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Kumar M, Aaron R, Varkki SD, Danda S, Ranganathan S, Paul GR. A rare variant c.1802T>C (p. Ile601Thr) associated with severe phenotype among people with cystic fibrosis from south India, and potential genetic admixture in Réunion, France. Pediatr Pulmonol 2024. [PMID: 38501349 DOI: 10.1002/ppul.26965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 03/20/2024]
Affiliation(s)
- Madhan Kumar
- Department of Pediatrics, Christian Medical College, Vellore, India
| | - Rekha Aaron
- Department of Medical Genetics, Christian Medical College, Vellore, India
| | - Sneha D Varkki
- Department of Pediatrics, Christian Medical College, Vellore, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, India
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, University of Melbourne, Australia
| | - Grace R Paul
- Division of Pulmonary and Sleep Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
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2
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Doyle LW, Ranganathan S, Mainzer RM, Cheong JL. Relationships of Severity of Bronchopulmonary Dysplasia with Adverse Neurodevelopmental Outcomes and Poor respiratory Function at 7-8 Years of Age. J Pediatr 2024:114005. [PMID: 38453001 DOI: 10.1016/j.jpeds.2024.114005] [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: 11/14/2023] [Revised: 02/14/2024] [Accepted: 02/29/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE To clarify the relationships of three definitions of severity of bronchopulmonary dysplasia (BPD) with adverse neurodevelopmental and respiratory outcomes at early school-age. STUDY DESIGN Participants comprised 218 consecutive survivors to 7-8 years of age born either <28 weeks' gestation or weighing <1000 g in Victoria, Australia, in 2005. BPD was classified as none, Grade 1 (mild), Grade 2 (moderate), or Grade 3 (severe), using two commonly accepted definitions: 1) Jobe2001, and 2) Higgins2018, and our own 3) VICS2005, adapted from Jensen2019. Outcomes included major neurodevelopmental disability, low intelligence quotient and academic achievement, poor motor function, and poor respiratory function as assessed by spirometry. Outcomes for children with each grade of BPD were compared with children with no BPD. RESULTS Of the 218 survivors, 132 (61%) had BPD on Jobe2001 criteria, and 113 (52%) had BPD on both Higgins2018 and VICS2005 criteria. Grade 1 on any criteria was not associated with any adverse neurodevelopmental outcomes. Grade 1 on both Higgins2018 and VICS2005 was associated with reduced spirometry. Grade 2 on both Higgins2018 and VICS2005, and Grade 3 on all criteria were associated with increased risk for both adverse neurodevelopmental and respiratory outcomes. CONCLUSIONS Compared with no BPD, receiving additional oxygen up to 29% but no positive pressure support at 36 weeks' postmenstrual age increased the risk of abnormal respiratory function but not adverse neurodevelopment. Receiving ≥30% oxygen or any positive pressure support at 36 weeks increased the risk of both adverse outcomes.
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Affiliation(s)
- Lex W Doyle
- Department of Obstetrics, Gynaecology and Newborn Health, The Royal Women's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Newborn Services, The Royal Women's Hospital, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
| | - Sarath Ranganathan
- Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Rheanna M Mainzer
- Department of Paediatrics, University of Melbourne, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Clinical Epidemiology and Biostatistics, Murdoch Children's Research Institute, Melbourne, Australia
| | - Jeanie Ly Cheong
- Department of Obstetrics, Gynaecology and Newborn Health, The Royal Women's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Newborn Services, The Royal Women's Hospital, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
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3
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Pham H, Vandeleur M, Ranganathan S. Neuropsychiatric symptoms with elexacaftor/tezacaftor/ivacaftor: What does this mean for children? Pediatr Pulmonol 2024; 59:537-539. [PMID: 37991124 DOI: 10.1002/ppul.26762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/22/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023]
Affiliation(s)
- Hiep Pham
- Respiratory and Sleep Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia
- Respiratory Diseases, Murdoch Research Children's Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Moya Vandeleur
- Respiratory and Sleep Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Sarath Ranganathan
- Respiratory and Sleep Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia
- Respiratory Diseases, Murdoch Research Children's Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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Di Giacomo AM, Schenker M, Medioni J, Mandziuk S, Majem M, Gravis G, Cornfeld M, Ranganathan S, Lou S, Csoszi T. A phase II study of retifanlimab, a humanized anti-PD-1 monoclonal antibody, in patients with solid tumors (POD1UM-203). ESMO Open 2024; 9:102387. [PMID: 38401247 PMCID: PMC10982862 DOI: 10.1016/j.esmoop.2024.102387] [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: 06/09/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND POD1UM-203, an open-label, multicenter, phase II study, evaluated retifanlimab, a humanized monoclonal antibody targeting programmed cell death protein-1 (PD-1) in patients with selected solid tumors where immune checkpoint inhibitor therapies have previously shown efficacy. PATIENTS AND METHODS Eligible patients (≥18 years) had measurable disease and included unresectable or metastatic melanoma, treatment-naive metastatic non-small-cell lung cancer (NSCLC) with high programmed death-ligand 1 (PD-L1) expression (tumor proportion score ≥50%), cisplatin-ineligible locally advanced/metastatic urothelial carcinoma (UC) with PD-L1 expression (combined positive score ≥10%), or treatment-naive locally advanced/metastatic clear-cell renal cell carcinoma (RCC). Retifanlimab 500 mg was administered intravenously every 4 weeks as a 30-min infusion. The primary endpoint was investigator-assessed overall response rate. RESULTS Overall, 121 patients (35 melanoma, 23 NSCLC, 29 UC, 34 RCC) were enrolled and treated. The overall response rate [95% confidence interval (CI)] was 40.0% (23.9-57.9) in the melanoma cohort, 34.8% (16.4-57.3) in the NSCLC cohort, 37.9% (20.7-57.7) in the UC cohort, and 23.5% (10.7-41.2) in the RCC cohort. Median duration of response was 11.5 months (95% CI 2.2-not reached) in the UC cohort, and was not reached in the other cohorts. Retifanlimab safety was consistent with previous experience for PD-(L)1 inhibitors. CONCLUSIONS Retifanlimab demonstrated durable antitumor activity in patients with melanoma, NSCLC, UC, or RCC. The efficacy and safety of retifanlimab were as expected for a PD-(L)1 inhibitor. These data support further study of retifanlimab in solid tumors.
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Affiliation(s)
- A M Di Giacomo
- University of Siena, Siena, Italy; Center for Immuno-Oncology, University Hospital of Siena, Siena, Italy
| | - M Schenker
- Centrul de Oncologie Sf. Nectarie, Oncologie Medicala, Craiova, Romania
| | - J Medioni
- Centre of Early Clinical Trials in Cancer, Hôpital Européen Georges-Pompidou, Université Paris Cité, Paris, France
| | - S Mandziuk
- Department of Clinical Oncology and Chemotherapy, Medical University of Lublin, Lublin, Poland
| | - M Majem
- Medical Oncology Department, Hospital de Sant Pau, Barcelona, Spain
| | - G Gravis
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Université, CRCM, Marseille, France
| | | | | | - S Lou
- Incyte Corporation, Wilmington, USA
| | - T Csoszi
- Hetényi Géza Kórház Onkológiai Központ, Szolnok, Hungary.
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Volkman T, Muruganandah V, Graham H, Tosif S, Stokes S, Ranganathan S. QuantiFERON Gold-In-Tube for the diagnosis of mycobacterial tuberculosis infection in children under 5 years of age: A systematic review and meta-analysis. PLoS One 2024; 19:e0295913. [PMID: 38166111 PMCID: PMC10760833 DOI: 10.1371/journal.pone.0295913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/07/2023] [Accepted: 12/01/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Previous meta-analysis regarding the performance of QuantiFERON Gold-In-Tube in children have yielded contrasting results. Emerging data in children younger than 5 years of age necessitates a new analysis. METHODS Systematic searches were conducted of MedLINE, EMBASE and Cochrane databases between 1998-2023. Pooled estimates of sensitivities and specificities of QFT-GIT compared to tuberculin skin test (TST) were calculated. The Kappa (k) coefficient was calculated for each study to determine the degree of congruence between TST and QFT-GIT results. Studies including patients co-infected with HIV or other immune compromising conditions or those treated with anti-tubercular treatment were excluded. RESULTS Seventeen studies (4335 patients) were included in quantitative analysis. All studies were conducted in middle to high income countries. They were conducted across 14 countries and 4 studies in countries with high TB incidence. The pooled sensitivity, specificity and DOR were 0.45 (0.42-0.48), 0.96 (0.96-0.97) and 18.84 (7.33-48.41) respectively. The ability of QFT-GIT to discriminate with disease and no disease was "good" as demonstrated by a summary receiver operating characteristic curve with area under curve of 0.7812. The average Kappa (k) co-efficient was 0.501 with a wide variety of values between studies (0.167 to 0.800). CONCLUSION The findings of this meta-analysis support the judicious use of QFT-GIT in children 5 years and under, with caution as a sole test to exclude Tuberculosis in this age group. The heterogeneity and methodological quality of diagnostic studies limits the generalisability of results.
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Affiliation(s)
- Thomas Volkman
- Department of General Paediatrics (Refugee Health), Perth Children’s Hospital, Perth, Western Australia, Australia
| | - Visai Muruganandah
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Children’s Emergency Department, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Hamish Graham
- Department of General Medicine, Royal Children’s Hospital Melbourne, Melbourne, Victoria, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Shidan Tosif
- Department of General Medicine, Royal Children’s Hospital Melbourne, Melbourne, Victoria, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Simon Stokes
- Department of General Paediatrics, Peninsula Health, Melbourne, Victoria, Australia
| | - Sarath Ranganathan
- Department of General Medicine, Royal Children’s Hospital Melbourne, Melbourne, Victoria, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
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Hammarberg K, Halliday J, Kennedy J, Burgner DP, Amor DJ, Doyle LW, Juonala M, Ranganathan S, Welsh L, Cheung M, McLachlan R, McBain J, Lewis S. Does being conceived by assisted reproductive technology influence adult quality of life? HUM FERTIL 2023; 26:1008-1014. [PMID: 35317704 DOI: 10.1080/14647273.2022.2042860] [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: 08/10/2021] [Accepted: 12/08/2021] [Indexed: 11/04/2022]
Abstract
Numerous studies have investigated the physical health and development of children and adolescents conceived with assisted reproductive technology (ART). Less is known about the quality of life of ART-conceived adults. This study explores the contributions of being conceived with ART and psychosocial cofactors present in young adulthood to the quality of life of adults aged 22-35 years. Young adults conceived through ART or natural conception (NC) completed questionnaires which included a standardized measure of quality of life (World Health Organization Quality of Life - Brief assessment (WHOQoL-BREF)) when aged 18-28 years (T1) and again when aged 22-35 years (T2). The WHOQoL-BREF has four domains: (i) Physical, (ii) Psychological, (iii) Social relationships and (iv) Environment. A total of 193 ART-conceived and 86 NC individuals completed both questionnaires. When accounting for other cofactors in multivariable analyses, being ART-conceived was strongly associated with higher scores (better quality of life) on the Social relationships, and Environment WHOQoL-BREF domains at T2. In addition, less psychological distress, a better relationship with parents, a better financial situation, and perceptions of being about the right weight at T1 were associated with higher scores on one or more of the WHOQoL-BREF domains at T2. In conclusion, being ART-conceived can confer advantages in quality of life in adulthood, independent of psychosocial cofactors.
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Affiliation(s)
- Karin Hammarberg
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Victorian Assisted Reproductive Treatment Authority, Melbourne, Australia
| | - Jane Halliday
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Joanne Kennedy
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - David P Burgner
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - David J Amor
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Lex W Doyle
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, University of Melbourne, Parkville, Australia
| | - Markus Juonala
- Department of Internal Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Liam Welsh
- Murdoch Children's Research Institute, Parkville, Australia
| | - Michael Cheung
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Robert McLachlan
- Monash IVF Group Pty Ltd, Richmond, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
| | | | - Sharon Lewis
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
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7
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Howitt G, Feng Y, Tobar L, Vassiliadis D, Hickey P, Dawson M, Ranganathan S, Shanthikumar S, Neeland M, Maksimovic J, Oshlack A. Benchmarking single-cell hashtag oligo demultiplexing methods. NAR Genom Bioinform 2023; 5:lqad086. [PMID: 37829177 PMCID: PMC10566318 DOI: 10.1093/nargab/lqad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/25/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023] Open
Abstract
Sample multiplexing is often used to reduce cost and limit batch effects in single-cell RNA sequencing (scRNA-seq) experiments. A commonly used multiplexing technique involves tagging cells prior to pooling with a hashtag oligo (HTO) that can be sequenced along with the cells' RNA to determine their sample of origin. Several tools have been developed to demultiplex HTO sequencing data and assign cells to samples. In this study, we critically assess the performance of seven HTO demultiplexing tools: hashedDrops, HTODemux, GMM-Demux, demuxmix, deMULTIplex, BFF (bimodal flexible fitting) and HashSolo. The comparison uses data sets where each sample has also been demultiplexed using genetic variants from the RNA, enabling comparison of HTO demultiplexing techniques against complementary data from the genetic 'ground truth'. We find that all methods perform similarly where HTO labelling is of high quality, but methods that assume a bimodal count distribution perform poorly on lower quality data. We also suggest heuristic approaches for assessing the quality of HTO counts in an scRNA-seq experiment.
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Affiliation(s)
- George Howitt
- Computational Biology Program, Peter MacCallum Cancer Centre, Parkville, VIC, 3010 Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010 Australia
| | - Yuzhou Feng
- Computational Biology Program, Peter MacCallum Cancer Centre, Parkville, VIC, 3010 Australia
| | - Lucas Tobar
- Computational Biology Program, Peter MacCallum Cancer Centre, Parkville, VIC, 3010 Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010 Australia
| | - Dane Vassiliadis
- Computational Biology Program, Peter MacCallum Cancer Centre, Parkville, VIC, 3010 Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010 Australia
| | - Peter Hickey
- The Walter and Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville, VIC 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Mark A Dawson
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010 Australia
- Centre for Cancer Research, The University of Melbourne, Parkville, VIC, Australia
| | - Sarath Ranganathan
- Respiratory Diseases, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Respiratory and Sleep Medicine, Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Shivanthan Shanthikumar
- Respiratory Diseases, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Respiratory and Sleep Medicine, Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Melanie Neeland
- Respiratory Diseases, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Jovana Maksimovic
- Computational Biology Program, Peter MacCallum Cancer Centre, Parkville, VIC, 3010 Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010 Australia
| | - Alicia Oshlack
- Computational Biology Program, Peter MacCallum Cancer Centre, Parkville, VIC, 3010 Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010 Australia
- School of Mathematics and Statistics, The University of Melbourne, Parkville, VIC, Australia
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Homaira N, Strachan R, Quinn H, Beggs S, Bhuiyan M, Bowen A, Fawcett LK, Gilbert GL, Lambert SB, Macartney K, Marshall HS, Martin AC, McCallum G, McCullagh A, McDonald T, Selvadurai H, McIntyre P, Oftadeh S, Ranganathan S, Saunders T, Suresh S, Wainwright C, Wilson A, Wong M, Jaffe A, Snelling T. Erratum to "Real world impact of 13vPCV in preventing invasive pneumococcal pneumonia in Australian children: A national study" [Vaccine 41(1) (2023) 85-91]. Vaccine 2023; 41:6401-6402. [PMID: 37625991 DOI: 10.1016/j.vaccine.2023.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Affiliation(s)
- Nusrat Homaira
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, NSW, Australia; Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia.
| | - Roxanne Strachan
- Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia
| | - Helen Quinn
- National Centre for Immunisation Research and Surveillance (NCIRS), Sydney Children's Hospital's Network, Westmead, NSW, Australia
| | - Sean Beggs
- Paediatric Department, Royal Hobart Hospital, Hobart, TAS, Australia; School of Medicine, University of Tasmania, Tasmania, Australia
| | - Mejbah Bhuiyan
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia; School of Medicine, University of Western Australia, Perth, Australia
| | - Asha Bowen
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia; School of Medicine, University of Western Australia, Perth, Australia
| | - Laura K Fawcett
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, NSW, Australia; Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia
| | | | - Stephen B Lambert
- Centre for Infectious Diseases-Public Health, Institute of Clinical Pathology and Medical Research, Westmead, NSW, Australia; Children's Health Queensland, Queensland Paediatric Infectious Diseases Laboratory, Brisbane, Queensland, Australia
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance (NCIRS), Sydney Children's Hospital's Network, Westmead, NSW, Australia; UQ Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Helen S Marshall
- Women's and Children's Health Network, North Adelaide, SA, Australia; Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Andrew C Martin
- Department of General Paediatrics, Perth's Children Hospital, Perth, Western Australia, Australia
| | - Gabrielle McCallum
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Angela McCullagh
- Department of Respiratory Medicine, Monash Children's Hospital, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia
| | | | - Hiran Selvadurai
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Peter McIntyre
- National Centre for Immunisation Research and Surveillance (NCIRS), Sydney Children's Hospital's Network, Westmead, NSW, Australia; Women's and Children's Health, University of Otago-Dunedin Campus, Dunedin, New Zealand
| | - Shahin Oftadeh
- Pneumococcal Reference Laboratory, Centre for Infectious Diseases and Microbiology, Institute of Clinical Pathology and Medical Research, Westmead, New South Wales, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Thomas Saunders
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Sadasivam Suresh
- Child Health Research Centre, University of Queensland, South Brisbane, Queensland, Australia; Respiratory and Sleep Medicine, Children's Health Queensland Hospital and Health Service , Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Claire Wainwright
- Child Health Research Centre, University of Queensland, South Brisbane, Queensland, Australia; Respiratory and Sleep Medicine, Children's Health Queensland Hospital and Health Service , Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Angela Wilson
- Department of Paediatrics, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Melanie Wong
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Adam Jaffe
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, NSW, Australia; Respiratory Department, Sydney Children's Hospital Randwick, NSW, Australia
| | - Tom Snelling
- Faculty of Medicine and Health School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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9
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Shanthikumar S, Ruseckaite R, Corda J, Mulrennan S, Ranganathan S, Douglas T. Telehealth use in Australian cystic fibrosis centers: Clinician experiences. Pediatr Pulmonol 2023; 58:2906-2915. [PMID: 37477510 DOI: 10.1002/ppul.26612] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/30/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Telehealth has been rapidly adopted by cystic fibrosis (CF) centers and ongoing use in routine CF care is endorsed by CF consumers. However, data describing CF clinician perceptions regarding telehealth are scarce. We aimed to describe clinician experiences and attitudes towards telehealth in CF care among health professionals across Australia. METHODS CF multidisciplinary health professionals from all CF clinics in Australia were sent an anonymous electronic survey. RESULTS Eighty-five responses were received representing 15 of 23 (65%) centers. Most clinicians reported using telehealth for routine clinic visits, and a range of other clinical encounters (69.9%). Telehealth was widely perceived as acceptable (91.8%), and clinicians were comfortable/very comfortable (81.2%) integrating telehealth into future CF care. Despite this, 64.1% of respondents considered telehealth clinics to be much worse than face-to-face clinics and 57.5% reported quality of care was somewhat/much worse using telehealth. Home spirometry was available in 73.7% of centers, however, only 26.7% of clinics could provide spirometers for >75% eligible patients. Growth and microbiology assessments were often missed in telehealth clinics and 75.7% reported a technical issue had prevented a telehealth consultation from occurring. CONCLUSIONS Telehealth for CF in Australia is considered feasible and acceptable by CF clinicians, although use of telehealth varies widely between centers. Concerns exist around the impact of telehealth on health outcomes, especially given core assessments are frequently omitted. Guidelines may help ensure the benefits of telehealth are realized for people with CF without compromising the standard of care.
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Affiliation(s)
- Shivanthan Shanthikumar
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
- Respiratory Diseases, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jen Corda
- Department of Physiotherapy, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Siobhain Mulrennan
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Institute for Respiratory Health, University of Western Australia, Nedlands, Western Australia, Australia
| | - Sarath Ranganathan
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
- Respiratory Diseases, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Tonia Douglas
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia
- Clinical Unit, Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia
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Kim SO, Shapiro JP, Cottrill KA, Collins GL, Shanthikumar S, Rao P, Ranganathan S, Stick SM, Orr ML, Fitzpatrick AM, Go YM, Jones DP, Tirouvanziam RM, Chandler JD. Substrate-dependent metabolomic signatures of myeloperoxidase activity in airway epithelial cells: Implications for early cystic fibrosis lung disease. Free Radic Biol Med 2023; 206:180-190. [PMID: 37356776 PMCID: PMC10513041 DOI: 10.1016/j.freeradbiomed.2023.06.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/14/2023] [Accepted: 06/23/2023] [Indexed: 06/27/2023]
Abstract
Myeloperoxidase (MPO) is released by neutrophils in inflamed tissues. MPO oxidizes chloride, bromide, and thiocyanate to produce hypochlorous acid (HOCl), hypobromous acid (HOBr), and hypothiocyanous acid (HOSCN), respectively. These oxidants are toxic to pathogens, but may also react with host cells to elicit biological activity and potential toxicity. In cystic fibrosis (CF) and related diseases, increased neutrophil inflammation leads to increased airway MPO and airway epithelial cell (AEC) exposure to its oxidants. In this study, we investigated how equal dose-rate exposures of MPO-derived oxidants differentially impact the metabolome of human AECs (BEAS-2B cells). We utilized enzymatic oxidant production with rate-limiting glucose oxidase (GOX) coupled to MPO, and chloride, bromide (Br-), or thiocyanate (SCN-) as substrates. AECs exposed to GOX/MPO/SCN- (favoring HOSCN) were viable after 24 h, while exposure to GOX/MPO (favoring HOCl) or GOX/MPO/Br- (favoring HOBr) developed cytotoxicity after 6 h. Cell glutathione and peroxiredoxin-3 oxidation were insufficient to explain these differences. However, untargeted metabolomics revealed GOX/MPO and GOX/MPO/Br- diverged significantly from GOX/MPO/SCN- for dozens of metabolites. We noted methionine sulfoxide and dehydromethionine were significantly increased in GOX/MPO- or GOX/MPO/Br--treated cells, and analyzed them as potential biomarkers of lung damage in bronchoalveolar lavage fluid from 5-year-olds with CF (n = 27). Both metabolites were associated with increasing bronchiectasis, neutrophils, and MPO activity. This suggests MPO production of HOCl and/or HOBr may contribute to inflammatory lung damage in early CF. In summary, our in vitro model enabled unbiased identification of exposure-specific metabolite products which may serve as biomarkers of lung damage in vivo. Continued research with this exposure model may yield additional oxidant-specific biomarkers and reveal explicit mechanisms of oxidant byproduct formation and cellular redox signaling.
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Affiliation(s)
- Susan O Kim
- Department of Pediatrics, Division of Pulmonary, Asthma, Cystic Fibrosis, and Sleep, Emory University, Atlanta, GA, USA
| | - Joseph P Shapiro
- Department of Pediatrics, Division of Pulmonary, Asthma, Cystic Fibrosis, and Sleep, Emory University, Atlanta, GA, USA
| | - Kirsten A Cottrill
- Department of Pediatrics, Division of Pulmonary, Asthma, Cystic Fibrosis, and Sleep, Emory University, Atlanta, GA, USA
| | - Genoah L Collins
- Department of Pediatrics, Division of Pulmonary, Asthma, Cystic Fibrosis, and Sleep, Emory University, Atlanta, GA, USA
| | - Shivanthan Shanthikumar
- Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, VIC, Australia; Respiratory Diseases, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Padma Rao
- Medical Imaging, Royal Children's Hospital, Parkville, VIC, Australia
| | - Sarath Ranganathan
- Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, VIC, Australia; Respiratory Diseases, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Stephen M Stick
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Michael L Orr
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Anne M Fitzpatrick
- Department of Pediatrics, Division of Pulmonary, Asthma, Cystic Fibrosis, and Sleep, Emory University, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Young-Mi Go
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Dean P Jones
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Rabindra M Tirouvanziam
- Department of Pediatrics, Division of Pulmonary, Asthma, Cystic Fibrosis, and Sleep, Emory University, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Joshua D Chandler
- Department of Pediatrics, Division of Pulmonary, Asthma, Cystic Fibrosis, and Sleep, Emory University, Atlanta, GA, USA; Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA.
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11
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Gao Y, Stokholm J, O'Hely M, Ponsonby AL, Tang MLK, Ranganathan S, Saffery R, Harrison LC, Collier F, Gray L, Burgner D, Molloy J, Sly PD, Brix S, Frøkiær H, Vuillermin P. Gut microbiota maturity mediates the protective effect of siblings on food allergy. J Allergy Clin Immunol 2023; 152:667-675. [PMID: 37150361 DOI: 10.1016/j.jaci.2023.02.034] [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: 10/23/2022] [Revised: 02/06/2023] [Accepted: 02/23/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND The mechanisms underlying the protective effect of older siblings on allergic disease remain unclear but may relate to the infant gut microbiota. OBJECTIVE We sought to investigate whether having older siblings decreases the risk of IgE-mediated food allergy by accelerating the maturation of the infant gut microbiota. METHODS In a birth cohort assembled using an unselected antenatal sampling frame (n = 1074), fecal samples were collected at 1 month, 6 months, and 1 year, and food allergy status at 1 year was determined by skin prick test and in-hospital food challenge. We used 16S rRNA gene amplicon sequencing to derive amplicon sequence variants. Among a random subcohort (n = 323), microbiota-by-age z scores at each time point were calculated using fecal amplicon sequence variants to represent the gut microbiota maturation over the first year of life. RESULTS A greater number of siblings was associated with a higher microbiota-by-age z score at age 1 year (β = 0.15 per an additional sibling; 95% CI, 0.05-0.24; P = .003), which was in turn associated with decreased odds of food allergy (odds ratio, 0.45; 95% CI, 0.33-0.61; P < .001). Microbiota-by-age z scores mediated 63% of the protective effect of siblings. Analogous associations were not observed at younger ages. CONCLUSIONS The protective effect of older siblings on the risk of developing IgE-mediated food allergy during infancy is substantially mediated by advanced maturation of the gut microbiota at age 1 year.
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Affiliation(s)
- Yuan Gao
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia; Child Health Research Unit, Barwon Health, Geelong, Australia; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Food Science, University of Copenhagen, Frederiksberg, Denmark
| | - Martin O'Hely
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Developing Brain Division, The Florey Institute for Neuroscience and Mental Health, Melbourne, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Leonard C Harrison
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia; Department of Medical Biology, University of Melbourne, Melbourne, Australia
| | - Fiona Collier
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia
| | - Lawrence Gray
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia; Child Health Research Unit, Barwon Health, Geelong, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - John Molloy
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia; Child Health Research Unit, Barwon Health, Geelong, Australia
| | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, Australia; Faculty of Health, Deakin University, Geelong, Australia
| | - Susanne Brix
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Hanne Frøkiær
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Vuillermin
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia; Child Health Research Unit, Barwon Health, Geelong, Australia.
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12
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Peters RL, Soriano VX, Lycett K, Flynn C, Idrose NS, Tang MLK, Wijesuriya R, Allen KJ, Ranganathan S, Lowe AJ, Perrett KP, Lodge CJ, Koplin JJ, Dharmage SC. Infant food allergy phenotypes and association with lung function deficits and asthma at age 6 years: a population-based, prospective cohort study in Australia. Lancet Child Adolesc Health 2023; 7:636-647. [PMID: 37506717 DOI: 10.1016/s2352-4642(23)00133-5] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Food allergy is considered a precursor to asthma in the context of the atopic march, but the relationship between infant food allergy phenotypes and lung function and asthma in childhood is unclear. We aimed to examine the association between food sensitisation and challenge-confirmed food allergy in infancy, as well as persistent and resolved food allergy up to age 6 years, and the risk of lung function deficits and asthma at age 6 years. METHODS The longitudinal, population-based HealthNuts cohort study in Melbourne, VIC, Australia, recruited 5276 infants children aged 1 year who attended council-run immunisation sessions between Sept 28, 2007, and Aug 5, 2011. At age 1 year, all children completed skin prick testing to four food allergens (egg, peanut, sesame, and either shrimp or cow's milk) and an oral food challenge (egg, peanut, and sesame) at the Royal Children's Hospital in Melbourne. Parents completed questionnaires about their infant's allergy history, demographic characteristics, and environmental exposures. At age 6 years, children were invited for a health assessment that included skin prick testing for ten foods (milk, egg, peanut, wheat, sesame, soy, shrimp, cashew, almond, and hazelnut) and eight aeroallergens (alternaria, cladasporum, house dust mite, cat hair, dog hair, bermuda grass, rye grass, and birch mix), oral food challenges, and lung function testing by spirometry. Questionnaires completed by parents (different to those completed at age 1 year) captured the child's allergy and respiratory history and demographics. We investigated associations between food allergy phenotypes (food-sensitised tolerance or food allergy; and ever, transient, persistent, or late-onset food allergy), lung function spirometry measures (forced expiratory volume in 1 sec [FEV1] and forced vital capacity [FVC] z-scores, FEV1/FVC ratio, forced expiratory flow at 25% and 75% of the pulmonary volume [FEF25-75%], and bronchodilator responsiveness), and asthma using regression methods. Only children with complete data on the exposure, outcome, and confounders were included in models. Infants without food sensitisation or food allergy at age 1 year and 6 years served as the reference group. FINDINGS Of 5276 participants, 3233 completed the health assessment at age 6 years and were included in this analysis. Food allergy, but not food-sensitised tolerance, at age 1 year was associated with reduced FEV1 and FVC (aβ -0·19 [95% CI -0·32 to -0·06] and -0·17 [-0·31 to -0·04], respectively) at age 6 years. Transient egg allergy was associated with reduced FEV1 and FVC compared with never having egg allergy (-0·18 [95% CI -0·33 to -0·03] and -0·15 [-0·31 to 0·00], respectively), whereas persistent egg allergy was not (FEV1 -0·09 [-0·48 to 0·31]; FVC -0·20 [-0·62 to 0·21]). Transient peanut allergy was associated with reduced FEV1 and FVC (FEV1 aβ -0·37 [-0·79 to 0·04] and FVC aβ -0·55 [-0·98 to -0·12]), in addition to persistent peanut allergy (FEV1 aβ -0·30 [-0·54 to -0·06] and FVC aβ-0·30 [-0·55 to -0·05]), and late-onset peanut allergy (FEV1 aβ -0·62 [-1·06 to -0·18] and FVC aβ-0·49 [-0·96 to -0·03]). Estimates suggested that food-sensitised tolerance and food allergy were associated with reduced FEF25-75%, although some estimates were imprecise. Food allergy phenotypes were not associated with an FEV1/FVC ratio. Late-onset peanut allergy was the only allergy phenotype that was possibly associated with increased risk of bronchodilator responsiveness (2·95 [95% CI 0·77 to 11·38]). 430 (13·7%) of 3135 children were diagnosed with asthma before age 6 years (95% CI 12·5-15·0). Both food-sensitised tolerance and food allergy at age 1 year were associated with increased asthma risk at age 6 years (adjusted odds ratio 1·97 [95% CI 1·23 to 3·15] and 3·69 [2·81 to 4·85], respectively). Persistent and late-onset peanut allergy were associated with higher asthma risk (3·87 [2·39 to 6·26] and 5·06 [2·15 to 11·90], respectively). INTERPRETATION Food allergy in infancy, whether it resolves or not, is associated with lung function deficits and asthma at age 6 years. Follow-up studies of interventions to prevent food allergy present an opportunity to examine whether preventing these food allergies improves respiratory health. FUNDING National Health & Medical Research Council of Australia, Ilhan Food Allergy Foundation, AnaphylaxiStop, the Charles and Sylvia Viertel Medical Research Foundation, the Victorian Government's Operational Infrastructure Support Program.
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Affiliation(s)
- Rachel L Peters
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
| | - Victoria X Soriano
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Kate Lycett
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Deakin University, Burwood, VIC, Australia
| | - Catherine Flynn
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Nur Sabrina Idrose
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Mimi L K Tang
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, VIC, Australia
| | - Rushani Wijesuriya
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Katrina J Allen
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Adrian J Lowe
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Kirsten P Perrett
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, VIC, Australia
| | - Caroline J Lodge
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Jennifer J Koplin
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Child Health Research Centre, University of Queensland, South Brisbane, QLD, Australia
| | - Shyamali C Dharmage
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
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13
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Le HHTC, Vien NT, Dang TN, Ware RS, Phung D, Thai PK, Ranganathan S, Vinh NN, Dung PHT, Thanh HN, Dung TTT, Hien TT, Sly PD, Le An P. Wearing masks as a protective measure for children against traffic-related air pollution: A comparison of perceptions between school children and their caregivers in Ho Chi Minh City, Vietnam. Trop Med Int Health 2023; 28:753-762. [PMID: 37615211 PMCID: PMC10946546 DOI: 10.1111/tmi.13923] [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] [Indexed: 08/25/2023]
Abstract
BACKGROUND Traffic-related air pollution (TRAP) problems are unlikely to be solved in the short term, making it imperative to educate children on protective measures to mitigate the negative impact on their health. Children and their caregivers may hold differing views on wearing a face mask as a safeguard against air pollution. While many studies have focused on predicting children's health-protective behaviours against air pollution, few have explored the differences in perceptions between children and their caregivers. OBJECTIVES To examine this, we conducted a study that compared the health beliefs of two generations and evaluated the factors that influence the use of masks by children to reduce air pollution exposure. METHODS The study was conducted in 24 secondary schools and involved 8420 children aged 13-14 and their caregivers. We used a Health Belief Model (HBM)-based instrument containing 17-item self-administered health beliefs questionnaires to gather data. The results were analysed using hierarchical logistic regression to determine the probability of children frequently wearing masks to protect against TRAP. RESULTS Our study showed both children and caregivers recognised that several factors could influence mask-wearing among children: discomfort or difficulty breathing while wearing a mask and forgetting to bring a mask when going outside; perceived threats of the poor quality of air and children's respiratory health problems; and cues to mask use (i.e., seeing most of their friends wearing facemasks and ease of finding masks in local stores). However, only children were significantly concerned with public perception of their appearance while wearing a mask. Females were more likely to wear masks, and caregivers with higher levels of education were more likely to encourage their children to wear masks. Children who commuted to schools by walking, biking, or motorbiking were also more accepting of mask-wearing than those who travelled by car or bus. CONCLUSIONS Children and their caregivers hold different perceptions of wearing masks to protect against air pollution. Children are more susceptible to social judgements regarding their appearance when wearing a mask.
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Affiliation(s)
- Hong H. T. C. Le
- Faculty of MedicineThe University of QueenslandBrisbane CityQueenslandAustralia
- Children's Health and Environment ProgramCentre for Children's Health ResearchBrisbane CityQueenslandAustralia
| | - Nguyen Truong Vien
- Department of Environmental and Occupational HealthPham Ngoc Thach University of MedicineHo Chi Minh CityVietnam
| | - Tran Ngoc Dang
- Faculty of Public HealthUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Robert S. Ware
- Menzies Health Institute QueenslandGriffith UniversityBrisbane CityQueenslandAustralia
| | - Dung Phung
- School of Public HealthThe University of QueenslandBrisbane CityQueenslandAustralia
| | - Phong K. Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS)The University of QueenslandBrisbane CityQueenslandAustralia
| | | | - Nguyen Nhu Vinh
- Centre for the Training of Family Medicine, Faculty of MedicineUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Phan Hoang Thuy Dung
- Grant and Innovation CenterUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Huynh Ngoc Thanh
- Faculty of Public HealthUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Truong Thi Thuy Dung
- Faculty of Public HealthUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - To Thi Hien
- University of Science, Vietnam National UniversityHo Chi Minh CityVietnam
| | - Peter D. Sly
- Children's Health and Environment ProgramCentre for Children's Health ResearchBrisbane CityQueenslandAustralia
| | - Pham Le An
- Centre for the Training of Family Medicine, Faculty of MedicineUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
- Grant and Innovation CenterUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
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14
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Doyle LW, Ranganathan S, Spittle A, Opie G, Mainzer R, Cheong JL. Expiratory airflow at 7-8 years of age in children born extremely low birthweight from 14 years before to 14 years after the introduction of exogenous surfactant. EClinicalMedicine 2023; 62:102115. [PMID: 37533420 PMCID: PMC10393553 DOI: 10.1016/j.eclinm.2023.102115] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 08/04/2023] Open
Abstract
Background It is unclear if expiratory airflow in survivors born extremely low birth weight (ELBW; 500-999 g) has improved after the introduction of exogenous surfactant into clinical practice in 1991. The primary aim of this study was to describe the changes in airflow at 7-8 years of age of survivors born ELBW in five discrete cohorts from 14 years before to 14 years after the introduction of exogenous surfactant into clinical practice. Methods The cohorts comprised consecutive survivors born ELBW in 1977-82 and 1985-87 at the Royal Women's Hospital, Melbourne, and in 1991-92, 1997 and 2005 in the state of Victoria, Australia. Survival rates to 2-years of age for infants born ELBW in the state of Victoria rose from approximately 1-in-4 to 3-in-4 over the time of this study. Expiratory airflow measurements at 7-8 years included the forced expired volume in 1 s (FEV1), converted to z-scores for age, height, sex, and race. Findings There were 596 ELBW participants with expiratory flow data, 280 (47%) of whom had bronchopulmonary dysplasia (BPD). Overall, there was little change in zFEV1 over the 28-year period (mean change per year; 0.003, 95% CI -0.010, 0.015, P = 0.67). There was, however, evidence of an interaction between BPD and year; zFEV1 in those who had BPD fell over time (mean change per year -0.019, 95% CI -0.037, -0.009, P = 0.035), whereas zFEV1 improved in those who did not have BPD (mean change per year 0.021, 95% CI 0.006, 0.037, P = 0.007). Interpretation Contrary to recent evidence, expiratory airflow of children born ELBW has not improved with the introduction of surfactant, and may be deteriorating in those who had BPD. Funding National Health and Medical Research Council (Australia); Victorian Government's Operational Infrastructure Support Program.
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Affiliation(s)
- Lex W. Doyle
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Newborn Services, The Royal Women's Hospital, Melbourne, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - S. Ranganathan
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Australia
| | - A.J. Spittle
- Newborn Services, The Royal Women's Hospital, Melbourne, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - G. Opie
- Neonatal Services, Mercy Hospital for Women, Melbourne, Australia
| | - R.M. Mainzer
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Clinical Epidemiology and Biostatistics, Murdoch Children's Research Institute, Melbourne, Australia
| | - Jeanie L.Y. Cheong
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Melbourne, Australia
- Newborn Services, The Royal Women's Hospital, Melbourne, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
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15
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Shanthikumar S, Chen K, Soriano VX, Nguyen L, Koplin JJ, Tang MLK, Lowe AJ, Lodge CJ, Idrose NS, Ranganathan S, Thompson B, Dharmage SC, Peters RL. Comparing definitions of bronchodilator response in a population-based cohort of 6-year-old children. Pediatr Pulmonol 2023. [PMID: 37154521 DOI: 10.1002/ppul.26456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Affiliation(s)
- Shivanthan Shanthikumar
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Respiratory and Sleep Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Katherine Chen
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of General Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia
| | | | - Lily Nguyen
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Jennifer J Koplin
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Child Health Research Centre, University of Queensland, South Brisbane, Queensland, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Allergy and Immunology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Adrian J Lowe
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Allergy and Lung Health Unit, The University of Melbourne, Parkville, Victoria, Australia
| | - Caroline J Lodge
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Allergy and Lung Health Unit, The University of Melbourne, Parkville, Victoria, Australia
| | - Nur Sabrina Idrose
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Allergy and Lung Health Unit, The University of Melbourne, Parkville, Victoria, Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Respiratory and Sleep Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Bruce Thompson
- Melbourne School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Shyamali C Dharmage
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Allergy and Lung Health Unit, The University of Melbourne, Parkville, Victoria, Australia
| | - Rachel L Peters
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, The University of Melbourne, Parkville, Victoria, Australia
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16
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Schultz A, McLeod C, Berry S, Marsh J, McKenzie A, Messer M, Wood J, Saville B, Jaffe A, Ranganathan S, Stick S, Wark P, Webb S, Snelling T. BEAT CF pulmonary exacerbations core protocol for evaluating the management of pulmonary exacerbations in people with cystic fibrosis. Trials 2023; 24:211. [PMID: 36949472 PMCID: PMC10031862 DOI: 10.1186/s13063-023-07076-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/05/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Cystic fibrosis (CF) is a rare, inherited, life-limiting condition predominantly affecting the lungs, for which there is no cure. The disease is characterized by recurrent pulmonary exacerbations (PEx), which are thought to drive progressive lung damage. Management of these episodes is complex and generally involves multiple interventions targeting different aspects of disease. The emergence of innovative trials and use of Bayesian statistical methods has created renewed opportunities for studying heterogeneous populations in rare diseases. Here, we present the protocol for the BEAT CF PEx cohort, a prospective, multi-site, perpetual, platform enrolling adults and children with CF. The BEAT CF PEx cohort will be used to evaluate the comparative effectiveness of interventions for the treatment of PEx requiring intensive therapy (PERITs), with a primary focus on short-term improvements in lung function. This will be achieved through the conduct of cohort-nested studies, including adaptive clinical trials, within the BEAT CF PEx cohort. This protocol will outline key features of the BEAT CF PEx cohort, including the design, implementation, data collection and management, governance and analysis, and dissemination of results. METHODS This platform will be conducted across multiple sites, commencing with CF treatment centers in Australia. People of all ages with a clinical diagnosis of CF will be eligible to participate, except those who have previously received a lung transplant. Data including demographic and clinical information, treatment details, and outcomes (including safety, microbiology, and patient-reported outcome measures including quality of life scores) will be systematically collected and securely stored via a digital centralized trial management system (CTMS). The primary endpoint is the absolute change in the percentage predicted forced expiratory volume in 1 s (ppFEV1) from the commencement of intensive therapy to 7 to 10 days afterwards. DISCUSSION The BEAT CF PEx cohort will report clinical, treatment, and outcome data for PEx among people with CF and is intended to serve as a core (master) protocol for future nested, interventional trials evaluating treatment(s) for these episodes. The protocols for nested sub-studies are beyond the scope of this document and will be reported separately. TRIAL REGISTRATION ANZCTR BEAT CF Platform - ACTRN12621000638831. Registration date: Sept. 26, 2022.
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Affiliation(s)
- Andre Schultz
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Nedlands, Australia
- Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, Australia
| | - Charlie McLeod
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Australia.
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Australia.
| | | | - Julie Marsh
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Australia
| | - Anne McKenzie
- School of Population and Global Health, University of Western Australia, Nedlands, Australia
| | - Mitch Messer
- Telethon Kids CONNECT, Telethon Kids Institute, Nedlands, Australia
| | - Jamie Wood
- Department of Rehabilitation and Human Performance, Abilities Research Centre, Icahn School of Medicine, Mount Sinai, New York, USA
| | | | - Adam Jaffe
- Discipline of Paediatrics and Child Health, Faculty of Medicine and Health, University of New South Wales, Kensington, Australia
- Sydney Children's Hospital, Randwick, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, University of Melbourne, Parkville, Australia
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Australia
- Respiratory Diseases Research Group, Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia
| | - Steve Stick
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Nedlands, Australia
- Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, Australia
- School of Population and Global Health, University of Western Australia, Nedlands, Australia
| | - Peter Wark
- Immune Health Program, Hunter Medical Research Institute, University of Newcastle, Callaghan, Australia
- Sleep Medicine Division, John Hunter Hospital, New Lambton Heights, Australia
| | - Steve Webb
- Australian and New Zealand Intensive Care Research Centre, Monash University, Clayton, Australia
- St John of God Hospital, Subiaco, Australia
| | - Tom Snelling
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
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17
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Le HHTC, Le An P, Vinh NN, Ware RS, Phung D, Thai PK, Ranganathan S, Dang TN, Dung PHT, Thuong DTH, Phung H, Hien TT, Sly PD. Burden of asthma-like symptoms and a lack of recognition of asthma in Vietnamese children. J Asthma 2023; 60:516-524. [PMID: 35427209 DOI: 10.1080/02770903.2022.2066002] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Lack of recognition of asthma in childhood results in unmet asthma treatment needs and leads to the risk of sub-optimal respiratory health. The present study assessed the prevalence of asthmatic under-recognition in middle school children in Vietnam. METHODS We conducted a school-based survey among 15,112 Vietnamese children. Most of them are aged from 13 to 14. Schools and students were recruited using multi-stage sampling. Respiratory symptoms were collected via self-report using a standardized tool from the International Study of Asthma and Allergies in Childhood. Under-recognition of asthma was defined as a presence of at least one asthma-like symptom but a negative response to having ever asthma. Associations were investigated using logistic regression. RESULTS Prevalence of asthma-like symptoms was 27.3% and prevalence of physician-diagnosed asthma was 8.5%. Over 80% of symptomatic children were not diagnosed with asthma. Under-recognition of asthma was found more in girls (adjusted odds ratio; aOR = 1.75; 95%CI: 1.54 to 1.98). CONCLUSIONS Asthma is significantly under-recognized in Vietnamese middle-school children. Urgent action is required to improve the recognition of asthma in Vietnam.
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Affiliation(s)
- Hong H T C Le
- Faculty of Medicine, The University of Queensland, St Lucia, QLD, Australia.,Children's Health and Environment Program, Centre for Children's Health Research, Brisbane, QLD, Australia
| | - Pham Le An
- Centre for the Training of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Nhu Vinh
- Centre for the Training of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Dung Phung
- School of Public Health, Faculty of Medicine, The University of Queensland, St Lucia, QLD, Australia
| | - Phong K Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, St Lucia, QLD, Australia
| | | | - Tran Ngoc Dang
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Phan Hoang Thuy Dung
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Do Thi Hoai Thuong
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hai Phung
- School of Public Health, Faculty of Medicine, The University of Queensland, St Lucia, QLD, Australia
| | - To Thi Hien
- University of Science, Vietnam National University Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Peter D Sly
- Children's Health and Environment Program, Centre for Children's Health Research, Brisbane, QLD, Australia
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18
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Baker A, Grobler A, Davies K, Griffiths A, Hiscock H, Kubba H, Peters RL, Ranganathan S, Rimmer J, Rose E, Rowe K, Simpson CM, Davidson A, Nixon G, Perrett KP. Effectiveness of Intranasal Mometasone Furoate vs Saline for Sleep-Disordered Breathing in Children: A Randomized Clinical Trial. JAMA Pediatr 2023; 177:240-247. [PMID: 36648937 PMCID: PMC9857783 DOI: 10.1001/jamapediatrics.2022.5258] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/24/2022] [Indexed: 01/18/2023]
Abstract
Importance Obstructive sleep-disordered breathing (SDB) in children is characterized by snoring and difficulty breathing during sleep. SDB affects at least 12% of otherwise healthy children and is associated with significant morbidity. Evidence from small clinical trials suggests that intranasal corticosteroids improve SDB as measured by polysomnography; however, the effect on symptoms and quality of life is unclear. Objective To determine whether intranasal mometasone furoate is more effective than intranasal saline for improving symptoms and quality of life in children with SDB. Design, Setting, and Participants The MIST trial was a multicenter, randomized, double-blind, placebo-controlled trial, recruiting participants from June 8, 2018, to February 13, 2020. Children aged 3 to 12 years who were referred to a specialist for significant SDB symptoms were included; exclusions were previous adenotonsillectomy, body mass index greater than the 97th percentile, and severe SDB. Randomization was stratified by site, and data were analyzed on an intention-to-treat basis from October 28, 2020, to September 25, 2022. Interventions Participants were randomly assigned to receive mometasone furoate, 50 μg, or sodium chloride (saline), 0.9%, 1 spray per nostril daily, dispensed in identical bottles. Main Outcomes and Measures The primary outcome was resolution of significant SDB symptoms (ie, reduction to a level no longer requiring referral to a specialist as per the American Academy of Pediatrics guidelines) at 6 weeks, measured by parental report of symptoms using the SDB Score. Results A total of 276 participants (mean [SD] age, 6.1 [2.3] years; 146 male individuals [53%]) were recruited, 138 in each treatment arm. Resolution of significant SDB symptoms occurred in 56 of 127 participants (44%) in the mometasone group and 50 of 123 participants (41%) in the saline group (risk difference, 4%; 95% CI, -8% to 16%; P = .51) with 26 participants lost to follow-up and missing values managed by multiple imputation. The main adverse effects were epistaxis, affecting 12 of 124 participants (9.7%) in the mometasone group and 18 of 120 participants (15%) in the saline group, and nasal itch/irritation, affecting 12 of 124 participants (9.7%) in the mometasone group and 22 of 120 participants (18%) in the saline group. Conclusions and Relevance Results of this randomized clinical trial suggest that there was no difference in treatment effect between intranasal mometasone and saline for the management of SDB symptoms. The results suggest that almost one-half of children with SDB could be initially managed in the primary care setting and may not require referral to specialist services, as is currently recommended. Trial Registration Australian New Zealand Clinical Trials Registry: ANZCTRN12618000448246.
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Affiliation(s)
- Alice Baker
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of General Medicine, Royal Children’s Hospital, Melbourne, Australia
| | - Anneke Grobler
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Karen Davies
- Department of Otolaryngology, Royal Children’s Hospital, Melbourne, Australia
| | - Amanda Griffiths
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Respiratory and Sleep Medicine, Royal Children’s Hospital, Melbourne, Australia
| | - Harriet Hiscock
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Health Services Research Unit, Royal Children’s Hospital, Melbourne, Australia
- Centre for Community Child Health, Royal Children’s Hospital, Melbourne, Australia
| | - Haytham Kubba
- Department of Otolaryngology, Royal Hospital for Children, Glasgow, Scotland
| | - Rachel L. Peters
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Respiratory and Sleep Medicine, Royal Children’s Hospital, Melbourne, Australia
| | - Joanne Rimmer
- Department of Otolaryngology–Head and Neck Surgery, Monash Health, Melbourne, Australia
- Department of Surgery, Monash University, Melbourne, Australia
| | - Elizabeth Rose
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Otolaryngology, Royal Children’s Hospital, Melbourne, Australia
- Department of Otolaryngology, University of Melbourne, Melbourne, Australia
| | - Katherine Rowe
- Department of General Medicine, Royal Children’s Hospital, Melbourne, Australia
| | - Catherine M. Simpson
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Community Child Health, Royal Children’s Hospital, Melbourne, Australia
| | - Andrew Davidson
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne Children’s Trial Centre, Melbourne Children’s, Melbourne, Australia
| | - Gillian Nixon
- Melbourne Children's Sleep Centre, Monash Children’s Hospital, Monash Health, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
| | - Kirsten P. Perrett
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne Children’s Trial Centre, Melbourne Children’s, Melbourne, Australia
- Department of Allergy and Immunology, Royal Children’s Hospital, Melbourne, Australia
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19
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Sanders DB, Deschamp AR, Hatch JE, Slaven JE, Gebregziabher N, Corput MKVD, Tiddens HAWM, Rosenow T, Storch GA, Hall GL, Stick SM, Ranganathan S, Ferkol TW, Davis SD. Association between early respiratory viral infections and structural lung disease in infants with cystic fibrosis. J Cyst Fibros 2022; 21:1020-1026. [PMID: 35523715 PMCID: PMC10564322 DOI: 10.1016/j.jcf.2022.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 01/18/2021] [Revised: 04/15/2022] [Accepted: 04/17/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Infants with cystic fibrosis (CF) develop structural lung disease early in life, and viral infections are associated with progressive lung disease. We hypothesized that the presence of respiratory viruses would be associated with structural lung disease on computed tomography (CT) of the chest in infants with CF. METHODS Infants with CF were enrolled before 4 months of age. Multiplex PCR assays were performed on nasal swabs to detect respiratory viruses during routine visits and when symptomatic. Participants underwent CT imaging at approximately 12 months of age. Associations between Perth-Rotterdam Annotated Grid Morphometric Analysis for CF (PRAGMA-CF) CT scores and respiratory viruses and symptoms were assessed with Spearman correlation coefficients. RESULTS Sixty infants were included for analysis. Human rhinovirus was the most common virus detected, on 28% of tested nasal swabs and in 85% of participants. The median (IQR) extent of lung fields that was healthy based on PRAGMA-CF was 98.7 (0.8)%. There were no associations between PRAGMA-CF and age at first virus, or detection of any virus, including rhinovirus, respiratory syncytial virus, or parainfluenza. The extent of airway wall thickening was associated with ever having wheezed (ρ = 0.31, p = 0.02) and number of encounters with cough (ρ = 0.25, p = 0.0495). CONCLUSIONS Infants with CF had minimal structural lung disease. We did not find an association between respiratory viruses and CT abnormalities. Wheezing and frequency of cough were associated with early structural changes.
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Affiliation(s)
- Don B Sanders
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Ashley R Deschamp
- Department of Pediatrics, University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, USA
| | - Joseph E Hatch
- Department of Pediatrics, UNC Children's, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - James E Slaven
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Netsanet Gebregziabher
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mariette Kemner-van de Corput
- Department of Paediatrics, Erasmus MC - Sophia Children's Hospital, University Medial Center Rotterdam, Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC - Sophia Children's Hospital, University Medial Center Rotterdam, Netherlands
| | - Harm A W M Tiddens
- Department of Paediatrics, Erasmus MC - Sophia Children's Hospital, University Medial Center Rotterdam, Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC - Sophia Children's Hospital, University Medial Center Rotterdam, Netherlands
| | - Tim Rosenow
- The Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Nedlands, Western Australia; Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute and School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Gregory A Storch
- Department of Pediatrics, Washington University, St. Louis Children's Hospital, St. Louis, MO, USA
| | - Graham L Hall
- Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute and School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Stephen M Stick
- Department of Pediatrics, University of Western Australia, Telethon Kids Institute, Perth, Australia
| | - Sarath Ranganathan
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Australia; Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Thomas W Ferkol
- Department of Pediatrics, Washington University, St. Louis Children's Hospital, St. Louis, MO, USA
| | - Stephanie D Davis
- Department of Pediatrics, UNC Children's, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
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20
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Shanthikumar S, Ranganathan S, Neeland MR. Ivacaftor, not ivacaftor/lumacaftor, associated with lower pulmonary inflammation in preschool cystic fibrosis. Pediatr Pulmonol 2022; 57:2549-2552. [PMID: 35791043 PMCID: PMC9796514 DOI: 10.1002/ppul.26063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/16/2022] [Accepted: 07/04/2022] [Indexed: 01/01/2023]
Affiliation(s)
- Shivanthan Shanthikumar
- Infection and Immunity Theme, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Respiratory and Sleep Medicine, Royal Children's Hospital, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Sarath Ranganathan
- Infection and Immunity Theme, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Respiratory and Sleep Medicine, Royal Children's Hospital, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Melanie R Neeland
- Infection and Immunity Theme, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
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21
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Shanthikumar S, Kim S, Giacalone V, Rao P, Ranganathan S, Karpievitch Y, Stick S, Boucher R, Tirouvanziam R, Chandler J, Esther C. 446 Metabolites in early life bronchoalveolar fluid associate with future bronchiectasis risk in children with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01136-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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22
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Du Berry C, Nesci C, Cheong JL, FitzGerald T, Mainzer R, Ranganathan S, Doyle LW, Vrijlandt EJ, Welsh L. Long-term expiratory airflow of infants born moderate-late preterm: A systematic review and meta-analysis. EClinicalMedicine 2022; 52:101597. [PMID: 35923430 PMCID: PMC9340512 DOI: 10.1016/j.eclinm.2022.101597] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Moderate-late preterm (MLP; 32 to <37 weeks' gestation) birth is associated with reduced expiratory airflow during child, adolescent and adult years. However, some studies have reported only minimal airflow limitation and hence it is unclear if clinical assessment in later life is warranted. Our aim was to compare maximal expiratory airflow in children and adults born MLP with term-born controls, and with expected norms. METHODS We systematically reviewed studies reporting z-scores for spirometric indices (forced expired volume in 1 second [FEV1], forced vital capacity [FVC], FEV1/FVC ratio and forced expiratory flow at 25-75% of FVC [FEF25-75%]) from participants born MLP aged five years or older, with or without a term-born control group from 4 databases (MEDLINE, CINAHL, Embase, Emcare). Publications were searched for between the 22nd of September 2021 to the 29th of September 2021. A meta-analysis of eligible studies was conducted using a random effects model. The study protocol was published in PROSPERO (CRD #42021281518). FINDINGS We screened 4970 articles and identified 18 relevant studies, 15 of which were eligible for meta-analysis (8 with term-born controls and 7 without). Compared with controls, MLP participants had lower z-scores (mean difference [95% confidence interval] I2) for FEV1: -0.22 [-0.35, -0.09] 49.3%, FVC: -0.23 [-0.4, -0.06] 71.8%, FEV1/FVC: -0.11 [-0.20 to -0.03] 9.3% and FEF25-75%: -0.27 [-0.41 to -0.12] 21.9%. Participants born MLP also had lower z-scores, on average, when compared with a z-score of 0 (mean [95% CI] I2) for FEV1: -0.26 [-0.40 to -0.11] 85.2%, FVC: -0.18 [-0.34 to -0.02] 88.3%, FEV1/FVC: -0.24 [-0.43 to -0.05] 90.5% and FEF25-75%: -0.33 [-0.54 to -0.20] 94.7%. INTERPRETATION Those born MLP had worse expiratory airflows than those born at term, and compared with norms, although reductions were modest. Clinicians should be aware that children and adults born MLP may be at higher risk of obstructive lung disease compared with term-born peers. FUNDING This work is supported by grants from the National Health and Medical Research Council (Centre of Research Excellence #1153176, Project grant #1161304); Medical Research Future Fund (Career Development Fellowship to J.L.Y Cheong #1141354) and from the Victorian Government's Operational Infrastructure Support Programme. C. Du Berry's PhD candidature is supported by the Melbourne Research Scholarship and the Centre of Research Excellence in Newborn Medicine.
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Affiliation(s)
- Cassidy Du Berry
- Department of Paediatrics, The University of Melbourne, Australia
- Respiratory Group, Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia
- Department of Respiratory Medicine, The Royal Children's Hospital Melbourne, Australia
- Corresponding author at: Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, 3052, Australia.
| | - Christopher Nesci
- Department of Respiratory Medicine, The Royal Children's Hospital Melbourne, Australia
| | - Jeanie L.Y. Cheong
- Department of Obstetrics and Gynaecology, The University of Melbourne, Australia
- Victorian Infant Brain Studies Group, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- Newborn Research, The Royal Women's Hospital Melbourne, Australia
| | - Tara FitzGerald
- Department of Physiotherapy, The University of Melbourne, Australia
- Victorian Infant Brain Studies Group, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
| | - Rheanna Mainzer
- Department of Paediatrics, The University of Melbourne, Australia
- Respiratory Group, Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia
- Clinical Epidemiology and Biostatistics Unit, Population Health, Murdoch Children's Research Institute, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, The University of Melbourne, Australia
- Respiratory Group, Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia
- Department of Respiratory Medicine, The Royal Children's Hospital Melbourne, Australia
| | - Lex W. Doyle
- Department of Paediatrics, The University of Melbourne, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Australia
- Victorian Infant Brain Studies Group, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- Newborn Research, The Royal Women's Hospital Melbourne, Australia
| | - Elianne J.L.E. Vrijlandt
- Department of Pediatric Pulmonology and Pediatric Allergy, Beatrix Children's Hospital, and the Groningen Research Institute for Asthma and COPD, the Netherlands
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Liam Welsh
- Department of Paediatrics, The University of Melbourne, Australia
- Respiratory Group, Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia
- Department of Respiratory Medicine, The Royal Children's Hospital Melbourne, Australia
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23
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Gao Y, O’Hely M, Quinn TP, Ponsonby AL, Harrison LC, Frøkiær H, Tang MLK, Brix S, Kristiansen K, Burgner D, Saffery R, Ranganathan S, Collier F, Vuillermin P. Maternal gut microbiota during pregnancy and the composition of immune cells in infancy. Front Immunol 2022; 13:986340. [PMID: 36211431 PMCID: PMC9535361 DOI: 10.3389/fimmu.2022.986340] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/05/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Preclinical studies have shown that maternal gut microbiota during pregnancy play a key role in prenatal immune development but the relevance of these findings to humans is unknown. The aim of this prebirth cohort study was to investigate the association between the maternal gut microbiota in pregnancy and the composition of the infant’s cord and peripheral blood immune cells over the first year of life. Methods The Barwon Infant Study cohort (n=1074 infants) was recruited using an unselected sampling frame. Maternal fecal samples were collected at 36 weeks of pregnancy and flow cytometry was conducted on cord/peripheral blood collected at birth, 6 and 12 months of age. Among a randomly selected sub-cohort with available samples (n=293), maternal gut microbiota was characterized by sequencing the 16S rRNA V4 region. Operational taxonomic units (OTUs) were clustered based on their abundance. Associations between maternal fecal microbiota clusters and infant granulocyte, monocyte and lymphocyte subsets were explored using compositional data analysis. Partial least squares (PLS) and regression models were used to investigate the relationships/associations between environmental, maternal and infant factors, and OTU clusters. Results We identified six clusters of co-occurring OTUs. The first two components in the PLS regression explained 39% and 33% of the covariance between the maternal prenatal OTU clusters and immune cell populations in offspring at birth. A cluster in which Dialister, Escherichia, and Ruminococcus were predominant was associated with a lower proportion of granulocytes (p=0.002), and higher proportions of both central naïve CD4+ T cells (CD4+/CD45RA+/CD31−) (p<0.001) and naïve regulatory T cells (Treg) (CD4+/CD45RA+/FoxP3low) (p=0.02) in cord blood. The association with central naïve CD4+ T cells persisted to 12 months of age. Conclusion This birth cohort study provides evidence consistent with past preclinical models that the maternal gut microbiota during pregnancy plays a role in shaping the composition of innate and adaptive elements of the infant’s immune system following birth.
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Affiliation(s)
- Yuan Gao
- School of Medicine, Deakin University, Geelong, VIC, Australia
- Child Health Research Unit, Barwon Health, Geelong, VIC, Australia
- Faculty of Science, Copenhagen University, København, Denmark
| | - Martin O’Hely
- School of Medicine, Deakin University, Geelong, VIC, Australia
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
| | | | - Anne-Louise Ponsonby
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
- The Early Brain Science Department, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - Leonard C. Harrison
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia
| | - Hanne Frøkiær
- Faculty of Science, Copenhagen University, København, Denmark
| | - Mimi L. K. Tang
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Susanne Brix
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Karsten Kristiansen
- Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Dave Burgner
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Richard Saffery
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Sarath Ranganathan
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Fiona Collier
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Peter Vuillermin
- School of Medicine, Deakin University, Geelong, VIC, Australia
- Child Health Research Unit, Barwon Health, Geelong, VIC, Australia
- *Correspondence: Peter Vuillermin,
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24
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Margaroli C, Horati H, Garratt LW, Giacalone VD, Schofield C, Dittrich AS, Rosenow T, Dobosh BS, Lim HS, Frey DL, Veltman M, Silva GL, Brown MR, Schultz C, Tiddens HAWM, Ranganathan S, Chandler JD, Qiu P, Peng L, Scholte BJ, Mall MA, Kicic A, Guglani L, Stick SM, Janssens HM, Tirouvanziam R. Macrophage PD-1 associates with neutrophilia and reduced bacterial killing in early cystic fibrosis airway disease. J Cyst Fibros 2022; 21:967-976. [PMID: 35732550 DOI: 10.1016/j.jcf.2022.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/17/2022] [Accepted: 06/02/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Macrophages are the major resident immune cells in human airways coordinating responses to infection and injury. In cystic fibrosis (CF), neutrophils are recruited to the airways shortly after birth, and actively exocytose damaging enzymes prior to chronic infection, suggesting a potential defect in macrophage immunomodulatory function. Signaling through the exhaustion marker programmed death protein 1 (PD-1) controls macrophage function in cancer, sepsis, and airway infection. Therefore, we sought to identify potential associations between macrophage PD-1 and markers of airway disease in children with CF. METHODS Blood and bronchoalveolar lavage fluid (BALF) were collected from 45 children with CF aged 3 to 62 months and structural lung damage was quantified by computed tomography. The phenotype of airway leukocytes was assessed by flow cytometry, while the release of enzymes and immunomodulatory mediators by molecular assays. RESULTS Airway macrophage PD-1 expression correlated positively with structural lung damage, neutrophilic inflammation, and infection. Interestingly, even in the absence of detectable infection, macrophage PD-1 expression was elevated and correlated with neutrophilic inflammation. In an in vitro model mimicking leukocyte recruitment into CF airways, soluble mediators derived from recruited neutrophils directly induced PD-1 expression on recruited monocytes/macrophages, suggesting a causal link between neutrophilic inflammation and macrophage PD-1 expression in CF. Finally, blockade of PD-1 in a short-term culture of CF BALF leukocytes resulted in improved pathogen clearance. CONCLUSION Taken together, these findings suggest that in early CF lung disease, PD-1 upregulation associates with airway macrophage exhaustion, neutrophil takeover, infection, and structural damage.
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Affiliation(s)
- Camilla Margaroli
- Department of Pediatrics, Center for CF & Airways Disease Research, Children's Healthcare of Atlanta, IMPEDE-CF Program, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Hamed Horati
- Department of Pediatrics, Div. of Respiratory Medicine and Allergology, I-BALL program, Erasmus MC-Sophia Children's Hospital, University Hospital Rotterdam, Rotterdam, The Netherlands
| | - Luke W Garratt
- AREST-CF Program, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Vincent D Giacalone
- Department of Pediatrics, Center for CF & Airways Disease Research, Children's Healthcare of Atlanta, IMPEDE-CF Program, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Craig Schofield
- AREST-CF Program, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - A Susanne Dittrich
- Department of Translational Pulmonology, Translational Lung Research Center (TLRC), German Center for Lung Research (DZL) and Department of Pulmonology, and Critical Care Medicine, Thoraxklinik at the University of Heidelberg, Heidelberg, Germany
| | - Tim Rosenow
- AREST-CF Program, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Brian S Dobosh
- Department of Pediatrics, Center for CF & Airways Disease Research, Children's Healthcare of Atlanta, IMPEDE-CF Program, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Hong S Lim
- Department of Biomedical engineering, The Georgia Institute of Technology and Emory University, Atlanta, GA, United States of America
| | - Dario L Frey
- Department of Translational Pulmonology, Translational Lung Research Center (TLRC), German Center for Lung Research (DZL) and Department of Pulmonology, and Critical Care Medicine, Thoraxklinik at the University of Heidelberg, Heidelberg, Germany
| | - Mieke Veltman
- Department of Pediatrics, Div. of Respiratory Medicine and Allergology, I-BALL program, Erasmus MC-Sophia Children's Hospital, University Hospital Rotterdam, Rotterdam, The Netherlands
| | - George L Silva
- Department of Pediatrics, Center for CF & Airways Disease Research, Children's Healthcare of Atlanta, IMPEDE-CF Program, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Milton R Brown
- Department of Pediatrics, Center for CF & Airways Disease Research, Children's Healthcare of Atlanta, IMPEDE-CF Program, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Carsten Schultz
- Department of Physiology and Pharmacology, Oregon Health & Science University, Portland, OR, United States of America
| | - Harm A W M Tiddens
- Department of Pediatrics, Div. of Respiratory Medicine and Allergology, I-BALL program, Erasmus MC-Sophia Children's Hospital, University Hospital Rotterdam, Rotterdam, The Netherlands
| | - Sarath Ranganathan
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, and Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Australia
| | - Joshua D Chandler
- Department of Pediatrics, Center for CF & Airways Disease Research, Children's Healthcare of Atlanta, IMPEDE-CF Program, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Peng Qiu
- Department of Biomedical engineering, The Georgia Institute of Technology and Emory University, Atlanta, GA, United States of America
| | - Limin Peng
- Department of Pediatrics, Center for CF & Airways Disease Research, Children's Healthcare of Atlanta, IMPEDE-CF Program, Emory University School of Medicine, Atlanta, GA, United States of America; Department of Biostatistics, Emory University School of Public Health, Atlanta, GA, United States of America
| | - Bob J Scholte
- Department of Pediatrics, Div. of Respiratory Medicine and Allergology, I-BALL program, Erasmus MC-Sophia Children's Hospital, University Hospital Rotterdam, Rotterdam, The Netherlands
| | - Marcus A Mall
- Department of Translational Pulmonology, Translational Lung Research Center (TLRC), German Center for Lung Research (DZL) and Department of Pulmonology, and Critical Care Medicine, Thoraxklinik at the University of Heidelberg, Heidelberg, Germany; Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Anthony Kicic
- AREST-CF Program, Telethon Kids Institute, University of Western Australia, Perth, Australia; Department of Respiratory and Sleep Medicine, Perth Children's Hospital and Faculty of Medicine, University of Western Australia, Perth, Western Australia, Australia; School of Public Heath, Curtin University, Perth, Western Australia, Australia
| | - Lokesh Guglani
- Department of Pediatrics, Center for CF & Airways Disease Research, Children's Healthcare of Atlanta, IMPEDE-CF Program, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Stephen M Stick
- AREST-CF Program, Telethon Kids Institute, University of Western Australia, Perth, Australia; Department of Respiratory and Sleep Medicine, Perth Children's Hospital and Faculty of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Hettie M Janssens
- Department of Pediatrics, Div. of Respiratory Medicine and Allergology, I-BALL program, Erasmus MC-Sophia Children's Hospital, University Hospital Rotterdam, Rotterdam, The Netherlands
| | - Rabindra Tirouvanziam
- Department of Pediatrics, Center for CF & Airways Disease Research, Children's Healthcare of Atlanta, IMPEDE-CF Program, Emory University School of Medicine, Atlanta, GA, United States of America.
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25
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Ranganathan S, Entezari P, Gabr A, Gordon A, Kulik L, Desai K, Thornburg B, Riaz A, Salem R, Lewandowski R. Abstract No. 309 Evaluating liver function status trends in hepatocellular carcinoma patients with intermediate-stage disease undergoing radioembolization: a longitudinal study. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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26
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Ponsonby AL, Collier F, O'Hely M, Tang MLK, Ranganathan S, Gray L, Morwitch E, Saffery R, Burgner D, Dwyer T, Sly PD, Harrison LC, Vuillermin P. Household size, T regulatory cell development, and early allergic disease: a birth cohort study. Pediatr Allergy Immunol 2022; 33:e13810. [PMID: 35754137 PMCID: PMC9545943 DOI: 10.1111/pai.13810] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children born to larger households have less allergic disease. T regulatory cell (Treg) development may be a relevant mechanism, but this has not been studied longitudinally. OBJECTIVE We aim to (i) describe how prenatal and postnatal environmental factors are associated with Treg development and (ii) investigate whether serial Treg measures predict allergic outcomes at 1 year of age. METHODS A birth cohort (n = 1074) with information on prenatal and postnatal early life factors. Both naïve Treg (nTreg) and activated Treg (aTreg) cell populations (as a proportion of CD4+ T cells) were available in 463 infants at birth (cord blood), 600 at 6 months, and 675 at 12 months. 191 infants had serial measures. Measures of allergic status at 12 months were polysensitization (sensitization to 2 or more allergens), clinically proven food allergy, atopic eczema, and atopic wheeze. RESULTS Infants born to larger households (3 or more residents) had higher longitudinal nTreg proportions over the first postnatal year with a mean difference (MD) of 0.67 (95% CI 0.30-1.04)%. Higher nTreg proportions at birth were associated with a reduced risk of infant allergic outcomes. Childcare attendance and breastfeeding were associated with higher longitudinal nTreg proportions (MD 0.48 (95% CI 0.08-0.80)%. CONCLUSION Multiple prenatal and postnatal microbial factors are associated with nTreg and aTreg development. Larger household size was associated with higher nTreg at birth which in turn was associated with reduced allergic sensitization and disease at 12 months of age.
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Affiliation(s)
- Anne-Louise Ponsonby
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Fiona Collier
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Martin O'Hely
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.,School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Lawrence Gray
- School of Medicine, Deakin University, Geelong, Victoria, Australia.,Barwon Health, Geelong, Victoria, Australia
| | - Ellen Morwitch
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.,National Centre of Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Terence Dwyer
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.,The George Institute for Global Health, Oxford University, Oxford, UK
| | - Peter D Sly
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.,University of Queensland, South Brisbane, Queensland, Australia
| | | | - Peter Vuillermin
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.,School of Medicine, Deakin University, Geelong, Victoria, Australia.,Barwon Health, Geelong, Victoria, Australia
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27
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Mansell T, Saffery R, Burugupalli S, Ponsonby AL, Tang MLK, O'Hely M, Bekkering S, Smith AAT, Rowland R, Ranganathan S, Sly PD, Vuillermin P, Collier F, Meikle P, Burgner D. Early life infection and proinflammatory, atherogenic metabolomic and lipidomic profiles in infancy: a population-based cohort study. eLife 2022; 11:75170. [PMID: 35535496 PMCID: PMC9090335 DOI: 10.7554/elife.75170] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Received: 11/01/2021] [Accepted: 04/24/2022] [Indexed: 01/03/2023] Open
Abstract
Background: The risk of adult onset cardiovascular and metabolic (cardiometabolic) disease accrues from early life. Infection is ubiquitous in infancy and induces inflammation, a key cardiometabolic risk factor, but the relationship between infection, inflammation, and metabolic profiles in early childhood remains unexplored. We investigated relationships between infection and plasma metabolomic and lipidomic profiles at age 6 and 12 months, and mediation of these associations by inflammation. Methods: Matched infection, metabolomics, and lipidomics data were generated from 555 infants in a pre-birth longitudinal cohort. Infection data from birth to 12 months were parent-reported (total infections at age 1, 3, 6, 9, and 12 months), inflammation markers (high-sensitivity C-reactive protein [hsCRP]; glycoprotein acetyls [GlycA]) were quantified at 12 months. Metabolic profiles were 12-month plasma nuclear magnetic resonance metabolomics (228 metabolites) and liquid chromatography/mass spectrometry lipidomics (776 lipids). Associations were evaluated with multivariable linear regression models. In secondary analyses, corresponding inflammation and metabolic data from birth (serum) and 6-month (plasma) time points were used. Results: At 12 months, more frequent infant infections were associated with adverse metabolomic (elevated inflammation markers, triglycerides and phenylalanine, and lower high-density lipoprotein [HDL] cholesterol and apolipoprotein A1) and lipidomic profiles (elevated phosphatidylethanolamines and lower trihexosylceramides, dehydrocholesteryl esters, and plasmalogens). Similar, more marked, profiles were observed with higher GlycA, but not hsCRP. GlycA mediated a substantial proportion of the relationship between infection and metabolome/lipidome, with hsCRP generally mediating a lower proportion. Analogous relationships were observed between infection and 6-month inflammation, HDL cholesterol, and apolipoprotein A1. Conclusions: Infants with a greater infection burden in the first year of life had proinflammatory and proatherogenic plasma metabolomic/lipidomic profiles at 12 months of age that in adults are indicative of heightened risk of cardiovascular disease, obesity, and type 2 diabetes. These findings suggest potentially modifiable pathways linking early life infection and inflammation with subsequent cardiometabolic risk. Funding: The establishment work and infrastructure for the BIS was provided by the Murdoch Children’s Research Institute (MCRI), Deakin University, and Barwon Health. Subsequent funding was secured from National Health and Medical Research Council of Australia (NHMRC), The Shepherd Foundation, The Jack Brockhoff Foundation, the Scobie & Claire McKinnon Trust, the Shane O’Brien Memorial Asthma Foundation, the Our Women’s Our Children’s Fund Raising Committee Barwon Health, the Rotary Club of Geelong, the Minderoo Foundation, the Ilhan Food Allergy Foundation, GMHBA, Vanguard Investments Australia Ltd, and the Percy Baxter Charitable Trust, Perpetual Trustees. In-kind support was provided by the Cotton On Foundation and CreativeForce. The study sponsors were not involved in the collection, analysis, and interpretation of data; writing of the report; or the decision to submit the report for publication. Research at MCRI is supported by the Victorian Government’s Operational Infrastructure Support Program. This work was also supported by NHMRC Senior Research Fellowships to ALP (1008396); DB (1064629); and RS (1045161) , NHMRC Investigator Grants to ALP (1110200) and DB (1175744), NHMRC-A*STAR project grant (1149047). TM is supported by an MCRI ECR Fellowship. SB is supported by the Dutch Research Council (452173113).
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Affiliation(s)
- Toby Mansell
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Satvika Burugupalli
- Metabolomics Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia.,The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia.,Royal Children's Hospital, Parkville, Australia
| | - Martin O'Hely
- Murdoch Children's Research Institute, Parkville, Australia.,Deakin University, Geelong, Australia
| | - Siroon Bekkering
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Internal Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Centre, Nijmegen, Netherlands
| | | | | | - Sarath Ranganathan
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia.,Royal Children's Hospital, Parkville, Australia
| | - Peter D Sly
- Murdoch Children's Research Institute, Parkville, Australia.,Child Health Research Centre, University of Queensland, Brisbane, Australia
| | - Peter Vuillermin
- Murdoch Children's Research Institute, Parkville, Australia.,Deakin University, Geelong, Australia.,Child Health Research Unit, Barwon Health, Geelong, Australia
| | - Fiona Collier
- Deakin University, Geelong, Australia.,Child Health Research Unit, Barwon Health, Geelong, Australia
| | - Peter Meikle
- Metabolomics Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - David Burgner
- Department of Paediatrics, University of Melbourne, Parkville, Australia.,Department of Paediatrics, Monash University, Clayton, Australia
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28
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McElroy R, Talesh GA, Harpur CM, Carzino R, Corbett AJ, Pellicci DG, Ranganathan S, Sutton P. Unconventional T Cell Immunity in the Lungs of Young Children with Cystic Fibrosis. FRONT BIOSCI-LANDMRK 2022; 27:149. [DOI: 10.31083/j.fbl2705149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/14/2022] [Accepted: 04/21/2022] [Indexed: 11/06/2022]
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29
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Doyle LW, Ranganathan S, Cheong J. Bronchopulmonary dysplasia and expiratory airflow at 8 years in children born extremely preterm in the post-surfactant era. Thorax 2022; 78:484-488. [PMID: 35459746 DOI: 10.1136/thoraxjnl-2022-218792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/29/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND It is unclear if bronchopulmonary dysplasia (BPD) is independently associated with reduced expiratory airflow at school age. OBJECTIVE To determine the independent associations of moderate-severe BPD, mild BPD, gestational age and birth weight z-score with expiratory airflow in children born extremely preterm (EP; <28 weeks' gestation). METHODS All EP survivors born in Victoria, Australia, in three eras (1991-1992, n=225; 1997, n=151; and 2005, n=170) were recruited at birth and 418/546 (77%) had valid spirometry data at 8 years. BPD was classified as moderate-severe (oxygen requirement at 36 weeks' postmenstrual age), or mild (oxygen >28 days but not at 36 weeks' postmenstrual age). Expiratory airflow variables, including the forced expired volume in 1 s (FEV1), were measured and values converted to z-scores. RESULTS Compared with no BPD (n=94), moderate-severe BPD (n=193) was associated with a substantial reduction in expiratory airflow (eg, zFEV1 mean difference -0.69, 95% CI -0.97 to -0.41; p<0.001), but mild BPD (n=131) was not (zFEV1 mean difference 0.01, 95% CI -0.28 to 0.31; p=0.93). On multivariable analysis, moderate-severe BPD remained strongly associated with reduced airflow (zFEV1 mean difference -0.63, 95% CI -0.92 to -0.33; p<0.001), but mild BPD (zFEV1 mean difference 0.04, 95% CI -0.26 to 0.34; p=0.27), gestational age (zFEV1 0.06 mean increase per week, 95% CI -0.05 to 0.17; p=0.29) and birth weight z-score (zFEV1 0.07 mean increase per SD, 95% CI -0.06 to 0.20; p=0.28) were not. CONCLUSIONS In children born EP, moderate-severe BPD, but not mild BPD was independently associated with reduced expiratory airflow at 8 years.
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Affiliation(s)
- Lex William Doyle
- Neonatal Services, The Royal Women's Hospital, Parkville, Victoria, Australia .,Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia.,Clinical Sciences, Murdoch Children's Research Institute Clinical Sciences Theme, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Jeanie Cheong
- Neonatal Services, The Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia.,Clinical Sciences, Murdoch Children's Research Institute Clinical Sciences Theme, Parkville, Victoria, Australia
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30
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Craig S, Powell CVE, Nixon GM, Oakley E, Hort J, Armstrong DS, Ranganathan S, Kochar A, Wilson C, George S, Phillips N, Furyk J, Lawton B, Borland ML, O'Brien S, Neutze J, Lithgow A, Mitchell C, Watkins N, Brannigan D, Wood J, Gray C, Hearps S, Ramage E, Williams A, Lew J, Jones L, Graudins A, Dalziel S, Babl FE. Treatment patterns and frequency of key outcomes in acute severe asthma in children: a Paediatric Research in Emergency Departments International Collaborative (PREDICT) multicentre cohort study. BMJ Open Respir Res 2022; 9:9/1/e001137. [PMID: 35301198 PMCID: PMC8932260 DOI: 10.1136/bmjresp-2021-001137] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/27/2022] [Indexed: 11/04/2022] Open
Abstract
RATIONALE Severe acute paediatric asthma may require treatment escalation beyond systemic corticosteroids, inhaled bronchodilators and low-flow oxygen. Current large asthma datasets report parenteral therapy only. OBJECTIVES To identify the use and type of escalation of treatment in children presenting to hospital with acute severe asthma. METHODS Retrospective cohort study of children with an emergency department diagnosis of asthma or wheeze at 18 Australian and New Zealand hospitals. The main outcomes were use and type of escalation treatment (defined as any of intensive care unit admission, nebulised magnesium, respiratory support or parenteral bronchodilator treatment) and hospital length of stay (LOS). MEASUREMENTS AND MAIN RESULTS Of 14 029 children (median age 3 (IQR 1-3) years; 62.9% male), 1020 (7.3%, 95% CI 6.9% to 7.7%) had treatment escalation. Children with treatment escalation had a longer LOS (44.2 hours, IQR 27.3-63.2 hours) than children without escalation 6.7 hours, IQR 3.5-16.3 hours; p<0.001). The most common treatment escalations were respiratory support alone (400; 2.9%, 95% CI 2.6% to 3.1%), parenteral bronchodilator treatment alone (380; 2.7%, 95% CI 2.5% to 3.0%) and both respiratory support and parenteral bronchodilator treatment (209; 1.5%, 95% CI 1.3% to 1.7%). Respiratory support was predominantly nasal high-flow therapy (99.0%). The most common intravenous medication regimens were: magnesium alone (50.4%), magnesium and aminophylline (24.6%) and magnesium and salbutamol (10.0%). CONCLUSIONS Overall, 7.3% children with acute severe asthma received some form of escalated treatment, with 4.2% receiving parenteral bronchodilators and 4.3% respiratory support. There is wide variation treatment escalation.
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Affiliation(s)
- Simon Craig
- Paediatric Emergency Department, Monash Medical Centre, Monash Emergency Research Collaborative, Monash Health, Clayton, Victoria, Australia .,Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Colin V E Powell
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.,Department of Emergency Medicine, Sidra Medicine, Ad-Dawhah, Doha, Qatar
| | - Gillian M Nixon
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.,Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Ed Oakley
- Emergency Department, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Emergency Research, Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Departments of Paediatrics and Critical Care, University of Melbourne, Parkville, Victoria, Australia
| | - Jason Hort
- Emergency Department, Children's Hospital at Westmead, Westmead, New South Wales, Australia.,The University of Sydney Sydney Medical School, Sydney, New South Wales, Australia
| | - David S Armstrong
- Respiratory and Sleep Medicine, Monash Children's Hospital, Clayton, Victoria, Australia
| | - Sarath Ranganathan
- Respiratory Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Amit Kochar
- Emergency Department, Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia
| | - Catherine Wilson
- Emergency Research, Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Shane George
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia.,Emergency Medicine and Children's Critical Care Service, Gold Coast University Hospital, Southport, Queensland, Australia.,Child Health Research Centre, Faculty of Medicine, University of Queensland, South Brisbane, Queensland, Australia
| | - Natalie Phillips
- Child Health Research Centre, Faculty of Medicine, University of Queensland, South Brisbane, Queensland, Australia.,Emergency Department, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Jeremy Furyk
- Emergency Department, Townsville Hospital and Health Service, Townsville, Queensland, Australia.,Emergency Department, University Hospital Geelong, Geelong, Victoria, Australia
| | - Ben Lawton
- Emergency Department, Queensland Children's Hospital, South Brisbane, Queensland, Australia.,Emergency Department, Logan Hospital, Loganholme, Queensland, Australia
| | - Meredith L Borland
- Emergency Department, Perth Children's Hospital, Nedlands, Western Australia, Australia.,Divisions of Emergency Medicine and Paediatrics, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Sharon O'Brien
- Emergency Department, Perth Children's Hospital, Nedlands, Western Australia, Australia.,School of Nursing, Curtin University Faculty of Health Sciences, Perth, Western Australia, Australia
| | - Jocelyn Neutze
- Kidz First Emergency Department, Middlemore Hospital, Auckland, New Zealand
| | - Anna Lithgow
- Department of Paediatrics, Royal Darwin Hospital, Tiwi, Northern Territory of Australia, Australia
| | - Clare Mitchell
- Emergency Department, Royal Darwin Hospital, Tiwi, Northern Territory of Australia, Australia
| | - Nick Watkins
- Emergency Department, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Domhnall Brannigan
- Emergency Department, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Joanna Wood
- Emergency Department, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Charmaine Gray
- Emergency Department, Flinders Medical Centre, Bedford Park, South Australia, Australia.,Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Stephen Hearps
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Emma Ramage
- Paediatric Emergency Department, Monash Medical Centre, Monash Emergency Research Collaborative, Monash Health, Clayton, Victoria, Australia.,Paediatric Intensive Care, Monash Children's Hospital, Clayton, Victoria, Australia
| | - Amanda Williams
- Emergency Research, Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Jamie Lew
- Emergency Department, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Leonie Jones
- Emergency Department, Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Andis Graudins
- Emergency Department, Dandenong Hospital, Monash Emergency Research Collaborative, Monash Health, Clayton, Victoria, Australia.,Department of Medicine, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Stuart Dalziel
- Emergency Department, Starship Children's Health, Auckland, Auckland, New Zealand.,Departments of Surgery and Paediatrics, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Auckland, New Zealand
| | - Franz E Babl
- Emergency Department, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Emergency Research, Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Departments of Paediatrics and Critical Care, University of Melbourne, Parkville, Victoria, Australia
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31
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Chen Q, Langenbach S, Li M, Xia YC, Gao X, Gartner MJ, Pharo EA, Williams SM, Todd S, Clarke N, Ranganathan S, Baker ML, Subbarao K, Stewart AG. ACE2 Expression in Organotypic Human Airway Epithelial Cultures and Airway Biopsies. Front Pharmacol 2022; 13:813087. [PMID: 35359837 PMCID: PMC8963460 DOI: 10.3389/fphar.2022.813087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/31/2022] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an acute respiratory disease with systemic complications. Therapeutic strategies for COVID-19, including repurposing (partially) developed drugs are urgently needed, regardless of the increasingly successful vaccination outcomes. We characterized two-dimensional (2D) and three-dimensional models (3D) to establish a physiologically relevant airway epithelial model with potential for investigating SARS-CoV-2 therapeutics. Human airway basal epithelial cells maintained in submerged 2D culture were used at low passage to retain the capacity to differentiate into ciliated, club, and goblet cells in both air-liquid interface culture (ALI) and airway organoid cultures, which were then analyzed for cell phenotype makers. Airway biopsies from non-asthmatic and asthmatic donors enabled comparative evaluation of the level and distribution of immunoreactive angiotensin-converting enzyme 2 (ACE2). ACE2 and transmembrane serine proteinase 2 (TMPRSS2) mRNA were expressed in ALI and airway organoids at levels similar to those of native (i.e., non-cultured) human bronchial epithelial cells, whereas furin expression was more faithfully represented in ALI. ACE2 was mainly localized to ciliated and basal epithelial cells in human airway biopsies, ALI, and airway organoids. Cystic fibrosis appeared to have no influence on ACE2 gene expression. Neither asthma nor smoking status had consistent marked influence on the expression or distribution of ACE2 in airway biopsies. SARS-CoV-2 infection of ALI cultures did not increase the levels of selected cytokines. Organotypic, and particularly ALI airway cultures are useful and practical tools for investigation of SARS-CoV-2 infection and evaluating the clinical potential of therapeutics for COVID-19.
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Affiliation(s)
- Qianyu Chen
- Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, VIC, Australia
- ARC Centre for Personalized Therapeutics Technologies, University of Melbourne, Parkville, VIC, Australia
| | - Shenna Langenbach
- Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, VIC, Australia
- ARC Centre for Personalized Therapeutics Technologies, University of Melbourne, Parkville, VIC, Australia
| | - Meina Li
- Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, VIC, Australia
- ARC Centre for Personalized Therapeutics Technologies, University of Melbourne, Parkville, VIC, Australia
| | - Yuxiu C. Xia
- Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, VIC, Australia
| | - Xumei Gao
- Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, VIC, Australia
- ARC Centre for Personalized Therapeutics Technologies, University of Melbourne, Parkville, VIC, Australia
| | - Matthew J. Gartner
- Department of Microbiology and Immunology, University of Melbourne, Parkville, VIC, Australia
| | - Elizabeth A. Pharo
- CSIRO, Health and Biosecurity Business Unit, Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | - Sinéad M. Williams
- CSIRO, Health and Biosecurity Business Unit, Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | - Shawn Todd
- CSIRO, Health and Biosecurity Business Unit, Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | - Nadeene Clarke
- Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, VIC, Australia
| | - Sarath Ranganathan
- Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Pediatrics, Melbourne Medical School, University of Melbourne, Parkville, VIC, Australia
| | - Michelle L. Baker
- CSIRO, Health and Biosecurity Business Unit, Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | - Kanta Subbarao
- Department of Microbiology and Immunology, University of Melbourne, Parkville, VIC, Australia
- WHO Collaborating Centre for Reference and Research on Influenza at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Alastair G. Stewart
- Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, VIC, Australia
- ARC Centre for Personalized Therapeutics Technologies, University of Melbourne, Parkville, VIC, Australia
- *Correspondence: Alastair G. Stewart,
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32
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Marx W, Thomson S, O'Hely M, Symeonides C, Collier F, Tang MLK, Loughman A, Burgner D, Saffery R, Pham C, Mansell T, Sly PD, Vuillermin P, Ranganathan S, Ponsonby AL. Maternal inflammatory and omega-3 fatty acid pathways mediate the association between socioeconomic disadvantage and childhood cognition. Brain Behav Immun 2022; 100:211-218. [PMID: 34896180 DOI: 10.1016/j.bbi.2021.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 09/27/2021] [Revised: 11/28/2021] [Accepted: 12/03/2021] [Indexed: 10/19/2022] Open
Abstract
Poor cognitive outcomes in early childhood predict poor educational outcomes and diminished health over the life course. We sought to investigate (i) whether maternal metabolites predict child cognition, and (ii) if maternal metabolomic profile mediates the relationship between environmental exposures and child cognition. Metabolites were measured using nuclear magnetic resonance-based metabolomics in pregnant women from a population-derived birth cohort. Child cognition was measured at age 2 years. In 662 mother-child pairs, elevated inflammatory markers (β = -2.62; 95% CI -4.10, -1.15; P = 0.0005) and lower omega-3 fatty acid-related metabolites (β = 0.49; 95% CI 0.09, 0.88; P = 0.02) in the mother were associated with lower child cognition and partially mediated the association between lower child cognition and multiple risk factors common to socioeconomic disadvantage. Modifying maternal prenatal metabolic pathways related to inflammation and omega-3 fatty acids may offset the adverse associations between prenatal risk factors related to socioeconomic disadvantage and low child cognition.
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Affiliation(s)
- Wolfgang Marx
- Florey Institute for Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC 3052, Australia; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, 299 Ryrie Street, Geelong, VIC 3220, Australia
| | - Sarah Thomson
- Florey Institute for Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC 3052, Australia
| | - Martin O'Hely
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, 299 Ryrie Street, Geelong, VIC 3220, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia
| | - Christos Symeonides
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia; Minderoo Foundation, Perth, VIC 6000, Australia; Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia
| | - Fiona Collier
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, 299 Ryrie Street, Geelong, VIC 3220, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia; Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia; University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia
| | - Amy Loughman
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, 299 Ryrie Street, Geelong, VIC 3220, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia
| | - Cindy Pham
- Florey Institute for Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC 3052, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia
| | - Toby Mansell
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia
| | - Peter D Sly
- Child Health Research Centre, The University of Queensland, 62 Graham St, South Brisbane, QLD 4101, Australia
| | - Peter Vuillermin
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, 299 Ryrie Street, Geelong, VIC 3220, Australia; Barwon Health, Bellerine St, Geelong, VIC 3220, Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia
| | - Anne-Louise Ponsonby
- Florey Institute for Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC 3052, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia.
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33
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Du Berry C, Saunders T, McMinn A, Tosif S, Shanthikumar S, Vandeleur M, Harrison J, Burgner D, Ranganathan S, Crawford N, Wurzel D. Is cardiorespiratory disease associated with increased susceptibility of SARS-CoV-2 in children? Pediatr Pulmonol 2021; 56:3664-3668. [PMID: 34473903 PMCID: PMC8661609 DOI: 10.1002/ppul.25642] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/29/2021] [Accepted: 08/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND There are limited data in pediatric populations evaluating whether chronic cardiorespiratory conditions are associated with increased risk of coronavirus disease 2019 (COVID-19). We aimed to compare the rates of chronic cardiac and respiratory disease in children testing positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2[+]) compared with those testing negative (SARS-CoV-2[-]) at our institution. METHOD Prospective cohort with nested case-control study of all children tested by polymerase chain reaction (PCR) for SARS-CoV-2 by nasopharyngeal/oropharyngeal sampling between March and October 2020. Children were identified prospectively via laboratory notification with age and sex-matching of SARS-CoV-2[+] to SARS-CoV-2[-] (1:2). Clinical data were extracted from the electronic medical record. RESULTS In total, 179 SARS-CoV-2[+] children (44% females, median age 3.5 years, range: 0.1-19.0 years) were matched to 391 SARS-CoV-2[-] children (42% female, median age 3.7 years, range: 0.1-18.3 years). The commonest comorbidities showed similar frequencies in the SARS-CoV-2[+] and [-] groups: asthma (n = 9, 5% vs. n = 17, 4.4%, p = 0.71), congenital heart disease (n = 6, 3.4% vs. n = 7, 1.8%, p = 0.25) and obstructive sleep apnoea (n = 4, 2.2% vs. n = 10, 2.3%, p = 0.82). In the SARS-CoV-2[+] group, the prevalence of symptomatic disease was similar among children with and without cardiorespiratory comorbidities (n = 12, 75% vs. n = 103, 57%, p = 0.35). A high proportion of children hospitalized with SARS-CoV-2 infection had cardiac comorbidities (23.8%). CONCLUSIONS In this single site data set, rates of pre-existing cardiorespiratory disease were similar in SARS-CoV-2[+] and SARS-CoV-2[-] children. Rates of symptomatic infection were similar between children with and without cardiorespiratory comorbidity. High rates of comorbid cardiac disease were observed among hospitalized children with COVID-19 warranting further research to inform vaccine prioritization.
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Affiliation(s)
- Cassidy Du Berry
- Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.,The Royal Children's Hospital Melbourne, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Thomas Saunders
- Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.,The Royal Children's Hospital Melbourne, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Alissa McMinn
- Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.,The Royal Children's Hospital Melbourne, Melbourne, Australia
| | - Shidan Tosif
- Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.,The Royal Children's Hospital Melbourne, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Shivanthan Shanthikumar
- Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.,The Royal Children's Hospital Melbourne, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Moya Vandeleur
- Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.,The Royal Children's Hospital Melbourne, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Joanne Harrison
- Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.,The Royal Children's Hospital Melbourne, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - David Burgner
- Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.,The Royal Children's Hospital Melbourne, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Sarath Ranganathan
- Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.,The Royal Children's Hospital Melbourne, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Nigel Crawford
- Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.,The Royal Children's Hospital Melbourne, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Danielle Wurzel
- Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.,The Royal Children's Hospital Melbourne, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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34
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Pattie P, Ranganathan S, Harrison J, Vidmar S, Hall GL, Foong RE, Harper A, Ramsey K, Wurzel D. Quality of life is poorly correlated to lung disease severity in school-aged children with cystic fibrosis. J Cyst Fibros 2021; 21:e188-e203. [PMID: 34801433 DOI: 10.1016/j.jcf.2021.11.005] [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] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/07/2021] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is no data exclusively on the relationship between health-related quality-of-life (HRQOL) and lung disease severity in early school-aged children with cystic fibrosis (CF). Using data from the Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) we assessed the relationships between HRQOL, lung function and structure. METHODS 125 children aged 6.5-10 years enrolled in the AREST CF program were included from CF clinics at Royal Children's Hospital (RCH), Melbourne (n = 66) and Perth Children's Hospital (PCH), Perth (n = 59), Australia. Demographics, HRQOL measured by Cystic Fibrosis Questionnaire-Revised (CFQ-R), spirometry, multiple-breath washout (MBW) and chest CT were collected across two years. Correlation between CFQ-R scores and lung structure/function parameters and agreement between parent-proxy and child-reported HRQOL were evaluated. RESULTS No correlation was observed between most CFQ-R domain scores and FEV1 z-scores, excepting weak-positive correlation with parent CFQ-R Physical (rho = 0.21, CI 0.02-0.37), and Weight (rho = 0.21, CI 0.03-0.38) domain and child Body domain (rho = 0.26, CI 0.00-0.48). No correlation between most CFQ-R domain scores and LCI values was noted excepting weak-negative correlation with parent Respiratory (rho = -0.23, CI -0.41--0.05), Emotional (rho = -0.24, CI -0.43--0.04), and Physical (-0.21, CI -0.39--0.02) domains. Furthermore, structural lung disease on CT data demonstrated little to no association with CFQ-R parent and child domain scores. Additionally, no agreement between child self-report and parent-proxy CFQ-R scores was observed across the majority of domains and visits. CONCLUSION HRQOL correlated poorly with lung function and structure in early school-aged children with CF, hence clinical trials should consider these outcomes independently when determining study end-points.
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Affiliation(s)
- Phillip Pattie
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia.
| | - Sarath Ranganathan
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia; Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Joanne Harrison
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia; Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Suzanna Vidmar
- Department of Paediatrics, The University of Melbourne, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
| | - Graham L Hall
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia; School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Rachel E Foong
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia; School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Alana Harper
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Kathryn Ramsey
- Wal-yan Respiratory Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Danielle Wurzel
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia; Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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35
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Deschamp A, Chen Y, Wang W, Rasic M, Hatch J, Sanders D, Ranganathan S, Ferkol T, Perkins D, Davis S, Finn P. 200: The association of growth and the gut microbiome in infants with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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36
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Esther C, Shanthikumar S, Schultz A, McNally P, Ranganathan S, Stick S, Boucher R. 576: Ivacaftor treatment alters the relationship between mucoinflammation and structural lung disease in preschool-aged children with CF. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01999-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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37
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Muston HN, Slaven JE, Tiller C, Clem C, Ferkol TW, Ranganathan S, Davis SD, Ren CL. Hyperinflation is associated with increased respiratory rate and is a more sensitive measure of cystic fibrosis lung disease during infancy compared to forced expiratory measures. Pediatr Pulmonol 2021; 56:2854-2860. [PMID: 34143539 PMCID: PMC8373786 DOI: 10.1002/ppul.25538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/24/2021] [Accepted: 06/02/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND The goal of this study was to identify clinical features associated with abnormal infant pulmonary function tests (iPFTs), specifically functional residual capacity (FRC), in infants with cystic fibrosis (CF) diagnosed via newborn screen (NBS). We hypothesized that poor nutritional status in the first 6-12 months would be associated with increased FRC at 12-24 months. METHODS This study utilized a combination of retrospectively and prospectively collected data from ongoing research studies and iPFTs performed for clinical indications. Demographic and clinical features were obtained from the electronic medical record. Forced expiratory flows and volumes were obtained using the raised volume rapid thoracoabdominal technique (RVRTC) and FRC was measured via plethysmography. RESULTS A total of 45 CF NBS infants had iPFTs performed between 12 and 24 months. Mean forced vital capacity, forced expiratory volume in 0.5 s, and forced expiratory flows were all within normal limits. In contrast, the mean FRC z-score was 2.18 (95% confidence interval [CI] = 1.48, 2.88) and the mean respiratory rate (RR) z-score was 1.42 (95% CI = 0.95, 1.89). There was no significant association between poor nutritional status and abnormal lung function. However, there was a significant association between higher RR and increased FRC, and a RR cutoff of 36 breaths/min resulted in 92% sensitivity to detect hyperinflation with 32% specificity. CONCLUSION These results suggest that FRC is a more sensitive measure of early CF lung disease than RVRTC measurements and that RR may be a simple, noninvasive clinical marker to identify CF NBS infants with hyperinflation.
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Affiliation(s)
- Heather N Muston
- Division of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - James E Slaven
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Christina Tiller
- Division of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Charles Clem
- Division of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Thomas W Ferkol
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Sarath Ranganathan
- Department of Paediatrics, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia
| | - Stephanie D Davis
- Department of Pediatrics, The University of North Carolina, Chapel Hill, North Carolina, USA
| | - Clement L Ren
- Division of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
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38
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Soriano V, Koplin J, Forrester M, Peters R, O'Hely M, Dharmage S, Wright R, Ranganathan S, Burgner D, Thompson K, Dwyer T, Vuillermin P, Ponsonby AL. 357Infant pacifier sanitization and risk of food allergy: the Barwon Infant Study. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.625] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Environmental microbial exposure and human gut microbiota play a role in development of the immune system and susceptibility to food allergy. Pacifier use has been inconsistently associated with allergy, but the association between sanitization and food allergy is unknown. We investigated the association between infant pacifier use, with a consideration of sanitization, and food allergy at age 1 in the Barwon Infant Study (BIS).
Methods
Questionnaire data were collected prospectively from pregnant mothers from the Barwon region of south-east Australia at baseline and at infant ages 1, 6, and 12 months. Pacifier sanitization was defined as the joint exposure of a pacifier and cleaning methods (antiseptic, mouth, tap water, boiling). Challenge-proven food allergy was determined at age 1.
Results
Any pacifier use at 6 months was associated with food allergy (aOR, 1.94; 95% CI, 1.04-3.61), but not at other ages. This overall association was driven by the joint exposure pacifier-antiseptic use (aOR, 5.90; 95% CI, 2.18-15.97) compared to no pacifier use. Among pacifier users, pacifier-antiseptic was still associated with food allergy (aOR, 3.88; 95% CI, 1.55-9.72) when compared to pacifier-no antiseptic use. Further, increased use of pacifier-antiseptic at 0, 1 or 2 interviews over the first 6 months was associated with higher food allergy risk (ptrend=0.005).
Conclusions
Joint exposure to antiseptics and pacifiers at 6 months increased the odds of food allergy, showing a trend with increased use over time.
Key messages
This is the first report of pacifiers used with antiseptic being positively associated with challenge-proven food allergy.
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Affiliation(s)
- Victoria Soriano
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Jennifer Koplin
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Mike Forrester
- School of Medicine, Deakin University, Geelong, Australia
- Children's Services, Barwon Health, Geelong, Australia
- St John of God Hospital, Geelong, Australia
| | - Rachel Peters
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Martin O'Hely
- Murdoch Children's Research Institute, Parkville, Australia
- School of Medicine, Deakin University, Geelong, Australia
- Child Health Research Unit, Barwon Health, Geelong, Australia
| | - Shyamali Dharmage
- School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Rosemary Wright
- Research School of Population Health, Australian National University, Canberra, Australia
| | | | - David Burgner
- Murdoch Children's Research Institute, Parkville, Australia
| | | | - Terence Dwyer
- Murdoch Children's Research Institute, Parkville, Australia
| | - Peter Vuillermin
- Murdoch Children's Research Institute, Parkville, Australia
- School of Medicine, Deakin University, Geelong, Australia
- Children's Services, Barwon Health, Geelong, Australia
| | - Anne-Louise Ponsonby
- School of Population and Global Health, University of Melbourne, Parkville, Australia
- Neuroepidemiology Research Group, Florey Institute for Neuroscience and Mental Health, Parkville, Australia
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39
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Watts SC, Judd LM, Carzino R, Ranganathan S, Holt KE. Genomic Diversity and Antimicrobial Resistance of Haemophilus Colonizing the Airways of Young Children with Cystic Fibrosis. mSystems 2021; 6:e0017821. [PMID: 34463568 DOI: 10.1128/msystems.00178-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 08/04/2021] [Indexed: 11/20/2022] Open
Abstract
Respiratory infection during childhood is a key risk factor in early cystic fibrosis (CF) lung disease progression. Haemophilus influenzae and Haemophilus parainfluenzae are routinely isolated from the lungs of children with CF; however, little is known about the frequency and characteristics of Haemophilus colonization in this context. Here, we describe the detection, antimicrobial resistance (AMR), and genome sequencing of H. influenzae and H. parainfluenzae isolated from airway samples of 147 participants aged ≤12 years enrolled in the Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) program, Melbourne, Australia. The frequency of colonization per visit was 4.6% for H. influenzae and 32.1% for H. parainfluenzae, 80.3% of participants had H. influenzae and/or H. parainfluenzae detected on at least one visit, and using genomic data, we estimate 15.6% of participants had persistent colonization with the same strain for at least two consecutive visits. Isolates were genetically diverse and AMR was common, with 52% of H. influenzae and 82% of H. parainfluenzae displaying resistance to at least one drug. The genetic basis for AMR could be identified in most cases; putative novel determinants include a new plasmid encoding blaTEM-1 (ampicillin resistance), a new inhibitor-resistant blaTEM allele (augmentin resistance), and previously unreported mutations in chromosomally carried genes (pbp3, ampicillin resistance; folA/folP, cotrimoxazole resistance; rpoB, rifampicin resistance). Acquired AMR genes were more common in H. parainfluenzae than H. influenzae (51% versus 21%, P = 0.0107) and were mostly associated with the ICEHin mobile element carrying blaTEM-1, resulting in more ampicillin resistance in H. parainfluenzae (73% versus 30%, P = 0.0004). Genomic data identified six potential instances of Haemophilus transmission between participants, of which three involved participants who shared clinic visit days. IMPORTANCE Cystic fibrosis (CF) lung disease begins during infancy, and acute respiratory infections increase the risk of early disease development and progression. Microbes involved in advanced stages of CF are well characterized, but less is known about early respiratory colonizers. We report the population dynamics and genomic determinants of AMR in two early colonizer species, namely, Haemophilus influenzae and Haemophilus parainfluenzae, collected from a pediatric CF cohort. This investigation also reveals that H. parainfluenzae has a high frequency of AMR carried on mobile elements that may act as a potential reservoir for the emergence and spread of AMR to H. influenzae, which has greater clinical significance as a respiratory pathogen in children. This study provides insight into the evolution of AMR and the colonization of H. influenzae and H. parainfluenzae in a pediatric CF cohort, which will help inform future treatment.
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Affiliation(s)
- Stephen C Watts
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbournegrid.1008.9, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Central Clinical School, Monash Universitygrid.1002.3, Melbourne, Victoria, Australia
| | - Louise M Judd
- Department of Infectious Diseases, Central Clinical School, Monash Universitygrid.1002.3, Melbourne, Victoria, Australia
| | - Rosemary Carzino
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sarath Ranganathan
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbournegrid.1008.9, Melbourne, Victoria, Australia
| | - Kathryn E Holt
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbournegrid.1008.9, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Central Clinical School, Monash Universitygrid.1002.3, Melbourne, Victoria, Australia
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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Matricciani L, Dumuid D, Paquet C, Fraysse F, Wang Y, Baur LA, Juonala M, Ranganathan S, Lycett K, Kerr JA, Burgner D, Wake M, Olds T. Corrigendum to "Sleep and cardiometabolic health in children and adults: examining sleep as a component of the 24-hour day" [Sleep Med 78 (2020) 63-74]. Sleep Med 2021; 86:166. [PMID: 34429259 DOI: 10.1016/j.sleep.2021.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Lisa Matricciani
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia.
| | - Dorothea Dumuid
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Catherine Paquet
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia; Faculté des Sciences de l'Administration, Université Laval, Quebéc, QC, Canada
| | - François Fraysse
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Yichao Wang
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia
| | | | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Sarath Ranganathan
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Kate Lycett
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; The Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Jessica A Kerr
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - David Burgner
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Melissa Wake
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; The University of Auckland, Grafton, Auckland, New Zealand; Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Tim Olds
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
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Matricciani L, Paquet C, Fraysse F, Grobler A, Wang Y, Baur L, Juonala M, Nguyen MT, Ranganathan S, Burgner D, Wake M, Olds T. Sleep and cardiometabolic risk: a cluster analysis of actigraphy-derived sleep profiles in adults and children. Sleep 2021; 44:6124580. [PMID: 33515457 DOI: 10.1093/sleep/zsab014] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/21/2020] [Indexed: 12/16/2022] Open
Abstract
STUDY OBJECTIVES Sleep plays an important role in cardiometabolic health. Although the importance of considering sleep as a multidimensional construct is widely appreciated, studies have largely focused on individual sleep characteristics. The association between actigraphy-derived sleep profiles and cardiometabolic health in healthy adults and children has not been examined. METHODS This study used actigraphy-measured sleep data collected between February 2015 and March 2016 in the Child Health CheckPoint study. Participants wore actigraphy monitors (GENEActiv Original, Cambs, UK) on their nondominant wrist for 7 days and sleep characteristics (period, efficiency, timing, and variability) were derived from raw actigraphy data. Actigraphy-derived sleep profiles of 1,043 Australian children aged 11-12 years and 1,337 adults were determined using K-means cluster analysis. The association between cluster membership and biomarkers of cardiometabolic health (blood pressure, body mass index, apolipoproteins, glycoprotein acetyls, composite metabolic syndrome severity score) were assessed using Generalized Estimating Equations, adjusting for geographic clustering, with sex, socioeconomic status, maturity stage (age for adults, pubertal status for children), and season of data collection as covariates. RESULTS Four actigraphy-derived sleep profiles were identified in both children and adults: short sleepers, late to bed, long sleepers, and overall good sleepers. The overall good sleeper pattern (characterized by adequate sleep period time, high efficiency, early bedtime, and low day-to-day variability) was associated with better cardiometabolic health in the majority of comparisons (80%). CONCLUSION Actigraphy-derived sleep profiles are associated with cardiometabolic health in adults and children. The overall good sleeper pattern is associated with more favorable cardiometabolic health.
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Affiliation(s)
- Lisa Matricciani
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Catherine Paquet
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia.,Faculté des Sciences de l'Administration, Université Laval, Québec, QC, Canada
| | - François Fraysse
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Anneke Grobler
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Murdoch Children's Research Institute, Parkville, VIC,Australia
| | - Yichao Wang
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Murdoch Children's Research Institute, Parkville, VIC,Australia
| | - Louise Baur
- The University of Sydney, Sydney, NSW,Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Minh Thien Nguyen
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Murdoch Children's Research Institute, Parkville, VIC,Australia
| | - Sarath Ranganathan
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Murdoch Children's Research Institute, Parkville, VIC,Australia.,Respiratory Medicine, Royal Children's Hospital, Parkville, VIC, Australia
| | - David Burgner
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Murdoch Children's Research Institute, Parkville, VIC,Australia.,Department of General Medicine, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Melissa Wake
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,The University of Auckland, Grafton, Auckland, New Zealand.,Murdoch Children's Research Institute, Parkville, VIC,Australia
| | - Tim Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
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42
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Gao Y, Nanan R, Macia L, Tan J, Sominsky L, Quinn TP, O'Hely M, Ponsonby AL, Tang ML, Collier F, Strickland DH, Dhar P, Brix S, Phipps S, Sly PD, Ranganathan S, Stokholm J, Kristiansen K, Gray L, Vuillermin P. The maternal gut microbiome during pregnancy and offspring allergy and asthma. J Allergy Clin Immunol 2021; 148:669-678. [PMID: 34310928 DOI: 10.1016/j.jaci.2021.07.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
Environmental exposures during pregnancy that alter both the maternal gut microbiome and the infant's risk of allergic disease and asthma include a traditional farm environment and consumption of unpasteurized cow's milk, antibiotic use, dietary fiber and psychosocial stress. Multiple mechanisms acting in concert may underpin these associations and prime the infant to acquire immune competence and homeostasis following exposure to the extrauterine environment. Cellular and metabolic products of the maternal gut microbiome can promote the expression of microbial pattern recognition receptors, as well as thymic and bone marrow hematopoiesis relevant to regulatory immunity. At birth, transmission of maternally derived bacteria likely leverages this in utero programming to accelerate postnatal transition from a Th2 to Th1 and Th17 dominant immune phenotypes and maturation of regulatory immune mechanisms, which in turn reduce the child's risk of allergic disease and asthma. Although our understanding of these phenomena is rapidly evolving, the field is relatively nascent, and we are yet to translate existing knowledge into interventions that substantially reduce disease risk in humans. Here we review evidence that the maternal gut microbiome impacts the offspring's risk of allergic disease and asthma, discuss challenges and future directions for the field, and propose the hypothesis that maternal carriage of Prevotella copri during pregnancy decreases the offspring's risk of allergic disease via production of succinate which in turn promotes bone marrow myelopoiesis of dendritic cell precursors in the fetus.
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Affiliation(s)
- Yuan Gao
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia; Child Health Research Unit, Barwon Health, Geelong, Australia; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Ralph Nanan
- The Charles Perkins Center, the University of Sydney, Sydney, Australia
| | - Laurence Macia
- The Charles Perkins Center, the University of Sydney, Sydney, Australia; School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jian Tan
- The Charles Perkins Center, the University of Sydney, Sydney, Australia; School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Luba Sominsky
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia; Child Health Research Unit, Barwon Health, Geelong, Australia
| | - Thomas P Quinn
- Applied Artificial Intelligence Institute, Deakin University, Geelong, Australia
| | - Martin O'Hely
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia; Murdoch Children's Research Institute, Melbourne, Australia
| | - Anne-Louise Ponsonby
- The Florey Institute, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - Mimi Lk Tang
- Murdoch Children's Research Institute, Melbourne, Australia; University of Melbourne, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia
| | - Fiona Collier
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia
| | | | - Poshmaal Dhar
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia
| | - Susanne Brix
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Simon Phipps
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia; School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Queensland, Australia; Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - Peter D Sly
- Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia; Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Melbourne, Australia; University of Melbourne, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, 2820 Copenhagen, Denmark; Department of Pediatrics, Slagelse Hospital, 4200 Slagelse, Denmark
| | - Karsten Kristiansen
- BGI-Shenzhen, Shenzhen, China; China National Genebank, Shenzhen, China; Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Lawrence Gray
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia; Child Health Research Unit, Barwon Health, Geelong, Australia.
| | - Peter Vuillermin
- Institute for Physical and Mental Health and Clinical Transformation, Deakin University, Geelong, Australia; Child Health Research Unit, Barwon Health, Geelong, Australia.
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43
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Atlas G, Yap M, Lim A, Vidmar S, Smith N, King L, Jones A, Hong J, Ranganathan S, Simm PJ. The clinical features that contribute to poor bone health in young Australians living with cystic fibrosis: A recommendation for BMD screening. Pediatr Pulmonol 2021; 56:2014-2022. [PMID: 33724711 DOI: 10.1002/ppul.25375] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/27/2020] [Revised: 02/27/2021] [Accepted: 02/27/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND For Australians living with cystic fibrosis (CF), increased longevity means greater consideration needs to be given to long-term endocrine sequelae such as CF-related bone disease. Deficits in bone mass accrual are most likely to occur during childhood and adolescence. Current guidelines in Australia suggest repeat dual-energy X-ray absorptiometry (DXA) scans every 2 years. This study aims to stratify clinical factors that determine future bone health in the Australian CF population and use this to guide a more streamlined approach to bone health screening. METHODS This study was a retrospective audit of all patients diagnosed with CF who were treated at the Royal Children's Hospital Melbourne, Australia from 2000 to 2016 (n = 453). Two hundred and two patients had a DXA scan in the study period (191 with height-adjusted data) and 111 patients had more than one scan (108 with height-adjusted data). An investigation into the associations between bone mineral density (BMD) Z score and potential risk factors was conducted using DXA and historical data. RESULTS The main predictor of future BMD was the previous BMD Z score (p < .001). Other factors found to be determinants of BMD included nutritional status, lung function (FEV1 ), age, history of previous fracture, oral corticosteroid use, and the number of hospital admissions. However, after adjusting for previous BMD, evidence of an association remained only with nutritional status, FEV1 , and number of hospital admissions. CONCLUSION Second yearly scans may be unnecessary in children with an adequate DXA score on the initial scan who remain clinically stable. However, clinical deterioration in those whose BMD was previously normal, may require closer monitoring of bone health. We propose a guideline for the frequency of DXA monitoring in relation to clinical risk factors.
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Affiliation(s)
- Gabby Atlas
- Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Matthew Yap
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Angelina Lim
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Centre for Medicine Use and Safety, Monash University Parkville, Parkville, Victoria, Australia
| | - Suzanna Vidmar
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Nathan Smith
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Louise King
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Alicia Jones
- Monash Medical Centre, Clayton, Victoria, Australia.,Monash Centre for Health Research and Implementation, Monash University, Melbourne, Victoria, Australia
| | - Jason Hong
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Sarath Ranganathan
- Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Peter J Simm
- Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
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King PT, Dousha L, Clarke N, Schaefer J, Carzino R, Sharma R, Wan KL, Anantharajah A, O'Sullivan K, Lu ZX, Holdsworth SR, Ranganathan S, Bardin PG, Armstrong DS. Phagocyte extracellular traps in children with neutrophilic airway inflammation. ERJ Open Res 2021; 7:00883-2020. [PMID: 34164555 PMCID: PMC8215332 DOI: 10.1183/23120541.00883-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/16/2021] [Indexed: 12/02/2022] Open
Abstract
Childhood lung infection is often associated with prominent neutrophilic airway inflammation and excess production of proteases such as neutrophil elastase (NE). The mechanisms responsible for this inflammation are not well understood. One potentially relevant pathway is the production of extracellular traps by neutrophils (NETs) and macrophages (METs). The aim of this study was to measure NET and MET expression in children and the effect of deoxyribonculease (DNase) 1 and α1-antitrypsin (AAT) on this process. We studied 76 children (median age of 4.0 years) with cystic fibrosis or chronic cough who underwent investigational bronchoscopy. NETs, METs and neutrophil elastase activity in bronchoalveolar lavage (BAL) samples were measured using confocal microscopy and functional assays. The effects of DNase 1 and AAT on NET/MET expression and neutrophil elastase activity were examined in vitro. Both subject groups had airway neutrophilia with prominent BAL production of NETs with neutrophil elastase co-expression; the mean %±standard error of the mean of neutrophils expressing NETs in the cystic fibrosis group was 23.3±2.8% and in the non-cystic fibrosis group was 28.4±3.9%. NET expression was higher in subjects who had detectable neutrophil elastase activity (p≤0.0074). The percentage of macrophages expressing METs in the cystic fibrosis group was 10.7±1.2% and in the non-cystic fibrosis group was 13.2±1.9%. DNase 1 decreased NET/MET expression (p<0.0001), but increased neutrophil elastase activity (p≤0.0137). The combination of AAT and DNase 1 reduced neutrophil elastase activity (p≤0.0049). We observed prominent extracellular trap formation in symptomatic children with and without cystic fibrosis. This innate inflammatory response was down-regulated by a combination of currently available therapeutics. Prominent extracellular trap formation may be observed in young children with airway inflammation, with and without cystic fibrosis. This innate inflammatory response is down-regulated by a combination of currently available therapeutics.https://bit.ly/3bDaWyC
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Affiliation(s)
- Paul T King
- Monash Lung and Sleep, Monash Medical Centre, Melbourne, Australia.,Monash University Dept of Medicine, Monash Medical Centre, Melbourne, Victoria, Australia
| | - Lovisa Dousha
- Monash Lung and Sleep, Monash Medical Centre, Melbourne, Australia.,Monash University Dept of Medicine, Monash Medical Centre, Melbourne, Victoria, Australia
| | - Nadeene Clarke
- Paediatric Respiratory Medicine, Royal Children's Hospital, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Jennifer Schaefer
- Monash Lung and Sleep, Monash Medical Centre, Melbourne, Australia.,Monash Children's Hospital, Melbourne, Australia
| | - Rosemary Carzino
- Paediatric Respiratory Medicine, Royal Children's Hospital, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Roleen Sharma
- Monash Lung and Sleep, Monash Medical Centre, Melbourne, Australia.,Monash University Dept of Medicine, Monash Medical Centre, Melbourne, Victoria, Australia
| | - Ken L Wan
- Dept of Biochemistry, Monash Pathology, Monash Health, Melbourne, Australia
| | - Aveena Anantharajah
- Monash Lung and Sleep, Monash Medical Centre, Melbourne, Australia.,Monash Children's Hospital, Melbourne, Australia
| | - Kim O'Sullivan
- Monash University Dept of Medicine, Monash Medical Centre, Melbourne, Victoria, Australia
| | - Zhong X Lu
- Monash University Dept of Medicine, Monash Medical Centre, Melbourne, Victoria, Australia.,Dept of Biochemistry, Monash Pathology, Monash Health, Melbourne, Australia
| | - Stephen R Holdsworth
- Monash University Dept of Medicine, Monash Medical Centre, Melbourne, Victoria, Australia.,Dept of Immunology, Monash Health, Melbourne, Australia
| | - Sarath Ranganathan
- Paediatric Respiratory Medicine, Royal Children's Hospital, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia.,Dept of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Philip G Bardin
- Monash Lung and Sleep, Monash Medical Centre, Melbourne, Australia.,Monash University Dept of Medicine, Monash Medical Centre, Melbourne, Victoria, Australia.,Hudson Institute of Medical Research, Melbourne, Australia
| | - David S Armstrong
- Monash Lung and Sleep, Monash Medical Centre, Melbourne, Australia.,Monash Children's Hospital, Melbourne, Australia.,Monash University Dept of Paediatrics, Monash Medical Centre, Melbourne, Australia
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McNally P, Butler D, Karpievitch YV, Linnane B, Ranganathan S, Stick SM, Hall GL, Schultz A. Ivacaftor and Airway Inflammation in Preschool Children with Cystic Fibrosis. Am J Respir Crit Care Med 2021; 204:605-608. [PMID: 34077699 DOI: 10.1164/rccm.202012-4332le] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Paul McNally
- RCSI, 8863, Paediatrics, Dublin, Ireland.,Children's Health Ireland, 575376, Respiratory Medicine, Dublin, Ireland;
| | - Daryl Butler
- RCSI, 8863, Paediatrics, Dublin, Ireland.,Children's Health Ireland, 575376, Respiratory Medicine, Dublin, Ireland.,National Children's Research Centre, 549923, Dublin, Ireland
| | - Yuliya V Karpievitch
- Telethon Kids Institute, 117610, Respiratory Research Centre, West Perth, Western Australia, Australia
| | - Barry Linnane
- University of Limerick, 8808, School of Medicine and Centre for Interventions in Infection, Inflammation and Immunity (4i), Limerick, Ireland.,National Children's Research Centre, 549923, Dublin, Ireland
| | - Sarath Ranganathan
- The Royal Children's Hospital Melbourne, 6453, Department of Respiratory Medicine, Parkville, Victoria, Australia.,University of Melbourne, Department of Paediatrics, Parkville, Victoria, Australia.,Murdoch Childrens Research Institute, 34361, Parkville, Victoria, Australia
| | - Stephen M Stick
- Telethon Kids Institute, 117610, Wal-Yan Respiratory Research Centre, Nedlands, Australia.,Telethon Kids Institute, 117610, Northern Star Professor of Children's Respiratory Health Research, Nedlands, Australia.,Perth Children's Hospital, 60081, Department of Respiratory and Sleep Medicine, Nedlands, Australia
| | - Graham L Hall
- Telethon Kids Institute, 117610, Children's Lung Health, West Perth, Western Australia, Australia
| | - Andre Schultz
- Telethon Kids Institute, 117610, Wal-Yan Respiratory Research Centre, Perth, Western Australia, Australia.,Perth Children's Hospital, 60081, Department of Respiratory and Sleep Medicine, Nedlands, Western Australia, Australia.,The University of Western Australia, 2720, Division of Paediatrics, School of Medicine, Perth, Western Australia, Australia
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46
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Dawson SL, O'Hely M, Jacka FN, Ponsonby AL, Symeonides C, Loughman A, Collier F, Moreno-Betancur M, Sly P, Burgner D, Tang MLK, Saffery R, Ranganathan S, Conlon MA, Harrison LC, Brix S, Kristiansen K, Vuillermin P. Maternal prenatal gut microbiota composition predicts child behaviour. EBioMedicine 2021; 68:103400. [PMID: 34098340 PMCID: PMC8190443 DOI: 10.1016/j.ebiom.2021.103400] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 11/23/2020] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Murine studies demonstrate that maternal prenatal gut microbiota influences brain development and behaviour of offspring. No human study has related maternal gut microbiota to behavioural outcomes during early life. This study aimed to evaluate relationships between the prenatal faecal microbiota, prenatal diet and childhood behaviour. METHODS A sub-cohort of 213 mothers and 215 children were selected from a longitudinal pre-birth cohort. Maternal prenatal exposure measures collected during the third trimester included the faecal microbiota (generated using 16S rRNA amplicon sequencing), and dietary intake. The behavioural outcome used the Childhood Behaviour Checklist at age two. Models were adjusted for prenatal diet, smoking, perceived stress, maternal age and sample batch. FINDINGS We found evidence that the alpha diversity of the maternal faecal microbiota during the third trimester of pregnancy predicts child internalising behaviour at two years of age (-2·74, (-4·71, -0·78), p = 0·01 (Wald test), R2=0·07). Taxa from butyrate-producing families, Lachnospiraceae and Ruminococcaceae, were more abundant in mothers of children with normative behaviour. A healthy prenatal diet indirectly related to decreased child internalising behaviours via higher alpha diversity of maternal faecal microbiota. INTERPRETATION These findings support animal studies showing that the composition of maternal prenatal gut microbiota is related to offspring brain development and behaviour. Our findings highlight the need to evaluate potential impacts of the prenatal gut microbiota on early life brain development. FUNDING This study was funded by the National Health and Medical Research Council of Australia (1082307, 1147980), Murdoch Children's Research Institute, Barwon Health and Deakin University.
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Affiliation(s)
- Samantha L Dawson
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VIC, 3220, Australia; Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia
| | - Martin O'Hely
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VIC, 3220, Australia; Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia
| | - Felice N Jacka
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VIC, 3220, Australia; Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia; Black Dog Institute, NSW, Australia
| | - Anne-Louise Ponsonby
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia; The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Christos Symeonides
- Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia; The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Amy Loughman
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VIC, 3220, Australia
| | - Fiona Collier
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VIC, 3220, Australia; Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia; Barwon Health, Geelong, Victoria 3220, Australia
| | - Margarita Moreno-Betancur
- Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia; The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Peter Sly
- Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia; University of Queensland, South Brisbane, Queensland 4101, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia; The University of Melbourne, Parkville, Victoria 3052, Australia; The Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia; The University of Melbourne, Parkville, Victoria 3052, Australia; The Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia; The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia; The University of Melbourne, Parkville, Victoria 3052, Australia; The Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | - Michael A Conlon
- CSIRO Health and Biosecurity, Adelaide, South Australia 5000, Australia
| | - Leonard C Harrison
- The University of Melbourne, Parkville, Victoria 3052, Australia; Walter and Eliza Hall Institute, Parkville, Victoria 3052, Australia
| | - Susanne Brix
- Technical University of Denmark, Department of Biotechnology and Biomedicine, DK-2800 Kgs. Lyngby, Denmark
| | - Karsten Kristiansen
- University of Copenhagen, Laboratory of Genomics and Molecular Biomedicine, Department of Biology, Universitetsparken 13, 2100 Copenhagen, Denmark
| | - Peter Vuillermin
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VIC, 3220, Australia; Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia; Barwon Health, Geelong, Victoria 3220, Australia.
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47
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Shanthikumar S, Moore E, Corda J, Reardon N, Louey S, Frayman K, Harrison J, Ranganathan S. Patient and family perspectives regarding the use of telehealth for cystic fibrosis care. Pediatr Pulmonol 2021; 56:811-813. [PMID: 33433061 DOI: 10.1002/ppul.25262] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/21/2020] [Accepted: 12/25/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Shivanthan Shanthikumar
- Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia.,Respiratory, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Emily Moore
- Department of Physiotherapy, Royal Children's Hospital, Melbourne, Australia
| | - Jen Corda
- Department of Physiotherapy, Royal Children's Hospital, Melbourne, Australia
| | - Nicola Reardon
- Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Stef Louey
- Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia.,Respiratory, Murdoch Children's Research Institute, Melbourne, Australia
| | - Katherine Frayman
- Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia.,Respiratory, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Jo Harrison
- Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia.,Respiratory, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Sarath Ranganathan
- Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia.,Respiratory, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
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48
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Liu H, Sarkar S, Azzopardi K, Day S, Yeow S, Ranganathan S, Sutton P. A bacterial stimulation assay for bronchoalveolar lavage immune cells from young children with cystic fibrosis. Scand J Immunol 2021; 94:e13040. [PMID: 33759233 DOI: 10.1111/sji.13040] [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] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/21/2021] [Indexed: 11/28/2022]
Abstract
Cystic Fibrosis (CF) is primarily a progressive lung disease, characterized by chronic pulmonary infections with opportunistic pathogens. Such infections typically commence early in life, producing an inflammatory response marked by IL-8 chemokine production and neutrophilic infiltration, major contributory factors in CF progression. Studying this inflammation, especially early in life, is critical for developing new strategies for preventing or slowing disruption to the structural integrity of the CF airways. However, evaluating the immune responses of bronchoalveolar lavage (BAL) cells from children with CF faces technical challenges, including contamination carried from the lung due to pre-existing infections and low cell number availability. Here, we describe a technique for preparing BAL cells from young children with CF and using those cells in a bacterial stimulation assay. Initial antibiotic treatment proved essential for preventing resident bacteria from overgrowing BAL cell cultures, or non-specifically activating the cells. ACTB, identified as an optimal reference gene, was validated for accurate analysis of gene expression in these cells. Pseudomonas aeruginosa and Staphylococcus aureus were used as bacterial stimulants to evaluate the immune response of BAL cells from young children with CF. Addition of gentamicin prevented bacterial overgrowth, although if added after 3 hours of culture an extremely variable response resulted, with the bacteria causing a suppressive effect in some cultures. Addition of gentamicin after 1 hour of culture completely prevented this suppressive effect. This technique was then able to reproducibly measure the IL-8 response to stimulation with S. aureus and P. aeruginosa, including co-stimulation with both bacteria.
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Affiliation(s)
- Haipei Liu
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia.,Department of Pediatric Respiratory Medicine, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sohinee Sarkar
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia
| | - Kristy Azzopardi
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia
| | - Sophie Day
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia
| | - Serene Yeow
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia.,Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.,Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Vic., Australia
| | - Philip Sutton
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia.,Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia
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49
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Soriano VX, Koplin JJ, Forrester M, Peters RL, O'Hely M, Dharmage SC, Wright R, Ranganathan S, Burgner D, Thompson K, Dwyer T, Vuillerman P, Ponsonby AL. Infant pacifier sanitization and risk of challenge-proven food allergy: A cohort study. J Allergy Clin Immunol 2021; 147:1823-1829.e11. [PMID: 33810856 DOI: 10.1016/j.jaci.2021.01.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/07/2020] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Environmental microbial exposure plays a role in immune system development and susceptibility to food allergy. OBJECTIVE We sought to investigate whether infant pacifier use during the first postnatal year, with further consideration of sanitization, alters the risk of food allergy by age 1 year. METHODS The birth cohort recruited pregnant mothers at under 28 weeks' gestation in southeast Australia, with 894 families followed up when infants turned 1 year. Infants were excluded if born under 32 weeks, with a serious illness, major congenital malformation, or genetic disease. Questionnaire data, collected at recruitment and infant ages 1, 6, and 12 months, included pacifier use and pacifier sanitization (defined as the joint exposure of a pacifier and cleaning methods). Challenge-proven food allergy was assessed at 12 months. RESULTS Any pacifier use at 6 months was associated with food allergy (adjusted odds ratio, 1.94; 95% CI, 1.04-3.61), but not pacifier use at other ages. This overall association was driven by the joint exposure of pacifier-antiseptic use (adjusted odds ratio, 4.83; 95% CI, 1.10-21.18) compared with no pacifier use. Using pacifiers without antiseptic at 6 months was not associated with food allergy. Among pacifier users, antiseptic cleaning was still associated with food allergy (adjusted odds ratio, 3.56; 95% CI, 1.18-10.77) compared with no antiseptic use. Furthermore, persistent and repeated antiseptic use over the first 6 months was associated with higher food allergy risk (P = .029). CONCLUSIONS This is the first report of a pacifier-antiseptic combination being associated with a higher risk of subsequent food allergy. Future work should investigate underlying biological pathways.
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Affiliation(s)
- Victoria X Soriano
- Population Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Jennifer J Koplin
- Population Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Mike Forrester
- School of Medicine, Deakin University, Geelong, Australia; Children's Services, Barwon Health, Geelong, Australia; St John of God Hospital, Geelong, Australia
| | - Rachel L Peters
- Population Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Martin O'Hely
- School of Medicine, Deakin University, Geelong, Australia; Murdoch Children's Research Institute, Parkville, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Rosemary Wright
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, University of Melbourne, Parkville, Australia; Murdoch Children's Research Institute, Parkville, Australia
| | - David Burgner
- Department of Paediatrics, University of Melbourne, Parkville, Australia; Murdoch Children's Research Institute, Parkville, Australia
| | - Kristie Thompson
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, Australia
| | - Terence Dwyer
- Heart Research Group, Murdoch Children's Research Institute, Parkville, Australia; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Peter Vuillerman
- School of Medicine, Deakin University, Geelong, Australia; Children's Services, Barwon Health, Geelong, Australia; Murdoch Children's Research Institute, Parkville, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Parkville, Australia; Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Parkville, Australia; Neuroepidemiology Research Group, Florey Institute for Neuroscience and Mental Health, Parkville, Australia.
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50
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Cheong J, Cameron KLI, Thompson D, Anderson PJ, Ranganathan S, Clark R, Mentiplay B, Burnett A, Lee K, Doyle LW, Spittle AJ. Impact of moderate and late preterm birth on neurodevelopment, brain development and respiratory health at school age: protocol for a longitudinal cohort study (LaPrem study). BMJ Open 2021; 11:e044491. [PMID: 33518527 PMCID: PMC7852967 DOI: 10.1136/bmjopen-2020-044491] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Children born moderate to late preterm (MLP, 32-36 weeks' gestation) account for approximately 85% of all preterm births globally. Compared with children born at term, children born MLP are at increased risk of poor neurodevelopmental outcomes. Despite making up the largest group of preterm children, developmental outcomes of children born MLP are less well studied than in other preterm groups. This study aimed to (1) compare neurodevelopmental, respiratory health and brain magnetic resonance imaging (MRI) outcomes between children born MLP and term at 9 years of age; (2) examine the differences in brain growth trajectory from infancy to 9 years between children born MLP and term; and in children born MLP; (3) examine the relationship between brain development and neurodevelopment at 9 years; and (4) identify risk factors for poorer outcomes at 9 years. METHODS AND ANALYSIS The "LaPrem" (Late Preterm MRI Study) study is a longitudinal cohort study of children born MLP and term controls, born at the Royal Women's Hospital in Melbourne, Australia, between 2010 and 2013. Participants were recruited in the neonatal period and were previously followed up at 2 and 5 years. This 9-year school-age follow-up includes neuropsychology, motor and physical activities, and lung function assessments, as well as brain MRI. Outcomes at 9 years will be compared between birth groups using linear and logistic regressions. Trajectories of brain development will be compared between birth groups using mixed effects models. The relationships between MRI and neurodevelopmental outcomes, as well as other early predictors of poor 9-year outcomes, will be explored using linear and logistic regression. ETHICS AND DISSEMINATION This study was approved by the human research ethics committee at the Royal Children's Hospital, Melbourne, Australia. Study outcomes will be disseminated through peer-reviewed publications, conference presentations and social media.
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Affiliation(s)
- Jeanie Cheong
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Lillian Iona Cameron
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Deanne Thompson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Peter J Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Respiratory Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
- Respiratory Diseases, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Ross Clark
- Research Health Institute, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Benjamin Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Alice Burnett
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Katherine Lee
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Clinical Epidemiology and Biostatistics, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Lex William Doyle
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alicia J Spittle
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
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