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Lee SSY, Nilagiri VK, Lingham G, Blaszkowska M, Sanfilippo PG, Franchina M, Clark A, Mackey DA. Myopia progression following 0.01% atropine cessation in Australian children: Findings from the Western Australia - Atropine for the Treatment of Myopia (WA-ATOM) study. Clin Exp Ophthalmol 2024. [PMID: 38400607 DOI: 10.1111/ceo.14368] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/11/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND A rebound in myopia progression following cessation of atropine eyedrops has been reported, yet there is limited data on the effects of stopping 0.01% atropine compared to placebo control. This study tested the hypothesis that there is minimal rebound myopia progression after cessation of 0.01% atropine eyedrops, compared to a placebo. METHODS Children with myopia (n = 153) were randomised to receive 0.01% atropine eyedrops or a placebo (2:1 ratio) daily at bedtime during the 2-year treatment phase of the study. In the third year (wash-out phase), all participants ceased eyedrop instillation. Participants underwent an eye examination every 6 months, including measurements of spherical equivalent (SphE) after cycloplegia and axial length (AL). Changes in the SphE and AL during the wash-out phase and throughout the 3 years of the study (treatment + wash-out phase) were compared between the treatment and control groups. RESULTS During the 1-year wash-out phase, SphE and AL progressed by -0.41D (95% CI = -0.33 to -0.22) and +0.20 mm (95% CI = -0.46 to -0.36) in the treatment group compared to -0.28D (95% CI = 0.11 to 0.16) and +0.13 mm (95% CI = 0.18 to 0.21) in the control group. Progression in the treatment group was significantly faster than in the control group (p = 0.016 for SphE and <0.001 for AL). Over the 3-year study period, the cumulative myopia progression was similar between the atropine and the control groups. CONCLUSIONS These findings showed evidence of rapid myopia progression following cessation of 0.01% atropine. Further investigations are warranted to ascertain the long-term effects of atropine eyedrops.
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Affiliation(s)
- Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Vinay Kumar Nilagiri
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Gareth Lingham
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Centre for Eye Research Ireland, Environmental, Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Magdalena Blaszkowska
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Paul G Sanfilippo
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Maria Franchina
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Perth Children's Hospital, Perth, Western Australia, Australia
| | - Antony Clark
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Perth Children's Hospital, Perth, Western Australia, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
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Gamez C, Leffler J, Clark S, Corscadden K, Prescott SL, Palmer DJ, Strickland D. Egg-sensitised infants have elevated CD4 + effector memory T regulatory cells from birth. Clin Exp Allergy 2024; 54:34-45. [PMID: 38168058 DOI: 10.1111/cea.14431] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND IgE-mediated sensitisation to egg is common in infants. In some cases, the processes leading to egg sensitisation are established in early life, even before introduction to solid foods. The underlying mechanisms remain poorly understood. METHODS We performed detailed immune cell phenotyping of peripheral blood mononuclear cells and determined in vitro cytokine responses following allergen specific and non-specific immune stimulation. To determine if unique immune profiles were linked to early-life egg sensitisation, we compared 92 infants at 4-6 months of age, with (EggCAP+, n = 41) and without (EggCAP-, n = 51) early egg sensitisation. Additionally, 47 cord blood samples were analysed. For a subset of participants (n = 39), matching cord blood mononuclear cells were assessed by flow cytometry to establish the impact of IgE sensitisation on immune developmental trajectories. RESULTS EggCAP+ infants were found to exhibit a unique immune phenotype characterised by increased levels of circulating CD4+ T regulatory cells (Treg), CD4+ effector memory (EM) Treg and increased expression of the IgE receptor, FcεR1, on basophils. The increased CD4+ EM Treg profiles were already present in cord blood samples from EggCAP+ infants. A general Th2-skewing of the immune system was observed based on increased IL-13 production following phytohemagglutinin stimulation and by comparing immune developmental trajectories, EggCAP+ infants displayed an expansion of basophils and reduced levels of CD4- T cells compared to EggCAP- infants. CONCLUSIONS Immunological profiles associated with egg sensitisation are detectable in infant circulation at 4-6 months of age and at birth. Understanding the immune mechanisms underlying early-life sensitisation could provide important insights for future food allergy prevention strategies.
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Affiliation(s)
- Cristina Gamez
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Jonatan Leffler
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Sharon Clark
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Karli Corscadden
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Susan L Prescott
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
- Perth Children's Hospital, Nedlands, Western Australia, Australia
- The Nova Institute for Health, Baltimore, Maryland, USA
- Family and Community Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Debra J Palmer
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Deborah Strickland
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
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Richmond HJ, Swift VM, Doyle JE, Morrison NR, Weeks SA, Veselinović T, Jacoby P, Brennan‐Jones CG, Richmond PC, Lehmann D. Early onset of otitis media is a strong predictor of subsequent disease in urban Aboriginal infants: Djaalinj Waakinj cohort study. J Paediatr Child Health 2023; 59:729-734. [PMID: 36807593 PMCID: PMC10946761 DOI: 10.1111/jpc.16378] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 12/29/2022] [Accepted: 02/01/2023] [Indexed: 02/22/2023]
Abstract
AIM Australian Aboriginal and/or Torres Strait Islander children in rural/remote areas suffer high rates of persistent otitis media (OM) from early infancy. We aimed to determine the proportion of Aboriginal infants living in an urban area who have OM and investigate associated risk factors. METHODS Between 2017 and 2020, the Djaalinj Waakinj cohort study enrolled 125 Aboriginal infants at 0-12 weeks of age in the Perth South Metropolitan region, Western Australia. Proportion of children with OM based on tympanometry at ages 2, 6 and 12 months was evaluated, type B tympanogram indicating middle ear effusion. Potential risk factors were investigated by logistic regression with generalised estimating equations. RESULTS The proportion of children with OM was 35% (29/83) at 2 months, 49% (34/70) at 6 months and 49% (33/68) at 12 months of age. About 70% (16/23) of those with OM at ages 2 and/or 6 months had OM at 12 months compared with 20% (3/15) if no prior OM (relative risk = 3.48, 95% confidence interval (CI): 1.22-40.1). On multivariate analysis, infants living in houses with ≥1 person/room were at increased risk of OM (odds ratio = 1.78, 95% CI: 0.96-3.32). CONCLUSION Approximately half of Aboriginal infants enrolled into the South Metropolitan Perth project have OM by the age of 6 months and early onset of disease strongly predicts subsequent OM. Early surveillance for OM in urban areas is needed for early detection and management to reduce the risk of long-term hearing loss which can have serious developmental, social, behavioural, educational and economic consequences.
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Affiliation(s)
- Holly J Richmond
- Wesfarmers Centre of Vaccines and Infectious DiseasesTelethon Kids InstitutePerthWestern AustraliaAustralia
| | - Valerie M Swift
- Wesfarmers Centre of Vaccines and Infectious DiseasesTelethon Kids InstitutePerthWestern AustraliaAustralia
| | - June E Doyle
- Wesfarmers Centre of Vaccines and Infectious DiseasesTelethon Kids InstitutePerthWestern AustraliaAustralia
| | - Natasha R Morrison
- Wesfarmers Centre of Vaccines and Infectious DiseasesTelethon Kids InstitutePerthWestern AustraliaAustralia
| | - Sharon A Weeks
- Wesfarmers Centre of Vaccines and Infectious DiseasesTelethon Kids InstitutePerthWestern AustraliaAustralia
| | - Tamara Veselinović
- Wesfarmers Centre of Vaccines and Infectious DiseasesTelethon Kids InstitutePerthWestern AustraliaAustralia
- The Auditory Laboratory, School of Human SciencesUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Peter Jacoby
- Wesfarmers Centre of Vaccines and Infectious DiseasesTelethon Kids InstitutePerthWestern AustraliaAustralia
| | - Christopher G Brennan‐Jones
- Wesfarmers Centre of Vaccines and Infectious DiseasesTelethon Kids InstitutePerthWestern AustraliaAustralia
- School of Allied Health, Faculty of Health SciencesCurtin UniversityPerthWestern AustraliaAustralia
| | - Peter C Richmond
- Wesfarmers Centre of Vaccines and Infectious DiseasesTelethon Kids InstitutePerthWestern AustraliaAustralia
- Discipline of Paediatrics, School of MedicineUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Deborah Lehmann
- Telethon Kids Institute, University of Western AustraliaPerthWestern AustraliaAustralia
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Coleman LA, Khoo SK, Franks K, Prastanti F, Le Souëf P, Karpievitch YV, Laing IA, Bosco A. Personal Network Inference Unveils Heterogeneous Immune Response Patterns to Viral Infection in Children with Acute Wheezing. J Pers Med 2021; 11:1293. [PMID: 34945765 PMCID: PMC8706513 DOI: 10.3390/jpm11121293] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 12/01/2022] Open
Abstract
Human rhinovirus (RV)-induced exacerbations of asthma and wheeze are a major cause of emergency room presentations and hospital admissions among children. Previous studies have shown that immune response patterns during these exacerbations are heterogeneous and are characterized by the presence or absence of robust interferon responses. Molecular phenotypes of asthma are usually identified by cluster analysis of gene expression levels. This approach however is limited, since genes do not exist in isolation, but rather work together in networks. Here, we employed personal network inference to characterize exacerbation response patterns and unveil molecular phenotypes based on variations in network structure. We found that personal gene network patterns were dominated by two major network structures, consisting of interferon-response versus FCER1G-associated networks. Cluster analysis of these structures divided children into subgroups, differing in the prevalence of atopy but not RV species. These network structures were also observed in an independent cohort of children with virus-induced asthma exacerbations sampled over a time course, where we showed that the FCER1G-associated networks were mainly observed at late time points (days four-six) during the acute illness. The ratio of interferon- and FCER1G-associated gene network responses was able to predict recurrence, with low interferon being associated with increased risk of readmission. These findings demonstrate the applicability of personal network inference for biomarker discovery and therapeutic target identification in the context of acute asthma which focuses on variations in network structure.
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Affiliation(s)
- Laura A. Coleman
- Medical School (Paediatrics), University of Western Australia, Perth, WA 6009, Australia; (L.A.C.); (P.L.S.); (I.A.L.)
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (S.-K.K.); (K.F.); (F.P.); (Y.V.K.)
| | - Siew-Kim Khoo
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (S.-K.K.); (K.F.); (F.P.); (Y.V.K.)
- School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
| | - Kimberley Franks
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (S.-K.K.); (K.F.); (F.P.); (Y.V.K.)
- School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
| | - Franciska Prastanti
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (S.-K.K.); (K.F.); (F.P.); (Y.V.K.)
- School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
| | - Peter Le Souëf
- Medical School (Paediatrics), University of Western Australia, Perth, WA 6009, Australia; (L.A.C.); (P.L.S.); (I.A.L.)
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (S.-K.K.); (K.F.); (F.P.); (Y.V.K.)
| | - Yuliya V. Karpievitch
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (S.-K.K.); (K.F.); (F.P.); (Y.V.K.)
- School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
| | - Ingrid A. Laing
- Medical School (Paediatrics), University of Western Australia, Perth, WA 6009, Australia; (L.A.C.); (P.L.S.); (I.A.L.)
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (S.-K.K.); (K.F.); (F.P.); (Y.V.K.)
- School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
| | - Anthony Bosco
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia; (S.-K.K.); (K.F.); (F.P.); (Y.V.K.)
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