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Weeda LJZ, Bradshaw CJA, Judge MA, Saraswati CM, Le Souëf PN. How climate change degrades child health: A systematic review and meta-analysis. Sci Total Environ 2024; 920:170944. [PMID: 38360325 DOI: 10.1016/j.scitotenv.2024.170944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Children are more vulnerable than adults to climate-related health threats, but reviews examining how climate change affects human health have been mainly descriptive and lack an assessment of the magnitude of health effects children face. This is the first systematic review and meta-analysis that identifies which climate-health relationships pose the greatest threats to children. OBJECTIVES We reviewed epidemiologic studies to analyse various child health outcomes due to climate change and identify the relationships with the largest effect size. We identify population-specific risks and provide recommendations for future research. METHODS We searched four large online databases for observational studies published up to 5 January 2023 following PRISMA (systematic review) guidelines. We evaluated each included study individually and aggregated relevant quantitative data. We used quantitative data in our meta-analysis, where we standardised effect sizes and compared them among different groupings of climate variables and health outcomes. RESULTS Of 1301 articles we identified, 163 studies were eligible for analysis. We identified many relationships between climate change and child health, the strongest of which was increasing risk (60 % on average) of preterm birth from exposure to temperature extremes. Respiratory disease, mortality, and morbidity, among others, were also influenced by climate changes. The effects of different air pollutants on health outcomes were considerably smaller compared to temperature effects, but with most (16/20 = 80 %) pollutant studies indicating at least a weak effect. Most studies occurred in high-income regions, but we found no geographical clustering according to health outcome, climate variable, or magnitude of risk. The following factors were protective of climate-related child-health threats: (i) economic stability and strength, (ii) access to quality healthcare, (iii) adequate infrastructure, and (iv) food security. Threats to these services vary by local geographical, climate, and socio-economic conditions. Children will have increased prevalence of disease due to anthropogenic climate change, and our quantification of the impact of various aspects of climate change on child health can contribute to the planning of mitigation that will improve the health of current and future generations.
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Affiliation(s)
- Lewis J Z Weeda
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia.
| | - Corey J A Bradshaw
- Global Ecology | Partuyarta Ngadluku Wardli Kuu, College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia; Australian Research Council Centre of Excellence for Australian Biodiversity and Heritage, EpicAustralia.org.au, Australia
| | - Melinda A Judge
- Telethon Kids Institute, Perth, Western Australia, Australia; Department of Mathematics and Statistics, University of Western Australia, Perth, Western Australia, Australia
| | | | - Peter N Le Souëf
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia; Telethon Kids Institute, Perth, Western Australia, Australia
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Coenen I, de Jong E, Jones AC, Khoo SK, Foo S, Howland SW, Ginhoux F, Le Souëf PN, Holt PG, Strickland DH, Laing IA, Leffler J. Impaired interferon response in plasmacytoid dendritic cells from children with persistent wheeze. J Allergy Clin Immunol 2024; 153:1083-1094. [PMID: 38110059 DOI: 10.1016/j.jaci.2023.11.920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/31/2023] [Accepted: 11/24/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Impaired interferon response and allergic sensitization may contribute to virus-induced wheeze and asthma development in young children. Plasmacytoid dendritic cells (pDCs) play a key role in antiviral immunity as critical producers of type I interferons. pDCs also express the high-affinity IgE receptor through which type I interferon production may be negatively regulated. Whether antiviral function of pDCs is associated with recurrent episodes of wheeze in young children is not well understood. OBJECTIVE We sought to evaluate the phenotype and function of circulating pDCs in children with a longitudinally defined wheezing phenotype. METHODS We performed multiparameter flow cytometry on PBMCs from 38 children presenting to the emergency department with an acute episode of respiratory wheeze and 19 controls. RNA sequencing on isolated pDCs from the same individuals was also performed. For each subject, their longitudinal exacerbation phenotype was determined using the Western Australia public hospital database. RESULTS We observed a significant depletion of circulating pDCs in young children with a persistent phenotype of wheeze. The same individuals also displayed upregulation of the FcεRI on their pDCs. Based on transcriptomic analysis, pDCs from these individuals did not mount a robust systemic antiviral response as observed in children who displayed a nonrecurrent wheezing phenotype. CONCLUSIONS Our data suggest that circulating pDC phenotype and function are altered in young children with a persistent longitudinal exacerbation phenotype. Expression of high-affinity IgE receptor is increased and their function as major interferon producers is impaired during acute exacerbations of wheeze.
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Affiliation(s)
- Isabelle Coenen
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Emma de Jong
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Anya C Jones
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia; School of Medicine, University of Western Australia, Perth, Australia
| | - Siew-Kim Khoo
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Shihui Foo
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
| | - Shanshan Wu Howland
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
| | - Florent Ginhoux
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
| | - Peter N Le Souëf
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia; School of Medicine, University of Western Australia, Perth, Australia
| | - Patrick G Holt
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Deborah H Strickland
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Ingrid A Laing
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia; School of Medicine, University of Western Australia, Perth, Australia
| | - Jonatan Leffler
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia.
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Saraswati CM, Judge MA, Weeda LJZ, Bassat Q, Prata N, Le Souëf PN, Bradshaw CJA. Net benefit of smaller human populations to environmental integrity and individual health and wellbeing. Front Public Health 2024; 12:1339933. [PMID: 38504675 PMCID: PMC10949988 DOI: 10.3389/fpubh.2024.1339933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/13/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction The global human population is still growing such that our collective enterprise is driving environmental catastrophe. Despite a decline in average population growth rate, we are still experiencing the highest annual increase of global human population size in the history of our species-averaging an additional 84 million people per year since 1990. No review to date has accumulated the available evidence describing the associations between increasing population and environmental decline, nor solutions for mitigating the problems arising. Methods We summarize the available evidence of the relationships between human population size and growth and environmental integrity, human prosperity and wellbeing, and climate change. We used PubMed, Google Scholar, and Web of Science to identify all relevant peer-reviewed and gray-literature sources examining the consequences of human population size and growth on the biosphere. We reviewed papers describing and quantifying the risks associated with population growth, especially relating to climate change. Results These risks are global in scale, such as greenhouse-gas emissions, climate disruption, pollution, loss of biodiversity, and spread of disease-all potentially catastrophic for human standards of living, health, and general wellbeing. The trends increasing the risks of global population growth are country development, demographics, maternal education, access to family planning, and child and maternal health. Conclusion Support for nations still going through a demographic transition is required to ensure progress occurs within planetary boundaries and promotes equity and human rights. Ensuring the wellbeing for all under this aim itself will lower population growth and further promote environmental sustainability.
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Affiliation(s)
| | - Melinda A. Judge
- Telethon Kids Institute, Perth, WA, Australia
- School of Mathematics and Statistics, University of Western Australia, Nedlands, WA, Australia
| | - Lewis J. Z. Weeda
- School of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- Paediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Ndola Prata
- Bixby Center for Population Health and Sustainability, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Peter N. Le Souëf
- School of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - Corey J. A. Bradshaw
- Global Ecology | Partuyarta Ngadluku Wardli Kuu, College of Science and Engineering, Flinders University, Adelaide, SA, Australia
- Australian Research Council Centre of Excellence for Australian Biodiversity and Heritage, Wollongong, NSW, Australia
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Bochkov YA, Devries M, Tetreault K, Gangnon R, Lee S, Bacharier LB, Busse WW, Camargo CA, Choi T, Cohen R, De R, DeMuri GP, Fitzpatrick AM, Gergen PJ, Grindle K, Gruchalla R, Hartert T, Hasegawa K, Khurana Hershey GK, Holt P, Homil K, Jartti T, Kattan M, Kercsmar C, Kim H, Laing IA, Le Souëf PN, Liu AH, Mauger DT, Pappas T, Patel SJ, Phipatanakul W, Pongracic J, Seroogy C, Sly PD, Tisler C, Wald ER, Wood R, Lemanske RF, Jackson DJ, Gern JE. Rhinoviruses A and C elicit long-lasting antibody responses with limited cross-neutralization. J Med Virol 2023; 95:e29058. [PMID: 37638498 PMCID: PMC10484091 DOI: 10.1002/jmv.29058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023]
Abstract
Rhinoviruses (RVs) can cause severe wheezing illnesses in young children and patients with asthma. Vaccine development has been hampered by the multitude of RV types with little information about cross-neutralization. We previously showed that neutralizing antibody (nAb) responses to RV-C are detected twofold to threefold more often than those to RV-A throughout childhood. Based on those findings, we hypothesized that RV-C infections are more likely to induce either cross-neutralizing or longer-lasting antibody responses compared with RV-A infections. We pooled RV diagnostic data from multiple studies of children with respiratory illnesses and compared the expected versus observed frequencies of sequential infections with RV-A or RV-C types using log-linear regression models. We tested longitudinally collected plasma samples from children to compare the duration of RV-A versus RV-C nAb responses. Our models identified limited reciprocal cross-neutralizing relationships for RV-A (A12-A75, A12-A78, A20-A78, and A75-A78) and only one for RV-C (C2-C40). Serologic analysis using reference mouse sera and banked human plasma samples confirmed that C40 infections induced nAb responses with modest heterotypic activity against RV-C2. Mixed-effects regression modeling of longitudinal human plasma samples collected from ages 2 to 18 years demonstrated that RV-A and RV-C illnesses induced nAb responses of similar duration. These results indicate that both RV-A and RV-C nAb responses have only modest cross-reactivity that is limited to genetically similar types. Contrary to our initial hypothesis, RV-C species may include even fewer cross-neutralizing types than RV-A, whereas the duration of nAb responses during childhood is similar between the two species. The modest heterotypic responses suggest that RV vaccines must have a broad representation of prevalent types.
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Affiliation(s)
| | - Mark Devries
- University of Wisconsin-Madison, Madison, WI, United States
| | | | - Ronald Gangnon
- University of Wisconsin-Madison, Madison, WI, United States
| | - Sujin Lee
- Department of Pediatrics, Center for ViroScience and Cure, Emory University School of Medicine, Atlanta, GA, United States
| | | | | | - Carlos A. Camargo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Timothy Choi
- University of Wisconsin-Madison, Madison, WI, United States
| | - Robyn Cohen
- Boston University, Boston, MA, United States
| | - Ramyani De
- Department of Pediatrics, Center for ViroScience and Cure, Emory University School of Medicine, Atlanta, GA, United States
| | | | - Anne M. Fitzpatrick
- Department of Pediatrics, Emory University and Children’s Healthcare of Atlanta, Atlanta, GA, United States
| | - Peter J. Gergen
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Rockville, MD, United States
| | | | | | - Tina Hartert
- Vanderbilt University, Nashville, TN, United States
| | - Kohei Hasegawa
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | | | - Patrick Holt
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Kiara Homil
- University of Turku and Turku University Hospital, Turku, Finland
| | - Tuomas Jartti
- University of Turku and Turku University Hospital, Turku, Finland
- PEDEGO Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Meyer Kattan
- Columbia University, New York, NY, United States
| | | | - Haejin Kim
- Henry Ford Health Systems, Detroit, MI, United States
| | | | | | - Andrew H. Liu
- Children’s Hospital Colorado, University of Colorado, Aurora, CO, United States
| | | | - Tressa Pappas
- University of Wisconsin-Madison, Madison, WI, United States
| | | | | | | | | | - Peter D. Sly
- Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | | | - Ellen R. Wald
- University of Wisconsin-Madison, Madison, WI, United States
| | - Robert Wood
- Johns Hopkins University, Baltimore, MD, United States
| | | | | | - James E. Gern
- University of Wisconsin-Madison, Madison, WI, United States
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Bradshaw CJA, Perry C, Judge MA, Saraswati CM, Heyworth J, Le Souëf PN. Lower infant mortality, higher household size, and more access to contraception reduce fertility in low- and middle-income nations. PLoS One 2023; 18:e0280260. [PMID: 36812163 PMCID: PMC9946217 DOI: 10.1371/journal.pone.0280260] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 12/25/2022] [Indexed: 02/24/2023] Open
Abstract
Although average contraceptive use has increased globally in recent decades, an estimated 222 million (26%) of women of child-bearing age worldwide face an unmet need for family planning-defined as a discrepancy between fertility preferences and contraception practice, or failing to translate desires to avoid pregnancy into preventative behaviours and practices. While many studies have reported relationships between availability/quality of contraception and family planning, infant mortality, and fertility, these relationships have not been evaluated quantitatively across a broad range of low- and middle-income countries. Using publicly available data from 64 low- and middle-income countries, we collated test and control variables in six themes: (i) availability of family planning, (ii) quality of family planning, (iii) female education, (iv) religion, (v) mortality, and (vi) socio-economic conditions. We predicted that higher nation-level availability/quality of family-planning services and female education reduce average fertility, whereas higher infant mortality, greater household size (a proxy for population density), and religious adherence increase it. Given the sample size, we first constructed general linear models to test for relationships between fertility and the variables from each theme, from which we retained those with the highest explanatory power within a final general linear model set to determine the partial correlation of dominant test variables. We also applied boosted regression trees, generalised least-squares models, and generalised linear mixed-effects models to account for non-linearity and spatial autocorrelation. On average among all countries, we found the strongest associations between fertility and infant mortality, household size, and access to any form of contraception. Higher infant mortality and household size increased fertility, whereas greater access to any form of contraception decreased fertility. Female education, home visitations by health workers, quality of family planning, and religious adherence all had weak, if any, explanatory power. Our models suggest that decreasing infant mortality, ensuring sufficient housing to reduce household size, and increasing access to contraception will have the greatest effect on decreasing global fertility. We thus provide new evidence that progressing the United Nation's Sustainable Development Goals for reducing infant mortality can be accelerated by increasing access to family planning.
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Affiliation(s)
- Corey J. A. Bradshaw
- Global Ecology Partuyarta Ngadluku Wardli Kuu, College of Science and Engineering, Flinders University, Adelaide, SA, Australia
- National Health and Medical Research Council Special Initiative in Human Health and Environmental Change, Healthy Environments And Lives (HEAL) Network, Canberra, ACT, Australia
| | - Claire Perry
- School of Population and Global Health, The University of Western Australia, Crawley, WA, Australia
| | - Melinda A. Judge
- School of Medicine, The University of Western Australia, Crawley, WA, Australia
| | - Chitra M. Saraswati
- School of Medicine, The University of Western Australia, Crawley, WA, Australia
| | - Jane Heyworth
- School of Population and Global Health, The University of Western Australia, Crawley, WA, Australia
| | - Peter N. Le Souëf
- National Health and Medical Research Council Special Initiative in Human Health and Environmental Change, Healthy Environments And Lives (HEAL) Network, Canberra, ACT, Australia
- School of Medicine, The University of Western Australia, Crawley, WA, Australia
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Le Souëf PN, Saraswati CM, Judge M, Bradshaw CJ. Spatially explicit analyses of environmental and health data to determine past, emerging and future threats to child health. J Paediatr Child Health 2021; 57:1830-1834. [PMID: 34792242 DOI: 10.1111/jpc.15822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dire forecasts predict that an increasingly hostile environment globally will increase the threats to human health. Infants and young children are especially at risk because children are particularly vulnerable to climate-related stressors. The childhood diseases most affected, the breadth and magnitude of future health problems and the time frame over which these problems will manifest remain largely unknown. OBJECTIVES To review the possibility that spacially explicit analyses can be used to determine how climate change has affected children's health to date and whether these analyses can be used for future projections. METHODS As an example of whether these objectives can be achieved, all available Australian environmental and health databases were reviewed. RESULTS Environmental and health data in Australia have been collected for up to 30 years for the same spatial areas at 'Statistical Area level 1' (SA1) scale. SA1s are defined as having a population of between 200 and 800 people and collectively they cover the whole of Australia without gaps or overlap. Although the SA1 environmental and health data have been collected separately, they can be merged to allow detailed statistical analyses that can determine how climate change has affected the health of children. CONCLUSIONS The availability of environmental and health datasets that share the same precise spatial coordinates provides a pathway whereby past and emerging effects on child health can be measured and predicted into the future. Given that the future health and well-being of children is one of society's greatest concerns, this information is urgently needed.
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Affiliation(s)
- Peter N Le Souëf
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Chitra M Saraswati
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Melinda Judge
- School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Corey Ja Bradshaw
- Global Ecology Partuyarta Ngadluku Wardli Kuu, College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia
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Mathioudakis AG, Miligkos M, Boccabella C, Alimani GS, Custovic A, Deschildre A, Ducharme FM, Kalayci O, Murray C, Garcia AN, Phipatanakul W, Price D, Sheikh A, Agache IO, Bacharier L, Beloukas A, Bentley A, Bonini M, Castro-Rodriguez JA, De Carlo G, Craig T, Diamant Z, Feleszko W, Felton T, Gern JE, Grigg J, Hedlin G, Hossny EM, Ierodiakonou D, Jartti T, Kaplan A, Lemanske RF, Le Souëf PN, Mäkelä MJ, Mathioudakis GA, Matricardi P, Mitrogiorgou M, Morais-Almeida M, Nagaraju K, Papageorgiou E, Pité H, Pitrez PMC, Pohunek P, Roberts G, Tsiligianni I, Turner S, Vijverberg S, Winders TA, Wong GW, Xepapadaki P, Zar HJ, Papadopoulos NG. Management of asthma in childhood: study protocol of a systematic evidence update by the Paediatric Asthma in Real Life (PeARL) Think Tank. BMJ Open 2021; 11:e048338. [PMID: 34215609 PMCID: PMC8256789 DOI: 10.1136/bmjopen-2020-048338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Clinical recommendations for childhood asthma are often based on data extrapolated from studies conducted in adults, despite significant differences in mechanisms and response to treatments. The Paediatric Asthma in Real Life (PeARL) Think Tank aspires to develop recommendations based on the best available evidence from studies in children. An overview of systematic reviews (SRs) on paediatric asthma maintenance management and an SR of treatments for acute asthma attacks in children, requiring an emergency presentation with/without hospital admission will be conducted. METHODS AND ANALYSIS Standard methodology recommended by Cochrane will be followed. Maintenance pharmacotherapy of childhood asthma will be evaluated in an overview of SRs published after 2005 and including clinical trials or real-life studies. For evaluating pharmacotherapy of acute asthma attacks leading to an emergency presentation with/without hospital admission, we opted to conduct de novo synthesis in the absence of adequate up-to-date published SRs. For the SR of acute asthma pharmacotherapy, we will consider eligible SRs, clinical trials or real-life studies without time restrictions. Our evidence updates will be based on broad searches of Pubmed/Medline and the Cochrane Library. We will use A MeaSurement Tool to Assess systematic Reviews, V.2, Cochrane risk of bias 2 and REal Life EVidence AssessmeNt Tool to evaluate the methodological quality of SRs, controlled clinical trials and real-life studies, respectively.Next, we will further assess interventions for acute severe asthma attacks with positive clinical results in meta-analyses. We will include both controlled clinical trials and observational studies and will assess their quality using the previously mentioned tools. We will employ random effect models for conducting meta-analyses, and Grading of Recommendations Assessment, Development and Evaluation methodology to assess certainty in the body of evidence. ETHICS AND DISSEMINATION Ethics approval is not required for SRs. Our findings will be published in peer reviewed journals and will inform clinical recommendations being developed by the PeARL Think Tank. PROSPERO REGISTRATION NUMBERS CRD42020132990, CRD42020171624.
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Affiliation(s)
- Alexander G Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
- Athens Breath Centre, Athens, Greece
| | - Michael Miligkos
- First Department of Pediatrics, "Aghia Sofia" Children's Hospital, University of Athens, Athens, Attica, Greece
| | - Cristina Boccabella
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Milano, Lombardia, Italy
| | - Gioulinta S Alimani
- Athens Breath Centre, Athens, Greece
- Department of Biomedical Sciences, University of West Attica, Egaleo, Attica, Greece
| | - Adnan Custovic
- Department of Paediatrics, Imperial College London, London, UK
| | - A Deschildre
- Unité de Pneumologie et Allergologie Pédiatriques, Hôpital Jeanne de Flandre, CHU Lille, Lille, Hauts-de-France, France
| | | | - Omer Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe Universitesi, Ankara, Turkey
| | - Clare Murray
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Antonio Nieto Garcia
- Pulmonology and Allergy Unity, La Fe University and Polytechnic Hospital, Valencia, Comunidad Valenciana, Spain
| | - Wanda Phipatanakul
- Pediatric Allergy and Immunology, Children's Hospital Boston, Boston, Massachusetts, USA
| | - David Price
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
- Observational and Pragmatic Research Institute, Singapore
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | | | - Leonard Bacharier
- Department of Allergy, Immunology, and Pulmonary Medicine, University of Washington, Seattle, Washington, USA
| | - Apostolos Beloukas
- Department of Biomedical Sciences, University of West Attica, Egaleo, Attica, Greece
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Andrew Bentley
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
- Acute Intensive Care Unit, University Hospital of South Manchester NHS Foundation Trust, Manchester, Greater Manchester, UK
| | - Matteo Bonini
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Milano, Lombardia, Italy
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | | | - Giuseppe De Carlo
- Allergy and Airway Diseases Patient's Associations, European Federation of Pharmaceutical Industries and Associations, Brussels, Belgium
| | - Timothy Craig
- Allergy, Asthma and Immunology, Penn State University, Hershey, Pennsylvania, USA
| | - Zuzana Diamant
- Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Skane University Hospital Lund Hematological Clinic, Lund, Skåne, Sweden
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
- Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center of Groningen and QPS-NL, Groningen, Netherlands
| | - Wojciech Feleszko
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Warszawa, Poland
| | - Tim Felton
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - James E Gern
- Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jonathan Grigg
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, London, UK
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Stockholm, Sweden
| | - Elham M Hossny
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
| | - Despo Ierodiakonou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Rethimno, Greece
| | - Tuomas Jartti
- Department of Paediatrics, University of Turku, Turku, Finland
| | - Alan Kaplan
- Family Physician, Airways Group of Canada, University of Toronto, Toronto, Ontario, Canada
| | - Robert F Lemanske
- Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Mika J Mäkelä
- Department of Allergy, University of Helsinki, Helsinki, Uusimaa, Finland
| | | | - Paolo Matricardi
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité - University Medicine, Berlin, Germany
| | - Marina Mitrogiorgou
- Third Department of Paediatrics, National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | | | | | - Effie Papageorgiou
- Department of Biomedical Sciences, University of West Attica, Egaleo, Attica, Greece
| | - Helena Pité
- Allergy Center, Hospital CUF Descobertas, Lisboa, Portugal
- Allergy Center, CUF Infante Santo Hospital, Lisbon, Portugal
- Chronic Diseases Research Center (CEDOC), NOVA Medical School / Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Paulo M C Pitrez
- Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Petr Pohunek
- Paediatric Department, Motol University Hospital, Praha, Czech Republic
| | - Graham Roberts
- The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport Isle of Wight, UK
- Faculty of Medicine, Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton, Southampton, UK
- NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Ioanna Tsiligianni
- Department of Social Medicine, Faculty of Medicine, University of Crete, Rethimno, Greece
| | - Stephen Turner
- Department of Child Health, University of Aberdeen, Aberdeen, Aberdeen, UK
| | - Susanne Vijverberg
- Department of Respiratory Medicine and Department of Pediatric Pulmonology, University of Amsterdam, Amsterdam, Netherlands
| | - Tonya A Winders
- Allergy & Asthma, Global Patient Platform, Virginia, Virginia, USA
| | - Gary Wk Wong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, Western Cape, South Africa
- Unit on Child and Adolescent Health, Medical Reaserch Council, Cape Town, South Africa
| | - Nikolaos G Papadopoulos
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Attica, Greece
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8
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Annamalay AA, Abbott S, Khoo SK, Hibbert J, Bizzintino J, Zhang G, Laing I, Currie A, Le Souëf PN, Green RJ. The impact of cytokine levels in young South African children with and without HIV-associated acute lower respiratory infections. J Med Virol 2021; 93:3647-3655. [PMID: 33314189 DOI: 10.1002/jmv.26730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/18/2020] [Accepted: 12/06/2020] [Indexed: 11/09/2022]
Abstract
Altered host immune responses are considered to play a key role in the pathogenesis of acute lower respiratory infections (ALRI). The existing literature on cytokine responses in ALRI is largely focussed on adults from developed countries and there are few reports describing the role of cytokines in childhood ALRI, particularly in African or human immunodeficiency virus (HIV)-infected populations. To measure systemic cytokine levels in blood plasma from young South African children with and without ALRI and with and without HIV to determine associations between cytokine responses and disease status and respiratory viral identification. Blood plasma samples were collected from 106 hospitalized ALRI cases and 54 non-ALRI controls less than 2 years of age. HIV status was determined. Blood plasma concentrations of 19 cytokines, 7 chemokines, and 4 growth factors (epidermal growth factor, fibroblast growth factor-basic, hepatocyte growth factor, and vascular endothelial) were measured using The Human Cytokine 30-Plex Panel. Common respiratory viruses were identified by PCR. Mean cytokine concentrations for G-CSF, interferon (IFN)-γ, interleukin (IL)-5, and MCP-1 were significantly higher in ALRI cases than in nonrespiratory controls. Within the ALRI cases, several cytokines were higher in children with a virus compared with children without a virus. Mean cytokine concentrations for IFN-α, IFN-γ, IL-4, IL-5, IL-13, tumour necrosis factor-α, and MIP-1α were significantly lower in HIV-infected cases than in HIV-uninfected cases, while IP-10 and monokine induced by interferon-γ were significantly higher in HIV-infected cases than in HIV-uninfected cases. Certain cytokines are likely to play an important role in the host immune response to ALRI. HIV-infected children have impaired inflammatory responses to respiratory infections compared with HIV-uninfected children.
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Affiliation(s)
- Alicia A Annamalay
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Salome Abbott
- Division of Paediatric Pulmonology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Siew-Kim Khoo
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Julie Hibbert
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Joelene Bizzintino
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Guicheng Zhang
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Ingrid Laing
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Andrew Currie
- Medical, Molecular, and Forensic Sciences, Murdoch University, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Peter N Le Souëf
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Robin J Green
- Division of Paediatric Pulmonology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
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9
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Parker E, Judge MA, Macete E, Nhampossa T, Dorward J, Langa DC, Schacht CD, Couto A, Vaz P, Vitoria M, Molfino L, Idowu RT, Bhatt N, Naniche D, Le Souëf PN. HIV infection in Eastern and Southern Africa: Highest burden, largest challenges, greatest potential. South Afr J HIV Med 2021; 22:1237. [PMID: 34192070 PMCID: PMC8182467 DOI: 10.4102/sajhivmed.v22i1.1237] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/01/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The burden of HIV is especially concerning for Eastern and Southern Africa (ESA), as despite expansion of test-and-treat programmes, this region continues to experience significant challenges resulting from high rates of morbidity, mortality and new infections. Hard-won lessons from programmes on the ground in ESA should be shared. OBJECTIVES This report summarises relevant evidence and regional experts' recommendations regarding challenges specific to ESA. METHOD This commentary includes an in-depth review of relevant literature, progress against global goals and consensus opinion from experts. RESULTS Recommendations include priorities for essential research (surveillance data collection, key and vulnerable population education and testing, in-country testing trials and evidence-based support services to improve retention in care) as well as research that can accelerate progress towards the prevention of new infections and achieving ambitious global goals in ESA. CONCLUSION The elimination of HIV in ESA will require continued investment, commitment to evidence-based programmes and persistence. Local research is critical to ensuring that responses in ESA are targeted, efficient and evaluated.
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Affiliation(s)
- Erica Parker
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | - Melinda A Judge
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | | | | | - Jienchi Dorward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Denise C Langa
- Department of Surveillance, Instituto Nacional de Saúde, Maputo, Mozambique
| | | | - Aleny Couto
- National STI, HIV/AIDS Programme, Ministry of Health, Maputo, Mozambique
| | - Paula Vaz
- Fundaçao Ariel Glaser contra o SIDA pediátrico, Maputo, Mozambique
| | - Marco Vitoria
- Department of HIV/AIDS, World Health Organization, Geneva, Switzerland
| | | | - Rachel T Idowu
- Center for Global Health, Centers for Disease Control and Prevention, Maputo, Mozambique
| | - Nilesh Bhatt
- Elizabeth Glaser Pediatric AIDS Foundation, Maputo, Mozambique
| | - Denise Naniche
- Manhiça Health Research Centre, Manhiça, Mozambique
- Barcelona Institute for Global Health (ISGlobal), Spain
| | - Peter N Le Souëf
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
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10
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Choi T, Devries M, Bacharier LB, Busse W, Camargo CA, Cohen R, Demuri GP, Evans MD, Fitzpatrick AM, Gergen PJ, Grindle K, Gruchalla R, Hartert T, Hasegawa K, Khurana Hershey GK, Holt P, Homil K, Jartti T, Kattan M, Kercsmar C, Kim H, Laing IA, LeBeau P, Lee KE, Le Souëf PN, Liu A, Mauger DT, Ober C, Pappas T, Patel SJ, Phipatanakul W, Pongracic J, Seroogy C, Sly PD, Tisler C, Wald ER, Wood R, Gangnon R, Jackson DJ, Lemanske RF, Gern JE, Bochkov YA. Enhanced Neutralizing Antibody Responses to Rhinovirus C and Age-Dependent Patterns of Infection. Am J Respir Crit Care Med 2021; 203:822-830. [PMID: 33357024 PMCID: PMC8017585 DOI: 10.1164/rccm.202010-3753oc] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/23/2020] [Indexed: 01/10/2023] Open
Abstract
Rationale: Rhinovirus (RV) C can cause asymptomatic infection and respiratory illnesses ranging from the common cold to severe wheezing.Objectives: To identify how age and other individual-level factors are associated with susceptibility to RV-C illnesses.Methods: Longitudinal data from the COAST (Childhood Origins of Asthma) birth cohort study were analyzed to determine relationships between age and RV-C infections. Neutralizing antibodies specific for RV-A and RV-C (three types each) were determined using a novel PCR-based assay. Data were pooled from 14 study cohorts in the United States, Finland, and Australia, and mixed-effects logistic regression was used to identify factors related to the proportion of RV-C versus RV-A detection.Measurements and Main Results: In COAST, RV-A and RV-C infections were similarly common in infancy, whereas RV-C was detected much less often than RV-A during both respiratory illnesses and scheduled surveillance visits (P < 0.001, χ2) in older children. The prevalence of neutralizing antibodies to RV-A or RV-C types was low (5-27%) at the age of 2 years, but by the age of 16 years, RV-C seropositivity was more prevalent (78% vs. 18% for RV-A; P < 0.0001). In the pooled analysis, the RV-C to RV-A detection ratio during illnesses was significantly related to age (P < 0.0001), CDHR3 genotype (P < 0.05), and wheezing illnesses (P < 0.05). Furthermore, certain RV types (e.g., C2, C11, A78, and A12) were consistently more virulent and prevalent over time.Conclusions: Knowledge of prevalent RV types, antibody responses, and populations at risk based on age and genetics may guide the development of vaccines or other novel therapies against this important respiratory pathogen.
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Affiliation(s)
- Timothy Choi
- University of Wisconsin-Madison, Madison, Wisconsin
| | - Mark Devries
- University of Wisconsin-Madison, Madison, Wisconsin
| | | | | | | | | | | | | | - Anne M Fitzpatrick
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Peter J Gergen
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Rockville, Maryland
| | | | | | | | | | | | - Patrick Holt
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | | | - Tuomas Jartti
- University of Turku, Turku, Finland
- Universities of Oulu, Oulu, Finland
| | | | | | - Haejin Kim
- Henry Ford Health Systems, Detroit, Michigan
| | - Ingrid A Laing
- University of Western Australia, Perth, Western Australia, Australia
| | | | | | - Peter N Le Souëf
- University of Western Australia, Perth, Western Australia, Australia
| | - Andrew Liu
- University of Colorado, Denver, Colorado
| | | | | | | | | | | | | | | | - Peter D Sly
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia; and
| | | | - Ellen R Wald
- University of Wisconsin-Madison, Madison, Wisconsin
| | - Robert Wood
- Johns Hopkins University, Baltimore, Maryland
| | | | | | | | - James E Gern
- University of Wisconsin-Madison, Madison, Wisconsin
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11
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Schwager MJ, Song Y, Laing IA, Saiganesh A, Guo J, Le Souëf PN, Zhang G. Increased nasal Streptococcus pneumoniae presence in Western environment associated with allergic conditions in Chinese immigrants. Int J Hyg Environ Health 2021; 234:113735. [PMID: 33725492 DOI: 10.1016/j.ijheh.2021.113735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/15/2021] [Accepted: 03/04/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chinese immigrants living in Australia experience increased allergic conditions: asthma, eczema, hay fever and wheeze. Recently we reported diminished innate cytokine responses in long-term immigrants, potentially increasing their pathogenic viral load and microbial carriage. We hypothesise that a Western environment changes the nasal microbiome profile, and this altered profile may be associated with the development of allergic conditions. In this cross-sectional study, we aimed to examine the loading of viral and microbial respiratory pathogens in the upper airway. METHODS Adult Chinese immigrants were grouped depending on time spent in Australia: short-term (<6 years) or long-term (≥6 years). First, age- and gender-matched immigrants were selected for an initial screen using quantitative polymerase chain reaction (qPCR) micro-array panels. Then based on initial results the viruses, human parainfluenza 3 and rhinovirus, and the bacteria, Burkholderia spp., Staphylococcus aureus and Streptococcus pneumoniae, were validated using qPCR in the population. Associations for bacterial prevalence with atopic phenotypes were investigated. RESULTS Pooling the initial screen and validation subjects, S. aureus and S. pneumoniae had higher prevalence in long-term compared with short-term subjects (25.0% vs 8.1%, P = 0.012; and 76.8% vs 48.4%, P = 0.002). Those immigrants with nasal S. pneumoniae presence resided longer (average time 90.4 months) in Australia than immigrants without S. pneumoniae (52.7 months; P = 0.001). After adjusting for confounders, Chinese immigrants with S. pneumoniae carriage have a five-fold increased risk of doctor-diagnosed eczema (odds ratio, OR 5.36, 95% CI: 1.10-26.14; P = 0.038) compared to immigrants without S. pneumoniae carriage. There was a trend of S. pneumoniae abundance correlating with reduced host Toll-like receptor gene expression. CONCLUSION Our findings suggest that nasal S. pneumoniae may play a role in the development of allergic conditions in Chinese immigrants in a Western environment.
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Affiliation(s)
- Michelle J Schwager
- School of Public Health, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia; Centre for Genetic Origins of Health and Disease, Curtin University and the University of Western Australia (M409), Perth, Western Australia, 6009, Australia; Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia; Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia.
| | - Yong Song
- School of Public Health, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia; Centre for Genetic Origins of Health and Disease, Curtin University and the University of Western Australia (M409), Perth, Western Australia, 6009, Australia.
| | - Ingrid A Laing
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia; Division of Cardiovascular and Respiratory Sciences, The University of Western Australia (M560), 35 Stirling Highway, Perth, Western Australia, 6009, Australia.
| | - Aarti Saiganesh
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia.
| | - Jing Guo
- School of Public Health, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia; Centre for Genetic Origins of Health and Disease, Curtin University and the University of Western Australia (M409), Perth, Western Australia, 6009, Australia.
| | - Peter N Le Souëf
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia; Division of Paediatrics, School of Medicine, The University of Western Australia (M561), 35 Stirling Highway, Perth, Western Australia, 6009, Australia.
| | - Guicheng Zhang
- School of Public Health, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia; Centre for Genetic Origins of Health and Disease, Curtin University and the University of Western Australia (M409), Perth, Western Australia, 6009, Australia; Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia; Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia.
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12
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Guo J, Song Y, Saiganesh A, Hales BJ, Bosco A, Le Souëf PN, Zhang G. Toll-like receptor signalling has inverted U-shaped response over time with the Western environment. Allergy 2020; 75:2665-2667. [PMID: 32171026 DOI: 10.1111/all.14277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Jing Guo
- School of Public Health Curtin University Perth WA Australia
- Centre for genetic origins of health and disease Curtin University and the University of Western Australia Perth WA Australia
- Telethon Kids Institute Perth WA Australia
| | - Yong Song
- School of Public Health Curtin University Perth WA Australia
- Centre for genetic origins of health and disease Curtin University and the University of Western Australia Perth WA Australia
| | | | | | | | - Peter N. Le Souëf
- Division of Paediatrics Faculty of Health and Medical Sciences The University of Western Australia Perth WA Australia
| | - Guicheng Zhang
- School of Public Health Curtin University Perth WA Australia
- Centre for genetic origins of health and disease Curtin University and the University of Western Australia Perth WA Australia
- Telethon Kids Institute Perth WA Australia
- Division of Paediatrics Faculty of Health and Medical Sciences The University of Western Australia Perth WA Australia
- Curtin Health Innovation Research Institute Curtin University Perth WA Australia
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13
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Guo J, Zhang X, Saiganesh A, Peacock C, Chen S, Dykes GA, Hales BJ, Le Souëf PN, Zhang G. Linking the westernised oropharyngeal microbiome to the immune response in Chinese immigrants. Allergy Asthma Clin Immunol 2020; 16:67. [PMID: 32944027 PMCID: PMC7491349 DOI: 10.1186/s13223-020-00465-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Human microbiota plays a fundamental role in modulating the immune response. Western environment and lifestyle are envisaged to alter the human microbiota with a new microbiome profile established in Chinese immigrants, which fails to prime the immune system. Here, we investigated how differences in composition of oropharyngeal microbiome may contribute to patterns of interaction between the microbiome and immune system in Chinese immigrants living in Australia. Methods We recruited 44 adult Chinese immigrants: newly-arrived (n = 22, living in Australia < 6 months) and long-term Chinese immigrants (n = 22, living in Australia > 5 years), with age and gender matched. Oropharyngeal swabs, serum and whole blood were collected. The 16 s ribosomal RNA gene from the swabs was sequenced on the Illumina MiSeq platform. Innate immune responses were determined by 23 Toll-like receptors (TLR) pathway cytokines, while adaptive immune responses were determined by IgG-associated response to specific microbial/viral pathogens. Results The relative abundance of the genus Leptotrichia was higher in long-term immigrants as compared to that in newly-arrived Chinese immigrants, while the genus Deinococcus was significantly lower in long-term Chinese immigrants. The genera uncultured Lachnospiraceae, Erysipelotrichaceae UCG-007, Veillonella, and Actinomycetales_ambiguous taxa were negatively correlated with cytokine IL-6 in long-term Chinese immigrants (rho range: − 0.46 ~ − 0.73). With respect to adaptive immunity, several microbial taxa were significantly associated with IgG1 responsiveness to microbial antigens in long-term immigrants, while a significant correlation with IgG1 responsiveness to viral antigens was detected in newly-arrived immigrants. Conclusions The composition of the oropharyngeal microbiome varies between newly-arrived and long-term Chinese immigrants. Specific microbial taxa are significantly associated with immunological parameters but with different association patterns between newly-arrived and long-term Chinese immigrants.
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Affiliation(s)
- Jing Guo
- School of Public Health, Curtin University, Perth, WA Australia.,Centre for Genetic Origins of Health and Disease, Curtin University and the University of Western Australia, Perth, WA Australia
| | - Xiaoping Zhang
- School of Public Health, Curtin University, Perth, WA Australia.,China National Bamboo Research Centre, Key Laboratory of Resources and Utilization of Bamboo of State Forestry Administration, Hangzhou, Zhejiang China
| | - Aarti Saiganesh
- Telethon Kids Institute, The University of Western Australia, Perth, WA Australia
| | - Christopher Peacock
- Telethon Kids Institute, The University of Western Australia, Perth, WA Australia.,Marshall Centre for Infectious Disease, School of Pathology and Laboratory Medicine, The University of Western Australia, Perth, WA Australia
| | - Shu Chen
- School of Public Health, Curtin University, Perth, WA Australia
| | - Gary A Dykes
- School of Public Health, Curtin University, Perth, WA Australia
| | - Belinda J Hales
- Telethon Kids Institute, The University of Western Australia, Perth, WA Australia
| | - Peter N Le Souëf
- Telethon Kids Institute, The University of Western Australia, Perth, WA Australia.,Division of Cardiovascular and Respiratory Sciences, The University of Western Australia, Perth, WA Australia
| | - Guicheng Zhang
- School of Public Health, Curtin University, Perth, WA Australia.,Centre for Genetic Origins of Health and Disease, Curtin University and the University of Western Australia, Perth, WA Australia.,Telethon Kids Institute, The University of Western Australia, Perth, WA Australia.,Division of Cardiovascular and Respiratory Sciences, The University of Western Australia, Perth, WA Australia.,Curtin Health Innovation Research Institute, Curtin University, Perth, WA Australia
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14
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Leiter K, Franks K, Borland ML, Coleman L, Harris L, Le Souëf PN, Laing IA. Vitamin D receptor polymorphisms are associated with severity of wheezing illnesses and asthma exacerbations in children. J Steroid Biochem Mol Biol 2020; 201:105692. [PMID: 32380236 DOI: 10.1016/j.jsbmb.2020.105692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/27/2022]
Abstract
Single nucleotide polymorphisms (SNPs) of the vitamin D receptor (VDR) gene have shown linkage and association with asthma development in multiple cohort studies. However, the majority of investigations have focused on asthma phenotypes in cohorts with stable disease. We investigated the relationship between VDR SNPs and the frequency and severity of acute episodes of wheeze/asthma in a cohort of Australian children, as the ability to identify children at risk of more severe exacerbations could lead to personalized and improved genotype-specific treatment pathways. We successfully genotyped five SNPs of the VDR gene (rs2525046, rs9729, rs1544410 (BsmI), rs22239179, and rs2228570 (FokI)) in 657 children presenting to a tertiary children's hospital with acute asthma, bronchiolitis, or a wheezing illness. The relationships between VDR SNPs and exacerbation severity scores, β2-agonist use, and frequency of respiratory exacerbations were analysed using multiple regression. The rs2525046 (FokI) CT genotype was associated with higher VDR mRNA intensity levels (p = 0.007) compared to the CC genotype. A trend towards significance (p=0.056) was identified between the rs2525046 TT genotype and higher VDR mRNA intensity levels compared to the CC genotype. Children with rs2228570 AA genotype had higher exacerbation severity scores (p=0.001) and poorer β2-agonist treatment response (doses at 6 h: p = 0.009 and 12 h: p=0.033) compared to those with the GG genotype. Children with rs1544410 (BsmI) TT genotype had lower exacerbation severity scores (p = 0.005) compared to those with the CC genotype. Children with rs2228570 GA genotype presented to and/or were admitted to hospital more times since birth with respiratory (p = 0.011) and wheezing (p = 0.021) illnesses than children with the GG genotype. No associations were identified between rs9729, rs2525046 and r2239179 polymorphisms and acute wheezing/asthma variables. These findings suggest that genetic variants at the VDR locus may play a role in acute wheeze/asthma severity in children.
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Affiliation(s)
- Katharine Leiter
- School of Medicine, University of Western Australia, Perth, Australia
| | - Kimberley Franks
- School of Medicine, University of Western Australia, Perth, Australia; Telethon Kids Institute, Perth, Australia
| | - Meredith L Borland
- School of Medicine, University of Western Australia, Perth, Australia; Emergency Department, Princess Margaret Hospital, Perth, Australia
| | - Laura Coleman
- School of Medicine, University of Western Australia, Perth, Australia; Telethon Kids Institute, Perth, Australia
| | - Leesa Harris
- School of Medicine, University of Western Australia, Perth, Australia; Telethon Kids Institute, Perth, Australia
| | - Peter N Le Souëf
- School of Medicine, University of Western Australia, Perth, Australia; Telethon Kids Institute, Perth, Australia
| | - Ingrid A Laing
- School of Medicine, University of Western Australia, Perth, Australia; Telethon Kids Institute, Perth, Australia.
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15
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Owens L, Laing IA, Murdzoska J, Zhang G, Turner SW, Le Souëf PN. Glutathione S-Transferase Genotype Protects against In Utero Tobacco-linked Lung Function Deficits. Am J Respir Crit Care Med 2020; 200:462-470. [PMID: 30726102 DOI: 10.1164/rccm.201807-1332oc] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: In utero tobacco exposure is associated with reduced lung function from infancy. Antioxidant enzymes from the glutathione S-transferase (GST) family may protect against these lung function deficits.Objectives: To assess the long-term effect of in utero smoke exposure on lung function into adulthood, and to assess whether GSTT1 and GSTM1 active genotypes have long-term protective effects on lung function.Methods: In this longitudinal study based on a general population (n = 253), lung function was measured during infancy and at 6, 11, 18, and 24 years. GSTM1 and GSTT1 genotype was analyzed in a subgroup (n = 179). Lung function was assessed longitudinally from 6 to 24 years (n = 199).Measurements and Main Results: Exposure to maternal in utero tobacco was associated with lower FEV1 and FVC longitudinally from 6 to 24 years (mean difference, -3.87% predicted, P = 0.021; -3.35% predicted, P = 0.035, respectively). Among those homozygous for the GSTM1-null genotype, in utero tobacco exposure was associated with lower FEV1 and FVC compared with those with no in utero tobacco exposure (mean difference, -6.2% predicted, P = 0.01; -4.7% predicted, P = 0.043, respectively). For those with GSTM1 active genotype, there was no difference in lung function whether exposed to maternal in utero tobacco or not. In utero tobacco exposure was associated with deficits in lung function among those with both GSTT1-null and GSTT1-active genotypes.Conclusions: Certain GST genotypes may have protective effects against the long-term deficits in lung function associated with in utero tobacco exposure. This offers potential preventative targets in antioxidant pathways for at-risk infants of smoking mothers.
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Affiliation(s)
- Louisa Owens
- 1School of Medicine, University of Western Australia, Perth, Western Australia, Australia.,2School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ingrid A Laing
- 1School of Medicine, University of Western Australia, Perth, Western Australia, Australia.,3Telethon Kids Institute, Subiaco, Western Australia, Australia
| | | | - Guicheng Zhang
- 4School of Public Health, Curtin University, Bentley, Western Australia, Australia.,5Centre for Genetic Origins of Health and Disease, University of Western Australia and Curtin University, Western Australia, Australia; and
| | - Steve W Turner
- 6Child Health, University of Aberdeen, Aberdeen, United Kingdom
| | - Peter N Le Souëf
- 1School of Medicine, University of Western Australia, Perth, Western Australia, Australia
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16
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Cuthbertson L, Oo SWC, Cox MJ, Khoo SK, Cox DW, Chidlow G, Franks K, Prastanti F, Borland ML, Gern JE, Smith DW, Bizzintino JA, Laing IA, Le Souëf PN, Moffatt MF, Cookson WOC. Viral respiratory infections and the oropharyngeal bacterial microbiota in acutely wheezing children. PLoS One 2019; 14:e0223990. [PMID: 31622414 PMCID: PMC6797130 DOI: 10.1371/journal.pone.0223990] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/02/2019] [Indexed: 12/31/2022] Open
Abstract
Acute viral wheeze in children is a major cause of hospitalisation and a major risk factor for the development of asthma. However, the role of the respiratory tract microbiome in the development of acute wheeze is unclear. To investigate whether severe wheezing episodes in children are associated with bacterial dysbiosis in the respiratory tract, oropharyngeal swabs were collected from 109 children with acute wheezing attending the only tertiary paediatric hospital in Perth, Australia. The bacterial community from these samples was explored using next generation sequencing and compared to samples from 75 non-wheezing controls. No significant difference in bacterial diversity was observed between samples from those with wheeze and healthy controls. Within the wheezing group, attendance at kindergarten or preschool was however, associated with increased bacterial diversity. Rhinovirus (RV) infection did not have a significant effect on bacterial community composition. A significant difference in bacterial richness was observed between children with RV-A and RV-C infection, however this is likely due to the differences in age group between the patient cohorts. The bacterial community within the oropharynx was found to be diverse and heterogeneous. Age and attendance at day care or kindergarten were important factors in driving bacterial diversity. However, wheeze and viral infection were not found to significantly relate to the bacterial community. Bacterial airway microbiome is highly variable in early life and its role in wheeze remains less clear than viral influences.
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Affiliation(s)
- Leah Cuthbertson
- National Heart and Lung Institute, Imperial College, London, England, United Kingdom
- * E-mail:
| | - Stephen W. C. Oo
- Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Respiratory Department, Perth Children’s Hospital, Perth, Western Australia
| | - Michael J. Cox
- National Heart and Lung Institute, Imperial College, London, England, United Kingdom
| | - Siew-Kim Khoo
- Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| | - Des W. Cox
- Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
| | - Glenys Chidlow
- Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Perth, Australia
| | - Kimberley Franks
- Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| | - Franciska Prastanti
- Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| | - Meredith L. Borland
- Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Emergency Department, Perth Children’s Hospital, Perth, Australia
- Division of Emergency Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
| | - James E. Gern
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - David W. Smith
- Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Perth, Australia
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
| | - Joelene A. Bizzintino
- Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| | - Ingrid A. Laing
- Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| | - Peter N. Le Souëf
- Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| | - Miriam F. Moffatt
- National Heart and Lung Institute, Imperial College, London, England, United Kingdom
| | - William O. C. Cookson
- National Heart and Lung Institute, Imperial College, London, England, United Kingdom
- Royal Brompton and Harefield NHS Foundation Trust, London, England, United Kingdom
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17
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Bradshaw CJA, Otto SP, Mehrabi Z, Annamalay AA, Heft-Neal S, Wagner Z, Le Souëf PN. Testing the socioeconomic and environmental determinants of better child-health outcomes in Africa: a cross-sectional study among nations. BMJ Open 2019; 9:e029968. [PMID: 31570408 PMCID: PMC6773304 DOI: 10.1136/bmjopen-2019-029968] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 09/03/2019] [Accepted: 09/12/2019] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE We sought to test hypotheses regarding the principal correlates of child-health performance among African nations based on previous evidence collected at finer spatial scales. DESIGN Retrospective, cross-sectional study. SETTING All countries in Africa, excluding small-island nations. PRIMARY AND SECONDARY OUTCOME MEASURES We defined a composite child-health indicator for each country comprising the incidence of stunting, deaths from respiratory disease, deaths from diarrhoeal disease, deaths from other infectious disease and deaths from injuries for children aged under 5 years. We also compiled national-level data for Africa to test the effects of country-level water quality, air pollution, food supply, breast feeding, environmental performance, per capita wealth, healthcare investment, population density and governance quality on the child-health indicator. RESULTS Across nations, child health was lowest when water quality, improved sanitation, air quality and environmental performance were lowest. There was also an important decline in child health as household size (a proxy for population density) increased. The remaining variables had only weak effects, but in the directions we hypothesised. CONCLUSIONS These results emphasise the importance of continued investment in clean water and sanitation services, measures to improve air quality and efforts to restrict further environmental degradation, to promote the UN's Sustainable Development Goal 3 target to '… end preventable deaths of newborns and children under 5' and Goal 6 to '… ensure access to water and sanitation for all' by 2030.
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Affiliation(s)
- Corey J A Bradshaw
- Global Ecology, College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia
| | - Sarah P Otto
- Department of Zoology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Zia Mehrabi
- Institute for Resources, Environment and Sustainability, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alicia A Annamalay
- Discipline of Paediatrics, University of Western Australia, Crawley, Western Australia, Australia
| | - Sam Heft-Neal
- Center on Food Security and the Environment, Stanford University, Stanford, California, USA
| | | | - Peter N Le Souëf
- Discipline of Paediatrics, University of Western Australia, Crawley, Western Australia, Australia
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18
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Khoo SK, Read J, Franks K, Zhang G, Bizzintino J, Coleman L, McCrae C, Öberg L, Troy NM, Prastanti F, Everard J, Oo S, Borland ML, Maciewicz RA, Le Souëf PN, Laing IA, Bosco A. Upper Airway Cell Transcriptomics Identify a Major New Immunological Phenotype with Strong Clinical Correlates in Young Children with Acute Wheezing. J Immunol 2019; 202:1845-1858. [PMID: 30745463 DOI: 10.4049/jimmunol.1800178] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 01/08/2019] [Indexed: 01/10/2023]
Abstract
Asthma exacerbations are triggered by rhinovirus infections. We employed a systems biology approach to delineate upper-airway gene network patterns underlying asthma exacerbation phenotypes in children. Cluster analysis unveiled distinct IRF7hi versus IRF7lo molecular phenotypes, the former exhibiting robust upregulation of Th1/type I IFN responses and the latter an alternative signature marked by upregulation of cytokine and growth factor signaling and downregulation of IFN-γ. The two phenotypes also produced distinct clinical phenotypes. For IRF7lo children, symptom duration prior to hospital presentation was more than twice as long from initial symptoms (p = 0.011) and nearly three times as long for cough (p < 0.001), the odds ratio of admission to hospital was increased more than 4-fold (p = 0.018), and time to recurrence was shorter (p = 0.015). In summary, our findings demonstrate that asthma exacerbations in children can be divided into IRF7hi versus IRF7lo phenotypes with associated differences in clinical phenotypes.
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Affiliation(s)
- Siew-Kim Khoo
- Division of Cardiovascular and Respiratory Sciences, The University of Western Australia, Perth, Western Australia 6009, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia
| | - James Read
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia
| | - Kimberley Franks
- Division of Cardiovascular and Respiratory Sciences, The University of Western Australia, Perth, Western Australia 6009, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia
| | - Guicheng Zhang
- Division of Cardiovascular and Respiratory Sciences, The University of Western Australia, Perth, Western Australia 6009, Australia.,School of Public Health, Curtin University, Perth, Western Australia 6102, Australia.,Centre for Genetic Origins of Health and Disease, The University of Western Australia, Perth, Western Australia 6009, Australia and Curtin University, Perth, Western Australia 6102, Australia
| | - Joelene Bizzintino
- Division of Cardiovascular and Respiratory Sciences, The University of Western Australia, Perth, Western Australia 6009, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia
| | - Laura Coleman
- Division of Cardiovascular and Respiratory Sciences, The University of Western Australia, Perth, Western Australia 6009, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia
| | - Christopher McCrae
- Respiratory Inflammation and Autoimmunity, IMED Biotech Unit, AstraZeneca, Gothenburg, 431 53 Mölndal, Sweden
| | - Lisa Öberg
- Respiratory Inflammation and Autoimmunity, IMED Biotech Unit, AstraZeneca, Gothenburg, 431 53 Mölndal, Sweden
| | - Niamh M Troy
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia
| | - Franciska Prastanti
- Division of Cardiovascular and Respiratory Sciences, The University of Western Australia, Perth, Western Australia 6009, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia
| | - Janet Everard
- Division of Cardiovascular and Respiratory Sciences, The University of Western Australia, Perth, Western Australia 6009, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia
| | - Stephen Oo
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia 6009, Australia
| | - Meredith L Borland
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia 6009, Australia.,Perth Children's Hospital, Perth, Western Australia 6009, Australia; and.,Division of Emergency Medicine, School of Medicine, The University of Western Australia, Perth, Western Australia 6009, Australia
| | - Rose A Maciewicz
- Respiratory Inflammation and Autoimmunity, IMED Biotech Unit, AstraZeneca, Gothenburg, 431 53 Mölndal, Sweden
| | - Peter N Le Souëf
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia.,Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia 6009, Australia
| | - Ingrid A Laing
- Division of Cardiovascular and Respiratory Sciences, The University of Western Australia, Perth, Western Australia 6009, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia
| | - Anthony Bosco
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia;
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19
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Saiganesh A, Hales BJ, Li Y, Holt PG, Le Souëf PN, Zhang G. A marked shift in innate and adaptive immune response in chinese immigrants living in a western environment. Allergy 2018; 73:2092-2094. [PMID: 29935021 DOI: 10.1111/all.13531] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Aarti Saiganesh
- School of Paediatrics and Child Health University of Western Australia Perth WA Australia
- Telethon Kids Institute University of Western Australia Perth WA Australia
| | - Belinda J. Hales
- Telethon Kids Institute University of Western Australia Perth WA Australia
| | - Yuchun Li
- Xinxiang Medical University Henan China
| | - Patrick G. Holt
- Telethon Kids Institute University of Western Australia Perth WA Australia
| | - Peter N. Le Souëf
- School of Paediatrics and Child Health University of Western Australia Perth WA Australia
| | - Guicheng Zhang
- School of Paediatrics and Child Health University of Western Australia Perth WA Australia
- Telethon Kids Institute University of Western Australia Perth WA Australia
- Xinxiang Medical University Henan China
- School of Public Health Curtin University Perth WA Australia
- Centre for Genetic Origins of Health and Disease Faculty of Health and Medical Sciences Faculty of Health and Medical Sciences Curtin University he University of Western Australia and Royal Perth Hospital Research Foundation Perth WA Australia
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20
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Owens L, Laing IA, Zhang G, Turner S, Le Souëf PN. Prevalence of allergic sensitization, hay fever, eczema, and asthma in a longitudinal birth cohort. J Asthma Allergy 2018; 11:173-180. [PMID: 30147342 PMCID: PMC6095121 DOI: 10.2147/jaa.s170285] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose The aim of this study was to longitudinally assess the prevalence of allergic sensitization, asthma, eczema and hay fever from infancy to adulthood in a single cohort. Participants and methods This prospective study is based on a longitudinal birth cohort of 253 participants, with respiratory and immunological assessments at 1, 6, 11, 18 and 24 years of age. Subjects were recruited from an urban maternity hospital. Retention rates varied from 45% to 72% at follow-up assessments. Asthma diagnosis was based on physician diagnosis of asthma and symptoms/medications in the previous 12 months. Allergic sensitization was defined by the positive skin prick test. Hay fever and eczema were based on a questionnaire. Results The prevalence of allergic sensitization rose from 19% (n=33) at 1 year of age to 71% (n=77) at 24 years of age. The rate of asthma halved from 25% at 6 years of age to 12%–15% between 11 and 24 years of age, but the prevalence of allergic sensitization among those with asthma doubled from 50% at 6 years of age to 100% at 24 years of age. Hay fever rates rose throughout childhood from 7% at 6 years of age to 44% at 24 years of age, while the prevalence of eczema reduced from 25% at 6 years of age to 16% at 24 years of age. Parental atopy doubled the odds of asthma in their offspring by 24 years of age (odds ratio [OR]= 2.63, 95% CI 1.1–6.2, p=0.029). In all, 74% of those with asthma at 24 years of age also reported hay fever. The relationship between eczema and asthma was only significant up to 11 years of age, and the relationship between hay fever and asthma was stronger in adolescence and early adulthood than in early childhood. Conclusion Patterns of atopic disorders vary throughout childhood. Although the prevalence of allergic sensitization and hay fever rose throughout childhood and the prevalence of asthma reduced, the strength of their relationship with asthma increased with age.
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Affiliation(s)
- Louisa Owens
- School of Medicine, University of Western Australia, Perth, WA, Australia, .,School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia,
| | - Ingrid A Laing
- Telethon Kids Institute, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Guicheng Zhang
- School of Public Health, Curtin University, Perth, WA, Australia.,Centre for Genetic Origins of Health and Disease, University of Western Australia, Perth, WA, Australia
| | - Stephen Turner
- School of Medical Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - Peter N Le Souëf
- School of Medicine, University of Western Australia, Perth, WA, Australia,
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21
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Cox DW, Khoo SK, Zhang G, Lindsay K, Keil AD, Knight G, Gern JE, Laing IA, Bizzintino J, Le Souëf PN. Rhinovirus is the most common virus and rhinovirus-C is the most common species in paediatric intensive care respiratory admissions. Eur Respir J 2018; 52:13993003.00207-2018. [PMID: 29976655 DOI: 10.1183/13993003.00207-2018] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/13/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Desmond W Cox
- Respiratory Dept, Our Lady's Children's Hospital, Dublin, Ireland.,School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Siew-Kim Khoo
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Guicheng Zhang
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.,School of Public Health, Curtin University, Centre for Genetic Origins of Health and Disease, Curtin University and the University of Western Australia, Perth, Australia
| | - Katie Lindsay
- Microbiology Dept, PathWest Laboratory Medicine, Perth, Australia
| | - Anthony D Keil
- Microbiology Dept, PathWest Laboratory Medicine, Perth, Australia
| | - Geoff Knight
- Paediatric Intensive Care, Princess Margaret Hospital, Perth, Australia
| | - James E Gern
- Dept of Paediatrics, University of Wisconsin-Madison, Madison, WI, USA
| | - Ingrid A Laing
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Joelene Bizzintino
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
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22
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Owens L, Laing IA, Zhang G, Turner S, Le Souëf PN. Airway function in infancy is linked to airflow measurements and respiratory symptoms from childhood into adulthood. Pediatr Pulmonol 2018; 53:1082-1088. [PMID: 29806178 DOI: 10.1002/ppul.24062] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/10/2018] [Accepted: 05/08/2018] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Increasing evidence suggests that poor lung function in adulthood is determined very early in life. Our study aims were: (1) identify factors associated with early infant lung function; (2) quantify the link between early infant lung function and early adult lung function; and (3) identify environmental and inherited factors which predict lung function throughout the post-natal growth period. METHODS In this longitudinal study, 253 individuals were recruited antenatally. Lung function and allergy testing occurred at 1, 6, 12 months, 6, 11, 18, and 24 years of age. The relationship between lung function at 1 month (V'maxFRC) and spirometry variables at each follow-up was evaluated. Early life predictors of spirometry were assessed longitudinally using linear mixed models. RESULTS V'maxFRC correlated positively with FEF25-75% at every assessment from 6 to 24 years and FEV1 /FVC at 11 and 24 years and inversely with airway responsiveness at 6 and 18 years. Maternal asthma and smoking in pregnancy were associated with lower FEV1 from 6 to 24 years (-99 mL, P = 0.03; -77 mL, P = 0.045 respectively). Lower V'maxFRC at 1 month was associated with asthma and wheeze through to 24 years. CONCLUSION Lung airflow measurements track from birth into early adulthood, suggesting a permanent and stable airway framework is laid down in the antenatal period. Lower infant airway function is associated with respiratory symptoms into adulthood, indicating the link is clinically important. Antenatal and early life exposures must be addressed in order to maximize airway growth and reduce lifelong respiratory compromise.
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Affiliation(s)
- Louisa Owens
- School of Medicine University of Western Australia, Perth, Australia
- School of Women's and Children's Health, University of New South Wales, Australia
| | - Ingrid A Laing
- Telethon Kids Institute, Subiaco, Western Australia, Australia
- School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - Guicheng Zhang
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
- Centre for Genetic Origins of Health and Disease, University of Western Australia and Curtin University
| | - Steve Turner
- School of Medical Sciences, University of Aberdeen, Aberdeen, Scotland
| | - Peter N Le Souëf
- School of Medicine University of Western Australia, Perth, Australia
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23
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Leffler J, Jones AC, Hollams EM, Prastanti F, Le Souëf PN, Holt PG, Bosco A, Laing IA, Strickland DH. Basophil counts in PBMC populations during childhood acute wheeze/asthma are associated with future exacerbations. J Allergy Clin Immunol 2018; 142:1639-1641.e5. [PMID: 30036597 DOI: 10.1016/j.jaci.2018.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/09/2018] [Accepted: 07/10/2018] [Indexed: 01/08/2023]
Affiliation(s)
- Jonatan Leffler
- Telethon Kids Institute, University of Western Australia, Subiaco, Australia.
| | - Anya C Jones
- Telethon Kids Institute, University of Western Australia, Subiaco, Australia; Division of Paediatrics, University of Western Australia, Crawley, Australia
| | - Elysia M Hollams
- Telethon Kids Institute, University of Western Australia, Subiaco, Australia
| | - Franciska Prastanti
- School of Biomedical Sciences, University of Western Australia, Crawley, Australia
| | - Peter N Le Souëf
- Telethon Kids Institute, University of Western Australia, Subiaco, Australia; Division of Paediatrics, University of Western Australia, Crawley, Australia
| | - Patrick G Holt
- Telethon Kids Institute, University of Western Australia, Subiaco, Australia; Child Health Research Centre, University of Queensland, Queensland, Australia
| | - Anthony Bosco
- Telethon Kids Institute, University of Western Australia, Subiaco, Australia
| | - Ingrid A Laing
- Telethon Kids Institute, University of Western Australia, Subiaco, Australia; School of Biomedical Sciences, University of Western Australia, Crawley, Australia
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24
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Belgrave DCM, Granell R, Turner SW, Curtin JA, Buchan IE, Le Souëf PN, Simpson A, Henderson AJ, Custovic A. Lung function trajectories from pre-school age to adulthood and their associations with early life factors: a retrospective analysis of three population-based birth cohort studies. Lancet Respir Med 2018; 6:526-534. [PMID: 29628377 DOI: 10.1016/s2213-2600(18)30099-7] [Citation(s) in RCA: 173] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/15/2018] [Accepted: 02/16/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Maximal lung function in early adulthood is an important determinant of mortality and COPD. We investigated whether distinct trajectories of lung function are present during childhood and whether these extend to adulthood and infancy. METHODS To ascertain trajectories of FEV1, we studied two population-based birth cohorts (MAAS and ALSPAC) with repeat spirometry from childhood into early adulthood (1046 participants from 5-16 years and 1390 participants from 8-24 years). We used a third cohort (PIAF) with repeat lung function measures in infancy (V'maxFRC) and childhood (FEV1; 196 participants from 1 month to 18 years of age) to investigate whether these childhood trajectories extend from early life. We identified trajectories using latent profile modelling. We created an allele score to investigate genetic associations of trajectories, and constructed a multivariable model to identify their early-life predictors. FINDINGS We identified four childhood FEV1 trajectories: persistently high, normal, below average, and persistently low. The persistently low trajectory (129 [5%] of 2436 participants) was associated with persistent wheezing and asthma throughout follow-up. In genetic analysis, compared with the normal trajectory, the pooled relative risk ratio per allele was 0·96 (95% CI 0·92-1·01; p=0·13) for persistently high, 1·01 (0·99-1·02; p=0·49) for below average, and 1·05 (0·98-1·13; p=0·13) for persistently low. Most children in the low V'maxFRC trajectory in infancy did not progress to the low FEV1 trajectory in childhood. Early-life factors associated with the persistently low trajectory included recurrent wheeze with severe wheezing exacerbations, early allergic sensitisation, and tobacco smoke exposure. INTERPRETATION Reduction of childhood smoke exposure and minimisation of the risk of early-life sensitisation and wheezing exacerbations might reduce the risk of diminished lung function in early adulthood. FUNDING None.
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Affiliation(s)
| | - Raquel Granell
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - John A Curtin
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Manchester Academic Health Science Centre, Manchester, UK
| | - Iain E Buchan
- Health Informatics, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Angela Simpson
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Manchester Academic Health Science Centre, Manchester, UK
| | - A John Henderson
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Adnan Custovic
- Section of Paediatrics, Department of Medicine, Imperial College London, London, UK
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25
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Saiganesh A, Hales BJ, Chen S, Filipovska-Naumovska E, Pereira G, Garand M, Kollmann TR, Currie AJ, Le Souëf PN, Zhang G. The Western environment reduces innate immune cytokine production in Chinese immigrants. J Allergy Clin Immunol 2018; 141:1504-1507.e3. [DOI: 10.1016/j.jaci.2017.11.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 11/02/2017] [Accepted: 11/23/2017] [Indexed: 10/18/2022]
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26
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Lethbridge R, Prastanti F, Robertson C, Oo S, Khoo SK, Le Souëf PN, Laing IA. Prospective Assessment of Rhinovirus Symptoms and Species Recurrence in Children With and Without an Acute Wheezing Exacerbation. Viral Immunol 2018; 31:299-305. [PMID: 29446705 DOI: 10.1089/vim.2017.0152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
To assess if the difference in species-specific immune response to RV-C correlates with a higher frequency of reinfection, shorter time to reinfection, or different symptom severity than infections with RV-A or RV-B. Forty-three patients were enrolled of which 34 were successfully tracked longitudinally over 3 months, with nasal swabs and symptom questionnaires provided every 2 weeks to identify rhinovirus (RV) strains and the concurrent symptomatology. No difference was found in the time to reinfection with an RV species between RV-C and RV-A or RV-B (p = 0.866). There was a trend toward more rapid reinfection with the same species in RV-C than RV-A (55.1 days vs. 67.9 days), but this failed to reach statistical significance (p = 0.105). RV infections were generally associated with only minor symptoms, with rhinorrhea being the only significantly associated symptom (p = 0.01). RV-C was shown to have higher levels of lethargy and wheeze than other RV species. Time to reinfection with subsequent RV is not influenced by the species of the preceding RV.
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Affiliation(s)
- Robert Lethbridge
- School of Paediatrics and Child Health, University of Western Australia , Perth, Australia
| | - Franciska Prastanti
- School of Paediatrics and Child Health, University of Western Australia , Perth, Australia
| | - Cassandra Robertson
- School of Paediatrics and Child Health, University of Western Australia , Perth, Australia
| | - Stephen Oo
- School of Paediatrics and Child Health, University of Western Australia , Perth, Australia
| | - Siew-Kim Khoo
- School of Paediatrics and Child Health, University of Western Australia , Perth, Australia
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia , Perth, Australia
| | - Ingrid A Laing
- School of Paediatrics and Child Health, University of Western Australia , Perth, Australia
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Gaido CM, Granland C, Laing IA, Souëf PNL, Thomas WR, Currie AJ, Hales BJ. T-cell responses against rhinovirus species A and C in asthmatic and healthy children. Immun Inflamm Dis 2017; 6:143-153. [PMID: 29124902 PMCID: PMC5818445 DOI: 10.1002/iid3.206] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 10/13/2017] [Accepted: 10/18/2017] [Indexed: 12/28/2022]
Abstract
Background Infections by rhinovirus (RV) species A and C are the most common causes of exacerbations of asthma and a major cause of exacerbations of other acute and chronic respiratory diseases. Infections by both species are prevalent in pre‐school and school‐aged children and, particularly for RV‐C, can cause severe symptoms and a need for hospitalization. While associations between RV infection and asthma are well established, the adaptive immune‐mechanisms by which RV infections influence asthma exacerbations are yet to be defined. Objective The aim of this study was to characterize and compare T‐cell responses between RV‐A and RV‐C and to test the hypothesis that T‐cell responses would differ between asthmatic children and healthy controls. Methods A multi‐parameter flow cytometry assay was used to characterize the in vitro recall T‐cell response against RV‐A and RV‐C in PBMCs from children with acute asthma (n = 22) and controls (n = 26). The responses were induced by pools of peptides containing species‐specific VP1 epitopes of RV‐A and RV‐C. Results Regardless of children's clinical status, all children that responded to the in vitro stimulation (>90%) had a similar magnitude of CD4+ T‐cell responses to RV‐A and RV‐C. However, asthmatic children had a significantly lower number of circulating regulatory T cells (Tregs), and healthy controls had significantly more Tregs induced by RV‐A than RV‐C. Conclusions and Clinical Relevance The comparable recall memory T‐cell responses in asthmatic and control children to both RV‐A and RV‐C show that differences in the antibody and inflammatory responses previously described are likely to be due to regulation, with a demonstrated candidate being reduced regulatory T‐cells. The reduced Treg numbers demonstrated here could explain the asthmatic's inability to appropriately control immunopathological responses to RV infections.
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Affiliation(s)
- Cibele M Gaido
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.,School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Caitlyn Granland
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.,School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Ingrid A Laing
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.,School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia.,Princess Margaret Hospital for Children, Perth, Australia
| | - Wayne R Thomas
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Andrew J Currie
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia.,School of Veterinary & Life Sciences, Murdoch University, Perth, Australia
| | - Belinda J Hales
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
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28
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Clifford HD, Hayden CM, Khoo SK, Naniche D, Mandomando IM, Zhang G, Richmond P, Le Souëf PN. Genetic Variants in the IL-4/IL-13 Pathway Influence Measles Vaccine Responses and Vaccine Failure in Children from Mozambique. Viral Immunol 2017; 30:472-478. [PMID: 28594599 DOI: 10.1089/vim.2017.0014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Despite effective measles vaccines, measles still causes severe morbidity and mortality worldwide, particularly in developing countries. The Th2 pathway involving interleukin (IL)-4 and IL-13 cytokines, and their receptor IL-4Rα, play important roles in the Th1/Th2 balance and antibody production. A Th2 skewing of the cytokine milieu may affect vaccine responses. We investigated IL-4, IL-13, and IL-4Rα polymorphisms and their impact on measles IgG responses and measles vaccine failure, in two separate cohorts: 12-month-old Australian children immunized with measles-mumps-rubella vaccine (n = 137) and a case/control cohort of children aged 6 months-14 years from Mozambique, Africa (n = 89), some of whom were vaccinated, but still contracted measles (vaccine failure). We found that IL-4Rα haplotypes for Val75Ile, Ser503Pro, and Arg576Gln were associated with measles IgG in Mozambican children (p = 0.016 and p = 0.032 for Val.Pro.Arg and Val.Ser.Arg, respectively), but not Australian children. IL-4Rα 503Pro was more prevalent in Mozambique vaccine failure cases compared with controls (p = 0.008). We showed that the impact of Th2 genes on measles vaccine responses differs between ethnicities and IL-4Rα polymorphisms may work in combination to affect measles antibody responses and vaccine failure in Mozambican children. Studies in this area are particularly important in developing countries like Mozambique where measles is still a major health issue.
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Affiliation(s)
- Holly D Clifford
- 1 Telethon Kids Institute, University of Western Australia , Perth, Western Australia, Australia
| | - Catherine M Hayden
- 2 School of Pediatrics and Child Health, University of Western Australia , Perth, Western Australia, Australia
| | - Siew-Kim Khoo
- 1 Telethon Kids Institute, University of Western Australia , Perth, Western Australia, Australia .,2 School of Pediatrics and Child Health, University of Western Australia , Perth, Western Australia, Australia
| | - Denise Naniche
- 3 Centro de Investigação em Saúde da Manhiça , Manhiça, Mozambique .,4 Barcelona Centre for International Health Research (CRESIB), Universitat de Barcelona , Barcelona, Spain
| | - Inacio M Mandomando
- 3 Centro de Investigação em Saúde da Manhiça , Manhiça, Mozambique .,5 Instituto Nacional de Saúde (INS) , Ministério de Saúde, Maputo, Mozambique
| | - Guicheng Zhang
- 1 Telethon Kids Institute, University of Western Australia , Perth, Western Australia, Australia .,2 School of Pediatrics and Child Health, University of Western Australia , Perth, Western Australia, Australia
| | - Peter Richmond
- 1 Telethon Kids Institute, University of Western Australia , Perth, Western Australia, Australia .,2 School of Pediatrics and Child Health, University of Western Australia , Perth, Western Australia, Australia
| | - Peter N Le Souëf
- 1 Telethon Kids Institute, University of Western Australia , Perth, Western Australia, Australia
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29
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Owens L, Laing IA, Zhang G, Le Souëf PN. Infant lung function predicts asthma persistence and remission in young adults. Respirology 2016; 22:289-294. [PMID: 27637998 DOI: 10.1111/resp.12901] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 06/10/2016] [Accepted: 07/14/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Asthma in adults is associated with a persistent reduction in lung function from childhood, but this link has not been assessed back to infancy. Reduced infant lung function (ILF), a measure of antenatal and infant lung growth, is associated with asthma into adolescence. Our aim was to assess whether this link persists into adulthood and whether ILF can predict the remission of asthma symptoms in young adults. METHODS The study cohort was an unselected full-term birth cohort of 253 subjects enrolled antenatally with lung function assessments at 1, 6 and 12 months (maximum expiratory flow at functional residual capacity, V'maxFRC), and 6, 11, 18 and 24 years (spirometry) of age. RESULTS Infants with V'maxFRC in the lowest quartile at 1 month had an OR of 5.1 (95% CI: 2-13, P = 0.001) for asthma at 24 years. Subjects with asthma at 24 years had a mean V'maxFRC at 1 month of 69% predicted (95% CI: 48-90%) versus 110% (95% CI: 101-119%) in non-asthmatic patients (P = 0.001). Subjects with current versus resolved asthma symptoms at 24 years had a mean V'maxFRC at 1 month of 69% predicted (95% CI: 53-84%) versus 105% (88-123%), respectively (P = 0.003). Subjects with current asthma at 24 years had persistently lower lung function from infancy with a mean reduction of 16.2% (95% CI: 8.1-24.3%, P < 0.0001). CONCLUSION Reduced lung function in early infancy is predictive of persistent asthma in young adults and a persistent reduction in lung function, suggesting abnormal lung development and growth in utero or very early in life.
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Affiliation(s)
- Louisa Owens
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Ingrid A Laing
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.,Telethon Kids Institute, Perth, Western Australia, Australia
| | - Guicheng Zhang
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.,School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
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30
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Annamalay AA, Abbott S, Sikazwe C, Khoo SK, Bizzintino J, Zhang G, Laing I, Chidlow GR, Smith DW, Gern J, Goldblatt J, Lehmann D, Green RJ, Le Souëf PN. Respiratory viruses in young South African children with acute lower respiratory infections and interactions with HIV. J Clin Virol 2016; 81:58-63. [PMID: 27317881 PMCID: PMC7106452 DOI: 10.1016/j.jcv.2016.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND Human rhinovirus (RV) is the most common respiratory virus and has been associated with frequent and severe acute lower respiratory infections (ALRI). The prevalence of RV species among HIV-infected children in South Africa is unknown. OBJECTIVES To describe the prevalence of respiratory viruses, including RV species, associated with HIV status and other clinical symptoms in children less than two years of age with and without ALRI in Pretoria, South Africa. STUDY DESIGN Nasopharyngeal aspirates were collected from 105 hospitalized ALRI cases and 53 non-ALRI controls less than two years of age. HIV status was determined. Common respiratory viruses were identified by PCR, and RV species and genotypes were identified by semi-nested PCR, sequencing and phylogenetic tree analyses. RESULTS Respiratory viruses were more common among ALRI cases than controls (83.8% vs. 69.2%; p=0.041). RV was the most commonly identified virus in cases with pneumonia (45.6%) or bronchiolitis (52.1%), regardless of HIV status, as well as in controls (39.6%). RV-A was identified in 26.7% of cases and 15.1% of controls while RV-C was identified in 21.0% of cases and 18.9% of controls. HIV-infected children were more likely to be diagnosed with pneumonia than bronchiolitis (p<0.01). RSV was not identified in any HIV-infected cases (n=15) compared with 30.6% of HIV-uninfected cases (n=85, p=0.013), and was identified more frequently in bronchiolitis than in pneumonia cases (43.8% vs. 12.3%; p<0.01). CONCLUSIONS RV-A and RV-C are endemic in South African children and HIV infection may be protective against RSV and bronchiolitis.
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Affiliation(s)
- Alicia A Annamalay
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia.
| | - Salome Abbott
- Division of Paediatric Pulmonology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Chisha Sikazwe
- Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, Perth, Australia
| | - Siew-Kim Khoo
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Joelene Bizzintino
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Guicheng Zhang
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; School of Public Health, Curtin University, Perth, Australia
| | - Ingrid Laing
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Glenys R Chidlow
- Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, Perth, Australia
| | - David W Smith
- Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, Perth, Australia
| | - James Gern
- University of Wisconsin-Madison, Madison, USA
| | - Jack Goldblatt
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Deborah Lehmann
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Robin J Green
- Division of Paediatric Pulmonology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
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31
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Annamalay AA, Lanaspa M, Khoo SK, Madrid L, Acácio S, Zhang G, Laing IA, Gern J, Goldblatt J, Bizzintino J, Lehmann D, Le Souëf PN, Bassat Q. Rhinovirus species and clinical features in children hospitalised with pneumonia from Mozambique. Trop Med Int Health 2016; 21:1171-80. [PMID: 27353724 PMCID: PMC7169728 DOI: 10.1111/tmi.12743] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objectives To describe the prevalence of human rhinovirus (RV) species in children hospitalised with pneumonia in Manhiça, Mozambique, and the associations between RV species and demographic, clinical and laboratory features. Methods Nasopharyngeal aspirates were collected from children 0 to 10 years of age (n = 277) presenting to Manhiça District Hospital with clinical pneumonia. Blood samples were collected for HIV and malaria testing, blood culture and full blood counts, and a chest X‐ray was performed. A panel of common respiratory viruses was investigated using two independent multiplex RT‐PCR assays with primers specific for each virus and viral type. RV species and genotypes were identified by seminested PCR assays, sequencing and phylogenetic tree analyses. Results At least one respiratory virus was identified in 206 (74.4%) children hospitalised with clinical pneumonia. RV was the most common virus identified in both HIV‐infected (17 of 38, 44.7%) and HIV‐uninfected (74 of 237, 31.2%; P = 0.100) children. RV‐A was the most common RV species identified (47 of 275, 17.0%), followed by RV‐C (35/275, 12.6%) and RV‐B (8/275, 2.9%). Clinical presentation of the different RV species was similar and overlapping, with no particular species being associated with specific clinical features. Conclusions RV‐A and RV‐C were the most common respiratory viruses identified in children hospitalised with clinical pneumonia in Manhiça. Clinical presentation of RV‐A and RV‐C was similar and overlapping.
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Affiliation(s)
- Alicia A Annamalay
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Miguel Lanaspa
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Siew-Kim Khoo
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Lola Madrid
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sozinho Acácio
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Guicheng Zhang
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,School of Public Health, Curtin University, Perth, WA, Australia
| | - Ingrid A Laing
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - James Gern
- University of Wisconsin-Madison, Madison, WI, USA
| | - Jack Goldblatt
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia
| | - Joelene Bizzintino
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Deborah Lehmann
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
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32
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Zhang G, Wang K, Schultz E, Khoo SK, Zhang X, Annamalay A, Laing IA, Hales BJ, Goldblatt J, Le Souëf PN. Western environment/lifestyle is associated with increased genome methylation and decreased gene expression in Chinese immigrants living in Australia. Environ Mol Mutagen 2016; 57:65-73. [PMID: 26671525 DOI: 10.1002/em.21989] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 11/06/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Several human diseases and conditions are disproportionally distributed in the world with a significant "Western-developed" vs. "Eastern-developing" gradient. METHODS We compared genome-wide DNA methylation of peripheral blood mononuclear cells in 25 newly arrived Chinese immigrants living in a Western environment for less than 6 months ("Newly arrived") with 23 Chinese immigrants living in the Western environment for more than two years ("Long-term") with a mean of 8.7 years, using the Infinium HumanMethylation450 BeadChip. In a sub-group of both subject groups (n = 12 each) we also investigated genome-wide gene expression using a Human HT-12 v4 expression beadChip. RESULTS There were 62.5% probes among the total number of 382,250 valid CpG sites with greater mean Beta (β) in "Long-term" than in "Newly arrived". In the regions of CpG islands and gene promoters, compared with the CpG sites in all other regions, lower percentages of CpG sites with mean methylation levels in "Long-term" greater than "Newly arrived" were observed, but still >50%. The increase of methylation was associated with a general decrease of gene expression in Chinese immigrants living in the Western environment for a longer period of time. After adjusting for age, gender and other confounding factors the findings remained. CONCLUSION Chinese immigrants living in Australia for a longer period of time have increased overall genome methylation and decreased overall gene expression compared with newly arrived immigrants.
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Affiliation(s)
- Guicheng Zhang
- School of Public Health, Curtin University, Perth, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Kui Wang
- School of Medicine, Shihezhi University, Xinjiang, China
- Biostatistical Analysis Pty Ltd, Australia
- The University of Queensland, Brisbane, Australia
| | - Ennee Schultz
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Siew-Kim Khoo
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Xiaopeng Zhang
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
- Thoracic Surgery Department, Hebei General Hospital, Shijiazhuang, People's Republic of China
| | - Alicia Annamalay
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Ingrid A Laing
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Belinda J Hales
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Jack Goldblatt
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
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Cox DW, Mullane D, Zhang GC, Turner SW, Hayden CM, Goldblatt J, Landau LI, Le Souëf PN. Longitudinal assessment of airway responsiveness from 1 month to 18 years in the PIAF birth cohort. Eur Respir J 2015; 46:1654-61. [PMID: 26493795 DOI: 10.1183/13993003.00397-2015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 06/25/2015] [Indexed: 01/29/2023]
Abstract
The Perth Infant Asthma Follow-up (PIAF) study involves a birth cohort of unselected subjects who have undergone longitudinal assessments of airway responsiveness at 1, 6 and 12 months and 6, 11 and 18 years of age. The aim of this study was to determine the relationship between increased airway responsiveness throughout childhood and asthma in early adult life.Airway responsiveness to histamine, assessed as a dose-response slope (DRS), and a respiratory questionnaire were completed at 1, 6 and 12 months and 6, 11 and 18 years of age.253 children were initially recruited and studied. Airway responsiveness was assessed in 203, 174, 147, 103, 176 and 137 children at the above-mentioned time points, respectively (39 participants being assessed on all test occasions). Asthma at 18 years was associated with increased airway responsiveness at 6, 12 and 18 years, but not during infancy (slope 0.24, 95% CI 0.06-0.42; p=0.01; slope 0.25, 95% CI 0.08-0.49; p=0.006; and slope 0.56, 95% CI 0.29-0.83; p<0.001, respectively).Increased airway responsiveness and its association with asthma at age 18 years is established between infancy and 6 years. We propose that airway responsiveness in early life reflects the initial airway geometry and airway responsiveness later in childhood increasingly reflects immunological responses to environmental influences.
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Affiliation(s)
- Desmond W Cox
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - Dave Mullane
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Guicheng C Zhang
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia School of Public Health, Curtin University, Perth, Australia
| | - Steve W Turner
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Catherine M Hayden
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Jack Goldblatt
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia King Edward Memorial Hospital, Perth, Australia
| | - Lou I Landau
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia Respiratory Medicine, Princess Margaret Hospital, Perth, Australia
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Iwasaki J, Smith WA, Khoo SK, Bizzintino J, Zhang G, Cox DW, Laing IA, Le Souëf PN, Thomas WR, Hales BJ. Comparison of rhinovirus antibody titers in children with asthma exacerbations and species-specific rhinovirus infection. J Allergy Clin Immunol 2014; 134:25-32. [PMID: 24767874 DOI: 10.1016/j.jaci.2014.03.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 02/14/2014] [Accepted: 03/19/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND Asthma exacerbations are associated with human rhinovirus (HRV) infections, and more severe exacerbations are associated with HRV-C. We have previously shown that the HRV-C-specific antibody response is low in healthy adult sera and that most of the antibody to HRV-C is cross-reactive with HRV-A. OBJECTIVES To compare the antibody response to each HRV species in asthmatic and nonasthmatic children in whom the type of HRV infection was known. METHODS Total and specific IgG₁ binding to HRV viral capsid protein antigens of HRV-A, -B, and -C were tested in the plasma from nonasthmatic children (n = 47) and children presenting to the emergency department with asthma exacerbations (n = 96). HRV, found in most of the children at the time of their exacerbation (72%), was analyzed using molecular typing. RESULTS Asthmatic children had higher antibody responses to HRV. The titers specific to HRV-A, and to a lesser extent HRV-B, were higher than in nonasthmatic controls. The species-specific responses to HRV-C were markedly lower than titers to HRV-A and HRV-B in both asthmatic and nonasthmatic children (P < .001). The titers both at presentation and after convalescence were not associated with the HRV genotype detected during the exacerbation. CONCLUSIONS The higher total anti-HRV antibody titers of asthmatic children and their higher anti-HRV-A and -B titers show their development of a heightened antiviral immune response. The low species-specific HRV-C titers found in all groups, even when the virus was found, point to a different and possibly less efficacious immune response to this species.
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Affiliation(s)
- Jua Iwasaki
- Telethon Institute for Child Health Research, University of Western Australia, Perth, Australia
| | - Wendy-Anne Smith
- Telethon Institute for Child Health Research, University of Western Australia, Perth, Australia
| | - Siew-Kim Khoo
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Joelene Bizzintino
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Guicheng Zhang
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; School of Public Health, Curtin University, Perth, Australia
| | - Des W Cox
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Ingrid A Laing
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Wayne R Thomas
- Telethon Institute for Child Health Research, University of Western Australia, Perth, Australia
| | - Belinda J Hales
- Telethon Institute for Child Health Research, University of Western Australia, Perth, Australia; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.
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35
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Bousquet J, Gern JE, Martinez FD, Anto JM, Johnson CC, Holt PG, Lemanske RF, Le Souëf PN, Tepper RS, von Mutius ERM, Arshad SH, Bacharier LB, Becker A, Belanger K, Bergström A, Bernstein DI, Cabana MD, Carroll KN, Castro M, Cooper PJ, Gillman MW, Gold DR, Henderson J, Heinrich J, Hong SJ, Jackson DJ, Keil T, Kozyrskyj AL, Lødrup Carlsen KC, Miller RL, Momas I, Morgan WJ, Noel P, Ownby DR, Pinart M, Ryan PH, Schwaninger JM, Sears MR, Simpson A, Smit HA, Stern DA, Subbarao P, Valenta R, Wang X, Weiss ST, Wood R, Wright AL, Wright RJ, Togias A, Gergen PJ. Birth cohorts in asthma and allergic diseases: report of a NIAID/NHLBI/MeDALL joint workshop. J Allergy Clin Immunol 2014; 133:1535-46. [PMID: 24636091 DOI: 10.1016/j.jaci.2014.01.018] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 01/16/2014] [Accepted: 01/21/2014] [Indexed: 11/30/2022]
Abstract
Population-based birth cohorts on asthma and allergies increasingly provide new insights into the development and natural history of the diseases. More than 130 birth cohorts focusing on asthma and allergy have been initiated in the last 30 years. A National Institute of Allergy and Infectious Diseases; National Heart, Lung, and Blood Institute; Mechanisms of the Development of Allergy (MeDALL; Framework Programme 7 of the European Commission) joint workshop was held in Bethesda, Maryland, on September 11-12, 2012, with 3 objectives: (1) documenting the knowledge that asthma/allergy birth cohorts have provided, (2) identifying the knowledge gaps and inconsistencies, and (3) developing strategies for moving forward, including potential new study designs and the harmonization of existing asthma birth cohort data. The meeting was organized around the presentations of 5 distinct workgroups: (1) clinical phenotypes, (2) risk factors, (3) immune development of asthma and allergy, (4) pulmonary development, and (5) harmonization of existing birth cohorts. This article presents the workgroup reports and provides Web links (AsthmaBirthCohorts.niaid.nih.gov or www.medall-fp7.eu), where the reader will find tables describing the characteristics of the birth cohorts included in this report, the type of data collected at differing ages, and a selected bibliography provided by the participating birth cohorts.
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Affiliation(s)
- Jean Bousquet
- University Hospital, Montpellier and INSERM U1018, Villejuif, France.
| | - James E Gern
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | | | - Josep M Anto
- Centre for Research in Environmental Epidemiology (CREAL) and IMIM (Hospital del Mar Research Institute) and CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut, Barcelona, Spain
| | - Christine C Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Mich
| | - Patrick G Holt
- Telethon Institute for Child Health Research, University of Western Australia, and Queensland Children's Medical Research Institute, University of Queensland, Brisbane, Australia
| | - Robert F Lemanske
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, Princess Margaret Hospital for Children, University of Western Australia, Perth, Australia
| | - Robert S Tepper
- Indiana University School of Medicine, James Whitcomb Riley Hospital for Children, Indianapolis, Ind
| | | | - S Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, and the David Hide Asthma and Allergy Research Centre, Isle of Wight, United Kingdom
| | | | - Allan Becker
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kathleen Belanger
- Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, School of Medicine, New Haven, Conn
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - David I Bernstein
- Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Michael D Cabana
- Departments of Pediatrics, Epidemiology & Biostatistics, the University of California, San Francisco, Calif
| | - Kecia N Carroll
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Mario Castro
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, Mo
| | - Philip J Cooper
- Liverpool School of Tropical Medicine, Liverpool, and Escuela de Biologia, Pontificia Universidad Catolica del Ecuador, Quito, Ecuador
| | - Matthew W Gillman
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Mass
| | - Diane R Gold
- Channing Division of Network Medicine, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, and Harvard School of Public Health, Department of Environmental Health, Boston, Mass
| | - John Henderson
- School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Joachim Heinrich
- Helmholtz Zentrum, Muenchen, German Center for Environmental Health, Institute of Epidemiology I, Munich, Germany
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Daniel J Jackson
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitaetsmedizin Berlin, Berlin, and Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Anita L Kozyrskyj
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Rachel L Miller
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University, New York, NY
| | - Isabelle Momas
- Department of Public Health and Biostatistics, Paris Descartes University, Sorbonne, and Paris Municipal Department of Social Action, Childhood, and Health, Paris, France
| | - Wayne J Morgan
- Department of Pediatrics, University of Arizona, Tucson, Ariz
| | - Patricia Noel
- Division of Lung Diseases, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, Bethesda, Md
| | | | - Mariona Pinart
- Centre for Research in Environmental Epidemiology (CREAL) and IMIM (Hospital del Mar Research Institute) and CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Patrick H Ryan
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Julie M Schwaninger
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Malcolm R Sears
- Department of Medicine, AstraZeneca Chair in Respiratory Epidemiology, McMaster University, Hamilton, Ontario, Canada
| | - Angela Simpson
- Centre for Respiratory and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, University of Manchester and University Hospital of South Manchester, Manchester, United Kingdom
| | - Henriette A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Debra A Stern
- Arizona Respiratory Center, University of Arizona, Tucson, Ariz
| | - Padmaja Subbarao
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Xiaobin Wang
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md
| | - Scott T Weiss
- Harvard Medical School, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Robert Wood
- Department of Pediatrics, Division of Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Anne L Wright
- Arizona Respiratory Center and the Department of Pediatrics, University of Arizona College of Medicine, Tucson, Ariz
| | - Rosalind J Wright
- Department of Pediatrics and Mindich Child Health & Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alkis Togias
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Peter J Gergen
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
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Cox DW, Bizzintino J, Ferrari G, Khoo SK, Zhang G, Whelan S, Lee WM, Bochkov YA, Geelhoed GC, Goldblatt J, Gern JE, Laing IA, Le Souëf PN. Human rhinovirus species C infection in young children with acute wheeze is associated with increased acute respiratory hospital admissions. Am J Respir Crit Care Med 2013; 188:1358-64. [PMID: 23992536 PMCID: PMC5447292 DOI: 10.1164/rccm.201303-0498oc] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 08/13/2013] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Human rhinovirus species C (HRV-C) is the most common cause of acute wheezing exacerbations in young children presenting to hospital, but its impact on subsequent respiratory illnesses has not been defined. OBJECTIVES To determine whether acute wheezing exacerbations due to HRV-C are associated with increased hospital attendances due to acute respiratory illnesses (ARIs). METHODS Clinical information and nasal samples were collected prospectively from 197 children less than 5 years of age, presenting to hospital with an acute wheezing episode. Information on hospital attendances with an ARI before and after recruitment was subsequently obtained. MEASUREMENTS AND MAIN RESULTS HRV was the most common virus identified at recruitment (n = 135 [68.5%]). From the 120 (88.9%) samples that underwent typing, HRV-C was the most common HRV species identified, present in 81 (67.5%) samples. Children with an HRV-related wheezing illness had an increased risk of readmission with an ARI (relative risk, 3.44; 95% confidence interval, 1.17-10.17; P = 0.03) compared with those infected with any other virus. HRV-C, compared with any other virus, was associated with an increased risk of a respiratory hospital admission before (49.4% vs. 27.3%, respectively; P = 0.004) and within 12 months (34.6% vs. 17.0%; P = 0.01) of recruitment. Risk for subsequent ARI admissions was further increased in atopic subjects (relative risk, 6.82; 95% confidence interval, 2.16-21.55; P = 0.001). Admission risks were not increased for other HRV species. CONCLUSIONS HRV-C-related wheezing illnesses were associated with an increased risk of prior and subsequent hospital respiratory admissions. These associations are consistent with HRV-C causing recurrent severe wheezing illnesses in children who are more susceptible to ARIs.
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Affiliation(s)
- Desmond W. Cox
- Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- School of Paediatrics and Child Health and
- Respiratory Department, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
| | - Joelene Bizzintino
- School of Paediatrics and Child Health and
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia
| | | | | | | | | | | | - Yury A. Bochkov
- Department of Pediatrics, University of Wisconsin–Madison, Madison, Wisconsin
| | | | | | - James E. Gern
- Department of Pediatrics, University of Wisconsin–Madison, Madison, Wisconsin
| | - Ingrid A. Laing
- School of Paediatrics and Child Health and
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia
| | - Peter N. Le Souëf
- Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- School of Paediatrics and Child Health and
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Clifford HD, Hayden CM, Khoo SK, Naniche D, Mandomando IM, Zhang G, Richmond P, Le Souëf PN. Polymorphisms in key innate immune genes and their effects on measles vaccine responses and vaccine failure in children from Mozambique. Vaccine 2012; 30:6180-5. [PMID: 22871352 DOI: 10.1016/j.vaccine.2012.07.063] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 07/23/2012] [Accepted: 07/24/2012] [Indexed: 11/25/2022]
Abstract
Despite an effective vaccine, measles remains a major health problem globally, particularly in developing countries. More than 30% of children show primary vaccine failure and therefore remain vulnerable to measles. Genetic variation in key innate pathogen recognition receptors, such as the measles cell entry receptors CD46 and SLAM, measles attachment receptor DC-SIGN, the antiviral toll-like receptors (TLR)3, TLR7 and TLR8, and the cytosolic antiviral receptor RIG-I, may significantly affect measles IgG antibody responses. Measles is still highly prevalent in developing countries such as those in Africa however there is no previous data on the effect of these innate immune genes in a resident African population. Polymorphisms (n=29) in the candidate genes were genotyped in a cohort of vaccinated children (n=238) aged 6 months-14 years from Mozambique, Africa who either had vaccine failure and contracted measles (cases; n=66) or controls (n=172). Contrasting previous associations with measles responses in Caucasians and/or strong evidence for candidacy, we found little indication that these key innate immune genes affect measles IgG responses in our cohort of Mozambican children. We did however identify that CD46 and TLR8 variants may be involved in the occurrence of measles vaccine failure. This study highlights the importance of genetic studies in resident, non-Caucasian populations, from areas where determining the factors that may affect measles control is of a high priority.
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Affiliation(s)
- Holly D Clifford
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.
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Clifford HD, Yerkovich ST, Khoo SK, Zhang G, Upham J, Le Souëf PN, Richmond P, Hayden CM. TLR3 and RIG-I gene variants: associations with functional effects on receptor expression and responses to measles virus and vaccine in vaccinated infants. Hum Immunol 2012; 73:677-85. [PMID: 22504413 DOI: 10.1016/j.humimm.2012.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 02/14/2012] [Accepted: 03/19/2012] [Indexed: 01/08/2023]
Abstract
Measles virus causes severe morbidity and mortality, despite the availability of measles vaccines. Successful defence against viral pathogens requires early recognition of virus-specific patterns by innate receptors like Toll-like receptor (TLR)3 and the RNA helicase, retinoic acid inducible gene-I (RIG-I). Genetic differences in these receptors may influence the primary immune responses to measles and the efficacy of measles vaccine. In 1-year-old Australian infants after their first measles vaccine dose, we investigated functional effects of TLR3 and RIG-I polymorphisms on intracellular protein expression using flow cytometry, cytokine responses to receptor ligands and measles lysate, and post-vaccination measles IgG levels. We found that TLR3 Leu412Phe was significantly associated with IFN-α/β response after stimulation with TLR3 ligand, poly(I:C) (P=0.024). Downregulation of TLR3 protein expression in NK cells after poly(I:C) was also associated with this variant (P=0.011). In contrast, measles-specific expression, cytokine responses and antibody responses were not associated with TLR3 polymorphisms. No associations were found with RIG-I variants. These results suggest that a TLR3 polymorphism has functional effects on receptor expression and cytokine response. However, this did not translate to an effect on specific responses to measles virus or vaccine. We found no evidence that RIG-I polymorphisms were involved in measles immune responses.
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MESH Headings
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Cells, Cultured
- DEAD Box Protein 58
- DEAD-box RNA Helicases/genetics
- DEAD-box RNA Helicases/immunology
- Female
- Gene Expression Regulation/drug effects
- Gene Expression Regulation/immunology
- Genetic Association Studies
- Humans
- Immunity, Cellular/drug effects
- Immunity, Humoral/drug effects
- Immunoglobulin G/blood
- Immunoglobulin G/immunology
- Infant
- Interferon-beta/blood
- Interferon-beta/immunology
- Interferon-gamma/blood
- Interferon-gamma/immunology
- Killer Cells, Natural/drug effects
- Killer Cells, Natural/immunology
- Male
- Measles/immunology
- Measles/metabolism
- Measles/prevention & control
- Measles virus/immunology
- Measles-Mumps-Rubella Vaccine/administration & dosage
- Measles-Mumps-Rubella Vaccine/immunology
- Poly I-C/pharmacology
- Polymorphism, Single Nucleotide/genetics
- Polymorphism, Single Nucleotide/immunology
- Receptors, Immunologic
- Toll-Like Receptor 3/genetics
- Toll-Like Receptor 3/immunology
- Vaccination
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Affiliation(s)
- Holly D Clifford
- School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia.
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Guinovart C, Dobaño C, Bassat Q, Nhabomba A, Quintó L, Manaca MN, Aguilar R, Rodríguez MH, Barbosa A, Aponte JJ, Mayor AG, Renom M, Moraleda C, Roberts DJ, Schwarzer E, Le Souëf PN, Schofield L, Chitnis CE, Doolan DL, Alonso PL. The role of age and exposure to Plasmodium falciparum in the rate of acquisition of naturally acquired immunity: a randomized controlled trial. PLoS One 2012; 7:e32362. [PMID: 22412865 PMCID: PMC3296698 DOI: 10.1371/journal.pone.0032362] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 01/26/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The rate of acquisition of naturally acquired immunity (NAI) against malaria predominantly depends on transmission intensity and age, although disentangling the effects of these is difficult. We used chemoprophylaxis to selectively control exposure to P. falciparum during different periods in infancy and explore the effect of age in the build-up of NAI, measured as risk of clinical malaria. METHODS AND FINDINGS A three-arm double-blind randomized placebo-controlled trial was conducted in 349 infants born to Mozambican HIV-negative women. The late exposure group (LEG) received monthly Sulfadoxine-Pyrimethamine (SP) plus Artesunate (AS) from 2.5-4.5 months of age and monthly placebo from 5.5-9.5 months; the early exposure group (EEG) received placebo from 2.5-4.5 months and SP+AS from 5.5-9.5 months; and the control group (CG) received placebo from 2.5-9.5 months. Active and passive case detection (PCD) were conducted from birth to 10.5 and 24 months respectively. The primary endpoint was time to first or only episode of malaria in the second year detected by PCD. The incidence of malaria during the second year was of 0.50, 0.51 and 0.35 episodes/PYAR in the LEG, EEG and CG respectively (p = 0.379 for the adjusted comparison of the 3 groups). The hazard ratio of the adjusted comparison between the LEG and the CG was 1.38 (0.83-2.28, p = 0.642) and that between the EEG and the CG was 1.35 (0.81-2.24, p = 0.743). CONCLUSIONS After considerably interfering with exposure during the first year of life, there was a trend towards a higher risk of malaria in the second year in children who had received chemoprophylaxis, but there was no significant rebound. No evidence was found that the age of first exposure to malaria affects the rate of acquisition of NAI. Thus, the timing of administration of antimalarial interventions like malaria vaccines during infancy does not appear to be a critical determinant. TRIAL REGISTRATION ClinicalTrials.gov NCT00231452.
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Affiliation(s)
- Caterina Guinovart
- Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
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Rueter K, Bizzintino J, Martin AC, Zhang G, Hayden CM, Geelhoed GC, Goldblatt J, Laing IA, Le Souëf PN. Symptomatic viral infection is associated with impaired response to treatment in children with acute asthma. J Pediatr 2012; 160:82-7. [PMID: 21855894 DOI: 10.1016/j.jpeds.2011.06.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Revised: 04/21/2011] [Accepted: 06/22/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To examine the influence of viral respiratory infection (VRI) on treatment response in acute asthma in children. STUDY DESIGN A total of 218 children (mean age, 6.6 years) with acute asthma were recruited. Symptoms were recorded, an asthma severity score was determined, and whenever possible, a per-nasal aspirate was obtained for detection of viruses. Each child's response to inhaled β(2)-agonists was assessed after 6, 12, and 24 hours. RESULTS The 168 children with VRI symptoms received more treatment with inhaled β(2)-agonists after 6 hours (P = .010), 12 hours (P = .002), and 24 hours (P = .0005) compared with the 50 children without such symptoms. Asthma severity did not differ between the 2 groups. A per-nasal aspirate was obtained from 77% of the children. The most frequently identified virus was rhinovirus (61.4%). Among children with symptoms of a VRI, those with rhinovirus had an impaired response to β(2)-agonists at 6 hours (P = .032). CONCLUSION Children with acute asthma and symptoms of VRI respond less effectively to β(2)-agonists after 6, 12, or 24 hours and thus may benefit from more intense therapy and monitoring.
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Schultz A, Le Souëf TJ, Looi K, Zhang G, Le Souëf PN, Devadason SG. Validation of methodology for recording breathing and simulating drug delivery through spacers and valved holding chambers. J Aerosol Med Pulm Drug Deliv 2011; 23:311-22. [PMID: 20455768 DOI: 10.1089/jamp.2008.0733] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Output from spacers (or valved holding chambers) is sensitive to changes in breathing pattern. Different spacers have unique characteristics that may influence breathing. A method used for breathing simulation, where the simulated breathing can be recorded on subjects while they are using spacers, may allow for more accurate in vitro estimation of drug delivery in specific populations, using specific spacers. METHODS A flow chamber was used to record breathing while salbutamol was administered to two adult subjects through different spacers. Each subject performed a series of breathing patterns over a range of different inhalation volumes and flows. Salbutamol "inhaled" by subjects was captured on inspiratory filters and quantified by ultraviolet spectrophotometry. Recorded breathing patterns were simulated and ex vivo drug delivery was compared to in vitro drug delivery. Three equipment configurations were used to validate different aspects of the methodology. Configuration 1: breathing recorded by pneumotachometer placed directly between a human subject and the spacer. Breathing simulation performed with an identical setup. Configuration 2: spacer enclosed within a flow-chamber while breathing was recorded. Breathing simulation performed with an identical setup. Configuration 3: spacer enclosed in flow chamber to record breathing, but not when simulating breathing. In each configuration, the ex vivo and in vitro (simulated) filter doses were compared. RESULTS Configuration 1: the median difference between ex vivo and in vitro filter doses was 0.4% (range: -12.2 to 6.9%). Configuration 2: the median difference was -2.3% (range: -9.0 to 5.0%). Configuration 3: the median difference was 1.7% (range: -11.5 to 3.9%). CONCLUSION Our results indicate that in vitro simulated drug delivery using this method of recording using a flow chamber, closely approximates ex vivo total drug delivery. This technique allows for recording of breathing on patients while they are using spacers, with minimum increase in dead space or resistance, and no physical alteration in the patient-device interface.
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Affiliation(s)
- André Schultz
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia.
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Zhang G, Hayden CM, Goldblatt J, Holt P, Le Souëf PN. Th2 Cytokine Levels Distort the Association of IL-10 and IFN-γ with Allergic Phenotypes. ISRN Allergy 2011; 2011:405813. [PMID: 23724228 PMCID: PMC3658504 DOI: 10.5402/2011/405813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 11/28/2011] [Indexed: 12/03/2022]
Abstract
The expression of allergic phenotypes involves complex inter-relationships among several Th2 and Th1 cytokines as well as the regulator cytokine interleukin (IL)-10. These direct or indirect interrelationships may distort the true associations of cytokine responses with these phenotypes. In this study, we aimed to clarify the effects of the regulatory cytokine IL-10 and Th1 cytokine interferon-gamma (IFN-γ) on allergic phenotypes after adjusting for the correlations with Th2 cytokines. After adjusting for Th2 cytokines, IL-10 and IFN-γ were protective against atopy. Adjusted levels of IL-10 and IFN-γ stimulated with house-dust mite (HDM) were significantly lower in atopics than non-atopics, for IL-10 adjusting for IL-5 (P = 0.002), IL-13 (P = 0.012), IL-9 (P = 0.016), and IL-4 (P = 0.043), and for IFN-γ adjusting for IL-5 (P = 0.005), IL-13 (P = 0.005), and IL-9 (P = 0.037). IL-10 and IFN-γ levels stimulated with phytohaemagglutinin (PHA) and staphylococcal enterotoxin B (SEB) exhibited a similar pattern. The adjusted levels of IL-10 and IFN-γ stimulated with HDM, PHA or SEB were all significantly negatively correlated with total serum IgE, except for IFN-γ stimulated with SEB. Levels of Th2 cytokines distort the associations of IL-10 and IFN-γ with allergic phenotypes. Removing the covariance with Th2 cytokines, both IL-10 and IFN-γ were protective against atopy.
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Affiliation(s)
- Guicheng Zhang
- School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, GPO Box D184, Perth, WA 6840, Australia ; Telethon Institute for Child Health Research and UWA Centre for Child Health Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, GPO Box D184, Perth, WA 6840, Australia
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Schultz EN, Devadason SG, Khoo SK, Zhang G, Bizzintino JA, Martin AC, Goldblatt J, Laing IA, Le Souëf PN, Hayden CM. The role of GSTP1 polymorphisms and tobacco smoke exposure in children with acute asthma. J Asthma 2010; 47:1049-56. [PMID: 20858151 DOI: 10.1080/02770903.2010.508856] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The glutathione S-transferase enzymes (GSTs) play an important role in the detoxification of environmental tobacco smoke (ETS), which contributes to airway inflammation, a key component of asthma. Genetic variation in GST genes may influence individuals' ability to detoxify environmental pollutants. OBJECTIVE To examine the role of polymorphisms in GSTP1 (Ile105Val and Ala114Val), alone and in combination with ETS exposure, on atopy and asthma severity. METHODS GSTP1 Ile105Val and Ala114Val were genotyped and ETS exposure was assessed by parental questionnaire, which was validated by urinary cotinine measurements. Associations between ETS exposure, GSTP1 polymorphisms, and their interaction on atopy and asthma severity were investigated. RESULTS For the functional GSTP1 105 SNP, those with the Ile/Ile genotype had odds for atopy of 2.77 (p = .054) when assessed by genotype alone, which increased to 9.02 (p = .050) when ETS was included, relative to individuals with other genotypes. Likewise, compared to children with other GSTP1 114 genotypes, those with Ala/Ala genotype had a 5.47-fold (p = .002) increased risk of atopy (p = .020) when assessed by genotype alone, increasing to 9.17-fold when ETS was included. The 105 Ile/Ile individuals all had the AA (105 Ile/Ile and 114 Ala/Ala) haplotype group; therefore, the odds for atopy were the same. Individuals without any *C haplotype (105 Val and 114 Val allele) who were exposed to ETS had a 9.17-fold increased risk of atopy when compared with individuals with at least one *C haplotype and not exposed to ETS (p = .020). CONCLUSION There were significant interactions between GSTP1 SNPs, atopy, and ETS exposure in this cohort.
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Affiliation(s)
- En Nee Schultz
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.
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Schultz A, Le Souëf TJ, Venter A, Zhang G, Devadason SG, Le Souëf PN. Aerosol inhalation from spacers and valved holding chambers requires few tidal breaths for children. Pediatrics 2010; 126:e1493-8. [PMID: 21078734 DOI: 10.1542/peds.2010-1377] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The goal was to determine the number of breaths required to inhale salbutamol from different spacers/valved holding chambers (VHCs). METHODS Breathing patterns were recorded for 2- to 7-year-old children inhaling placebo from 4 different spacers/VHCs and were simulated by a flow generator. Drug delivery with different numbers of tidal breaths and with a single maximal breath was compared. RESULTS With tidal breathing, mean inhalation volumes were large, ranging from 384 mL to 445 mL. Mean values for drug delivery with an Aerochamber Plus (Trudell, London, Canada) were 40% (95% confidence interval [CI]: 34%-46%) and 41% (95% CI: 36%-47%) of the total dose with 2 and 9 tidal breaths, respectively. Mean drug delivery values with these breath numbers with a Funhaler (Visiomed, Perth, Australia) were 39% (95% CI: 34%-43%) and 38% (95% CI: 35%-42%), respectively. With a Volumatic (GlaxoSmithKline, Melbourne, Australia), mean drug delivery values with 2 and 9 tidal breaths were 37% (95% CI: 33%-41%) and 43% (95% CI: 40%-46%), respectively (P = .02); there was no significant difference in drug delivery with 3 versus 9 tidal breaths. With the modified soft drink bottle, drug delivery. Drug delivery was not improved with a single maximal breath with any device. CONCLUSION For young children, tidal breaths through a spacer/VHC were much larger than expected. Two tidal breaths were adequate for small-volume VHCs and a 500-mL modified soft drink bottle, and 3 tidal breaths were adequate for the larger Volumatic VHC.
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Affiliation(s)
- André Schultz
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.
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Abstract
Despite major advances in the understanding of the pathogenesis of asthma and improvements in management, the accompanying benefits from public health initiatives and clinical practice have arguably been less than expected. For example, there are no effective public health strategies or treatment regimes that reduce the risk of developing asthma or influence its natural history. These represent priority areas for future translational research, which would need to investigate genetic and environmental interactions and vaccine strategies. In terms of asthma management it is tempting to focus on novel drug therapies; however, a case can be made that the priority is to undertake research that leads to improvements in the use of existing treatments through public health and primary care initiatives. Guidelines represent an important component of this approach, with recommendations for asthma imbedded within respiratory guidelines that can be implemented in the developing world where other acute and chronic respiratory disorders are common. This approach offers the best opportunity to close the gap between what is currently achieved in asthma management and that which is potentially achievable.
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Affiliation(s)
- Robert J Hancox
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Murdzoska J, Devadason SG, Khoo SK, Landau LI, Young S, Goldblatt J, Zhang G, Le Souëf PN, Hayden CM. In UteroSmoke Exposure and Role of Maternal and Infant Glutathione S-Transferase Genes on Airway Responsiveness and Lung Function in Infancy. Am J Respir Crit Care Med 2010; 181:64-71. [DOI: 10.1164/rccm.200812-1887oc] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Bizzintino JA, Khoo SK, Zhang G, Martin AC, Rueter K, Geelhoed GC, Goldblatt J, Laing IA, Le Souëf PN, Hayden CM. Leukotriene pathway polymorphisms are associated with altered cysteinyl leukotriene production in children with acute asthma. Prostaglandins Leukot Essent Fatty Acids 2009; 81:9-15. [PMID: 19524426 DOI: 10.1016/j.plefa.2009.05.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Revised: 05/12/2009] [Accepted: 05/21/2009] [Indexed: 10/20/2022]
Abstract
Cysteinyl leukotrienes (cysLTs) are pro-inflammatory mediators with increasing evidence for a role in childhood acute asthma. This study examined the influence of polymorphisms in cysLT pathway genes on urinary leukotriene E(4) (uLTE(4)) levels and clinical status in acute asthmatic children. Children aged 2-16 years were recruited during an asthma attack (n=205). Where possible, asthma severity scores were assigned, ALOX5AP G-336A, ALOX5 G-1708A, LTC4S A-444C and G-1072A, GPX4 C718T, and CYSTLTR1 T927C genotypes were determined and uLTE(4) was measured in acute and convalescent samples. uLTE(4) levels were higher acutely compared with convalescence (acute GM: 115.7pg/mg creatinine; 95% CI 88.6-151.1, convalescence GM: 66.4pg/mg creatinine; 95% CI 51.5-85.6; n=50 paired samples, p=0.003) and paired sample analysis showed genotype-specific effects with significantly increased uLTE(4) for LTC(4)S-444AA (acute GM: 127.9pg/mg creatinine; 95% CI 91.8-178.3, convalescence GM: 68.2pg/mg creatinine; 95% CI 50.5-92.0; n=32, p=0.002), LTC(4)S-1072 GG (acute GM: 126.7pg/mg creatinine; 95% CI 95.4-168.3, convalescence GM: 78.9pg/mg creatinine; 95% CI 59.7-104.1; n=39, p=0.019) and CYSLTR1 927 TT/T_ (acute GM: 96.8pg/mg creatinine; 95% CI 73.8-126.9, convalescence GM: 62.4pg/mg creatinine; 95% CI 46.8-83.3; n=28, p=0.036) but not AC/CC, GA/AA, or TC/CC/C_, respectively. When we compared the allele frequencies of the CYSLTR1 SNP between asthmatics and non-asthmatics, the 927C allele was found to be a risk allele for asthma (OR=2.13, 95% CI: 1.06-4.26, p=0.033). Genotypes were not associated with acute or convalescent uLTE(4) levels alone and neither the SNPs nor uLTE(4) correlated with acute asthma severity. Leukotriene pathway gene polymorphisms may influence the magnitude of cysLT production during an attack, yet their influence alone may not be substantial enough to alter the severity of exacerbations.
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Affiliation(s)
- Joelene A Bizzintino
- School of Paediatrics and Child Health, University of Western Australia, GPO Box D184, Perth, WA 6840, Australia
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Turner SW, Young S, Goldblatt J, Landau LI, Le Souëf PN. Childhood asthma and increased airway responsiveness: a relationship that begins in infancy. Am J Respir Crit Care Med 2008; 179:98-104. [PMID: 18990677 DOI: 10.1164/rccm.200805-804oc] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Asthma is associated with increased airway responsiveness (AR), but the age when this relationship becomes established is not clear. The present study tested the hypothesis that the association between increased AR and asthma is established after 1 month of age. OBJECTIVES To relate AR in infancy to asthma in childhood. METHODS As part of a birth cohort study, AR was determined at 1 (early infancy), 6 (mid-infancy), and 12 months of age (late infancy). At 11 years of age (childhood), AR and the presence of asthma symptoms were determined. MEASUREMENTS AND MAIN RESULTS Of the 253 study subjects enrolled, AR was determined in 202 in early infancy, 174 in mid-infancy, 147 in late infancy, and 176 in childhood. Increased AR in late infancy, but not in early or mid-infancy, was associated with increased wheeze at 11 years of age (P = 0.016). Increased AR in infancy persisted into childhood in association with male gender, early respiratory illness, and maternal smoking and asthma. Among the 116 subjects assessed in late infancy and childhood, recent wheeze was present in 35% of children with increased AR at both ages, 13% with increased AR in childhood only, 12% for those with increased AR in late infancy only, and 0% for those who did not have increased AR at either age (P = 0.023); the proportions of children with diagnosed asthma in the corresponding groups were 27, 20, 12, and 0% (P = 0.038). CONCLUSIONS The association between increased infantile AR and childhood asthma emerges at the end of the first year of life.
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Affiliation(s)
- Stephen W Turner
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.
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Martin AC, Zhang G, Rueter K, Khoo SK, Bizzintino J, Hayden CM, Geelhoed GC, Goldblatt J, Laing IA, Le Souëf PN. Beta2-adrenoceptor polymorphisms predict response to beta2-agonists in children with acute asthma. J Asthma 2008; 45:383-8. [PMID: 18569231 DOI: 10.1080/02770900801971792] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this study was to determine the influence of single nucleotide polymorphisms in the beta(2)-adrenoceptor gene, on the response to inhaled beta(2)-agonists in children with acute asthma. We hypothesised that children with polymorphisms that generate enhanced receptor downregulation in vitro, Gly16 and Gln27, would have a slower response to beta(2)-agonist therapy during acute asthma. One hundred and forty-eight children with acute asthma were recruited and genotyped for beta(2)Arg16Gly and beta(2)Gln27Glu. For Gln27Glu, individuals Gln27Gln took longest to stretch out to 1, 2 and 4 hourly beta(2)-agonists, followed by heterozygotes who were intermediate and Glu27Glu who responded most rapidly (1 hourly: 2.6 hr vs. 2.0 vs. 1.4, p = 0.02; 2 hourly: 10.6 hr vs. 10.7 vs. 6.8, p = 0.07; 4 hourly: 29.8 hr vs. 28.5 vs. 24.3, p = 0.30). The ability to prospectively identify children who respond less effectively to beta (2)-agonists during an acute asthma attack has the potential to allow the generation of genotype-specific treatment pathways.
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Affiliation(s)
- Andrew C Martin
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia
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Le Souëf PN. Variations in genetic influences on the development of asthma throughout childhood, adolescence and early adult life. Curr Opin Allergy Clin Immunol 2007; 6:317-22. [PMID: 16954783 DOI: 10.1097/01.all.0000244790.18486.be] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Asthma is likely to be due to many aetiological factors, the effect of each varying considerably with age. Now that there are well established candidate genes for asthma, using genetics to examine age-related susceptibility to asthma offers a new approach to understanding the basic underlying mechanisms. RECENT FINDINGS Since few long-term, longitudinal asthma studies exist, opportunities to examine age-related genetic susceptibility have been limited, but have produced some specific findings. The CCR5Delta32 polymorphism renders the chemokine receptor nonfunctional and is associated with reduced asthma susceptibility in children but not adults. In CD14 C-159T, the -159C allele has been associated with increased atopy in mid-childhood, but not in young adults. IL-12beta is a promoter polymorphism associated with reduced lung function in girls but not boys in mid-childhood only. Regarding the beta(2)adrenoceptor, results from three studies suggest that Arg16 can be associated with impaired airway function in infancy and Gly16 with asthma and wheeze in mid-childhood. SUMMARY Age-related genetic susceptibility studies are likely to make a major contribution to understanding basic mechanisms in asthma, but the limited number of suitable cohorts has meant that to date few studies have been reported.
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Affiliation(s)
- Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.
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