL versus 0.83 (1.82) mg/mL, respectively in the initial two visits and 2.56 (6.29) mg/mL versus 0.78 (1.40) mg/mL in the following two visits (both P < 0.05). There are well correlations between PC20-EW1 and PC20-EW2 (r = 0.99, P < 0.01), PC20-DV1 and PC20-DV2 (r = 0.88, P < 0.01), and between PC20-EW1 and PC20-DV1 (r = 0.91, P < 0.01), PC20-EW2 and PC20-DV2 (r = 0.78, P < 0.01). CONCLUSIONS PC20 -FEV1 measured by using the two conventional jet nebulisers was both repeatable and the results were highly correlated.
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Affiliation(s)
- Zheng Zhu
- Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Lab of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongyu Wang
- Guangzhou Institute of Respiratory Health, State Key Lab of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Firestone Institute for Respiratory Health, The Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Yanqing Xie
- Guangzhou Institute of Respiratory Health, State Key Lab of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiaying An
- Guangzhou Institute of Respiratory Health, State Key Lab of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jing Li
- Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Lab of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jinping Zheng
- Guangzhou Institute of Respiratory Health, State Key Lab of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Furuhata M, Otsuka Y, Kaneita Y, Nakagome S, Jike M, Itani O, Ohida T. Factors Associated with the Development of Childhood Asthma in Japan: A Nationwide Longitudinal Study. Matern Child Health J 2021; 24:911-922. [PMID: 32342275 DOI: 10.1007/s10995-020-02944-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Many environmental factors are related to the development of asthma. However, the key factors of childhood asthma onset have not been sufficiently elucidated. Further, low-weight births have increased in Japan. The aim of this study was to examine the risk factors for the incidence of childhood asthma and to evaluate whether these risk factors differ according to birth weight in Japan. METHODS We used the National Longitudinal Survey from 2001 to 2010. Multiple logistic regression analyses were conducted to determine the effects of gender, birth weight, single vs. multiple births, birth order, nutrition, keeping pets in the home, place of residence, annual household income, and parent ages, smoking behaviors, and educational backgrounds on asthma-related hospital visits. RESULTS Overall, 45,060 children were analyzed. The rate of cumulative hospital visits until age 10 was 18.9%. Birth weight < 2500 g (adjusted odds ratio [AOR] = 1.14, 95% confidence interval [CI] 1.03-1.26), being a boy (AOR = 1.27, 95% CI 1.21-1.33), having older siblings (AOR = 1.07, 95% CI 1.02-1.14), parental smoking behavior, mother`s age, and low household income (AOR = 1.17, 95% CI 1.10-1.24) were associated with asthma-related hospital visits. DISCUSSION Parental smoking behavior is a key risk factor for the development of asthma. Among low birth weight infants, being a boy, having older siblings, and father`s smoking behavior were predictive factors for the development of asthma. However, low birth weight was not associated with the development of asthma after 6 years of age.
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Affiliation(s)
- Masakazu Furuhata
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan.
| | - Yoshitaka Kaneita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Sachi Nakagome
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Maki Jike
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Osamu Itani
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Takashi Ohida
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
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Li X, Song P, Zhu Y, Lei H, Chan KY, Campbell H, Theodoratou E, Rudan I. The disease burden of childhood asthma in China: a systematic review and meta-analysis. J Glob Health 2020. [DOI: 10.7189/jogh.10.010801] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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10
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Li X, Song P, Zhu Y, Lei H, Chan KY, Campbell H, Theodoratou E, Rudan I. The disease burden of childhood asthma in China: a systematic review and meta-analysis. J Glob Health 2020; 10:010801. [PMID: 32257166 PMCID: PMC7101212 DOI: 10.7189/jogh.10.01081] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background In China, childhood asthma prevalence showed a remarkable increase in the past decades. An updated epidemiological assessment of childhood asthma in China with a focus on prevalence and time trends is required. Methods We systematically searched three main Chinese databases and one English database to identify epidemiological studies of the prevalence of childhood asthma in China. Asthma cases were defined according to one of the five sets of Chinese diagnostic criteria which were established by the Children Respiratory Disease Group. We estimated age- and sex-specific prevalence of asthma using a multilevel mixed-effects logistic regression. We presented the time trends of asthma prevalence between 1990 and 2020 by age, sex and setting (urban vs rural), and also estimated the number of children affected by asthma in 2010. Results In 1990, the prevalence of asthma ranged from 0.13% (95% confidence interval (CI) = 0.10-0.20) in rural girls aged 14 years to 1.34% (95% CI = 1.11-1.67) in urban boys aged five years. In 2010, the overall prevalence of asthma in Chinese children aged 0-14 years was 2.12% (95% CI = 1.83-2.51), corresponding to 5.16 million children living with asthma. Children aged 5-9 years were with the highest prevalence estimate of 2.65% (95% CI = 2.31-3.12) and those aged 10-14 years were with the lowest (1.48%, 95% CI = 1.26-1.78). In 2020, it is expected that this disparity will continue, with the prevalence of asthma being at the lowest level among rural girls aged 14 years (1.11%, 95% CI = 0.82-1.54) and at the highest level among urban boys aged four years (10.27%, 95% CI = 8.61-12.18). Over the 30 years (1990-2020), the prevalence of asthma in children aged 0-14 years has increased in both sexes and settings, which was consistently the lowest in rural girls and the highest in urban boys. Conclusions This study shows that childhood asthma has been increasingly prevalent in China. Asthma is more frequent in boys and in rural areas. The detailed and systematic estimates of asthma prevalence in this study constitute the best currently available basis for policymaking, planning, and allocation of health and welfare resources related to the burden of childhood asthma in China.
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Affiliation(s)
- Xue Li
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,Joint first authors
| | - Peige Song
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,Joint first authors
| | - Yongjian Zhu
- Department of Cardiology, Zhengzhou University, Zhengzhou, China
| | - Haohao Lei
- Department of Social Science, University College London, London, UK
| | - Kit Yee Chan
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Evropi Theodoratou
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,Cancer Research UK Edinburgh Centre, Medical Research Council Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Hernández-Garduño E. Asthma mortality among Mexican children: Rural and urban comparison and trends, 1999-2016. Pediatr Pulmonol 2020; 55:874-881. [PMID: 31962009 DOI: 10.1002/ppul.24658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/09/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Although there are more studies showing higher asthma prevalence in urban rather than rural zones, few assessed asthma mortality by zone in children. The objective of this study is to compare asthma mortality rates (AMR) by zone of residence of Mexican children. DESIGN Using national death certificate and population projections data, AMR were compared in children aged 0 to 14 years by gender, age group, and zone of residence from 1999 to 2016. AMR trends were calculated using Joinpoint regression. RESULTS Of the 680 823 deaths, 2464 (0.36%) were due to asthma. Asthma mortality was higher in rural (0.65%) than urban (0.26%) zones, P < .0001. Whole period AMR median was also higher in rural vs urban zones (0.6 vs 0.3, respectively), P < .05. The average annual percent change (AAPC) of AMR for the whole period was -5.1 in all children with a higher percent decrease in rural vs urban zones (girls' AAPC = -6.3 vs -4.1, respectively and boys' AAPC = -4.8 vs -4.2, respectively). AMR decreased in children aged 0 to 4 from both zones (rural's AAPC: girls = -7.9, boys = -5.2; urban's AAPC: girls = -5.1, boys = -5.4), P < .05. No trend was found in children aged 5 to 14. CONCLUSIONS Asthma mortality in Mexican children is higher in rural than urban zones. The decrease of mortality over time in early childhood is reassuring. More research is needed to determine reasons for higher mortality in rural Mexico and for the lack of a favorable decreasing trend in children aged 5 to 14 from both zones.
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Affiliation(s)
- Eduardo Hernández-Garduño
- Dirección de Administración y Desarrollo de Personal, Instituto de Seguridad Social del Estado de México y Municipios (ISSEMyM), Toluca de Lerdo, Mexico
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Li LX, Lin SZ, Zhang RP, Chen SW. [Prevalence of pediatric asthma in the rural areas of China: a Meta analysis]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:380-386. [PMID: 32312379 PMCID: PMC7389704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/20/2020] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To systematically review the prevalence of pediatric asthma in the rural areas of China, and to provide data for the prevention and treatment of pediatric asthma. METHODS PubMed, Cochrane, China National Knowledge Infrastructure, Wanfang Database, and Embase were searched for cross-sectional studies on the prevalence of pediatric asthma in the rural areas of China published up to August 31, 2019. Two researchers independently conducted preliminary screening and data extraction. Stata 14.0 and R software were used to perform a Meta analysis of prevalence rate. Subgroup analysis was also performed. RESULTS A total of 24 articles were reviewed, with a sample size of 212 814 children, among whom there were 3 254 children with asthma, with an overall prevalence rate of 2.02% (95%CI: 1.67%-2.36%). Boys had a significantly higher prevalence rate than girls (3.64% vs 2.03%, P<0.001). The annual prevalence rate increased from 1.21% in 1990-1999 to 3.36% in 2011-2015. The prevalence rate of pediatric asthma was 3.15% in South China, which was higher than that in East China (2.31%), Southwest China (2.15%), North China (1.19%), and Central China (1.12%). Preschool children had the highest prevalence rate of 2.63%, followed by infants and young children (2.48%) and school-age children (1.41%). CONCLUSIONS The prevalence rate of pediatric asthma is relatively low but tends to increase in the rural areas of China. Boys have a higher prevalence rate of asthma than girls, and the prevalence rate is higher in South China. Preschool children have the highest prevalence rate.
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Affiliation(s)
- Li-Xiang Li
- Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
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13
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Li LX, Lin SZ, Zhang RP, Chen SW. [Prevalence of pediatric asthma in the rural areas of China: a Meta analysis]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:380-386. [PMID: 32312379 PMCID: PMC7389704 DOI: 10.7499/j.issn.1008-8830.1910164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To systematically review the prevalence of pediatric asthma in the rural areas of China, and to provide data for the prevention and treatment of pediatric asthma. METHODS PubMed, Cochrane, China National Knowledge Infrastructure, Wanfang Database, and Embase were searched for cross-sectional studies on the prevalence of pediatric asthma in the rural areas of China published up to August 31, 2019. Two researchers independently conducted preliminary screening and data extraction. Stata 14.0 and R software were used to perform a Meta analysis of prevalence rate. Subgroup analysis was also performed. RESULTS A total of 24 articles were reviewed, with a sample size of 212 814 children, among whom there were 3 254 children with asthma, with an overall prevalence rate of 2.02% (95%CI: 1.67%-2.36%). Boys had a significantly higher prevalence rate than girls (3.64% vs 2.03%, P<0.001). The annual prevalence rate increased from 1.21% in 1990-1999 to 3.36% in 2011-2015. The prevalence rate of pediatric asthma was 3.15% in South China, which was higher than that in East China (2.31%), Southwest China (2.15%), North China (1.19%), and Central China (1.12%). Preschool children had the highest prevalence rate of 2.63%, followed by infants and young children (2.48%) and school-age children (1.41%). CONCLUSIONS The prevalence rate of pediatric asthma is relatively low but tends to increase in the rural areas of China. Boys have a higher prevalence rate of asthma than girls, and the prevalence rate is higher in South China. Preschool children have the highest prevalence rate.
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Affiliation(s)
- Li-Xiang Li
- Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
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14
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Asia Pacific survey of physicians on asthma and allergic rhinitis (ASPAIR): data from China. Chin Med J (Engl) 2019; 132:1264-1271. [PMID: 30925548 PMCID: PMC6629359 DOI: 10.1097/cm9.0000000000000229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND In China, the prevalence of allergic rhinitis (AR) and asthma has increased in the past decade. As these two diseases frequently coexist, the Asia-Pacific Survey of Physicians on Asthma and Allergic Rhinitis (ASPAIR) study aimed to assess physicians' beliefs and treatment patterns of coexistent asthma-AR across six Asian countries. This analysis presents the results from China. METHODS The 200 hospital-based general physicians and pediatricians were interviewed from five cities in China. Physicians were questioned in-person about their knowledge, beliefs and management practices for patients with coexistent asthma-AR. RESULTS Approximately 70% of the physicians interviewed routinely evaluated their patients with asthma or AR for signs of coexistent disease. While the majority of physicians (>90% of physicians) recognized the increased burden of coexistent asthma-AR vs. one condition alone and that coexistent disease requires additional treatment, most physicians (96%) also believed that patients with coexistent asthma-AR were well managed if either condition alone improved. Similarly, although 71% of physicians selected a combination of intranasal and inhaled corticosteroids as their preferred treatment for coexistent asthma-AR, in line with treatment guidelines, two fifths of physicians indicated that treatment for coexistent disease requires too much medication and that their patients prefer oral medications and a third of physicians believed that corticosteroids should be delayed in children. CONCLUSIONS This survey demonstrates that physicians interviewed in China have a broad understanding of coexistent asthma-AR and its impact on patients. A holistic approach to patient management with informed decisions regarding patients' overall treatment will benefit patients who suffer from coexistent disease.
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Rodriguez A, Brickley E, Rodrigues L, Normansell RA, Barreto M, Cooper PJ. Urbanisation and asthma in low-income and middle-income countries: a systematic review of the urban-rural differences in asthma prevalence. Thorax 2019; 74:1020-1030. [PMID: 31278168 PMCID: PMC6860411 DOI: 10.1136/thoraxjnl-2018-211793] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 03/20/2019] [Accepted: 04/24/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Urbanisation has been associated with temporal and geographical differences in asthma prevalence in low-income and middle-income countries (LMICs). However, little is known of the mechanisms by which urbanisation and asthma are associated, perhaps explained by the methodological approaches used to assess the urbanisation-asthma relationship. OBJECTIVE This review evaluated how epidemiological studies have assessed the relationship between asthma and urbanisation in LMICs, and explored urban/rural differences in asthma prevalence. METHODS Asthma studies comparing urban/rural areas, comparing cities and examining intraurban variation were assessed for eligibility. Included publications were evaluated for methodological quality and pooled OR were calculated to indicate the risk of asthma in urban over rural areas. RESULTS Seventy articles were included in our analysis. Sixty-three compared asthma prevalence between urban and rural areas, five compared asthma prevalence between cities and two examined intraurban variation in asthma prevalence. Urban residence was associated with a higher prevalence of asthma, regardless of asthma definition: current-wheeze OR:1.46 (95% CI:1.22 to 1.74), doctor diagnosis OR:1.89 (95% CI:1.47 to 2.41), wheeze-ever OR:1.44 (95% CI:1.15 to 1.81), self-reported asthma OR:1.77 (95% CI:1.33 to 2.35), asthma questionnaire OR:1.52 (95% CI:1.06 to 2.16) and exercise challenge OR:1.96 (95% CI:1.32 to 2.91). CONCLUSIONS Most evidence for the relationship between urbanisation and asthma in LMICs comes from studies comparing urban and rural areas. These studies tend to show a greater prevalence of asthma in urban compared to rural populations. However, these studies have been unable to identify which specific characteristics of the urbanisation process may be responsible. An approach to understand how different dimensions of urbanisation, using contextual household and individual indicators, is needed for a better understanding of how urbanisation affects asthma. PROSPERO REGISTRATION NUMBER CRD42017064470.
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Affiliation(s)
- Alejandro Rodriguez
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Facultad de Ciencias Médicas de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
- Fundación Ecuatoriana para la Investigación en Salud, Quito, Ecuador
| | - Elizabeth Brickley
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Laura Rodrigues
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Mauricio Barreto
- Instituto de Saude Coletiva, Universidad Federal da Bahia, Salvador, Brazil
- Centrode de Integração de Dados e Conhecimentos para Saúde (CIDACS), FIOCRUZ, Salvador, Brazil
| | - Philip J Cooper
- Facultad de Ciencias Médicas de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
- Fundación Ecuatoriana para la Investigación en Salud, Quito, Ecuador
- Institute of Infection and Immunity, St George's University of London, London, UK
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16
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Zhu WJ, Liu CH, Zhao LQ, Zhao M, Sha L, Chang L, Hao CS, Qian Y, Chen YZ. The relationship between rhinovirus infection and acute wheezing in young children with recurrent wheezing. EUR J INFLAMM 2019. [DOI: 10.1177/2058739218818677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Asthma is a common chronic respiratory disease in childhood. The present study aims to assess the association between rhinovirus (RV) infection and acute wheezing in the occurrence of recurrent wheezing in 5-year old and younger children. A total of 109 children with recurrent wheezing and 70 children without wheezing (controls) were recruited from October 2013 to March 2015. Nasopharyngeal aspirate samples were obtained from all children. RV, human metapneumovirus (hMPV), and bocavirus (BoV) were tested by reverse transcription-polymerase chain reaction.Respiratory syncytial virus (RSV), parainfluenza virus (PIV), influenza virus (IV), and adenoviruses (ADV) were confirmed by detection of viral antigens via fluoroimmunoassay. Viral infection was more commonly detected in children with recurrent wheezing than in controls (odds ratio (OR): 6.10; 95% confidence interval (CI): 2.89–12.87). RV and RSV were found in both wheezing children and controls. However, RV was detected more in wheezing children than in controls (OR: 3.07; 95% CI: 1.37–6.90), followed by RSV (OR: 5.33; 95% CI: 1.53–18.62). Furthermore, RV more tended to infect wheezing children after infancy. Compared with children infected with other viruses, higher levels of eosinophil were found in wheezing children with RV infection ( P < 0.05). RV was the main pathogen that induced exacerbation in young children with recurrent wheezing. Furthermore, the rate of RV infection was higher in children above 1 year old. RV infection might be associated with high levels of eosinophil.
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Affiliation(s)
- Wen-Jing Zhu
- Center for Asthma Prevention and Education, Capital Institute of Pediatrics, Beijing, China
| | - Chuan-He Liu
- Center for Asthma Prevention and Education, Capital Institute of Pediatrics, Beijing, China
| | - Lin-Qing Zhao
- Laboratory of Virology, Capital Institute of Pediatrics, Beijing, China
| | - Min Zhao
- Laboratory of Virology, Capital Institute of Pediatrics, Beijing, China
| | - Li Sha
- Center for Asthma Prevention and Education, Capital Institute of Pediatrics, Beijing, China
| | - Li Chang
- Department of Respiratory Diseases, Capital Institute of Pediatrics, Beijing, China
| | - Chun-Sheng Hao
- Department of Urology, Capital Institute of Pediatrics, Beijing, China
| | - Yuan Qian
- Laboratory of Virology, Capital Institute of Pediatrics, Beijing, China
| | - Yu-Zhi Chen
- Center for Asthma Prevention and Education, Capital Institute of Pediatrics, Beijing, China
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Rider CF, Carlsten C. Air pollution and resistance to inhaled glucocorticoids: Evidence, mechanisms and gaps to fill. Pharmacol Ther 2018; 194:1-21. [PMID: 30138638 DOI: 10.1016/j.pharmthera.2018.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Substantial evidence indicates that cigarette smoke exposure induces resistance to glucocorticoids, the primary maintenance medication in asthma treatment. Modest evidence also suggests that air pollution may reduce the effectiveness of these critical medications. Cigarette smoke, which has clear parallels with air pollution, has been shown to induce glucocorticoid resistance in asthma and it has been speculated that air pollution may have similar effects. However, the literature on an association of air pollution with glucocorticoid resistance is modest to date. In this review, we detail the evidence for, and against, the effects of air pollution on glucocorticoid effectiveness, focusing on results from epidemiology and controlled human exposure studies. Epidemiological studies indicate a correlation between increased air pollution exposure and worse asthma symptoms. But these studies also show a mix of beneficial and harmful effects of glucocorticoids on spirometry and asthma symptoms, perhaps due to confounding influences, or the induction of glucocorticoid resistance. We describe mechanisms that may contribute to reductions in glucocorticoid responsiveness following air pollution exposure, including changes to phosphorylation or oxidation of the glucocorticoid receptor, repression by cytokines, or inflammatory pathways, and epigenetic effects. Possible interactions between air pollution and respiratory infections are also briefly discussed. Finally, we detail a number of therapies that may boost glucocorticoid effectiveness or reverse resistance in the presence of air pollution, and comment on the beneficial effects of engineering controls, such as air filtration and asthma action plans. We also call attention to the benefits of improved clean air policy on asthma. This review highlights numerous gaps in our knowledge of the interactions between air pollution and glucocorticoids to encourage further research in this area with a view to reducing the harm caused to those with airways disease.
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Affiliation(s)
- Christopher F Rider
- Respiratory Medicine, Faculty of Medicine, Chan-Yeung Centre for Occupational and Environmental Respiratory Disease (COERD), University of British Columbia, Vancouver, BC, Canada.
| | - Chris Carlsten
- Respiratory Medicine, Faculty of Medicine, Chan-Yeung Centre for Occupational and Environmental Respiratory Disease (COERD), University of British Columbia, Vancouver, BC, Canada; Institute for Heart and Lung Health, University of British Columbia, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Sanchez J, Sánchez A, Cardona R. Clinical differences between children with asthma and rhinitis in rural and urban areas. Colomb Med (Cali) 2018; 49:169-174. [PMID: 30104810 PMCID: PMC6084920 DOI: 10.25100/cm.v49i2.3015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 11/08/2017] [Accepted: 02/18/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Epidemiological studies have shown that children who grow up on traditional farms are protected from allergic diseases. However, less is known about if the environment influences the pharmacotherapy in these patients. OBJECTIVE To compare the treatment of asthmatic and rhinitis children from urban and rural areas in Medellín, Colombia. METHODS During one year, we follow up a group of children (6 to 14 years) with diagnostic of asthma or rhinitis living for more than five years in urban or rural area. A questionnaire with socio-demographic characteristics, pharmacotherapy treatments, was obtained each three months. Atopy evaluation, spirometry and clinical test for asthma and rhinitis severity were done at the beginning and one year later. RESULTS Eighty six point four percent patients completed the follow up (rural n: 134, urban n: 248). Patients in rural location required less salbutamol (p: 0.01), visit to emergency department (p <0.01) and have a less number of patients with FEV1 <80% (p: 0.05). For clinical control rural children require less pharmacotherapy than urban children (p: 0.01) and more patients with rhinitis (18% vs 8% p: 0.03) and asthma (23% vs 12% p: 0.01) in the rural group could suspended pharmacotherapy. Atopy (p: <0.07) and poli-sensitization (p: <0.08) was a little higher in urban than rural area. We observe that poverty/unhygienic indicators were risk factors for higher levels of specific IgE among patients from urban area. CONCLUSION Patients with respiratory allergies located in urban area require more pharmacotherapy and have less clinical response than rural children.
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Affiliation(s)
- Jorge Sanchez
- Group of Clinical and Experimental Allergy, IPS Universitaria Universidad de Antioquia. Medellin, Colombia
- Fundación para el Desarrollo de las Ciencias Médicas y Biológicas. Cartagena, Colombia
| | - Andres Sánchez
- Group of Clinical and Experimental Allergy, IPS Universitaria Universidad de Antioquia. Medellin, Colombia
- Medicine Department, Corporacion Universitaria Rafael Nuñez, Cartagena, Colombia
| | - Ricardo Cardona
- Group of Clinical and Experimental Allergy, IPS Universitaria Universidad de Antioquia. Medellin, Colombia
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Huo Y, Zhang HY. Genetic Mechanisms of Asthma and the Implications for Drug Repositioning. Genes (Basel) 2018; 9:genes9050237. [PMID: 29751569 PMCID: PMC5977177 DOI: 10.3390/genes9050237] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/21/2018] [Accepted: 04/26/2018] [Indexed: 12/20/2022] Open
Abstract
Asthma is a chronic disease that is caused by airway inflammation. The main features of asthma are airway hyperresponsiveness (AHR) and reversible airway obstruction. The disease is mainly managed using drug therapy. The current asthma drug treatments are divided into two categories, namely, anti-inflammatory drugs and bronchodilators. However, disease control in asthma patients is not very efficient because the pathogenesis of asthma is complicated, inducing factors that are varied, such as the differences between individual patients. In this paper, we delineate the genetic mechanisms of asthma, and present asthma-susceptible genes and genetic pharmacology in an attempt to find a diagnosis, early prevention, and treatment methods for asthma. Finally, we reposition some clinical drugs for asthma therapy, based on asthma genetics.
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Affiliation(s)
- Yue Huo
- Hubei Key Laboratory of Agricultural Bioinformatics, College of Informatics, Huazhong Agricultural University, Wuhan 430070, China.
| | - Hong-Yu Zhang
- Hubei Key Laboratory of Agricultural Bioinformatics, College of Informatics, Huazhong Agricultural University, Wuhan 430070, China.
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Guo X, Li Z, Ling W, Long J, Su C, Li J, Liang S, Su L. Epidemiology of childhood asthma in mainland China (1988-2014): A meta-analysis. Allergy Asthma Proc 2018; 39:15-29. [PMID: 29669661 PMCID: PMC5911512 DOI: 10.2500/aap.2018.39.4131] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND After the promotion of the two-child policy in recent years, the population of children in mainland China was bound to have a rapid growth, which would bring great challenges to public health. A number of cross-sectional studies on the epidemic of childhood asthma in mainland China were recently conducted, and varied prevalences were reported. Thus, knowing the epidemiology of childhood asthma in mainland China is of great necessity. OBJECTIVE Our study aimed to summarize the pooled prevalence of childhood asthma in mainland China and its time trend, gender difference, regional distribution, and age structure. METHODS Studies that reported the prevalence of childhood asthma in mainland China were identified via a systematic data base search through July 1, 2016. Meta-analysis was used to estimate the prevalence of childhood asthma and its subgroups, including gender, age groups, years, and regions. The regional distribution of the prevalence was set by province with the help of a geographic mapping software. The autoregressive integrated moving average model was used to predict the current prevalence of asthma. RESULTS A total of 117 studies published from 1988 to 2014 in mainland China with a total sample size of 2,678,696 were included. The overall current prevalence and lifetime prevalence of childhood asthma was 2.112% (95% confidence interval [CI], 1.977-2.247%) and 2.502% (95% CI, 2.166-2.838%), respectively. The difference of the prevalences between male and female patients was significant: odds ratio 1.54 (95% CI, 1.47-1.62) for the current prevalence and odds ratio 1.61 (95% CI, 1.47-1.77) for the lifetime prevalence. CONCLUSION The prevalence of childhood asthma in mainland China was low but has been increasing remarkably since 1998. Boys are more likely to have asthma throughout most of their childhood. Preschoolers (3-6 years old) showed a higher prevalence than the other age groups. The current prevalence of childhood asthma probably increased slightly from 2017 to 2019.
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Affiliation(s)
- Xiaojing Guo
- From the Department of Epidemiology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China, and
| | - Zhuoying Li
- From the Department of Epidemiology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China, and
| | - Weijun Ling
- From the Department of Epidemiology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China, and
| | - Jianxiong Long
- From the Department of Epidemiology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China, and
| | - Cuilin Su
- From the Department of Epidemiology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China, and
| | - Jinglin Li
- From the Department of Epidemiology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China, and
| | - Siqiao Liang
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Li Su
- From the Department of Epidemiology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China, and
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21
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Oluwole O, Rennie DC, Senthilselvan A, Dyck R, Afanasieva A, Adamko DJ, Lawson JA. Asthma diagnosis among children along an urban-rural gradient. J Asthma 2018; 55:1242-1252. [PMID: 29420108 DOI: 10.1080/02770903.2017.1407335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Studies have reported lower asthma prevalence in rural compared to urban areas. While environmental factors have mostly been implicated for these differences, the lower asthma prevalence could also be linked to asthma under-diagnosis in rural children. We investigate if rural children experience under-diagnosis of asthma more compared to urban children. METHODS In 2013, we conducted a cross-sectional survey of schoolchildren across an urban-rural gradient in Saskatchewan, Canada. The participants formed sampling frame for future studies. In 2015, we approached those who gave consent in 2013 for further testing, repeated the survey, and conducted clinical testing. Based on survey responses, children were classified into "no asthma," "at-risk-for-asthma," and "diagnosed asthma." We then classified asthma status as either "no asthma" or "probable asthma" based on a validated asthma algorithm. RESULTS The study population of 335 schoolchildren (aged 7-17 years) comprised of 73.4% from large urban, 13.7% from small urban, and 12.8% from rural areas. Proportion with report of physician-diagnosed asthma was 28.5% (Large urban), 34.8% (Small urban), and 20.9% (Rural). Mean percent predicted FEV1 and FEF25%-75% were lower in rural compared to small urban and large urban children (p < 0.05). Among those not classified as with "diagnosed asthma" by the survey, the algorithm further identified presence of asthma in 5.5% large urban, 8.1% small urban, and 18.8% rural children (p = 0.03). CONCLUSION The study revealed evidence of asthma underdiagnosis in rural areas and further supports the use of objective measures in addition to symptoms history when investigating asthma across urban-rural gradients.
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Affiliation(s)
- Oluwafemi Oluwole
- a Department of Community Health and Epidemiology , University of Saskatchewan , Saskatchewan , Canada.,b Canadian Centre for Health and Safety in Agriculture, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Donna C Rennie
- b Canadian Centre for Health and Safety in Agriculture, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada.,c College of Nursing , University of Saskatchewan , Saskatchewan , Canada
| | | | - Roland Dyck
- b Canadian Centre for Health and Safety in Agriculture, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada.,e Department of Medicine, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Anna Afanasieva
- b Canadian Centre for Health and Safety in Agriculture, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Darryl J Adamko
- f Department of Pediatrics , College of Medicine, University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Joshua A Lawson
- b Canadian Centre for Health and Safety in Agriculture, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada.,e Department of Medicine, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada
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Bian F, Wu YE, Zhang CL. Use of aerosol inhalation treatment with budesonide and terbutaline sulfate on acute pediatric asthmatic bronchitis. Exp Ther Med 2017; 14:1621-1625. [PMID: 28810628 PMCID: PMC5526142 DOI: 10.3892/etm.2017.4676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 06/08/2017] [Indexed: 12/13/2022] Open
Abstract
The use of oxygen-driven aerosol inhalation therapy with budesonide (suspension) and terbutaline sulfate for the treatment of pediatric asthmatic bronchitis was studied. Sixty pediatric patients diagnosed with asthmatic bronchitis in Xuzhou Children's Hospital during the period comprising April 2013 to December 2015 were enrolled in the study. After randomly dividing the patients into a control (conventional dexamethasone drip) and a treatment group (inhalation of budesonide with terbutaline sulfate) of 30 patients each, the symptoms were treated using antibiotics when necessary. The results of our evaluation showed the overall effective rate of treatment in the control group was 73.33% (40% with marked improvement, 33.33% with some improvement and 26.67% with no improvement) and that in the treatment group was 96.67% (73.73% with marked improvement, 23.33% with some improvement and only 3.33% with no improvement) with a statistically significant difference (p<0.05). The pulmonary functions of all pediatric patients showed no statistically significant differences in the pulmonary function indexes between the two groups before treatment (p>0.05). However, the differences in FEV1, FVC, FEV1/FVC and PEF between control and treatment groups before and after treatment were statistically significant (p<0.05), with overall improvement being higher in the treatment group. Finally, the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level in patients of the two groups improved significantly after treatment (p<0.05). The ESR and CRP level in the treatment group were improved to a higher degree than those in the control group (p<0.05). There were only minor adverse reactions in two patients in the treatment group, and the overall rate of adverse reactions was not significantly different between the two groups (p>0.05). Based on our evaluation the aerosol inhalation therapy of budesonide (suspension) with terbutaline sulfate has definite curative effects and is safe to use on pediatric asthmatic bronchitis patients. The approach is superior to the conventional dexamethasone treatment and is worth studying in larger populations for recommending it widely.
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Affiliation(s)
- Fangfang Bian
- Department of Respiration, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
| | - Yue-E Wu
- Department of Respiration, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
| | - Chong-Lin Zhang
- Department of Respiration, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
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