# ent

id: cord-016931-il8o0fps
type: PROTEIN
entity:
  nach der auslösenden Substanz dem beteiligten Immunmechanismus und dem betroffenen Organ unterschiedlich Die Einteilung der Erkrankungen erfolgt am sinnvollsten auf dem Boden


id: cord-016931-il8o0fps
type: PROTEIN
entity:
  Untersuchungen zur Bedeutung der Neuropeptide beim Asthma bronchiale sind daher erforderlich Unter dem Begriff Endotheline werden 3 Isoformen eines aus 21 Aminosäuren aufgebauten ubiquitären


id: cord-016931-il8o0fps
type: PROTEIN
entity:
  sind zur Erfassung einer systemisch entzündlichen Konstellation z B im Rahmen einer interkurrierenden Pneumonie oder anderer Infekte sinnvoll Darüber hinaus sind sie wenige Stunden nach Antigenexposition bei der exogen


id: cord-016931-il8o0fps
type: PROTEIN
entity:
  zur Durchführung und Auswertung unspezifischer bronchialer Provokationen sind den Empfehlungen der DGP zu entnehmen Unsere eigenen Untersuchungen zeigen dass Spezifität und Sensitivität des Provokationstests durch


id: cord-016931-il8o0fps
type: PROTEIN
entity:
  wird Immundeviation Die medikamentöse Behandlung allergischer Erkrankungen beruht auf einer Palette von Medikamenten


id: cord-016931-il8o0fps
type: GGP
entity:
  Muskulatur β 2 Sympathikomimetika oder auf die neurale Regulation des Bronchotonus Anticholinergika Bei


id: cord-016931-il8o0fps
type: CHEMICAL
entity:
  sich charakteristischerweise aktivierte IL 2 Rezeptor tragende IL 2R T Lymphozyten Innerhalb der CD4 Lymphozyten dominiert der Th2


id: cord-016931-il8o0fps
type: DISEASE
entity:
  Vorgängen beteiligt Die pharmakologische Wirksamkeit der derzeit zur Verfügung stehenden Neuropeptidrezeptorantagonisten


id: cord-016931-il8o0fps
type: CHEMICAL
entity:
  sich nach Epikutantestung anaphylaktische Reaktionen entwickeln können besonders bei Pyrazolonderivaten


id: cord-016931-il8o0fps
type: CHEMICAL
entity:
  diagnostische Vorgehen bei Verdacht auf eine allergische Erkrankung beruht auf der Durchführung allgemeiner


id: cord-016931-il8o0fps
type: DISEASE
entity:
  Rolle spielen ist bisher nicht bekannt Im Gegensatz zur chronisch obstruktiven Bronchitis wird beim Asthma bronchiale kein Emphysem


id: cord-016931-il8o0fps
type: CHEMICAL
entity:
  sich im Gegensatz zu anderen obstruktiven Atemwegserkrankungen chronisch obstruktive Bronchitis Mukoviszidose beim


id: cord-016931-il8o0fps
type: CHEMICAL
entity:
  ganzjährige Behandlung z B auch während der Pollensaison ist daher einer präsaisonalen Behandlung überlegen Eine


id: cord-016931-il8o0fps
type: CHEMICAL
entity:
  eine nicht H 1 Rezeptor vermittelte antientzündliche Wirkkomponente auch wenn die hier zugrunde liegenden molekularen Mechanismen noch nicht im Detail bekannt sind


id: cord-307202-iz1bo218
type: CELL_TYPE
entity:
  basement membrane airway smooth muscle hypertrophy leukocyte infiltration epithelial cell desquamation goblet cell


id: cord-307202-iz1bo218
type: GGP
entity:
  leukotrienes b abnormal smooth muscle behavior and c airway thickening Airway remodeling plays an important role in asthma pathogenesis Airway structural changes characteristic of airway remodeling occur because of prolonged airway inflammation Here prolonged release of inflammatory factors results in l Thickening of the smooth muscle bronchial walls


id: cord-258093-6fn8ei9f
type: ORG
entity:
  National Heart Lung and Blood Institute National Institute of Health National Asthma Education and Prevention Program Expert Panel Report


id: cord-018537-t1gi76nc
type: PROTEIN
entity:
  Zeit beobachtet werden sollten von größter Bedeutung Aufgrund dieser epidemiologischen Studien unterscheiden sich folgende Gruppen Die episodisch auftretenden meist transienten


id: cord-018537-t1gi76nc
type: PROTEIN
entity:
  Säuglingen mit BPD Die astronomisch hohen Kosten von Palivizumab und die regionale Variabilität der RSV Infektion haben zu vielen Debatten


id: cord-018537-t1gi76nc
type: PROTEIN
entity:
  nicht mehr eingesetzt Der Nutzen von systemischen Steroiden bei infektassoziierten obstruktiven Bronchitiden


id: cord-018537-t1gi76nc
type: PROTEIN
entity:
  zur Verfügung 7 Kap 11 2 bis 11 4 Insbesondere respiratorische Infekte spielen eine große Rolle als Triggerfaktor


id: cord-018537-t1gi76nc
type: PROTEIN
entity:
  ist häufig und besonders gefährlich Patienten mit der Diagnose Asthma bronchiale und entsprechenden Allergien sind daher unbedingt auf


id: cord-018537-t1gi76nc
type: PROTEIN
entity:
  Kinder und Jugendliche Abb 27 13 bzw Kinder unter 5 Jahren Tab 27 9 Hierbei ist beachtenswert dass jegliches Auftreten von Symptomen


id: cord-018537-t1gi76nc
type: PROTEIN
entity:
  Ziel mit überschaubarem medikamentösem Aufwand ohne wesentliche therapiebedingte unerwünschte Nebenwirkungen zu erreichen Die Abb 27 16 gibt ein Stufenschema


id: cord-018537-t1gi76nc
type: PROTEIN
entity:
  der inspiratorische Stridor Abb 27 18c In und Exspirationszeiten werden dadurch verlängert und beeinträchtigen


id: cord-018537-t1gi76nc
type: PROTEIN
entity:
  nicht vermeiden kann eine nachfolgende Intubation notwendig werden Hierzu nimmt man stets einen etwas


id: cord-018537-t1gi76nc
type: GGP
entity:
  Häufung zwischen dem 4 und 6 Lebensmonat Die überwiegende Mehrzahl der akuten Bronchiolitiden werden durch das Respiratory Syncytial Virus


id: cord-018537-t1gi76nc
type: GGP
entity:
  begonnen im Jahr 1972 mit Follow up von 9 26 Jahren kam zu denselben Resultaten Zusammenfassend lässt sich also sagen dass früher Krankheitsbeginn eine schon im Kindesalter eingeschränkte Lungenfunktion sowie Atopie konstante Risikofaktoren für später persistierendes Asthma sind Wie aus oben genannten Beispielen ersichtlich ist sind Geburtskohorten und Longitudinalstudien ein wichtiger und spannender Forschungsansatz um Krankheitsverlauf Outcome und Modulatoren verstehen zu lernen Ihr Nachteil ist


id: cord-018537-t1gi76nc
type: WORK_OF_ART
entity:
  Expert Panel Report 3 Guidelines for the Diagnosis and Management of Asthma Full Report Leitlinie zur


id: cord-018537-t1gi76nc
type: CHEMICAL
entity:
  dieser epidemiologischen Studien unterscheiden sich folgende Gruppen Die episodisch auftretenden meist transienten


id: cord-018537-t1gi76nc
type: DISEASE
entity:
  assoziiert Die RSV Bronchiolitis verläuft besonders im sehr frühen Säuglingsalter mit noch unreifem Immunsystem besonders schwer Es gibt Hinweise dafür dass die Anfälligkeit junger Säuglinge auf ihre


id: cord-018537-t1gi76nc
type: CHEMICAL
entity:
  Milz sowie einem horizontalen Rippenverlauf mit ungünstigem Ansatz der inspiratorischen Interkostalmuskulatur einhergeht Langandauernde Atemanstrengungen können bei schwerem Verlauf zur respiratorischen Erschöpfung führen Speziell bei Frühgeborenen und sehr jungen Säuglingen 3 Monate kann


id: cord-018537-t1gi76nc
type: CHEMICAL
entity:
  sind z T genetisch prädisponiert Die Umweltinteraktionen spielen hier eine bedeutende Rolle Die meisten dieser Phänomene werden in anderen Kapiteln behandelt 7 Kap 5 bis 7 die


id: cord-018537-t1gi76nc
type: DISEASE
entity:
  Anzahl der ungeplanten Hausarztbesuche wurde reduziert und eine leichte Verbesserung der Lungenfunktion wurde nachgewiesen Die eingeschränkte Evidenzlage


id: cord-018537-t1gi76nc
type: CHEMICAL
entity:
  eine bronchiale Hyperreaktivität bei der Lungenfunktionstestung objektiviert Bei Vorliegen einer eosinophilen Entzündung ist


id: cord-018537-t1gi76nc
type: CHEMICAL
entity:
  sich nach derzeitigem Wissen um eine erworbene Idiosynkrasie des Arachidonsäuremetabolismus Bei Kindern tritt das Analgetika Asthma sehr selten


id: cord-018537-t1gi76nc
type: CHEMICAL
entity:
  geschaffen werden j Epidemiologie und Ätiologie Anstrengungsasthma betrifft bis zu 80 aller Kinder mit Asthma


id: cord-018537-t1gi76nc
type: CHEMICAL
entity:
  sind Beschwerdefreiheit normale Lungenfunktion und normale bronchiale Reagibilität sodass dem asthmakranken


id: cord-018537-t1gi76nc
type: CHEMICAL
entity:
  Zusätzlich kann täglich lokal Budesonidlösung instilliert werden wobei der additive Effekt zur sytemischen


id: cord-023331-jrvmgnu3
type: DISEASE
entity:
  respiratory viruses enteroviruses coronaviruses human metapneumovirus adenovirus parainfluenza influenza RSV rhinoviruses


id: cord-016009-qa7bcsbu
type: CELL_LINE
entity:
  bronchus 50 Large cell undifferentiated carcinoma About 10 15 of lung cancers It can appear in any part of the lung and tends to grow and spread quickly A subtype of large cell carcinoma


id: cord-016009-qa7bcsbu
type: PROTEIN
entity:
  protein RI transforming growth factor b receptor I RII transforming growth factor b receptor II SARA Smad anchor


id: cord-016009-qa7bcsbu
type: PROTEIN
entity:
  receptor activation STAT signal transducer and activator of transcription TCF T cell factor TGF transforming growth factor


id: cord-016009-qa7bcsbu
type: GGP
entity:
  growth factor ECM extracellular matrix EGF epidermal growth factor EMT epithelial mesenchymal transition HSC hepatic stellate cell IL interleukin MMP matrix metalloproteinase TGF transforming growth factor TIMP


id: cord-016009-qa7bcsbu
type: CHEMICAL
entity:
  bananas grapes strawberries citrus fruits tomatoes nuts chocolate pineapples fish spinach fermented foods


id: cord-016009-qa7bcsbu
type: CHEMICAL
entity:
  alpha 1 antitrypsin deficiency Let s talk about Alpha 1 Antitrypsin Deficiency Alpha1 antitrypsin deficiency


id: cord-017412-1avevzya
type: PROTEIN
entity:
  Human Body DOI 10 1007 978 1 4419 7089 3_7 sha 4295cf87a4463c98e5bb14d4befc748895ad5670 doc_id 17412 cord_uid 1avevzya


id: cord-017412-1avevzya
type: DNA
entity:
  nuclear ribosomal internal transcribed spacer 1 Nihon Ishinkin Gakkai zasshi Allergic bronchopulmonary aspergillosis An experimental model of rhinovirus induced chronic obstructive pulmonary disease exacerbations a pilot study Diagnosis and immunotherapy of mould allergy IV


id: cord-022467-j2trahab
type: DISEASE
entity:
  rhinovirus coronavirus adenovirus respiratory syncytial virus RSV influenza virus and parainfluenza virus 101 121 139 Transmission varies


id: cord-340583-kjrxrk50
type: CELL_LINE
entity:
  California Covid 19 Testing Hospital Admission and Intensive Care Among 2 026 227 United States Veterans Aged 54 75 Years Factors


id: cord-340583-kjrxrk50
type: LAW
entity:
  the ISARIC WHO Clinical Characterisation Protocol Case Fatality Rate and Characteristics of Patients Dying in Relation to COVID 19


id: cord-305838-i0ck2oo0
type: ORG
entity:
  the Diagnosis Management and Prevention of Chronic Obstructive Pulmonary Disease Reevaluation of Diagnosis in Adults With


id: cord-305838-i0ck2oo0
type: ORG
entity:
  Congenital Cardiology AEPC International Society for Heart and Lung Transplantation ISHLT Cystic Fibrosis Pulmonary Guidelines Chronic Medications for Maintenance of Lung Health


id: cord-305838-i0ck2oo0
type: WORK_OF_ART
entity:
  Away From Work A New Approach for Identifying Patients with Undiagnosed Chronic Obstructive Pulmonary Disease Case


id: cord-305838-i0ck2oo0
type: ORG
entity:
  Health Towards Reliable Data Collection and Annotation to Extract Pulmonary Digital Biomarkers Using Mobile Sensors SpiroSmart


id: cord-022527-a0x6lws3
type: CELL_TYPE
entity:
  human airway epithelial cells Interleukin 4 interleukin 13 signal transducer and activator of transcription factor 6


id: cord-022527-a0x6lws3
type: GGP
entity:
  IL 5 54 61e63 66 67 which could further amplify the process of differentiation and proliferation More


id: cord-022527-a0x6lws3
type: GGP
entity:
  ADP receptor antagonist clopidogrel Plavix Bristol Myers Squibb New York NY and SanofieAventis Paris France and acetylsalicylic acid aspirin


id: cord-332737-iclruwmx
type: CELL_LINE
entity:
  epithelial cell shedding goblet cell hyperplasia hypertrophy and hyperplasia of the airway smooth muscle bundles


id: cord-260472-xvvfguht
type: DISEASE
entity:
  influenza A H5N1 viruses The structure of H5N1 avian influenza neuraminidase suggests new opportunities for drug design Comparison of the efficacy and safety of live attenuated cold adapted influenza vaccine trivalent


id: cord-017789-rhoisec4
type: PROTEIN
entity:
  mit einer Neutrophilie verbunden ist haben Lipoxine hier eine entscheidende gegenregulatorische Bedeutung Lipoxine und AT LX A4


id: cord-017789-rhoisec4
type: PROTEIN
entity:
  Bildung von R Varianten der Resolvine Durch Acetylsalicylsäure ASA wird DHA über ASA acetylierte COX 2 an Entzündungsorten


id: cord-017789-rhoisec4
type: PROTEIN
entity:
  RvT4 haben folgende Strukturformeln 7 13 20 Trihydroxy Docosapentaensäure 7 12 13 Trihydroxy Docosapentaensäure 7 8 13 Trihydroxy Docosapentaensäure 7 13 Dihydroxy Docosapentaensäure Ausgehend von


id: cord-017789-rhoisec4
type: PROTEIN
entity:
  hingegen ein Verhältnis von ca 50 1 Sonnenblumenöl 120 1 und Distelöl 150 1 auf Pflanzensamen enthalten


id: cord-017789-rhoisec4
type: PROTEIN
entity:
  von migrierenden Zellen und geringerer Migrationsdistanz Sperling et al 1993 wobei in einer Dosis Wirkungsstudie 1 3


id: cord-017789-rhoisec4
type: GGP
entity:
  Strukturformeln 7 13 20 Trihydroxy Docosapentaensäure 7 12 13 Trihydroxy Docosapentaensäure 7 8 13 Trihydroxy Docosapentaensäure 7 13 Dihydroxy Docosapentaensäure Ausgehend von der n 3


id: cord-017789-rhoisec4
type: GGP
entity:
  IL 4 Expression von aktivierten CD4 T Zellen die IgE Serumwerte sowie die entzündliche Infiltration der betroffenen Hautareale und kann dadurch die Entwicklung einer atopischen Dermatitis unterdrücken Kim


id: cord-017789-rhoisec4
type: GGP
entity:
  Auftreten von allergischen Erkrankungen OR adj 0 76 95 CI 0 61 0 94 und die Sensibilisierung gegenüber Nahrungs und Pollenallergenen OR adj 0 76 0 58 1 0


id: cord-017789-rhoisec4
type: CHEMICAL
entity:
  Allergene z B Hausstaubmilbe Hopfenpollen bzw auch Bakterien z B Staphylococcus aureus s 7 Abschn 7 3 IL 33 aktivieren


id: cord-017789-rhoisec4
type: DISEASE
entity:
  aktuelle Studie bei giemenden Kindern im Vergleich zu Gesunden eine reduzierte Menge von Lipoxinen aber auch weniger Annexin A1 nachwies Eke Gungor et al 2014 Somit sind Lipoxine


id: cord-017789-rhoisec4
type: CHEMICAL
entity:
  meisten Patienten mit schwerem Asthma und einer FEV1 80 nur ganz niedrige LX A4 Werte aufweisen Steigende Lipoxinwerte sind mit einer besseren


id: cord-017789-rhoisec4
type: CHEMICAL
entity:
  zu stoppen Bei nicht pathogenen Bakterien werden diese Mechanismen nicht aktiviert Diese Selbstheilung zu


id: cord-017789-rhoisec4
type: CHEMICAL
entity:
  entzündliche Zellprofile aufweisen kann bei beiden Erkrankungen im fortgeschrittenem Stadium eine neutrophil dominierte Inflammation


id: cord-017789-rhoisec4
type: CHEMICAL
entity:
  zwei bis drei Fischmahlzeiten mit niedrigem Quecksilbergehalt pro Woche zu sich nehmen sollten 200 bis 300 g pro Woche Auch Kinder sollten ab


id: cord-010078-8lkkez3n
type: WORK_OF_ART
entity:
  Clinical Guidelines for the Manual Titration of Positive Airway Pressure in Patients with Obstructive Sleep Apnea in Journal of Clinical Sleep Medicine 2008


id: cord-010078-8lkkez3n
type: DISEASE
entity:
  allergic rhinitis idiopathic pulmonary hypertension hypersensitivity pneumonitis occupational respiratory disease


id: cord-010078-8lkkez3n
type: DISEASE
entity:
  pleural and pericardial effusions pericardial thickening enlarged pulmonary artery and esophageal dilatation HRCT


id: cord-016783-8x05oh5q
type: ORG
entity:
  the World Allergy Organization Project Report and Guidelines on Prevention of Allergy and Allergic Asthma


id: cord-016783-8x05oh5q
type: DISEASE
entity:
  asthma Respiratory syncytial virus and parainfluenza viruses Clinical Virology Localization of human rhinovirus replication


id: cord-332053-df44guu7
type: PROTEIN
entity:
  b Ronina Covar MD c d Anna Faino MS e Jennifer Fish CPNP f Paige Pickering BS g Preveen Ramamoorthy MD g Melanie Gleason PAC b


id: cord-332053-df44guu7
type: WORK_OF_ART
entity:
  The Effect of Viral Infection on Exhaled Nitric Oxide in Children with Acute Asthma Exacerbations Jonathan Malka MD a b


id: cord-332053-df44guu7
type: ORG
entity:
  Bethesda Md National Institutes of Health National Heart Lung and Blood Institute Standardization of spirometry


id: cord-312613-1nl7q6cy
type: DISEASE
entity:
  human rhinoviruses paramyxoviruses coronaviruses and bocavirus during acute respiratory tract infections


id: cord-320431-0877trhh
type: PROTEIN
entity:
  nuclear factor κB pathways Dangerassociated molecular patterns and danger signals in idiopathic pulmonary fibrosis Toll like receptors


id: cord-320431-0877trhh
type: GGP
entity:
  EGF receptor Ras Raf extracellular signalregulated kinase cascade and Sp1 13 and epidermal growth factor receptor


id: cord-320431-0877trhh
type: DISEASE
entity:
  asthmatic human airway Epidermal growth factor system regulates mucin production in airways Van Seuningen I


id: cord-280859-3ff72mlq
type: DISEASE
entity:
  human rhinovirus RV respiratory syncytial virus RSV enterovirus EV influenza virus and human metapneumovirus hMPV 2


id: cord-023239-06a03o14
type: LAW
entity:
  a Lung Function Test in Cystic Fibrosis A Cystic Fibrosis Foundation Workshop Report Plethysmographic


id: cord-023239-06a03o14
type: DISEASE
entity:
  postural drainage active cycle of breathing oscillatory positive expiratory pressure devices and high frequency assisted airway clearance


id: cord-254766-585iu5ey
type: ORG
entity:
  Woolcock Institute of Medical Research Australian Institute of Health and Welfare Data Fact Sheet Asthma Statistics National Institutes of Health National Heart Lung


id: cord-271790-3s8o774l
type: DISEASE
entity:
  influenza parainfluenza enterovirus and adenovirus 2 must not be forgotten and research is underway into the importance of more recently discovered viruses including hMPV human Metapneumovirus 11 coronavirus NLG 3 12 and HKV 1 13 human parovirus 14 and torquetenovirus 15 RSV and RV


id: cord-271790-3s8o774l
type: DISEASE
entity:
  respiratory syncytial virus parainfluenza 3 adenovirus and rhinovirus sequences in respiratory tract of infants by polymerase chain reaction


id: cord-023713-daz2vokz
type: DATE
entity:
  1956 1958 1960 1962 1964 1966 1968 1970 1972 1974 1976 1978 1980 1982 1986 1988 1990 1992 1994 1996 1998 2000 1984 2002


id: cord-023713-daz2vokz
type: ORG
entity:
  National Heart Lung and Blood Institute World Health Organization Global Initiative for Asthma Public Health Service National Institutes of Health NIH


id: cord-023713-daz2vokz
type: CHEMICAL
entity:
  vitamin C carotenoids flavonoids polyunsaturated fatty acids vitamin D folate 122 133 foods e g fruits vegetables metals


id: cord-023713-daz2vokz
type: DISEASE
entity:
  Bacillus subtilis papain fungal amylase wood dust or barks e g Western red cedar oak reactive dyes drugs e g penicillin methyldopa metals


id: cord-022653-qa1uph35
type: PROTEIN
entity:
  IL 6 median 12 06 vs 3 08 pg mL P 001 ET 1 median 2 06 vs 1 59 pg mL P 029 vWF median 3284 vs 2730 IU mL P 013 and E sel median 52 6 vs 42 3 ng mL P 05


id: cord-022653-qa1uph35
type: GGP
entity:
  E selectin E sel inter cellular adhesion molecule 1 ICAM 1 endothelin 1 ET 1 von Willebrand factor vWF


id: cord-022653-qa1uph35
type: GGP
entity:
  juice 1 2 4 5 drops 5drops 0 13 mL sublingually starting concentration chosen according to the endpoint SPT


id: cord-022653-qa1uph35
type: ORG
entity:
  Ballegaard AR Madsen CB Bøgh KL National Food Institute Technical University of Denmark Søborg Denmark


id: cord-327610-cm3vkpcn
type: ORG
entity:
  Mechanisms and Management of Asthma Exacerbations Precision Medicine and Phenotypes Endotypes Genotypes Regiotypes


id: cord-327610-cm3vkpcn
type: ORG
entity:
  New Molecular Targets for the Treatment of Neutrophilic Diseases Models of Respiratory Infections Virus Induced Asthma Exacerbations


id: cord-327610-cm3vkpcn
type: WORK_OF_ART
entity:
  The Innate Cytokines Il 25 IL 33 and TSLP Cooperate in the Induction of Type 2 Innate Lymphoid Cell Exansion and Mucous Metaplasia


id: cord-327610-cm3vkpcn
type: WORK_OF_ART
entity:
  Inhibitory Effects of Resveratrol on Airway Remodeling by Transforming Growth Factor β Smad Signaling Pathway


id: cord-019347-tj3ye1mx
type: DNA
entity:
  Blaziene A Chomiciene L Jurgauskiene N Ciaponiene Vilnius Lithuania Background Sublingual specific immunotherapy


id: cord-019347-tj3ye1mx
type: GGP
entity:
  Aspergillus n 13 CC 0 71 Penicillium n 6 CC 0 69 Alternaria n 13 CC 0 62 Cladosporium n 8 CC 0 35 cat n 5 CC 0 31 and roach n 5 CC 0 16 The lowest correlation was for Dermatophagoides farina n 7 CC 0 03 Conclusion When


id: cord-019347-tj3ye1mx
type: GGP
entity:
  E Meltzer 1 Y Luo 2 L Shen 2 Z Guo 2 C Schemm 2 Y Huang 2 K Chen 2 P King 2 R Nave 3 D Banerji 2 S Rohatagi 2 1


id: cord-019347-tj3ye1mx
type: GGP
entity:
  SIT 1 01 0 01 per month 3 months after SIT and 1 99 0 25 per month at the end of the sixth month after SIT 26 7


id: cord-019347-tj3ye1mx
type: CHEMICAL
entity:
  conjugate pneumococcal polysaccharides A Yates 1 R deShazo 1 J Butler 1 G Howell 1 J Farley 1 H Liu 1 N Nanayakkura 2 G B Yi 1 R Rockhold 1 1 Jackson MS 2 Oxford MS INTRODUCTION Venom from S invicta


id: cord-019347-tj3ye1mx
type: DISEASE
entity:
  itchy nose p 0 0032 and reduced the severity of pollen effects on sneezing p 0 0451 itchy nose p 0 0178 and runny nose p 0 0327


id: cord-022650-phsr10jp
type: PROTEIN
entity:
  membrane antigens b cells CD3 CD19 CD45 CD19 CD5 CD45 CD19 CD23 CD45 CD19 CD25 CD45 CD19 CD40 CD45 CD19 CD86 CD45 CD3 CD4 CD40L CD45 CD19 CD45RA CD27 CD45


id: cord-022650-phsr10jp
type: GGP
entity:
  house dust mite tablet Matsuoka T 1 Kuroda Y 1 Igarashi S 1 Fukano C 2 Natsui K 2 Ohashi Doi K 2 Masuyama K 1 1


id: cord-022650-phsr10jp
type: GGP
entity:
  Smiljkovic D 3 Blatt K 3 Selb R 4 Stoecklinger A 5 Keller W 2 Valent P 3 Niederberger V 4 Thalhamer J 5 Valenta R 6 Flicker S 6 Background Bet v 1


id: cord-022650-phsr10jp
type: GGP
entity:
  Phl p 1 P 0 05 despite the lower concentration of pollen In Günzburg 66 children had no sensitization at all compared to 58 in Munich 80 of the


id: cord-022650-phsr10jp
type: GGP
entity:
  CD19 CD45 CD19 CD5 CD45 CD19 CD23 CD45 CD19 CD25 CD45 CD19 CD40 CD45 CD19 CD86 CD45 CD3 CD4 CD40L CD45 CD19 CD45RA CD27 CD45


id: cord-022650-phsr10jp
type: ORG
entity:
  between University of Health Sciences Ankara Child Hospital The Children Allergy and Immunology Clinic


id: cord-022650-phsr10jp
type: ORG
entity:
  Department of Allergy and Clinical Immunology National Research Institute for Child Health and Development Tokyo


id: cord-022650-phsr10jp
type: WORK_OF_ART
entity:
  Cabrera V Barrios J Callero A González CE Pérez E Martínez JA Hospital Universitario Nuestra Sra de la Candelaria Santa Cruz


id: cord-022650-phsr10jp
type: CHEMICAL
entity:
  5 p phenylenediamine 2 5 colophony 2 5 n isopropyl n fenil 4 fenilendiamin 2 5 mercaptobenzothiazole 2 5 benzocaine 2 5


id: cord-022650-phsr10jp
type: DISEASE
entity:
  grasses grass and olive olea sIgE tot for Phleum pratense and Olea europaea and some sIgE CRD rPhl p 1 rPhl p 5 rPhl p 7 rPhl p 12 rOle1 and nOle7 were determined Physicians


id: cord-022650-phsr10jp
type: CHEMICAL
entity:
  Pacitto A Bizzarri I Isidori C Tarsia M Esposito S Università degli Studi di Perugia Dipartimento di Scienze Chirurgiche


# bib

id: cord-000285-7p3b6tyf
author: HARTERT, Tina V.
date: 2010-04-08
txt: ./txt/cord-000285-7p3b6tyf.txt
cache: ./cache/cord-000285-7p3b6tyf.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992986/
doi: 10.1111/j.1440-1843.2010.01743.x
summary:
  The primary goals of the study are: (i) to investigate both the acute and the long-term health consequences of varying severity and aetiology of clinically significant viral respiratory tract infections on the outcomes of allergic rhinitis (AR) and early childhood asthma; and (ii) to identify the potentially modifiable factors that define children who are at greatest risk of developing asthma following infant respiratory viral infection. Thus, we designed the prospective TCRI to establish a base for the evaluation of both the risks and benefits of documented significant infant viral respiratory infection of varying severity and aetiology and other environmental exposures on childhood atopy outcomes and to establish a biospecimen repository for analyses including biomarker testing and genotyping. The TCRI is a prospective cohort of mother-infant dyads enrolled in a longitudinal investigation of the relationship of infant viral respiratory infection severity and aetiology and the interaction of other risk factors on the development of childhood asthma and allergic diseases.

title:
  The Tennessee Children''s Respiratory Initiative: Objectives, design and recruitment results of a prospective cohort study investigating infant viral respiratory illness and the development of asthma and allergic diseases

abstract:
  Background and objective: The ‘attack rate’ of asthma following viral lower respiratory tract infections (LRTI) is about 3–4 fold higher than that of the general population; however, the majority of children who develop viral LRTI during infancy do not develop asthma, and asthma incidence has been observed to continuously decrease with age. Thus, we do not understand how viral LRTI either predispose or serve as a marker of children to develop asthma. The Tennessee Children's Respiratory Initiative has been established as a longitudinal prospective investigation of infants and their biological mothers. The primary goals are to investigate both the acute and the long‐term health consequences of varying severity and aetiology of clinically significant viral respiratory tract infections on early childhood outcomes. Methods: Over four respiratory viral seasons, 2004–2008, term, non‐low birth weight previously healthy infants and their biological mothers were enrolled during an infant's acute viral respiratory illness. Longitudinal follow up to age 6 years is ongoing. Results: This report describes the study objectives, design and recruitment results of the over 650 families enrolled in this longitudinal investigation. The Tennessee Children's Respiratory Initiative is additionally unique because it is designed in parallel with a large retrospective birth cohort of over 95 000 mother–infant dyads with similar objectives to investigate the role of respiratory viral infection severity and aetiology in the development of asthma. Conclusions: Future reports from this cohort will help to clarify the complex relationship between infant respiratory viral infection severity, aetiology, atopic predisposition and the subsequent development of early childhood asthma and atopic diseases.


id: cord-010078-8lkkez3n
title: Invited Speakers
author: nan
date: 2010-11-24
txt: ./txt/cord-010078-8lkkez3n.txt
cache: ./cache/cord-010078-8lkkez3n.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7169233/
doi: 10.1111/j.1440-1843.2010.01863.x
abstract: nan
summary:
  Both modes of imaging discriminate early malignant lesions from non-specifi c infl ammation, aid in selecting appropriate sites for biopsy and better delineate tumor margins for more precise staging, but are of little value at present in clinical practice since most patients with malignant pleural effusions have extensive pleural involvement that is easy to diagnose with white light pleuroscopy For pleuroscopic guided pleural biopsies, specimens obtained with the rigid forceps are larger than those with the fl ex-rigid pleuroscope since they are limited by size of the fl exible forceps, which in turn depends on the diameter of the working channel. In the United Kingdom, a thrombosis group has been formed to promote awareness among parliamentarians about the risk and management of VTE; to increase knowledge of its causes, effects, and treatments; and to monitor the implementation of government initiatives and other researches being and this program has corrected the wrong perception that PTE is a rare disease in China Pulmonary hypertension (PH) is a common complication of chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD) or interstitial lung diseases (ILD).


id: cord-015893-e0fofgxq
title: Viral Disease, Air Pollutants, Nanoparticles, and Asthma
author: Ryhal, Bruce
date: 2011-05-03
txt: ./txt/cord-015893-e0fofgxq.txt
cache: ./cache/cord-015893-e0fofgxq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119993/
doi: 10.1007/978-1-4419-6836-4_11
summary:
  Sulfur dioxide, nitrogen dioxide, ozone, and particulate matter in air pollution may • exacerbate asthma, and patients should be cautioned to stay indoors when levels of these irritants are high. A study of children aged 6-8 years with asthma concluded that an asthma exacerbation was of a greater severity if a viral infection was present as opposed to a nonviral illness (7) . Inhaled corticosteroids and leukotriene receptor antagonists (LTRAs) are well known to control the number of wheezing exacerbations in school-age children with chronic persistent asthma, an effect that appears to encompass those episodes caused by viral illness. Viral respiratory infections, and to a lesser extent air pollution, are common triggers of exacerbations and may interact with individuals to affect the development of some forms of asthma. By understanding and anticipating respiratory viral infections and air pollution as important causes of asthma, the health care provider can provide superior care for those who suffer from this chronic disease.

abstract:
  Health care providers who treat patients with respiratory disease are often asked by their patients, “What caused my asthma? And what causes my asthma suddenly to become worse?” These questions have always been difficult to answer, and moving directly to a discussion of the management of asthma is a much easier road to take. In recent years, though, enough information has accumulated about the causes of asthma that one can weave a story containing useful advice that may help patients participate in the management of their disease. And there are also recent studies that can provide answers to the questions posed by physicians who have watched in puzzlement as their previously well-controlled asthma patients have spiraled rapidly out of control. This story has been growing increasingly complex, with an ever-expanding cast of players that sometimes creates a tangled web of interactions.


id: cord-016009-qa7bcsbu
title: Respiratory
author: Starkel, Julie L.
date: 2019-10-07
txt: ./txt/cord-016009-qa7bcsbu.txt
cache: ./cache/cord-016009-qa7bcsbu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120155/
doi: 10.1007/978-3-030-30730-1_51
summary:
  Disease that restricts airflow through either inflammation of the lining of the bronchial tubes or destruction of alveoli Increased risk of emphysema if genetic variant of alpha-1 antitrypsin deficiency and smoking or exposed to high levels of air pollution [11] Bronchiectasis A disorder of the airways that leads to airway dilation and destruction, chronic sputum production, and a tendency toward recurrent infection [39] Bronchiolitis Airway injury that can be caused by infections, irritants, toxic fumes, drug exposures, pneumonitis (typically viral), organ transplants, connective tissue disorders, vasculitis, or other insults [40] Dyspnea Shortness of breath or difficulty breathing [11] Emphysema Thinning and destruction of the alveoli, resulting in decreased oxygen transfer into the bloodstream and shortness of breath.

abstract:
  Lung disease rivals the position for the top cause of death worldwide. Causes and pathology of the myriad lung diseases are varied, yet nutrition can either affect the outcome or support treatment in the majority of cases. This chapter explores the modifiable risk factors, from lifestyle changes to dietary intake to specific nutrients, anti-nutrients, and toxins helpful for the nutritionist or dietitian working with lung disease patients. General lung health is discussed, and three major disease states are explored in detail, including alpha-1 antitrypsin deficiency, asthma, and idiopathic pulmonary fibrosis. Although all lung diseases have diverse causes, many integrative and functional medical nutrition therapies are available and are not being utilized in practice today. This chapter begins the path toward better nutrition education for the integrative and functional medicine professional.


id: cord-016173-ro7nhody
title: Pulmonary Disorders in Pregnancy
author: Louis, Mariam
date: 2014-08-13
txt: ./txt/cord-016173-ro7nhody.txt
cache: ./cache/cord-016173-ro7nhody.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120384/
doi: 10.1007/978-1-4614-1244-1_11
summary:
  Although most clinical practices use symptom-based, guideline-directed assessments to decide on medication use, recent data from a randomized controlled trial suggest lower rates of exacerbation, improved quality of life, and reduced neonatal hospitalization when management decisions were based on measurements of exhaled nitric oxide in pregnancy [ 10 ] . Changes in physiology and immunity associated with pregnancy may increase the risk of infection and severe outcomes in the pregnant women. In addition, infl uenza infection during pregnancy increases the risk of adverse fetal outcomes. Pregnant women are at increased risk for morbidity (including cardiorespiratory complications) and mortality from infl uenza compared with nonpregnant controls [ 43 -46 ] that is more pronounced in the second and third trimester of pregnancy [ 47 ] . In view of potential severe maternal disease from infl uenza and adverse fetal outcomes, benefi ts of treatment with antivirals likely outweigh the potential risks to the fetus.

abstract:
  Pregnancy is associated with some profound changes in the cardiovascular, respiratory, immune, and hematologic systems that impact the clinical presentation of respiratory disorders, their implications in pregnancy, and the decisions to treat. In addition, concerns for fetal well-being and safety of various interventions complicate the management of these disorders. In many circumstances, especially life-threatening ones, decisions are based upon a careful assessment of the risk benefit ratio rather than absolute safety of drugs and interventions. In this chapter, we review some of the common respiratory disorders that internists or obstetricians may be called upon to manage.


id: cord-016783-8x05oh5q
title: Early Interventions in Allergic Diseases
author: Arruda, L. Karla
date: 2010
txt: ./txt/cord-016783-8x05oh5q.txt
cache: ./cache/cord-016783-8x05oh5q.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121172/
doi: 10.1007/978-4-431-99362-9_23
summary:
  Evidence indicates that environmental factors acting early in life, including respiratory viral infections, exposure to pets and microbial products, day-care attendance, breast feeding, and exposure to allergens, tobacco smoke and other pollutants, are key events for establishment of sensitization and development of chronic, persistent symptoms of allergic diseases [1] . Evidence indicates that environmental factors acting early in life, including respiratory viral infections, exposure to pets and microbial products, day-care attendance, breast feeding, and exposure to allergens, tobacco smoke and other pollutants, are key events for establishment of sensitization and development of chronic, persistent symptoms of allergic diseases [1] . The relationship of exposure to microbial agents (endotoxin, fungal agents, and other microbial contaminants) early in life (3 months of age) and the development of atopic sensitization and physician-diagnosed asthma and wheeze in the first 4 years of life, in children of atopic mothers, was investigated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study.

abstract:
  Atopy has been defined as the genetic predisposition to develop IgE antibody responses to a variety of common environmental allergens. Clinically, atopy is expressed by asthma, allergic rhinoconjunctivitis and atopic dermatitis. It has been recognized that the “atopic march” evolves from food allergy and atopic dermatitis in the first 2 years of life, followed by asthma and allergic rhinitis. Over the past 30 years, the prevalence of allergies and asthma has increased significantly in developed countries, and asthma is one of the most common chronic diseases in children. Evidence indicates that environmental factors acting early in life, including respiratory viral infections, exposure to pets and microbial products, day-care attendance, breast feeding, and exposure to allergens, tobacco smoke and other pollutants, are key events for establishment of sensitization and development of chronic, persistent symptoms of allergic diseases [1]. It is thought that gene—environment interactions play a crucial role in these processes. Therefore, attempts to successfully prevent development of allergic diseases should be a priority. At present, there are no genetic markers for atopy or asthma which could be used routinely in clinical practice and family history of atopy has been used to identify children genetically at-risk of developing allergic diseases. These children from high-risk families have been the focus of most of the intervention studies.


id: cord-016931-il8o0fps
title: Allergie, Pathomechanismen, Krankheitsbilder
author: Kroegel, C.
date: 2008
txt: ./txt/cord-016931-il8o0fps.txt
cache: ./cache/cord-016931-il8o0fps.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121367/
doi: 10.1007/978-3-540-37692-7_3
summary:
  Eine detaillierte Besprechung aller in Tab. 3.1 aufgeführten allergischen Erkrankungen würde den zur Die diagnostische Abklärung erfolgt durch Bestimmung des spezifischen IgE gegenüber Insektengiftbestandteilen (Phospholipase, Melittin etc.) und durch einen Hauttest in Verbindung mit der Anamnese. Heute lässt sich die Rhinitis als Entzündung der nasalen Mukosa definieren, die einhergeht: ▬ klinisch mit Hypersekretion, Niesreiz sowie nasaler Kongestion, ▬ immunologisch auf dem Boden IgE-vermittelter Mechanismen gegenüber Allergenen mit lokaler Sekretion von Zytokinen, eosinophilem kationischem Protein (ECP) und anderen Mediatoren, ▬ histologisch mit einer Infiltration vor allem durch eosinophile Granulozyten und ▬ immunhistologisch mit einer Anreicherung aktivierter T-Lymphozyten und degranulierter eosinophiler Granulozyten. Sie gilt als die klassische allergische Immunreaktion bei Rhinitis allergica, allergischem Asthma bronchiale und atopischer Dermatitis, bildet aber auch eine Komponente der immunologischen Reaktion bei der allergischen bronchopulmonalen Aspergillose. Ausgangspunkt einer immunologischen Reaktion, wie auch der im Rahmen allergischer Erkrankungen, ist die Interaktion des Antigens/Allergens mit APC und einem genetisch definierten, spezifischen T-Zellklon.

abstract:
  Etwa ein Fünftel der Bevölkerung industrialisierter Länder leidet an mindestens einer Erkrankung aus dem allergischen Formenkreis. Hierzu gehören neben Manifestationen der Haut und des Gastrointestinaltrakts insbesondere die allergischen Erkrankungen der oberen und unteren Atemwege. Aufgrund der hohen und weiter steigenden Prävalenz von Allergien und den sich hieraus ableitenden volkswirtschaftlichen Belastungen ist die Allergologie in den letzten Jahren mehr und mehr in den Mittelpunkt des allgemeinen Interesses gerückt. Zudem haben neue wissenschaftliche Erkenntnisse zu einer Erweiterung des pathogenetischen Verständnisses insbesondere allergischer Atemwegserkrankungen geführt, die zunehmend auch die therapeutischen Möglichkeiten erweitern.


id: cord-017412-1avevzya
title: The Human Lung Microbiome
author: Losada, Liliana
date: 2010-10-11
txt: ./txt/cord-017412-1avevzya.txt
cache: ./cache/cord-017412-1avevzya.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121966/
doi: 10.1007/978-1-4419-7089-3_7
summary:
  Lower airway infections by bacteria, viruses, or fungi are among the most prevalent causes of transmissible disease in humans, with two to three million community-acquired (non-hospital-acquired) cases per year in the United States (Segreti et al., 2005) . Those with physically compromised airways or immune system deficiencies are subject to chronic microbial colonization of their airways and to high-frequency episodes of viral, bacterial, or fungal lower respiratory infections. Many associations with asthma have been detected including exposure to cigarette smoke (Thomson et al., 2004) , caesarean section birth relative to natural birth (Thavagnanam et al., 2008) , early viral respiratory infections (Gold and Wright, 2005; Harju et al., 2006) , early in life antibiotic use (Marra et al., 2006) , and living in the US (Gold and Wright, 2005) . Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations

abstract:
  The human lower respiratory tract is considered sterile in normal healthy individuals (Flanagan et al., 2007; Speert, 2006) despite the fact that every day we breathe in multiple microorganisms present in the air and aspirate thousands of organisms from the mouth and nasopharynx. This apparent sterility is maintained by numerous interrelated components of the lung physical structures such as the mucociliary elevator and components of the innate and adaptive immune systems (discussed below) (reviewed in (Diamond et al., 2000; Gerritsen, 2000)). However, it is possible that the observed sterility might be a result of the laboratory practices applied to study the flora of the lungs. Historically, researchers faced with a set of diseases characterized by a changing and largely cryptic lung microbiome have lacked tools to study lung ecology as a whole and have concentrated on familiar, cultivatable candidate pathogens.


id: cord-017789-rhoisec4
title: Lipidmediatoren und ihre Rolle bei Entzündungen und Allergien
author: Stockert, Karin
date: 2020-03-25
txt: ./txt/cord-017789-rhoisec4.txt
cache: ./cache/cord-017789-rhoisec4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7122452/
doi: 10.1007/978-3-662-58140-7_6
summary:
  Nachdem Th2-Zellen (neben den ILC2-Zellen) als hauptverantwortlich für die Bildung von Th2-Zytokinen angesehen werden, ist es sehr wahrscheinlich, dass der PGE2-EP2-Signalweg eine hemmende Wirkung auf die Th2-Zellproliferation hat und dadurch die allergische Sensibilisierung unterdrücken kann. Somit zeigt sich wiederum (wie bei den Untersuchungen bezüglich Remodeling), dass eine mangelnde Hochregulierung von COX-1 und COX-2 sowie fehlende Vermehrung von PGE2 unter inflammatorischen Bedingungen an der Entwicklung einer chronischen eosinophilen Rhinosinusitis mit Polypen sowohl mit als auch ohne Aspirin-Intoleranz beteiligt sind. Somit offenbart auch diese Studie, dass PGE2 eine protektive Wirkung auf die Lunge hat und als endogener Mediator die überschießende ILC2-Aktivierung der allergischen Inflammation "beruhigen" und gegensteuern kann. 2013): ILC2s sind dafür bekannt, dass sie nach Aktivierung durch die Atemwegsepithel-Zytokine IL-25, IL-33 und TSLP die Zytokine IL-13 und IL-5 freisetzen, aber auch antigenunabhängig als Antwort auf das Mastzellenprodukt Prostaglandin D2 (PGD2) und dadurch bei der Pathogenese von allergischen Erkrankungen eine Schlüsselrolle einnehmen.

abstract:
  Lipidmediatoren sind als lokal agierende Lipide nach dem Eindringen eines Krankheitserregers oder nach Gewebsverletzung im Zusammenspiel mit Interleukinen und Chemokinen zunächst für die sinnvollen proinflammatorischen Prozesse wie Calor, Rubor, Dolor, Tumor verantwortlich. Nach erfolgreich abgewehrter Infektion sind es wieder Lipidmediatoren, die mithelfen, die unschädlich gemachten Viren und Bakterien sowie nekrotisches Material aus dem Gewebe zu eliminieren, die Entzündungsreaktion zu stoppen und geschädigtes oder zerstörtes Gewebe zu regenerieren. Mit den Lipidmediatoren hat die Evolution wunderbare molekulare Netzwerke für kontrollierte Immunantworten auf Infektionen und Verletzungen geschaffen, die perfekt koordiniert zu einer Restitutio ad integrum führen und die die Homöostase im Gewebe wiederherstellen. Lange Zeit konzentrierte man sich auf die wissenschaftliche Beobachtung der entzündungsauslösenden Wirkung der Prostaglandine und Leukotriene. In letzter Zeit fokussiert die Forschung jedoch immer mehr auch die antiinflammatorischen und entzündungsauflösenden, schützenden und die Regeneration mediierenden Effekte der Lipidmediatoren, weil diese vor der Pathogenese von chronischen Erkrankungen, wie zum Beispiel Allergien, schützen können.


id: cord-018537-t1gi76nc
title: Obstruktive Atemwegserkrankungen
author: Frey, U.
date: 2013-10-05
txt: ./txt/cord-018537-t1gi76nc.txt
cache: ./cache/cord-018537-t1gi76nc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123435/
doi: 10.1007/978-3-642-34827-3_27
summary:
  Während im Säuglingsalter häufig vor allem virale Auslöser zu einmaligen obstruktiven Bronchitiden oder Bronchiolitiden führen, ist bei rezidivierenden Formen in jedem Alter, insbesondere beim Vorliegen von multiplen Auslösern, an ein frühkindliches Asthma bronchiale zu denken. Lebensjahr bei Kleinkindern verwendet, die eine akute virale Infektion der unteren Atemwege mit obstruktiver Symptomatik (auch wenn vorwiegend Pfeifen/Giemen vorliegt) erleiden, Dies wird in unseren Regionen als »virusinduziertes Wheezing«, »wheezy bronchitis« oder eben als obstruktive Bronchitis klassifiziert. Speziell bei Frühgeborenen und sehr jungen Säuglingen (<3 Monate) kann es ihm Rahmen von RSV-Infektionen zu zentralen Apnoen mit Bradykardien kommen, die vermutlich als Folge einer direkten Störung des Atemzentrums durch das Virus entstehen. Asthmaentwicklung Obwohl die »Huhn und Ei-Frage« nicht vollständig klar ist, nimmt man heute aufgrund von Erkenntnissen an großen Geburtskohorten an, dass frühe Virusinfektionen eher nur bei Kindern mit gewissen prädisponierenden Faktoren eine nachfolgenden Störung der Immunentwicklung und Allergie beeinflussen oder gar induzieren können (two hit hypothesis).

abstract:
  In den folgenden Abschnitten werden die verschiedenen Formen der obstruktiven Atemwegserkrankungen erläutert, die je nach Alter, prädisponierenden Risikofaktoren und auch je nach Art der Auslöser verschiedenartige Ausprägungen und Verlaufsformen (Phänotypen) annehmen können.


id: cord-019347-tj3ye1mx
title: ABSTRACT BOOK
author: nan
date: 2010-02-19
txt: ./txt/cord-019347-tj3ye1mx.txt
cache: ./cache/cord-019347-tj3ye1mx.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129269/
doi: 10.1016/s1081-1206(10)61294-x
abstract: nan
summary:
  Method:Case Report:A 15y/o w/f athlete presented with a two month history of recurrent hives and angioedema which she associated with ingestion of Halloween candy .One week before evaluation she had hives with Coconut as well.Her history was othewise unremarkable except for recurrent UTI''S, annual sinusitis, pneumonia in 1998 as well as migraines.She denied sexual activity.Her physical exam was normal.Results:An evaluation for autoimmune disease revealed normal ESR, ANA, DSDNA, mono and hepatitis serology as well as lyme titers however her CH50 was low17u/ml(normal 26-58U/ml)and evaluation of complement revealed c4 14mg/dl(normal 16-47mg//dl)and c2 <1.3mg/dl(normal 1.6-3.5mg/dl)with normal c3, c5-c9.Her father had nor-malc4 but c2 was 1.4mg/dl (normal 1.6-3.5mg/dl)Her sister had c2 of 1.5mg/dl and normal c4 and her mother had normal c2 and c4.Her workup included positive prick skin test to ragweed, ash and grass and she was started on Rhinocort and Clarinex seasonally.She has been followed for one year with resolution of hives and is asymptomatic.Her diagnosis had been confirmed by a pediatric rheumatologist.Conclusion;We present an atypical case of C2 complement deficiency in an currently asymptomatic individual.


id: cord-021905-fjcks7w4
title: Asthma Triggers: What Really Matters?
author: Win, Patrick H.
date: 2009-05-22
txt: ./txt/cord-021905-fjcks7w4.txt
cache: ./cache/cord-021905-fjcks7w4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152189/
doi: 10.1016/b978-032304289-5.10017-7
abstract: nan
summary:
  The level of cat allergen that is required to induce asthma symptoms is not well defined, so strict avoidance and proper cleaning after an animal has been removed from the household are key to preventing morbidity. Accordingly, improper setting of the central air humidifier (commonly part of a home''s central heating and air-conditioning unit) may worsen asthma control; while dehumidifiers set to keep humidity levels lower than 50% may be beneficial in reducing asthma symptoms from house-dust mite exposure. Similar to the aforementioned avoidance measures for pollen-sensitive asthmatic individuals, asthma symptoms from exposure to mold spores may be minimized by staying indoors as much as possible (especially during peak spore concentrations) and keeping home and automobile windows closed. Other important outdoor asthma triggers include exposure to vehicle traffic (especially diesel exhaust), which might exacerbate preexisting allergic conditions by enhancing airway responses to allergen, a potential compounding effect.


id: cord-022050-h24f0fpd
title: Acute Exacerbations of Chronic Obstructive Pulmonary Disease and Asthma
author: Naughton, Matthew T.
date: 2009-05-15
txt: ./txt/cord-022050-h24f0fpd.txt
cache: ./cache/cord-022050-h24f0fpd.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152396/
doi: 10.1016/b978-0-323-02844-8.50029-9
abstract: nan
summary:
  • Hypercapnic chronic obstructive pulmonary disease (COPD) patients should be treated with noninvasive ventilation and supplemental oxygen sufficient to overcome hypoxemia but avoid hyperoxia. Uncontrolled oxygen administration may precipitate acute hypercapnia in patients with acute COPD exacerbations as a result of relaxing hypoxic vasoconstriction, thereby allowing increased perfusion to regions with reduced alveolar ventilation. Most commonly, patients with severe asthma have a history of previous hospitalizations for asthma (some that may be near fatal), low socioeconomic status, female gender, obesity, nighttime symptoms, FEV 1 less than 60% with optimal treatment, continual symptoms, reduced quality of life, use of oral or systemic steroids in the past 12 months, use of more than canister of SABA per month, elevated residual volume-tototal lung capacity (RV:TLC) ratio on pulmonary function testing, and a peak expiratory flow rate variability of more than 30% (i.e., variability-(bestworst)/best reading). Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease.


id: cord-022155-9759i9wr
title: Sick Building Syndrome and Other Building-Related Illnesses
author: Nag, Pranab Kumar
date: 2018-08-18
txt: ./txt/cord-022155-9759i9wr.txt
cache: ./cache/cord-022155-9759i9wr.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153445/
doi: 10.1007/978-981-13-2577-9_3
summary:
  The SBS is a complex spectrum of ill health symptoms, such as mucous membrane irritation, asthma, neurotoxic effects, gastrointestinal disturbance, skin dryness, sensitivity to odours that may appear among occupants in office and public buildings, schools and hospitals. The mechanisms and causative factors of SBS and illnesses include, for example, the oxidative stress resulting from indoor pollutants, VOCs, office work-related stressors, humidification, odours associated with moisture and bioaerosol exposure. Different research groups emphasized on the association of prevalence of SBS symptoms among the office workers with the organic floor dust concentration, the floor covering of the workplaces, the age of the building, and the kind of ventilation system in operation. The assertion from the BASE study of the association of SBS with the increasing difference in concentration of CO 2 between indoor and outdoor brings forward the suggestion that a relative increase in the ventilation rates per person in an office building may reduce the prevalence of SBS symptoms.

abstract:
  Sick building syndrome (SBS) and building-related illnesses are omnipresent in modern high-rise buildings. The SBS is a complex spectrum of ill health symptoms, such as mucous membrane irritation, asthma, neurotoxic effects, gastrointestinal disturbance, skin dryness, sensitivity to odours that may appear among occupants in office and public buildings, schools and hospitals. Studies on large office buildings from USA, UK, Sweden, Finland, Japan, Germany, Canada, China, India, Netherlands, Malaysia, Taiwan, and Thailand, substantiate the occurrence of SBS phenomena. The accumulated effects of a multitude of factors, such as the indoor environmental quality, building characteristics, building dampness, and activities of occupants attribute to SBS. A building occupant manifests at least one symptom of SBS, the onset of two or more symptoms at least twice, and rapid resolution of symptoms following moving away from the workstation or building may be defined as having SBS. Based on the peer-reviewed documentation, this chapter elaborates the magnitude of building-related health consequences due to measurable environmental causations, and the size of the population affected. The mechanisms and causative factors of SBS and illnesses include, for example, the oxidative stress resulting from indoor pollutants, VOCs, office work-related stressors, humidification, odours associated with moisture and bioaerosol exposure. Related regulatory standards and strategies for management of SBS and other illnesses are elaborated.


id: cord-022467-j2trahab
title: Select Populations: Children
author: Loo, May
date: 2009-05-15
txt: ./txt/cord-022467-j2trahab.txt
cache: ./cache/cord-022467-j2trahab.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155731/
doi: 10.1016/b978-0-323-02028-2.50015-2
abstract: nan
summary:
  A recent clinical trial that included children over age 12 years and used a fixedcombination homeopathic remedy for a mean 4.1 days of treatment reported that 81.5% reported subjective feelings of being symptom free or significantly improved without complaint of any adverse side effects. 4 A randomized, double-blind, placebocontrolled study from Great Britain of 170 children with a starting median age of 4.2 years in the experimental group and 3.6 years in the placebo group concluded that individually prescribed homeopathic remedies seem to be ineffective in reducing symptoms or decreasing the use of antibiotics in pediatric patients with URI. 414 In a nonrandomized clinical trial involving 30 children ages 3 months to 8 years with chronic diarrhea of 2 to 4 months'' duration that was unresponsive to Western medicine and TCM, individualized acupuncture treatment eliminated symptoms and normalized stools.


id: cord-022527-a0x6lws3
title: Eosinophils in Human Disease
author: nan
date: 2012-10-12
txt: ./txt/cord-022527-a0x6lws3.txt
cache: ./cache/cord-022527-a0x6lws3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7158199/
doi: 10.1016/b978-0-12-394385-9.00013-4
abstract: nan
summary:
  The role of the eosinophils as key players in the pathophysiology of asthma has been debated, despite evidence that the cells are present and activated in the airway lumen and tissue 1 of patients with current asthma; are increased in number when asthma is uncontrolled 2 or severe 3 and decreased when asthma is controlled 4 ; and treatment strategies that aim to control airway eosinophilia are significantly more effective and less expensive in improving asthma control 5,6 and decreasing asthma exacerbations compared to guideline-based clinical strategies. 11 Since allergic asthma is primarily a T-helper type 2 (T h 2)-mediated disease, it is not surprising that cytokines driving eosinophilia are T h 2 cell products: specifically, granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-3 (IL-3), and interleukin-5 (IL-5), which signal through specific high-affinity cell-surface receptors linked to a common b-chaindall of which can act as eosinophil growth factors that promote formation of eosinophil/basophil (Eo/B) colony-forming units (CFU) in functional assays.


id: cord-022650-phsr10jp
title: Abstracts TPS
author: nan
date: 2018-08-14
txt: ./txt/cord-022650-phsr10jp.txt
cache: ./cache/cord-022650-phsr10jp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159469/
doi: 10.1111/all.13539
abstract: nan
summary:
  0685 | Skin prick test reactivity to aeroallergens in adult allergy clinic in a tertiary hospital: a 12-year retrospective study Results: Five different human sera were screened for specific IgE level against 29 different allergen sources using test methods of three different suppliers. Conclusion: This multicenter prospective study confirmed that stepwise single-dose OFC to egg will help to clarify the severity of egg allergy, and will contribute to improved food allergy manageMethod: The study design was a retrospective cohort study extracting data from the electronic chart of children older than 4 years who visited our out-patient clinic for egg or milk allergy and who underwent an oral food challenge test (OFC) twice within 24 months between November 2013 and December 2017. Results: In the base case analysis, using Italy clinical practice patients with moderate-to severe allergic rhino-conjunctivitis (SS ranging from 6 to 15 points) and a mean age at entry of 21 years, both SCIT and SLIT were associated with increased cost but superior efficacy compared to pharmacotherapy alone.


id: cord-022653-qa1uph35
title: Poster Discussion Session PDS
author: nan
date: 2017-08-30
txt: ./txt/cord-022653-qa1uph35.txt
cache: ./cache/cord-022653-qa1uph35.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159476/
doi: 10.1111/all.13251
abstract: nan
summary:
  0206 | G protein coupled receptor kinase 2 (GRK2) regulates endothelial permeability induced by Bradykinin 0208 | Pharmacokinetics (PK) and pharmacodynamics (PD) of c1 esterase inhibitor of chronic urticaria challenges most commonly identified were the following: time of onset of disease; frequency/duration of and provoking factors for wheals; diurnal variation; occurrence in relation to weekends, holidays, and foreign travel; shape, size, and distribution of wheals; associated angioedema; associated subjective symptoms of lesions; family and personal history regarding urticaria, atopy; previous or current allergies, infections, internal diseases, or other possible causes; psychosomatic and psychiatric diseases; surgical implantations and events during surgery; gastric/ intestinal problems; induction by physical agents or exercise; use of drugs; food allergies; relationship to the menstrual cycle; smoking habits; type of work, hobbies; stress; quality of life and emotional impact; previous therapy and response to therapy, and previous diagnostic procedures/results.


id: cord-022658-mq91h15t
title: Executive summary
author: nan
date: 2008-12-30
txt: ./txt/cord-022658-mq91h15t.txt
cache: ./cache/cord-022658-mq91h15t.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159496/
doi: 10.1111/j.1398-9995.1998.tb04885.x
summary:
  Patients with rhinitis or asthma caused by allergens for which the clinical efficacy and safety of SIT have been documented by placebo-controlled, doubleblind studies, and those requiring daily pharmacotherapy for longer periods (e.g., preventive treatment during a pollen season or perennially) are candidates for SIT. in most cases when significant airway comorbidity is present (asthma, chronic sinusitis, nasal polyps, or otitis media with effusion) when the diagnosis is in question or special diagnostic testing is required when occupational rhinitis is suspected, to distinguish between clear-cut allergic reactions and toxic or nonallergic reactions when poor symptom control necessitates a consultation for environmental control measures, pharmacotherapy, or specific immunotherapy when medication side-effects are intolerable when rhinitis is only part of a complex series of mucosal allergies.

abstract:
  Allergic rhinitis is now recognized as a major cause of morbidity that significantly impairs function and quality of life. Moreover, it is now widely held that the pathophysiologic mechanisms causing nasal allergy contribute, or predispose many individuals, to the development of other airway diseases, including asthma. Allergic rhinitis may well be a factor in 24% of children with otitis media with effusion (OME), and perhaps 28% of cases of chronic sinusitis. As many as 78% of persons with asthma aged 15 to 30 years have elevated serum IgE antibodies to five common aeroallergens. In many instances, nasal allergy signals the presence of more severe disease. Considerable evidence now suggests that early and appropriate intervention can improve the quality of life and productivity of patients with allergic rhinitis, enhance the academic performance of children, and reduce the prevalence of airway complications. The goal of treatment has shifted from mere symptom alleviation to blocking the pathophysiologic mechanisms that cause chronic allergic inflammation and leave patients vulnerable to airway infections. The earlier in a patient's life that this can be accomplished, the better the anticipated consequences. A panel of experts was convened in Amsterdam, The Netherlands, on 2 September 1996, to explore these issues and their impact on allergy prevention and treatment in primary care. Their undertaking was supported by an unrestricted educational grant from Schering‐Plough Pharmaceuticals.


id: cord-023239-06a03o14
title: II. Topic Sessions
author: nan
date: 2016-06-10
txt: ./txt/cord-023239-06a03o14.txt
cache: ./cache/cord-023239-06a03o14.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7168082/
doi: 10.1002/ppul.23455
abstract: nan
summary:
  The basics of inhaler technique / device / adherence / allergen exposure are all being maintained A retrospective analysis of follow-up of children with difficult asthma for up to six years revealed that those in whom underlying modifiable factors were identified and addressed had an improvement in lung function and reduction in exacerbations over time, while being able to reduce maintenance dose of inhaled steroids such that the majority fell below the threshold for problematic severe asthma 4 . Long-term follow up of children investigated in infancy and reassessed in later childhood have so far showed that reduced baseline lung function in symptomatic infants was significantly associated with subsequent respiratory morbidity as well as with the need of anti-asthma medication at the age of 3 years.


id: cord-023288-sqr33y72
title: Paediatric SIG: Poster Session
author: nan
date: 2008-03-12
txt: ./txt/cord-023288-sqr33y72.txt
cache: ./cache/cord-023288-sqr33y72.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7169050/
doi: 10.1111/j.1440-1843.2008.01252_11.x
abstract: nan
summary:
  Results Data indicate splice variant expression in dendritic cells from asthmatic patients is influenced by asthma severity. Methods Randomized controlled trials (RCTs) of GORD treatment in adults or children that reported asthma health outcomes and had symptomatic GORD were included and assessed in accordance with the standard Cochrane systematic review process. Results 11 male (44%) and 14 female (56%) patients with moderate to severe persistent asthma (mean age 44 years, SD = 11) participated. Methods A comprehensive range of intracellular T-cell and monocyte proand anti-inflammatory cytokines/chemokines was investigated in peripheral blood from 5 OSA patients and 5 aged-matched control subjects (with no evidence of sleep problems) using multiparameter flow cytometry. Methods Following completion of a 12-month exercise study, which included a supervised program (Intervention, n = 18) and control group (Control, n = 17), COPD subjects [mean age (SD): 66 (8); mean FEV1 (% predicted) = 56% (19)] were asked to complete a questionnaire.


id: cord-023713-daz2vokz
title: Epidemiology of Asthma and Allergic Airway Diseases
author: Devereux, Graham
date: 2013-09-06
txt: ./txt/cord-023713-daz2vokz.txt
cache: ./cache/cord-023713-daz2vokz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7173512/
doi: 10.1016/b978-0-323-08593-9.00049-8
abstract: nan
summary:
  A systematic review and metaanalysis of the longitudinal studies relating maternal vitamin D status during pregnancy to childhood outcomes concluded that high maternal dietary vitamin D intake is associated with a reduced risk of children wheezing up to the age of 5 years (OR = 0.56; 95% CI, 0.42 to 0.73). The Dutch Prevention and Incidence of Asthma and Mite allergy (PIAMA) birth cohort study related symptom data prospectively collected annually from 3863 children up to the age of 8 years to land-use regression estimates of individual NO 2 , PM 2.5 , and soot exposures at their birth addresses. 327 A systematic review and meta-analysis of prospective birth cohort studies evaluating the effects of allergen (i.e., HDM or dietary) avoidance during pregnancy concluded that early-life allergen avoidance in isolation does not reduce the likelihood of asthma in children at age 5 years (OR = 1.22; 95% CI, 0.83 to 1.78).


id: cord-252012-hdjbxah8
author: McErlean, Peter
date: 2010-11-01
txt: ./txt/cord-252012-hdjbxah8.txt
cache: ./cache/cord-252012-hdjbxah8.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0889856110000652
doi: 10.1016/j.iac.2010.08.001
summary:
  Traditionally associated with acute respiratory illness (ARI) or symptoms of the "common cold," the respiratory viruses implicated in asthma exacerbations predominantly possess RNA genomes with a distinct genome organization (positive [1] or negative [À] sense), virus particle (virion) morphology (enveloped or nonenveloped), host cell receptor interaction, and well-defined annual or seasonal prevalence. These "newly identified viruses" (NIVs) including human metapneumovirus (HMPV; described pre-SARS), the human rhinovirus (HRV) species C (HRV-Cs), human coronaviruses (HCoVs)-NL63 and -HKU1, human bocavirus (HBoV), and the KI and WU polyomaviruses (KIPyV and WUPyV) are now the focus of intense research, and their involvement in asthma exacerbations is slowly beginning to be determined. 34 In a retrospective study of clinical samples taken over a 20-year period from young children (median age 14.5 months), the percentage of lower respiratory tract illness (LRTI; including asthma exacerbations and bronchiolitis) associated with any HCoV, HCoV-NL63, or HCoV-OC43 was estimated to be 4.6%, 2.6%, and 1.9%, respectively.

title:
  Viral diversity in asthma: Immunology and Allergy Clinics of North America: Asthma and Infectious Disease

abstract:
  Asthma exacerbations are precipitated primarily by respiratory virus infection and frequently require immediate medical intervention. Studies of childhood and adult asthma have implicated a wide variety of respiratory viruses in exacerbations. By focusing on both RNA and DNA respiratory viruses and some newly identified viruses, this review illustrates the diversity and highlights some of the uncertainties that exist in our understanding of virus-related asthma exacerbations.


id: cord-252769-fe50u028
author: Mendes, J. Pinto
date: 2008-10-31
txt: ./txt/cord-252769-fe50u028.txt
cache: ./cache/cord-252769-fe50u028.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0873215915302750
doi: 10.1016/s0873-2159(15)30275-0
summary:
  Animal research is difficult to extrapolate to man but suggests RSV can induce allergic sensitisation 28 , increase bronchial and interleukin (IL)-13 hyperresponsiveness, and rão, na maioria dos casos, consequências remotas, embora algumas vezes descrevam sibilâncias que irão desaparecer aos 3 -5 anos e só raramente se prolongam, instalando -se ou não uma asma. This phenomenon has been put to the test in inhalatory challenge tests which could bring on asthma episodes or exacerbations in children and adults 82, 102 , but, to test this seeming paradox, it is not necessary to resort to these arguments as in a German study 82 , the degree of early life exposure to domestic endotoxins was in direct correla-Infecção na modulaçâo da asma J Pinto Mendes fende um efeito daquelas células na supressão simultânea das respostas Th 1 e Th 2 .

title:
  Infecção na modulaçâo da asma 1 1 Trabalho apresentado no XXIII Congresso de Pneumologia da SPP – Guarda, Novembro 2007 / Paper presented at the XXIII Congresso de Pneumologia da SPP / PSP Pulmonology Congress, Guarda, November 2007

abstract:
  Abstract This paper reviews the impact of infections on the onset and clinical course of bronchial asthma. A just emphasis is given to the role viral infections, particularly rhinovirus infections, play in exacerbations, and that played by respiratory syncytial virus, suspected of triggering the asthmatic syndrome. The mechanisms of the immune response to virus attacks are explained, highlighting the asthmatic and allergic patient’s weakened response, particularly in the perinatal period. Further stressed is a potentiating effect of viral aggression on the allergic response. The hygiene hypothesis and its lack of scientific consistency is detailed, at least as far as the role it seeks to confer on an unproven antagonism of the Th1 and Th2 lymphocyte responses. The current importance of research not into bacteria, but into bacterial products, including endotoxins, on the modulation of asthma and allergy is noted. Studies which, along these lines, show an environmental impact on genetic secretion in the phenotype are underlined. Also discussed in passing are several mechanisms which go towards explaining neutrophilic asthma – for many a contradiction, given eosinophilia’s stranglehold on asthmatic inflammation. Rev Port Pneumol 2008; XIV (5): 647-675


id: cord-254766-585iu5ey
title: Molecular and cellular mechanisms in the viral exacerbation of asthma
author: Tauro, Sharyn
date: 2008-08-13
txt: ./txt/cord-254766-585iu5ey.txt
cache: ./cache/cord-254766-585iu5ey.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S128645790800186X
doi: 10.1016/j.micinf.2008.07.037
summary:
  This review summarizes the evidence associated with factors that may contribute to the development or exacerbation of asthma including age, host factors, genetic polymorphisms, altered immune responses, and aspects of viral antigen expression. These observations suggest that respiratory viral infections lead to a prolonged period of increased antigen presentation in the airways resulting in de novo and memory T-cell responses not only to the virus but also to unrelated antigens including allergens. In addition to studies of primary infections, models studying the interactions between respiratory viral infections and allergen sensitization are essential in understanding the mechanisms of virus induced asthma exacerbations. These studies show that the immune responses to allergen sensitization and respiratory viral infections interact to cause persistent inflammation and AHR, symptomatic of the asthmatic response (Fig. 2) [53] . Recurrent respiratory syncytial virus infections in allergen sensitized mice lead to persistent airway inflammation and hyperresponsiveness

abstract:
  The aetiology of asthma associated with viral infection is complex. The dynamics that contribute to disease pathogenesis are multifactorial and involve overlapping molecular and cellular mechanisms, particularly the immune response to respiratory virus infection or allergen sensitization. This review summarizes the evidence associated with factors that may contribute to the development or exacerbation of asthma including age, host factors, genetic polymorphisms, altered immune responses, and aspects of viral antigen expression. This review also provides an important perspective of key events linked to the development of asthmatic disease and related pulmonary inflammation from human and animal studies, and discusses their relationship as targets for disease intervention strategies.


id: cord-257244-gryp0khc
author: Edwards, M. R.
date: 2017-08-10
txt: ./txt/cord-257244-gryp0khc.txt
cache: ./cache/cord-257244-gryp0khc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/28722755/
doi: 10.1111/all.13257
summary:
  Despite these important associations, the use of antiinfectives (antibiotics, antivirals, antifungals, vaccines) that specifically target known pathogens, or drugs that are based on or exploit microbe-host receptor interactions (toll-like receptor agonists, bacterial lysates) or are immunomodulators (vitamin D), and/or may work in part by altering our associated microbiology (probiotics) are, with the exception of severe asthma, seldom considered in asthma treatment, prevention and guidelines. Overall, antibiotic use is associated with asthma risk rather than protection at most stages of human development, including pregnancy, 10, 11 early life 12 and childhood, 13 although why this is so is a subject widely debated. 10 In retrospective studies, the association between antibiotic use and increased risk of asthma or wheezing in children is further confused due to the potential of reverse causation. Inhibiting virus replication through interfering with viral enzymes active within cells poses additional problems in drug discovery; however, several useful inhibitors for respiratory tract viruses have found their way into phase I/II clinical trials.

title:
  The potential of anti‐infectives and immunomodulators as therapies for asthma and asthma exacerbations

abstract:
  Asthma is responsible for approximately 25,000 deaths annually in Europe despite available medicines that maintain asthma control and reduce asthma exacerbations. Better treatments are urgently needed for the control of chronic asthma and reduction in asthma exacerbations, the major cause of asthma mortality. Much research spanning >20 years shows a strong association between microorganisms including pathogens in asthma onset, severity and exacerbation, yet with the exception of antibiotics, few treatments are available that specifically target the offending pathogens. Recent insights into the microbiome suggest that modulating commensal organisms within the gut or lung may also be a possible way to treat/prevent asthma. The European Academy of Allergy & Clinical Immunology Task Force on Anti‐infectives in Asthma was initiated to investigate the potential of anti‐infectives and immunomodulators in asthma. This review provides a concise summary of the current literature and aimed to identify and address key questions that concern the use of anti‐infectives and both microbe‐ and host‐based immunomodulators and their feasibility for use in asthma.


id: cord-258093-6fn8ei9f
author: Hanania, Nicola A.
date: 2011-08-25
txt: ./txt/cord-258093-6fn8ei9f.txt
cache: ./cache/cord-258093-6fn8ei9f.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/21872730/
doi: 10.1016/j.jaci.2011.06.048
summary:
  The aging lung Large, longitudinal, and more complete studies to determine the effects of aging on the function of the respiratory system Improved knowledge about lung structure-function relationships in older age using techniques of imaging and measures of lung function not requiring effort (eg, high-resolution computed tomographic scanning and forced oscillation) Improved assessment of lung processes underlying airflow limitation attributable to aging versus COPD or asthma, especially in asthmatic patients who smoke Studies to examine the effects of aging in ethnic groups and the role of gender Epidemiology, effect, diagnosis, and management Determine the true prevalence and cost of asthma in the older population Develop a uniform definition of asthma to be applied to health care records that will distinguish asthma from COPD and mixed asthma/COPD Evaluate evidence-based treatment algorithms for older asthmatic patients, such as those developed by the National Heart, Lung, and Blood Institute and Global Initiative For Asthma guidelines 7 Assess the effect of asthma treatment, including direct medical costs of care, indirect costs of care, and value of treatment in improving quality of life 8, 9 Assess the effect of comorbid conditions, especially COPD and congestive heart failure, on asthma 9 Characterize phenotypes of elderly asthma with regard to responses to therapy and long-term outcomes based on age of onset, duration of disease, and environmental triggers Develop algorithms for electronic medical record systems that are asthma-specific Evaluate effects of current asthma medications in older patients compared with younger patients Identify pharmacogenetic determinants of response to asthma medications in older adults Identify simpler and safer drug delivery systems and schedules for older adults Develop simple methods to differentiate COPD from asthma exacerbations in older adults

title:
  Asthma in the elderly: Current understanding and future research needs—a report of a National Institute on Aging (NIA) workshop

abstract:
  Asthma in the elderly is underdiagnosed and undertreated, and there is a paucity of knowledge on the subject. The National Institute on Aging convened this workshop to identify what is known and what gaps in knowledge remain and suggest research directions needed to improve the understanding and care of asthma in the elderly. Asthma presenting at an advanced age often has similar clinical and physiologic consequences as seen with younger patients, but comorbid illnesses and the psychosocial effects of aging might affect the diagnosis, clinical presentation, and care of asthma in this population. At least 2 phenotypes exist among elderly patients with asthma; those with longstanding asthma have more severe airflow limitation and less complete reversibility than those with late-onset asthma. Many challenges exist in the recognition and treatment of asthma in the elderly. Furthermore, the pathophysiologic mechanisms of asthma in the elderly are likely to be different from those seen in young asthmatic patients, and these differences might influence the clinical course and outcomes of asthma in this population.


id: cord-260472-xvvfguht
title: Antimicrobial strategies: An option to treat allergy?
author: Papadopoulos, Nikolaos G.
date: 2007-01-31
txt: ./txt/cord-260472-xvvfguht.txt
cache: ./cache/cord-260472-xvvfguht.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0753332206003350
doi: 10.1016/j.biopha.2006.10.004
summary:
  The association between upper respiratory viral infections and asthma exacerbations in children was demonstrated almost three decades ago using virus cultures and serological techniques [5] . Abbreviations: RTePCR, reverse transcriptionepolymerase chain reaction; RV, rhinovirus; PIV, parainfluenza virus; RSV, respiratory syncytial virus; MPV, human metapneumovirus; ICAM-1, intracellular adhesion molecule-1; IFN-b, interferon-beta; NGF, nerve growth factor; SP, substance P; NK1, neurokinin 1 receptor; MBL, mannose-binding lectin; LABA, long-acting b 2 agonists. In the human respiratory tract, all the above agents are able to produce a spectrum of clinical acute infection phenotypes, ranging from the common cold, croup and acute bronchiolitis, to pneumonia, although each virus has increased propensity for a particular clinical disease (e.g. parainfluenza for croup, RSV for severe bronchiolitis, influenza for pneumonia) [21, 22] . Rhinovirus is the key virus accounting for the majority of exacerbations both in children and adults and thus the effective treatment or prevention of that infection would be a major asset in asthma therapy.

abstract:
  Abstract Respiratory infections by bacteria and viruses often trigger symptoms of asthma in both adults and children. This observation and subsequent mechanistic studies have demonstrated important interactions among allergens, microbes and the atopic host. The mechanisms responsible for microbe-induced asthma exacerbations are only incompletely understood. A focal point of current research is the inflammatory response of the host following an encounter with a pathogenic microbe, including variations in chemokine and cytokine production and resulting in changes in bronchial hyper-responsiveness and lung function. Direct bronchial infection, exposure of nerves with resulting neurogenic inflammation and a deviated host immune response are among the mechanisms underlying these functional disorders. Lately, suboptimal innate immune responses, expressed as defective interferon production, have gained attention as they might be amenable to intervention. This review describes the suggested mechanisms involved in the complex interactions between ‘asthmagenic’ microbes, the immune system and atopy, based on in-vitro and in-vivo experimental models and epidemiological evidence. In addition, it provides a synopsis of potential therapeutic strategies either directly against the microorganisms or in respect to the associated inflammation.


id: cord-263556-y8vx4ie2
title: Prednisolone for the first rhinovirus‐induced wheezing and 4‐year asthma risk: A randomized trial
author: Koistinen, Annamari
date: 2017-08-06
txt: ./txt/cord-263556-y8vx4ie2.txt
cache: ./cache/cord-263556-y8vx4ie2.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1111/pai.12749
doi: 10.1111/pai.12749
summary:
  Based on our previous findings, 8, 9 we hypothesized that in children with high rhinovirus genome load, the effect of OCS is likely to last beyond 12 months by reducing the need for initiation of long-term asthma control medication. Second, in the placebo group, asthma risk was high: regular asthma control medication was initiated to all children with high rhinovirus genome load during the subsequent 14 months after the first acute rhinovirus-induced wheezing episode. No difference was found in overall analysis F I G U R E 3 The time to initiation of asthma control medication in children randomized to receive prednisolone or placebo for the first rhinovirus-induced wheezing episode. 9 In summary, early systemic short-course prednisolone treatment may be beneficial in reducing the risk for asthma control medication during the first 5 years in first-time wheezing preschool children whose episode was severe and associated with high rhinovirus genome load.

abstract:
  BACKGROUND: Previous findings show that corticosteroid treatment during the first acute wheezing episode may reduce recurrent wheezing in children with high rhinovirus genome load at 12‐month follow‐up. Longer‐term effects have not been investigated prospectively. METHODS: After PCR confirmation of rhinovirus from nasopharyngeal aspirate, 79 children with the first acute wheezing episode were randomized to receive orally prednisolone or placebo for 3 days. The initiation of asthma control medication before the age of 5 years was confirmed from medical record and/or from parental interview. The outcome was the time to initiation of regular asthma control medication. Interaction analysis examined rhinovirus genome load. RESULTS: Fifty‐nine (75%) children completed the follow‐up. Asthma control medication was initiated in 40 (68%) children at the median age of 20 months. Overall, prednisolone did not affect the time to initiation of asthma control medication when compared to placebo (P=.99). Rhinovirus load modified the effect of prednisolone regarding the time to initiation of asthma control medication (P‐value for interaction=.04). In children with high rhinovirus load (>7000 copies/mL; n=23), the risk for initiation of medication was lower in the prednisolone group compared to the placebo group (P=.05). In the placebo group, asthma medication was initiated to all children with high rhinovirus load (n=9) during the 14 months after the first wheezing episode. CONCLUSIONS: Overall, prednisolone did not affect the time to initiation of asthma control medication when compared to placebo. However, prednisolone may be beneficial in first‐time wheezing children whose episode was severe and associated with high rhinovirus load. (ClinicalTrials.gov, NCT00731575).


id: cord-267835-ic0oqqln
author: Jones, K.
date: 1996-08-31
txt: ./txt/cord-267835-ic0oqqln.txt
cache: ./cache/cord-267835-ic0oqqln.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/8796235/
doi: 10.1016/s0954-6111(96)90116-x
summary:
  There is a need to examine further the proper role, if any, of antibiotics in such situations, to determine the optimum dose and course length of oral steroid therapy, and to continue validating the use of self-management plans in acute asthma management. Thus, there is a need to examine further GPs'' ideas regarding current management of acute asthma attacks in general practice, with particular reference to those associated with respiratory tract infection. This study aimed to examine the reported usage of oral steroids and antibiotics in asthma attacks associated with respiratory tract infection managed in general practice, and the timing of follow-up consultations using a postal scenario-based questionnaire sent to all GP principals in one health district. The results show that most GPs would prescribe oral steroids when faced with an acute asthma attack associated with respiratory tract infection and managed within a general practice setting.

title:
  Management of acute asthma attacks associated with respiratory tract infection: a postal survey of general practitioners in the U.K.

abstract:
  Abstract Asthma attacks in general practice are frequently associated with respiratory tract infection. The aim of this study was to examine how U.K. general practitioners (GPs) might use oral steroids and antibiotics in such situations. The timing of follow-up and use of self-management plans were also examined. A postal questionnaire was sent to all 205 GP principals in Bath Health District, U.K. in February and March 1993. Respondents were asked questions regarding the management of an adult and a child presenting with acute asthma associated with respiratory tract infection. Replies were received from 185 of 205 (90%) doctors approached. Antibiotics would have been prescribed by 119 of 179 (66%) doctors for the adult and 98 of 169 (58%) doctors for the child. The modal initial dosage of oral prednisolone was 40 mg for the adult and 30 mg for the child, and modal duration of oral steroid dosage was 5 days for both adult and child. Planned follow-up was mainly doctor initiated within 24 h of initial consultation. There was low reported use of self-management plans (49% for adults and 33% in children over 7 years of age). Antibiotic prescription appears to be common practice by GPs when faced with an acute asthma attack associated with respiratory tract infection. There may also be inadequate duration of oral steroid courses in adults. There is a need to examine further the proper role, if any, of antibiotics in such situations, to determine the optimum dose and course length of oral steroid therapy, and to continue validating the use of self-management plans in acute asthma management.


id: cord-269554-fzu6dy4e
title: Asthma in COVID-19: An extra chain fitting around the neck?
author: Hussein, M. H.
date: 2020-07-15
txt: ./txt/cord-269554-fzu6dy4e.txt
cache: ./cache/cord-269554-fzu6dy4e.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.07.13.20153130
doi: 10.1101/2020.07.13.20153130
summary:
  Univariate analysis of COVID-19 outcomes revealed that asthma was significantly associated with higher rate of endotracheal intubation (40.3% vs 27.8%, p = 0.036), mechanical ventilation (both invasive and non-invasive) (70.7% vs 52.2%, p = 0.039), and longer hospital length of stay (15.14 ± 12.48 days vs 11.51 ± 10.58 days, p = 0.015). Asthma was not associated with a higher rate of Intensive Care Unit (ICU) admission (22.2% vs 14.9%, p = 0.12), acute respiratory distress syndrome (37.5% vs 30.9%, p = 0.27), or death (9.7% vs 13.5%, p = 0.45) among COVID-19 patients. On comparison to non-asthmatic obese patients, obese asthmatic patients were more likely to develop sepsis (25.9% vs 14.2%, p = 0.042), had higher risk of ICU admission (48.1% vs 33.2%, p = 0.042), and required prolonged intubation (2.73 ± 3.63 days vs 1.38 ± 2.07, p = 0.032).Impact of asthma comorbidity on COVID-19 outcomes

abstract:
  Introduction The novel coronavirus disease 2019 (COVID-19) has rapidly spread across the globe, overwhelming healthcare systems and depleting resources. The infection has a wide spectrum of presentations, and pre-existing comorbidities have been found to have a dramatic effect on the disease course and prognosis. We sought to analyze the effect of asthma on the disease progression and outcomes of COVID-19 patients. Methods We conducted a multi-center retrospective study of positively confirmed COVID-19 patients from multiple hospitals in Louisiana. Demographics, medical history, comorbidities, clinical presentation, daily laboratory values, complications, and outcomes data were collected and analyzed. The primary outcome of interest was in-hospital mortality. Secondary outcomes were Intensive Care Unit (ICU) admission, risk of intubation, duration of mechanical ventilation, and length of hospital stay. Results A total of 502 COVID-19 patients (72 asthma and 430 non-asthma cohorts) were included in the study. The frequency of asthma in hospitalized cohorts was 14.3%, higher than the national prevalence of asthma (7.7%). Univariate analysis revealed that asthma patients were more likely to be obese (75% vs 54.2%, p=0.001), with higher frequency of intubation (40.3% vs 27.8%, p = 0.036), and required longer duration of hospitalization (15.1{+/-}12.5 vs 11.5{+/-}10.6, p=0.015). After adjustment, multivariable analysis showed that asthmatic patients were not associated with higher risk of ICU admission (OR=1.81, 95%CI=0.98-3.09, p=0.06), endotracheal intubation (OR=1.77, 95%CI=0.99-3.04, p=0.06) or complications (OR=1.37, 95%CI=0.82-2.31, p=0.23). Asthmatic patients were not associated with higher odds of prolonged hospital length of stay (OR=1.48, 95%CI=0.82-2.66, p=0.20) or with the duration of ICU stay (OR=0.76, 95%CI=0.28-2.02, p=0.58). Kaplan-Meier curve showed no significant difference in overall survival of the two groups (p=0.65). Conclusion Despite the increased prevalence of hospitalization in asthmatic COVID-19 patients compared to the general population, after adjustment for other variables, it was neither associated with increased severity nor worse outcomes.


id: cord-270647-vn4kirrx
author: Romero-Espinoza, Jose A.
date: 2018-02-15
txt: ./txt/cord-270647-vn4kirrx.txt
cache: ./cache/cord-270647-vn4kirrx.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1371/journal.pone.0192878
doi: 10.1371/journal.pone.0192878
summary:
  OBJECTIVES: To describe the virome and bacteriome present in the upper respiratory tract of hospitalized children with a clinical diagnosis of asthma and pneumonia during an acute exacerbation and an acute respiratory illness ARI episode respectively. Both groups differ with respect to the associated virus and bacteria: while asthma exacerbations have been associated to a specific rhinovirus infection, pneumonia can be related to a wide range of bacterial, fungal and viral agents, with a high prevalence of Respiratory Syncytial Virus (RSV) [2, 7] . Here we describe the virome and bacteriome present in the Upper Respiratory Tract of hospitalized children clinically diagnosed with asthma and pneumonia, during an acute exacerbation and an ARI episode respectively, at the National Institute of Respiratory Diseases (INER, Mexico City) during 2014 and 2015 winter seasons. Prevalence of respiratory viral infection in children hospitalized for acute lower respiratory tract diseases, and association of rhinovirus and influenza virus with asthma exacerbations

title:
  Virome and bacteriome characterization of children with pneumonia and asthma in Mexico City during winter seasons 2014 and 2015

abstract:
  BACKGROUND: Acute asthma exacerbations and pneumonia are important causes of morbidity and mortality in children and may coexist in the same children, although symptom overlap may lead to difficulties in diagnosis. Microbial and viral diversity and differential abundance of either may play an important role in infection susceptibility and the development of acute and chronic respiratory diseases. OBJECTIVES: To describe the virome and bacteriome present in the upper respiratory tract of hospitalized children with a clinical diagnosis of asthma and pneumonia during an acute exacerbation and an acute respiratory illness ARI episode respectively. METHODS: During the winter seasons of 2013–2014 and 2014–2015, 134 nasopharyngeal swabs samples of children <15 years of age with ARI hospitalized at a referral hospital for respiratory diseases were selected based on clinical diagnosis of asthma or pneumonia. The virome and bacteriome were characterized using Whole Genome Sequencing (WGS) and in-house bioinformatics analysis pipeline. RESULTS: The Asthma group was represented mainly by RV-C, BoV-1 and RSV-B and the pneumonia group by Bacteriophage EJ-1 and TTMV. TTV was found in both groups with a similar amount of reads. About bacterial composition Moraxella catarrhalis, Propionibacterium acnes and Acinetobacter were present in asthma and Veillonella parvula and Mycoplasma pneumoniae in pneumonia. Streptococcus pneumoniae and Haemophilus influenzae were mostly found with both asthma and pneumonia. CONCLUSIONS: Our results show a complex viral and bacterial composition in asthma and pneumonia groups with a strong association of RV-C presence in asthmatic children. We observed Streptococcus pneumoniae and Haemophilus influenzae concurrently in both groups.


id: cord-270834-b625s54s
title: COVID-19 severity in hospitalized patients with asthma: A matched cohort study
author: Robinson, Lacey B.
date: 2020-10-22
txt: ./txt/cord-270834-b625s54s.txt
cache: ./cache/cord-270834-b625s54s.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jaip.2020.10.021
doi: 10.1016/j.jaip.2020.10.021
abstract: nan
summary:
  title: COVID-19 severity in hospitalized patients with asthma: A matched cohort study We matched 80 asthma inpatients with COVID-19 to 323 comparators ( Table I) . In the fully adjusted model, the risk of ICU admission was lower among asthma patients than 116 comparators (adjusted hazard ratio [aHR] 0.52, 95%CI:0.30-0.90) ( Table II) . In the fully 118 adjusted model, the risk of mechanical ventilation was lower among asthma patients than 119 comparators (aHR 0.42, 95%CI: 0.21-0.81). In this matched cohort study of MGH inpatients with COVID-19, we identified that asthma 126 patients were less likely to require ICU admission and mechanical ventilation but were not at 127 increased risk for death. Although current research specifically assessing asthma and COVID-19 remains limited, recent 133 reports suggest that asthma is not overrepresented among severe COVID-19 cases and may not 134 be associated with an increased risk of hospitalization or death.


id: cord-271790-3s8o774l
title: The role of infection in asthma
author: Pinto Mendes, J.
date: 2008-10-31
txt: ./txt/cord-271790-3s8o774l.txt
cache: ./cache/cord-271790-3s8o774l.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S2173511508702975
doi: 10.1016/s2173-5115(08)70297-5
summary:
  Animal research is difficult to extrapolate to man but suggests RSV can induce allergic sensitisation 28 , increase bronchial and interleukin (IL)-13 hyperresponsiveness, and rão, na maioria dos casos, consequências remotas, embora algumas vezes descrevam sibilâncias que irão desaparecer aos 3 -5 anos e só raramente se prolongam, instalando -se ou não uma asma. If viral infection in acute asthma, particularly RV -the most studied -is associated with neutrophilic inflammation, cellular lysis and production of interferons (IFNs) 46 and if the environment is rich in IL-4, the production of IL-5, RANTES (Regulated upon Activated T cell Expressed and Selected), eotaxin, eosinophilic infiltration and IgE production 47 generally occur. While children at risk at allergic asthma have long been told to avoid contact with these animals, it is concluded that prolonged early life exposure to Feld-1 induces a form of immune tolerance specific to that allergen 89 .

abstract:
  Abstract This paper reviews the impact of infections on the onset and clinical course of bronchial asthma. A just emphasis is given to the role viral infections, particularly rhinovirus infections, play in exacerbations, and that played by respiratory syncytial virus, suspected of triggering the asthmatic syndrome. The mechanisms of the immune response to virus attacks are explained, highlighting the asthmatic and allergic patient's weakened response, particularly in the perinatal period. Further stressed is a potentiating effect of viral aggression on the allergic response. The hygiene hypothesis and its lack of scientific consistency is detailed, at least as far as the role it seeks to confer on an unproven antagonism of the Th1 and Th2 lymphocyte responses. The current importance of research not into bacteria, but into bacterial products, including endotoxins, on the modulation of asthma and allergy is noted. Studies which, along these lines, show an environmental impact on genetic secretion in the phenotype are underlined. Also discussed in passing are several mechanisms which go towards explaining neutrophilic asthma – for many a contradiction, given eosinophilia's stranglehold on asthmatic inflammation.


id: cord-272742-q37xxkja
title: Aerosol treatments for childhood asthma in the era of COVID‐19
author: Mei‐Zahav, Meir
date: 2020-06-08
txt: ./txt/cord-272742-q37xxkja.txt
cache: ./cache/cord-272742-q37xxkja.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32511861/
doi: 10.1002/ppul.24849
abstract: nan
summary:
  key: cord-272742-q37xxkja authors: Mei‐Zahav, Meir; Amirav, Israel title: Aerosol treatments for childhood asthma in the era of COVID‐19 cord_uid: q37xxkja To the Editor, About 10% of children in the United States have asthma and aerosols are the cornerstone of treatment of asthma. Nebulizers (wet or jet) are one of the commonly used aerosol-generating medical devices and generate small particles that can spread to a larger distance than a normal breath. In conclusion, given that MDI/VHC has been shown to be as effective in numerous clinical situations, switching from nebulization to MDI/VHC treatment should be another important step that pediatricians can take in reducing COVID-19 spread, particularly among health caregivers. Meir Mei-Zahav MD 1, 2 Israel Amirav MD 2,3,4 1 Factors involved in the aerosol transmission of infection and control of ventilation in healthcare premises Holding chambers (spacers) versus nebulisers for beta-agonist treatment of acute asthma Paediatric asthma and COVID-19


id: cord-280210-6xivdgvt
title: Writing on Sports Medicine in Pandemic Times
author: Eichner, E. Randy
date: 2020-07-08
txt: ./txt/cord-280210-6xivdgvt.txt
cache: ./cache/cord-280210-6xivdgvt.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1249/jsr.0000000000000731
doi: 10.1249/jsr.0000000000000731
abstract: nan
summary:
  So I try to keep up with epidemiology, even though at this writing, in May 2020, more than 10,000 scientific or medical articles have already appeared on this novel coronavirus, SARS-CoV-2, that causes the disease COVID-19. So, against all odds, I will start with thoughts on infections and epidemics, on our primal fear of contagion, and on quarantine or "social distancing." Then, I will address four questions I have received that are relevant to athletes. Now is the time to read John Barry''s "The Great Influenza," on the deadliest plague in history, the influenza pandemic from early 1918 to early 1920 that killed up to 100 million people worldwide. Early in the acquired immune deficiency syndrome panic, a Boston neurosurgeon called for Massachusetts to quarantine "irresponsible" carriers of human immunodeficiency virus on Penikese Island. Question 3: If athletes test positive for the antibody, are they immune to this Coronavirus?


id: cord-280859-3ff72mlq
title: Multi‐season analyses of causative pathogens in children hospitalized with asthma exacerbation
author: Abe, Nozomi
date: 2019-08-12
txt: ./txt/cord-280859-3ff72mlq.txt
cache: ./cache/cord-280859-3ff72mlq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/31251831/
doi: 10.1111/pai.13102
summary:
  Nasopharyngeal mucosa cell samples were collected from the participants and examined by reverse transcription‐polymerase chain reaction to detect rhinovirus (RV), respiratory syncytial virus (RSV), enterovirus (EV), parainfluenza virus (PIV), Mycoplasma pneumoniae, and others. The median age and house-dust mite IgE levels at admission were significantly higher in the single infection group than those in the superinfection group (P < .001), whereas there were no significant differences in body temperature, SpO 2 , duration of hospitalization, serum levels of CRP, intensity of asthma exacerbation, and bronchial asthma severity between the two groups. The detection frequency of RV and RSV in our study was consistent with that in previous reports on the relationship between causative viruses and exacerbation in asthmatic patients, suggesting that our study illustrates the actual virus prevalence associated with asthma exacerbation. In conclusion, our three-season analysis on the prevalence of causative pathogens in hospitalized children with asthma exacerbation revealed that RV and RSV were most frequently detected.

abstract:
  BACKGROUND: Respiratory viral and mycoplasma infections are associated with childhood asthma exacerbations. Here, we explored epidemiologic profile of causative pathogens and possible factors for exacerbation in a single center over a three‐year period. METHODS: Hospitalized asthmatic children with attack aged 6 months‐17 years were recruited between 2012 and 2015 (n = 216). Nasopharyngeal mucosa cell samples were collected from the participants and examined by reverse transcription‐polymerase chain reaction to detect rhinovirus (RV), respiratory syncytial virus (RSV), enterovirus (EV), parainfluenza virus (PIV), Mycoplasma pneumoniae, and others. Clinical features, laboratory data, asthma exacerbation intensity, and asthma severity were compared among participants. Epidemiologic profile of causative pathogens and possible factors for exacerbation were explored. RESULTS: Viruses and/or Mycoplasma pneumoniae were detected in 75% of the participants. Rhinovirus (48%) was the most commonly detected virus in the participants with single infection, followed by RSV (6%). The median age at admission in the RV group was significantly higher than that in the RSV group. Insufficient asthma control and allergen sensitization were significantly related to RV‐associated asthma exacerbation. There was no seasonality of pathogen types associated with asthma exacerbation although a sporadic prevalence of EV‐D68 was observehinovirud. Rhinovirus were repeatedly detected in multiple admission cases. CONCLUSION: Our three‐year analysis revealed that patients with RV infection were significantly prone to repeated RV infection in the subsequent exacerbation and good asthma control could prevent RV‐associated asthma development and exacerbation. Multiple‐year monitoring allowed us to comprehend the profile of virus‐ and/or mycoplasma‐induced asthma exacerbation.


id: cord-281844-c0uhcatg
title: Exacerbation of asthma and airway infection: is the virus the villain?
author: Costa, Lusmaia D.C.
date: 2014-12-31
txt: ./txt/cord-281844-c0uhcatg.txt
cache: ./cache/cord-281844-c0uhcatg.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jped.2014.07.001
doi: 10.1016/j.jped.2014.07.001
summary:
  Abstract Objective To review the available literature on the association between acute viral respiratory tract infection and the onset of asthma exacerbations, identifying the most prevalent viruses, detection methods, as well as preventive and therapeutic aspects. Studies using reverse transcriptase polymerase chain reaction (RT-PCR) as the detection technique, isolated or combined with traditional methods, observed positivity for respiratory viruses in up to 92.2% of episodes of acute asthma exacerbation in children. Several authors have performed studies aiming to detect viruses in respiratory secretions of exacerbated asthma patients, showing a prevalence of viral identification that varies with several factors, such as patient age, time of the year, method of sample collection, and method of viral detection. The use of viral detection techniques with high sensitivity and specificity has increased the identification of some respiratory viruses in children with asthma exacerbation.

abstract:
  Abstract Objective To review the available literature on the association between acute viral respiratory tract infection and the onset of asthma exacerbations, identifying the most prevalent viruses, detection methods, as well as preventive and therapeutic aspects. Sources A search was conducted in PubMed, Lilacs, and SciELO databases, between the years 2002 and 2013, using the following descriptors: asthma exacerbation, virus, child, and acute respiratory infection. Summary of the findings A total of 42 original articles addressing the identification of respiratory viruses during episodes of asthma exacerbation were selected, mostly cross-sectional studies. There was a wide variation in the methodology of the assessed studies, particularly in relation to the children's age and methods of collection and viral detection. The results indicate that, in up to 92.2% of exacerbations, a viral agent was potentially the main triggering factor, and human rhinovirus was the most frequently identified factor. The pattern of viral circulation may have been responsible for the seasonality of exacerbations. The association between viral infections and allergic inflammation appears to be crucial for the clinical and functional uncontrolled asthma, but few studies have evaluated other triggering factors in association with viral infection. Conclusions Respiratory viruses are present in the majority of asthmatic children during episodes of exacerbation. The involved physiopathological mechanisms are yet to be fully established, and the synergism between allergic inflammation and viral infection appears to determine uncontrolled disease. The role of other triggering and protective agents is yet to be clearly determined.


id: cord-283870-b9hvcrd1
title: Asthma Exacerbations: Pathogenesis, Prevention, and Treatment
author: Castillo, Jamee R.
date: 2017-08-31
txt: ./txt/cord-283870-b9hvcrd1.txt
cache: ./cache/cord-283870-b9hvcrd1.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jaip.2017.05.001
doi: 10.1016/j.jaip.2017.05.001
summary:
  23 Finally, the use of inhaled IFN-b at the time of an upper respiratory infection reduces the airway viral load and improves clinical symptoms in patients with asthma. 50 ICS but under poor control, 50 Pauwels et al showed that highdose budesonide further reduced severe asthma exacerbations, that is, need for systemic corticosteroids, by nearly 50% compared with treatment with low-dose ICS in adults. In 2 replicate trials with a total of 912 adult patients with severe asthma and using ICS/LABA, adding tiotropium, 5 mcg, increased the time to first exacerbation by 56 days over placebo, and reduced exacerbations by 21% ( Figure 5 ). Two anti-IL-5 monoclonal antibodies, mepolizumab and reslizumab, are approved as maintenance therapy for patients with uncontrolled, persistent eosinophilic asthma with an exacerbation phenotype despite high-dose ICS.

abstract:
  Guideline-based management of asthma focuses on disease severity and choosing the appropriate medical therapy to control symptoms and reduce the risk of exacerbations. However, irrespective of asthma severity and often despite optimal medical therapy, patients may experience acute exacerbations of symptoms and a loss of disease control. Asthma exacerbations are most commonly triggered by viral respiratory infections, particularly with human rhinovirus. Given the importance of these events to asthma morbidity and health care costs, we will review common inciting factors for asthma exacerbations and approaches to prevent and treat these events.


id: cord-284313-rg3krh7d
title: Persistent Airway Obstruction After Virus Infection Is Not Associated With Airway Inflammation
author: Wood, Lisa G.
date: 2007-02-28
txt: ./txt/cord-284313-rg3krh7d.txt
cache: ./cache/cord-284313-rg3krh7d.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0012369215483254
doi: 10.1378/chest.06-1062
summary:
  Abstract Background:This study examined the contribution of airway inflammation to the delayed lung function recovery that occurs in some people following virus-induced asthma exacerbations. In contrast, during exacerbation, subjects with persistent airway obstruction showed no differences in inflammatory cell counts compared to stable subjects with asthma, nor did cell counts change postexacerbation. Table 3 indicates that during the exacerbation the CCQ was elevated in both the airwayrecovery and the persistent-airway-obstruction groups; then, at 4 to 6 weeks postexacerbation, a similar improvement in virus symptoms was seen in both groups (percentage change in CCQ) [Fig 1] . The poor lung function (percent predicted FEV 1 ) observed during the acute episode significantly improved in the airway-recovery group, with values returning to levels of stable asthma patients postexacerbation. 11 Conversely, patients in the persistent-airway-obstruction group showed a lower airway inflammatory profile during exacerbations similar to those with stable asthma (Fig 2) , and this did not change significantly postexacerbation (Table 4 ).

abstract:
  Abstract Background:This study examined the contribution of airway inflammation to the delayed lung function recovery that occurs in some people following virus-induced asthma exacerbations. Methods:Subjects (n = 40) were recruited at hospital admission for acute asthma exacerbation. Respiratory virus infection was diagnosed by viral nucleic acid detection and/or cell culture, using induced sputum, nasal, or throat swabs. Data collected included lung function, answers to common cold and asthma control questionnaires, and induced sputum cellular profiles. Subjects were reexamined 4 to 6 weeks postexacerbation and were compared with stable asthmatic subjects (n = 26) who had been recruited from ambulatory care clinics. Results:Persistent airway obstruction, defined as lung function improvement at follow-up (ie, change in FEV1percent predicted [Δ%FEV1]) of <15%, was observed in 10 subjects (25%). Airway recovery (Δ%FEV1, ≥ 15%) was observed in the remaining subjects (30 subjects; 75%). During the acute episode, the airway-recovery group had increased total cell count (p = 0.019), increased number of neutrophils (p = 0.005), and increased percentage of neutrophils (p = 0.0043) compared to the group of stable subjects with asthma. Postexacerbation, the airway-recovery group had reduced numbers of neutrophils and an increased percentage of eosinophils. In contrast, during exacerbation, subjects with persistent airway obstruction showed no differences in inflammatory cell counts compared to stable subjects with asthma, nor did cell counts change postexacerbation. Symptoms improved in both groups postexacerbation. However, in the persistent-airway-obstruction group, asthma remained uncontrolled. Conclusion:Persistent airway obstruction and uncontrolled asthma are observed in some people after viral asthma exacerbations. These abnormalities are not associated with inflammatory cell influx into the airway lining fluid during the exacerbation and may reflect the involvement of noncellular elements. Further work should explore other mechanisms leading to incomplete airway recovery.


id: cord-286328-ap0wfjhq
title: Nasal cytokine responses to natural colds in asthmatic children
author: Lewis, Toby C.
date: 2012-11-26
txt: ./txt/cord-286328-ap0wfjhq.txt
cache: ./cache/cord-286328-ap0wfjhq.txt
extension: .txt
mime: text/plain
url: https://deepblue.lib.umich.edu/bitstream/2027.42/94448/1/cea12005.pdf
doi: 10.1111/cea.12005
summary:
  CONCLUSIONS & CLINICAL RELEVANCE: We conclude that, in children with asthma, naturally-occurring viral infections apparently induce a robust innate immune response including expression of specific chemokines, IFNs and IFN-responsive genes. To further examine the innate immune response to viral infection in children with asthma, we measured nasal aspirate cytokine levels in 16 asthmatic children before and after upper respiratory tract infections. We also examined the effects of upper respiratory tract infection on mRNA levels of selected markers of viral infection, including IFNs. Finally, we evaluated a new method of virus detection using a single polymerase chain reaction-ligation detection reaction (PCR-LDR) multiplex assay. We performed home measurements of respiratory symptoms and collected nasal secretions (for detection of viral RNA by PCR and host biomarkers by PCR and ELISA) on 3 days during a week when children were healthy (not reporting upper respiratory tract infection or asthma symptoms), and again during a week when they experienced cold or flu-like symptoms.

abstract:
  BACKGROUND: The mechanisms by which viruses induce asthma exacerbations are not well-understood. OBJECTIVE: We characterized fluctuations in nasal aspirate cytokines during naturally-occurring respiratory viral infections in children with asthma. METHODS: Sixteen children underwent home collections of nasal aspirates when they were without cold symptoms and again during self-reported respiratory illnesses. The presence of viral infection was ascertained by multiplex PCR. Cytokines were measured by multiplex immune assay. mRNA expression for selected markers of viral infection was measured by RT-PCR. A cumulative respiratory symptom score was calculated for each day of measurement. Generalized estimated equations were used to evaluate associations between viral infection and marker elevation, and between marker elevation and symptom score. RESULTS: The 16 patients completed a total of 37 weeks of assessment (15 “well” weeks; 22 self-assessed “sick” weeks). Viral infections were detected in three of the “well” weeks and 17 of the “sick” weeks (10 rhinovirus, 3 coronavirus, 2 influenza A, 2 influenza B, 2 respiratory syncytial virus, 1 parainfluenza). Compared to virus-negative well weeks, nasal aspirate IFN-γ, CXCL8/IL-8, CXCL10/IP-10, CCL5/RANTES, CCL11/eotaxin-1, CCL2/MCP-1, CCL4/MIP-1β, CCL7/MCP-3 and CCL20/MIP3α protein levels increased during virus-positive sick weeks. Only a subset of cytokines (IFN-γ, CXCL8, CCL2, CCL4, CCL5 and CCL20) correlated with self-reported respiratory tract symptoms. While many aspirates were dilute and showed no mRNA signal, viral infection significantly increased the number of samples that were positive for IFN-λ1, IFN-λ2/3, TLR3, RIG-I and IRF7 mRNA. CONCLUSIONS & CLINICAL RELEVANCE: We conclude that, in children with asthma, naturally-occurring viral infections apparently induce a robust innate immune response including expression of specific chemokines, IFNs and IFN-responsive genes.


id: cord-288344-8dar2p3j
author: Yang, Xiaoyu
date: 2020-11-04
txt: ./txt/cord-288344-8dar2p3j.txt
cache: ./cache/cord-288344-8dar2p3j.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33148308/
doi: 10.1186/s13063-020-04830-0
summary:
  title: The rescue intervention strategy for asthma patients under severe air pollution: a protocol for a single-centre prospective randomized controlled trial Therefore, we hypothesize that the rescue intervention strategy of budesonide/formoterol plus original treatments under severe pollution may reduce the risk of asthma exacerbations caused by air pollution before patients have symptoms. When the air quality index (AQI) reported by the air pollution monitoring station for the study is no less than 200, participants in the RIS group will receive budesonide/formoterol (160 μg/4.5 μg/dose, 1 dose/time, b.i.d.) plus original treatments until the end of severe pollution (AQI < 200). This singlecentre, prospective, randomized and standard treatment parallel control clinical trial aimed to determine whether the rescue intervention strategy will reduce the risk of air pollution-related asthma exacerbations. This is a single-centre, prospective, randomized and standard treatment parallel control study aimed at decreasing the risk of asthma exacerbations under severe air pollution with a novel rescue intervention strategy.

title:
  The rescue intervention strategy for asthma patients under severe air pollution: a protocol for a single-centre prospective randomized controlled trial

abstract:
  BACKGROUND: Asthma is a common chronic airway inflammatory disease. Exacerbations of asthma not only accelerate the progression of the disease but also increase the incidence of hospitalization and death. Studies have shown that air pollution is a high-risk factor for asthma exacerbations. However, few treatment strategies have been recommended to reduce the risk of severe air pollution-related asthma exacerbations. METHODS/DESIGN: This is a single-centre, prospective, randomized and standard treatment parallel control clinical trial. Seventy-two asthma patients in the nonexacerbation stage according to GINA guidelines 2017 will be recruited and randomized into the rescue intervention strategy (RIS) group and control group. Original treatments for the participants will include no use of inhaled medicine, the use of short-acting β-agonists (SABA) on demand or the use of budesonide/formoterol (160 μg/4.5 μg/dose, 1–2 dose/time, b.i.d.). The rescue intervention strategy for the RIS group will be budesonide/formoterol plus the original treatment until the severe pollution ends (air quality index, AQI < 200). The control group will maintain the original treatment. The follow-up observation period will last 1 year. The primary outcome is the frequency of asthma exacerbations per year. Secondary outcomes include the mean number of unplanned outpatient visits, emergency visits, hospitalizations, medical costs and mortality caused by asthma exacerbations per patient per year. DISCUSSION: The results of this trial will provide a novel strategy to guide clinical practice in decreasing the risk of asthma exacerbations under severe air pollution. TRIAL REGISTRATION: ChiCTR ChiCTR1900026757. Registered on 20 October 2019—retrospectively registered


id: cord-289697-g24xib4l
title: Infectious triggers of asthma
author: MacDowell, Ana L.
date: 2005-03-01
txt: ./txt/cord-289697-g24xib4l.txt
cache: ./cache/cord-289697-g24xib4l.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0889856104000992
doi: 10.1016/j.iac.2004.09.011
summary:
  In addition to viral infections, RTIs with atypical organisms, such as Mycoplasma pneumoniae and Chlamydia pneumoniae, precipitate a significant proportion of acute episodes of wheezing, contribute to the severity and persistence of asthma, and may serve as the initial insult that leads to development of asthma [17] [18] [19] . The time course of influenza-induced asthma exacerbations was examined retrospectively in 20 asthmatic children 8 to 12 years of age with acute respiratory symptoms [28] . Respiratory syncytial virus (RSV) infects almost 100% of children by 2 years of age and is the most common cause of bronchiolitis and pneumonia in infants [34] . Thus, despite the efficacy of inhaled corticosteroids in the control of asthma and reduction of exacerbations, patients continue to experience exacerbations, particularly in the setting of viral RTIs. Several treatment approaches have been investigated in an attempt to reduce the morbidity associated with wheezing associated with RTIs. Brunette et al [98] examined the effect of a short course of oral corticosteroid administered in an unblinded manner at onset of URI symptoms in a group of children with histories of recurrent wheezing in the setting of viral infections.

abstract:
  There is abundant evidence that asthma is frequently exacerbated by infectious agents. Several viruses have been implicated in the inception and exacerbation of asthma. Recent attention has been directed at the role of infections with the atypical bacteria Mycoplasma pneumoniae and Chlamydia pneumoniae as agents capable of triggering asthma exacerbations and potentially as inciting agents for asthma. This article examines the evidence for interaction between specific infectious agents and exacerbations of asthma, including the immunopathology of infection-triggered asthma, and the current therapeutic options for management.


id: cord-293678-jfjc7wjb
title: SEVERE ASTHMA DURING THE COVID-19 PANDEMIC: CLINICAL OBSERVATIONS
author: Haroun-Díaz, Elisa
date: 2020-06-27
txt: ./txt/cord-293678-jfjc7wjb.txt
cache: ./cache/cord-293678-jfjc7wjb.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32599217/
doi: 10.1016/j.jaip.2020.06.033
abstract: nan
summary:
  title: SEVERE ASTHMA DURING THE COVID-19 PANDEMIC: CLINICAL OBSERVATIONS It is 110 estimated that the global economic burden of asthma is between 1.5 and 3 billion euros 111 annually, and higher costs are associated with greater disease severity (5). Severe asthma affects 3.9% of asthmatic patients (5). It is defined as an inflammatory 113 chronic respiratory disease that remains uncontrolled despite optimal therapy and 114 treatment of contributing factors, or which worsens when high-dose treatment is 115 decreased (6). Around 50% of patients with severe asthma experience uncontrolled or 116 partially controlled symptoms despite maximal treatment (5). The aim of this study is to determine the prevalence and characterization of COVID-19 120 infection among patients with severe asthma according to ERS/ATS criteria who 121 presented to our allergy department during the COVID-19 pandemic. ATS guidelines on definition, evaluation and treatment of 219 severe asthma


id: cord-295575-zgta5ah8
author: Howard, Evin
date: 2019-11-28
txt: ./txt/cord-295575-zgta5ah8.txt
cache: ./cache/cord-295575-zgta5ah8.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11882-019-0890-2
doi: 10.1007/s11882-019-0890-2
summary:
  The purpose of this literature review was to specifically examine asthma outcomes related to environmental exposures to microbial products, pertaining to endotoxin from bacteria-(1,3)-β-D-glucan and ergosterol from fungus, and common viruses associated with worsening asthma morbidity (rhinovirus, respiratory syncytial virus (RSV), enterovirus, and the influenza virus) during infancy, and to assess the risk of asthma development later in childhood [15] [16] [17] [18] (see Table 1 ). conducted a prospective longitudinal study examining whether early exposure to microbial products in dust was associated with allergy and asthma later in childhood for children in suburban areas using the following three birth cohort studies for children born between 1996 and 1999: [24••] , dust samples were collected from children''s mattresses, bedroom floors, and living room floors; and showed no association between endotoxin nor the fungal membrane lipid ergosterol in the development of asthma with exposure from birth to 7 years of age.

title:
  The Impact of Ambient Environmental Exposures to Microbial Products on Asthma Outcomes from Birth to Childhood

abstract:
  PURPOSE OF REVIEW: Asthma is a chronic respiratory condition with increasing domestic and worldwide prevalence that burdens individuals and the healthcare system with high costs associated with long-term treatments and acute emergency room (ER) visits. It can be triggered by ambient microbes, including bacteria, viruses, and fungi. In this review, we examine the outcomes of asthma patients in relation to environmental exposures to ambient microbe products, focusing on whether exposure leads to asthma development from birth to childhood and if particular microbes are associated with worsened asthma exacerbations. RECENT FINDINGS: Bacterial endotoxin is more prominent in homes with pets and may cause cytokine cascades that lead to asthma exacerbation. However, some studies have demonstrated a protective effect with early exposure. Patients with positive Aspergillus skin testing are more prone to moderate-severe or severe-uncontrolled asthma. Fungal sensitization is also associated with earlier onset of asthma and demonstrates a dose-dependent relationship of symptom severity and duration. Among viruses, rhinovirus has the greatest association with decreased lung function, severe asthma, and asthma-related hospital admissions. Distribution of microbial products and associated asthma symptoms depends on the geographical climate. Genetic variations among individuals also mitigate the effects of microbial products on asthma development and symptom severity. SUMMARY: Microbial products of bacteria, fungi, and viruses are associated with the development of asthma, more severe asthma symptoms, and worse outcomes. However, some early exposure studies have also demonstrated a protective effect. Bacterial and fungal products are related to decreased lung function and earlier onset of asthma. Viral products are related to asthma-associated hospital admissions; and the climate and patient genetics can also temper or intensify the relationships between microbial products, asthma development, and asthma symptom severity. Further research should focus on the effects of early microbe exposure and its interaction with human immune systems and asthma-related outcomes.


id: cord-299672-dq1y1gkc
title: Multiplex Molecular Detection of Respiratory Pathogens in Children With Asthma Exacerbation
author: Leung, Ting Fan
date: 2010-02-28
txt: ./txt/cord-299672-dq1y1gkc.txt
cache: ./cache/cord-299672-dq1y1gkc.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1378/chest.09-1250
doi: 10.1378/chest.09-1250
summary:
  Conclusions Respiratory viral infections are commonly found in children with asthma exacerbation, with HRV being the most important pathogen in our patients. Our primary outcome was the difference in detection rate for any respiratory pathogen between children with asthma with acute exacerbation and controls (ie, stable asthma). Secondary outcomes consisted of differences in the clinical severity of asthma exacerbation, lung function parameters, and fractional exhaled nitric oxide concentration (FeNO) in relation to patients with different respiratory pathogens. HRV infection was associated with asthma exacerbation in the children, which is consistent with FeNO was the only parameter that differed between patients with and without HRV, being signifi cantly lower in the former group ( P 5 .018). Identifi cation of viral and atypical bacterial pathogens in children hospitalized with acute respiratory infections in Hong Kong by multiplex PCR assays

abstract:
  Background Up to 80% of asthma exacerbations in white children are associated with viral upper respiratory infections. The relative importance of different respiratory pathogens and relevant microbiological data in Asian children are unclear. This study elucidated the epidemiology of respiratory infections in Hong Kong children with asthma exacerbation. Methods A total of 209 children aged 3-18 years with asthma exacerbations and 77 controls with stable asthma were recruited. The severity of asthma exacerbations was assessed according to Global Initiative for Asthma guideline, and subjects aged 6 years or older performed exhaled nitric oxide and spirometric measurements. Nested multiplex polymerase chain reaction was used to detect 20 different respiratory pathogens. Results Respiratory pathogens were detected in 105 (51.0%) subjects. The presence of any respiratory pathogen was associated with asthma exacerbation (odds ratio [OR], 2.77; 95% CI, 1.51–5.11; P < .001). Specifically, human rhinovirus (HRV) infection was more common among children with asthma exacerbation (OR, 2.38; 95% CI, 1.09–5.32; P = .018). All other pathogens or coinfections were not associated with asthmatic attacks. None of these respiratory infections was associated with the severity of asthma exacerbation (P > .15 for all). During peak HRV season in the winter of 2007 to 2008, this virus was detected in 46.4% of children with asthma exacerbations. Conclusions Respiratory viral infections are commonly found in children with asthma exacerbation, with HRV being the most important pathogen in our patients. Respiratory viral infection is a triggering factor for asthma exacerbation but does not correlate with its severity.


id: cord-300311-eah49b3g
title: What is the role of virus vaccination in patients with asthma?
author: Bueving, Herman J.
date: 2007-05-30
txt: ./txt/cord-300311-eah49b3g.txt
cache: ./cache/cord-300311-eah49b3g.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/17504664/
doi: 10.1007/s11882-007-0033-z
summary:
  Other studies are often based on selected populations with existing symptoms or complications, reflecting only the worst of the spectrum of disease caused by acute respiratory infections [9, [14] [15] [16] [17] ] and thus disregarding their often self-limiting nature. The availability of effective vaccines against the key viruses involved in asthma exacerbations thus could play an important role in its prevention. However, because of a lack of clinical effectiveness, the natural antigenic variations of the influenza virus, and the low average incidence of influenza, cost-effectiveness in children and adults with asthma will not be easily achieved if vaccination has to be delivered annually. Community study of role of viral infections in exacerbations of asthma in 9-11 year old children Effectiveness of influenza vaccine for the prevention of asthma exacerbations Influenza vaccination in patients with asthma: effect on the frequency of upper respiratory tract infections and exacerbations

abstract:
  It is estimated that viruses play a role in 30% to 80% of asthma exacerbations. Thus, virus vaccination in patients with asthma could play an important role in preventing asthma exacerbations and other complications. Influenza is the only agent for which a routine vaccine is currently available. This article discusses whether influenza vaccination in patients with asthma, based on the available evidence, is justified. Cost-effectiveness of (influenza) vaccination for patients with asthma is questionable. For the other major viruses involved, the present state of affairs is described. Although progress is being made, a vaccine may be available in the near future only for respiratory syncytial virus (RSV). Meanwhile, clinicians and patients should aim for an optimal treatment with the currently available asthma medication.


id: cord-301022-0q2ertja
title: Inhalant Allergies in Children
author: Mims, James W.
date: 2011-04-29
txt: ./txt/cord-301022-0q2ertja.txt
cache: ./cache/cord-301022-0q2ertja.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0030666511000570
doi: 10.1016/j.otc.2011.03.013
summary:
  38 However, dietary antigen avoidance has not proved to be effective in most studies and a 2008 review in Pediatrics states, "for infants at high risk of developing atopic disease, there is evidence that exclusive breastfeeding for at least 4 months compared with feeding intact cow milk protein formula decreases the cumulative incidence of atopic dermatitis and cow milk allergy in the first 2 years of life." 39 Beyond this, whether exposure to antigenic foods early in life promotes sensitization or tolerance is unclear. Although preventing allergy through environmental control has shown mixed results, two controlled studies have shown that treating young children who have atopic dermatitis with antihistamines decreases the risk of developing asthma. 101 This phenotype is also associated with early sensitization to food or inhalant allergens 102 and reduced lung function at age 6 years (compared with children with no history of wheezing with lower respiratory illnesses).

abstract:
  Children with chronic or recurrent upper respiratory inflammatory disease (rhinitis) should be considered for inhalant allergies. Risk factors for inhalant allergies in children include a first-degree relative with allergies, food allergy in infancy, and atopic dermatitis. Although inhalant allergies are rare in infancy, inhalant allergies are common in older children and impair quality of life and productivity. Differentiating between viral and allergic rhinitis can be challenging in children, but the child's age, history, and risk factors can provide helpful information. Allergic rhinitis is a risk factor for asthma, and if one is present, medical consideration of the other is warranted.


id: cord-303606-ypkia5x1
title: Is respiratory viral infection really an important trigger of asthma exacerbations in children?
author: Lee, So-lun
date: 2011-03-30
txt: ./txt/cord-303606-ypkia5x1.txt
cache: ./cache/cord-303606-ypkia5x1.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/21448631/
doi: 10.1007/s00431-011-1446-1
summary:
  We performed a prospective cohort study from September 2003 to December 2004 to delineate attributing the effect of different respiratory viral infections including newly discovered ones to asthma exacerbations in children in Hong Kong. Plausible explanations for much lower virus detection rate than previously reported include improved personal hygiene and precautionary measures taken during respiratory tract infections in the immediate post-severe acute respiratory syndrome period together with a significant contribution of other adverse factors like environmental air pollution. Plausible explanations for much lower virus detection rate than previously reported include improved personal hygiene and precautionary measures taken during respiratory tract infections in the immediate post-severe acute respiratory syndrome period together with a significant contribution of other adverse factors like environmental air pollution. Thus, we carried out a prospective study to delineate the current role of different viral respiratory tract infections including newly discovered respiratory viruses in asthma exacerbation in children in our locality.

abstract:
  We performed a prospective cohort study from September 2003 to December 2004 to delineate attributing the effect of different respiratory viral infections including newly discovered ones to asthma exacerbations in children in Hong Kong. One hundred and fourteen children aged 6–14 years with chronic stable asthma and on regular inhaled steroid were monitored for respiratory symptoms over a full calendar year from recruitment. They would attend the study clinic if peak expiratory flow rate decreased to below 80% of their baselines, if they met a predefined symptom score, or if parents subjectively felt them developing a cold. Virological diagnosis using virus culture, antigen detection, and polymerase chain reaction methods on nasal swab specimens would be attempted for all these visits irrespective of triggers. Physician diagnosed outcome of each episode was documented. Three hundred and five episodes of respiratory illnesses were captured in the cohort. Nasal specimens were available in 166 episodes, 92 of which were diagnosed as asthma exacerbations, and 74 non-asthma related episodes. Respiratory viruses were detected in 61 of 166 episodes (36.7%). There was no significant difference in virus detection rate between asthma exacerbations (32 out of 97 episodes, 34.8%) and non-asthma respiratory illnesses (29 out of 79 episodes, 39.2%). Although newly discovered respiratory viruses were identified in these episodes, rhinovirus was the commonest organism associated with both asthma exacerbations and non-asthma related episodes. Plausible explanations for much lower virus detection rate than previously reported include improved personal hygiene and precautionary measures taken during respiratory tract infections in the immediate post-severe acute respiratory syndrome period together with a significant contribution of other adverse factors like environmental air pollution. We conclude that not all viral infections in children with asthma lead to an asthma exacerbation and the attributing effect of different triggers of asthma exacerbations in children vary across different time periods and across different localities.


id: cord-304549-e8q8mck4
title: Genetic and environmental interaction in allergy and asthma()()
author: Holgate, Stephen T.
date: 2005-11-02
txt: ./txt/cord-304549-e8q8mck4.txt
cache: ./cache/cord-304549-e8q8mck4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/10588993/
doi: 10.1016/s0091-6749(99)70005-9
summary:
  Abnormal signaling between the epithelium, which is in contact with the environment, and the underlying (myo)fibroblasts and dendritic cells indicating reactivation of the epithelial mesenchymal trophic unit, which is involved in fetal lung development and branching, provide a basis for asthma that encapsulates both T(H)2 polarization and airway wall remodeling. Asthma is a complex disorder involving a combination of genetic and environmental interactions that culminate in a specific type of inflammation involving mast cells, eosinophils, and macrophages and polarization of T cell-mediated immunity toward enhanced production of cytokines encoded in a cluster on the long arm of chromosome 5. Two fundamental approaches are being used to discover susceptibility genes in asthma and atopy: linkage analysis with functional cloning and association analysis for mutations of "candidate" genes thought to be involved in disease pathogenesis. 55 In susceptible mice genetic linkage has shown that ozone-induced lung inflammation is directed by genes encoded on chromosome 17, including the strong candidate TNF-α, a pleiotropic cytokine generated during oxidant-induced cell injury.

abstract:
  Asthma is an inflammatory disorder of the airways involving coordinate up-regulation of T(H)2-type cytokines encoded in a cluster on chromosome 5q(31-33) on T cells and inflammatory cells. There is also a requirement for local airway susceptibility factors that, together with T(H)2 polarization, results in hyperresponsiveness, variable airflow obstruction, and, over time, remodeling of the airway wall. Asthma has strong genetic and environmental components that interact both in the induction and subsequent expression of the disease phenotypes. Multiple genes are involved and probably interact. Whole genome screens are beginning to identify gene-rich regions of special relevance to asthma and atopy, although a novel disease-related gene has yet to be discovered from these. By contrast, there are a plethora of candidate genes whose function in relation to disease pathophysiologic mechanisms and response to treatment are known. Two examples are polymorphisms involving IL-4 receptors and the enzymes controlling cysteinyl leukotriene production. Abnormal signaling between the epithelium, which is in contact with the environment, and the underlying (myo)fibroblasts and dendritic cells indicating reactivation of the epithelial mesenchymal trophic unit, which is involved in fetal lung development and branching, provide a basis for asthma that encapsulates both T(H)2 polarization and airway wall remodeling. (J Allergy Clin Immunol 1999;104:1139-46.)


id: cord-305838-i0ck2oo0
title: CHEST Reviews: Addressing reduced laboratory-based pulmonary function testing during a pandemic
author: Kouri, Andrew
date: 2020-07-08
txt: ./txt/cord-305838-i0ck2oo0.txt
cache: ./cache/cord-305838-i0ck2oo0.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0012369220318675
doi: 10.1016/j.chest.2020.06.065
summary:
  Home measurement of peak expiratory flow (PEF) using an inexpensive portable handheld device is already a guideline-recommended option to facilitate patient self-management in asthma and in the diagnosis of occupational asthma, but its role is less well defined in COPD. 37 Electronic portable spirometers have been studied and found to be comparable to conventional laboratory spirometry in several chronic respiratory conditions, such as asthma and COPD, cystic fibrosis, idiopathic pulmonary fibrosis, and post-lung and hematopoietic stem cell transplant monitoring. Oscillometry is emerging as an alternative form of pulmonary function testing that offers some advantages over conventional PFTs. 54 It has been shown to be more sensitive than spirometry in early diagnosis of COPD, 55, 56 to correlate better with respiratory symptoms and asthma control 57,58 as well as in identifying spirometrically silent episodes of biopsy-proven acute graft rejection following lung transplant.

abstract:
  Abstract To reduce the spread of SARS-CoV-2, many pulmonary function testing (PFT) laboratories have been closed or have significantly reduced their testing capacity. As these mitigation strategies may be necessary for the next 6-18 months to prevent recurrent peaks in disease prevalence, fewer objective measurements of lung function will alter the diagnosis and care of patients with chronic respiratory diseases. PFTs, which include spirometry, lung volumes, and diffusion capacity measurement, are essential to the diagnosis and management of patients with asthma, COPD, and other chronic lung conditions. Both traditional and innovative alternatives to conventional testing must now be explored. These may include peak expiratory flow devices, electronic portable spirometers, portable exhaled nitric oxide measurement, airwave oscillometry devices, as well as novel digital health tools such as smartphone microphone spirometers, and mobile health technologies along integration of machine learning approaches. The adoption of some novel approaches may not merely replace but could improve existing management strategies and alter common diagnostic paradigms. With these options come important technical, privacy, ethical, financial, and medicolegal barriers that must be addressed. However, the COVID-19 pandemic also presents a unique opportunity to augment conventional testing by including innovative and emerging approaches to measuring lung function remotely in patients with respiratory disease. The benefits of such an approach have the potential to enhance respiratory care and empower patient self-management well beyond the current global pandemic.


id: cord-307202-iz1bo218
title: Asthma
author: Shaw, Dominick
date: 2014-05-02
txt: ./txt/cord-307202-iz1bo218.txt
cache: ./cache/cord-307202-iz1bo218.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/B9780123868824000281
doi: 10.1016/b978-0-12-386882-4.00028-1
summary:
  Current asthma management involves a step-up and step-down approach based on asthma control with a large degree of heterogeneity in responses to the main drug classes currently in use: β(2)-adrenergic receptor agonists, corticosteroids, and leukotriene modifiers. Human studies have identified elevated numbers of cells expressing IL13 mRNA in the bronchial tissue of atopic and nonatopic asthmatic subjects [50] ; administration of recombinant IL13 in mouse lungs resulted in an increase in airway mucus secretion, development of subepithelial fibrosis, airway hyper-responsiveness (AHR), and eosinophilic airway inflammation-that is, several key features of the human disease [51] . While methods of stratifying asthma patients to specific treatments based on nongenetic factors such as clinical outcomes, cellular measures, or protein biomarkers have shown some success, a large body of work has investigated the potential of genetic markers as predictors of patient responses to existing therapies, i.e., pharmacogenetics.

abstract:
  Asthma is a common respiratory disease with a complex etiology involving a combination of genetic and environmental components. Current asthma management involves a step-up and step-down approach based on asthma control with a large degree of heterogeneity in responses to the main drug classes currently in use: β(2)-adrenergic receptor agonists, corticosteroids, and leukotriene modifiers. Importantly, asthma is heterogeneous with respect to clinical presentation and the inflammatory mechanisms that underlie it. This heterogeneity likely contributes to variable results in clinical trials, particularly when targeting specific inflammatory mediators. These factors have motivated a drive toward stratified medicine in asthma based on clinical/cellular outcomes or genetics (i.e., pharmacogenetics). Significant progress has been made in identifying genetic polymorphisms that influence the efficacy and potential for adverse effects of all main classes of asthma drugs. Importantly an emerging role for genetics in phase II development of newer therapies has been demonstrated (e.g., anti-IL4). Similarly, the stratification of patients based on clinical characteristics (e.g., blood and sputum eosinophil levels) has been critical in evaluating newer therapies (e.g., anti-IL5). As a proof of concept, anti-IgE is the latest therapy to be introduced into clinical practice, although only for severe, allergic patients (i.e., in a stratified manner). As new asthma genes are identified using genome-wide association, among other technologies, new targets (e.g., IL33/IL33 receptor (IL1RL1)) will emerge and pharmacogenetics in these development programs will be essential. In this chapter we review the current understanding of asthma pathobiology and its clinical presentation, as well as the use of stratified medicine, which holds great promise for maximizing clinical outcomes and minimizing adverse effects in existing and new therapies.


id: cord-308169-a0ft6wdy
title: EAACI position statement on asthma exacerbations and severe asthma
author: Custovic, A.
date: 2013-11-06
txt: ./txt/cord-308169-a0ft6wdy.txt
cache: ./cache/cord-308169-a0ft6wdy.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/24410781/
doi: 10.1111/all.12275
summary:
  A recently published consensus statement on severe asthma broadened the concept of ''difficult asthma'' to reflect the situation in less developed countries, where access to medications and appropriate care is a major issue, by defining three different patient groups including un(der)treated symptomatic patients, patients with low treatment adherence or unconventional therapies, and those remaining symptomatic despite high doses of anti-asthmatic therapies (13, 14) . Other similar initiatives included the EU-sponsored Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes (U-BIOPRED) consortium that has published a consensus-based systematic algorithm approach to differentiate between ''problematic'', ''difficult'' and ''severe refractory'' asthma in the evaluation of patients with chronic severe asthma symptoms for use in clinical research and specialized care (73) . These treatment options for patients with severe asthma who remain symptomatic despite adhering to standard medical care include novel anti-inflammatory drugs that have been shown in preliminary studies to be effective in treating airway inflammation in asthma and so warrant further investigation (32, (83) (84) (85) (86) , and other novel approaches such as bronchial thermoplasty (87) .

abstract:
  Asthma exacerbations and severe asthma are linked with high morbidity, significant mortality and high treatment costs. Recurrent asthma exacerbations cause a decline in lung function and, in childhood, are linked to development of persistent asthma. This position paper, from the European Academy of Allergy and Clinical Immunology, highlights the shortcomings of current treatment guidelines for patients suffering from frequent asthma exacerbations and those with difficult‐to‐treat asthma and severe treatment‐resistant asthma. It reviews current evidence that supports a call for increased awareness of (i) the seriousness of asthma exacerbations and (ii) the need for novel treatment strategies in specific forms of severe treatment‐resistant asthma. There is strong evidence linking asthma exacerbations with viral airway infection and underlying deficiencies in innate immunity and evidence of a synergism between viral infection and allergic mechanisms in increasing risk of exacerbations. Nonadherence to prescribed medication has been identified as a common clinical problem amongst adults and children with difficult‐to‐control asthma. Appropriate diagnosis, assessment of adherence and other potentially modifiable factors (such as passive or active smoking, ongoing allergen exposure, psychosocial factors) have to be a priority in clinical assessment of all patients with difficult‐to‐control asthma. Further studies with improved designs and new diagnostic tools are needed to properly characterize (i) the pathophysiology and risk of asthma exacerbations, and (ii) the clinical and pathophysiological heterogeneity of severe asthma.


id: cord-309421-725u6dau
author: Wechsler, Michael E.
date: 2020-10-13
txt: ./txt/cord-309421-725u6dau.txt
cache: ./cache/cord-309421-725u6dau.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s12931-020-01503-z
doi: 10.1186/s12931-020-01503-z
summary:
  METHODS: SOURCE is an ongoing phase 3, multicentre, randomized, double-blind, placebo-controlled study to evaluate the effect of tezepelumab 210 mg administered subcutaneously every 4 weeks on OCS dose reduction in adults with OCS-dependent asthma. SOURCE also aims to demonstrate that treatment with tezepelumab in patients with severe asthma is associated with reductions in exacerbation rates and improvements in lung function, asthma control and health-related quality of life, while reducing OCS dose. SOURCE also aims to demonstrate that treatment with tezepelumab in patients with severe asthma is associated with reductions in exacerbation rates and improvements in lung function, asthma control and healthrelated quality of life, while reducing OCS dose. In the phase 2b PATHWAY study (ClinicalTrials.gov identifier: NCT02054130), tezepelumab significantly reduced asthma exacerbations over 52 weeks by up to 71% compared with placebo in patients with severe, uncontrolled asthma, irrespective of baseline biomarker status [24, 26] , and improved lung function, asthma control and patient HRQoL [24] .

title:
  SOURCE: a phase 3, multicentre, randomized, double-blind, placebo-controlled, parallel group trial to evaluate the efficacy and safety of tezepelumab in reducing oral corticosteroid use in adults with oral corticosteroid dependent asthma

abstract:
  BACKGROUND: Many patients with severe asthma continue to experience asthma symptoms and exacerbations despite standard-of-care treatment. A substantial proportion of these patients require long-term treatment with oral corticosteroids (OCS), often at high doses, which are associated with considerable multiorgan adverse effects, including metabolic disorders, osteoporosis and adrenal insufficiency. Tezepelumab is a human monoclonal antibody that blocks the activity of the epithelial cytokine thymic stromal lymphopoietin. In the PATHWAY phase 2b study (NCT02054130), tezepelumab significantly reduced exacerbations by up to 71% in adults with severe, uncontrolled asthma. Several ongoing phase 3 trials (SOURCE, NCT03406078; NAVIGATOR, NCT03347279; DESTINATION, NCT03706079) are assessing the efficacy and safety of tezepelumab in patients with severe, uncontrolled asthma. Here, we describe the design and objectives of SOURCE, a phase 3 OCS-sparing study. METHODS: SOURCE is an ongoing phase 3, multicentre, randomized, double-blind, placebo-controlled study to evaluate the effect of tezepelumab 210 mg administered subcutaneously every 4 weeks on OCS dose reduction in adults with OCS-dependent asthma. The study comprises a 2-week screening and enrolment period, followed by an OCS optimization phase of up to 8 weeks and a 48-week treatment period, which consists of a 4-week induction phase, followed by a 36-week OCS reduction phase and an 8-week maintenance phase. The primary objective is to assess the effect of tezepelumab compared with placebo in reducing the prescribed OCS maintenance dose. The key secondary objective is to assess the effect of tezepelumab on asthma exacerbation rates. Other secondary objectives include the proportion of patients with a reduction in OCS dose (100% or 50% reduction or those receiving < 5 mg) and the effect of tezepelumab on lung function and patient-reported outcomes. CONCLUSIONS: SOURCE is evaluating the OCS-sparing potential of tezepelumab in patients with OCS-dependent asthma. SOURCE also aims to demonstrate that treatment with tezepelumab in patients with severe asthma is associated with reductions in exacerbation rates and improvements in lung function, asthma control and health-related quality of life, while reducing OCS dose. TRIAL REGISTRATION: NCT03406078 (ClinicalTrials.gov). Registered 23 January 2018. https://clinicaltrials.gov/ct2/show/NCT03406078


id: cord-312613-1nl7q6cy
title: Pediatric Asthma and Viral Infection()
author: Luz Garcia-Garcia, M.
date: 2016-03-26
txt: ./txt/cord-312613-1nl7q6cy.txt
cache: ./cache/cord-312613-1nl7q6cy.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1579212916300106
doi: 10.1016/j.arbr.2016.03.010
summary:
  Respiratory viral infections, particularly respiratory syncytial virus (RSV) and rhinovirus, are the most importance risk factors for the onset of wheezing in infants and small children. The association between bronchiolitis caused by RSV and the development of recurrent wheezing and/or asthma was first described more than 40 years ago, but it is still unclear whether bronchiolitis causes chronic respiratory symptoms, or if it is a marker for children with a genetic predisposition for developing asthma in the medium or long term. In the Childhood Origins of Asthma (COAST) study, which followed a cohort of 289 newborns with high risk of developing asthma, lower respiratory tract infection associated with rhinovirus was the main risk factor for presenting recurrent wheezing at 3 and 6 years of life, with an odds ratio of 10 for rhinovirus bronchiolitis compared to 2.6 for RSV bronchiolitis. 3 found that 80% of asthma exacerbations in asthmatic children aged 9-11 years were associated with viral respiratory infection, of which two thirds were caused by rhinovirus.

abstract:
  Respiratory viral infections, particularly respiratory syncytial virus (RSV) and rhinovirus, are the most importance risk factors for the onset of wheezing in infants and small children. Bronchiolitis is the most common acute respiratory infection in children under 1 year of age, and the most common cause of hospitalization in this age group. RSV accounts for approximately 70% of all these cases, followed by rhinovirus, adenovirus, metapneumovirus and bocavirus. The association between bronchiolitis caused by RSV and the development of recurrent wheezing and/or asthma was first described more than 40 years ago, but it is still unclear whether bronchiolitis causes chronic respiratory symptoms, or if it is a marker for children with a genetic predisposition for developing asthma in the medium or long term. In any case, sufficient evidence is available to corroborate the existence of this association, which is particularly strong when the causative agent of bronchiolitis is rhinovirus. The pathogenic role of respiratory viruses as triggers for exacerbations in asthmatic patients has not been fully characterized. However, it is clear that respiratory viruses, and in particular rhinovirus, are the most common causes of exacerbation in children, and some type of respiratory virus has been identified in over 90% of children hospitalized for an episode of wheezing. Changes in the immune response to viral infections in genetically predisposed individuals are very likely to be the main factors involved in the association between viral infection and asthma.


id: cord-312952-9gbb4own
title: The profile of respiratory pathogens in induced sputum of elderly and non-elderly asthmatics
author: WARDZYŃSKA, ALEKSANDRA
date: 2020-01-20
txt: ./txt/cord-312952-9gbb4own.txt
cache: ./cache/cord-312952-9gbb4own.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32140050/
doi: 10.5114/ceji.2019.92790
summary:
  While the majority of studies indicate that the detection rate of respiratory viruses in patients with asthma and healthy subjects is similar [10] , they have been found to differ with regard to the bacterial composition of the airways [11] . This technique was chosen for the present study, to test the hypothesis that elderly patients with asthma display a different profile of respiratory pathogens in the airways as compared to non-elderly asthmatics, and that this profile may be related to local airway and/or systemic inflammation. This study is the first to use the IS technique to compare detection rates of respiratory pathogens in the airways of elderly and non-elderly patients with asthma. Although the detection rate and profile of respiratory viruses in IS was similar in elderly and non-elderly patients with asthma, the presence of pathogens was associated with some clinical characteristics only in older subjects.

abstract:
  INTRODUCTION: Respiratory pathogens are thought to be involved in the pathogenesis and exacerbations of asthma at all ages; however, little is known about the airway microbiome in the elderly. AIM OF THE STUDY: To identify respiratory pathogens in the induced sputum (IS) of elderly asthmatics, and to determine the association between pathogens and the markers of asthma activity. MATERIAL AND METHODS: Twenty-nine subjects with stable asthma, 15 above 65 years of age and 14 aged 30-49 years, underwent clinical evaluation, fractional exhaled nitric oxide measurement, and sputum induction. Pathogens were detected by multiplex reverse transcription polymerase chain reaction. The periostin concentration of IS supernatants was measured by enzyme-linked immunosorbent assay. Serum eosinophil cationic protein and total IgE levels were measured by ImmunoCAP. RESULTS: Elderly patients, as compared to non-elderly, had significantly higher eosinophilia in IS, although other markers of eosinophilic inflammation were comparable. Half of the subjects were positive for Haemophilus influenzae. Chlamydophila pneumoniae was found in two subjects. Respiratory viruses were detected in more than 70% of patients. The detection rates and profiles of atypical bacteria and respiratory viruses were similar in both groups. Only in the elderly asthmatics was influenza A positivity associated with lower predicted FVC%, RSV A positivity connected with decreased tIgE concentration, and RSV B positivity related to a lower percentage of lymphocytes in IS. CONCLUSIONS: Despite the existence of differences in some clinical and inflammatory characteristics of asthma between elderly and non-elderly asthmatics, the pathogen detection rates in the IS from the two groups are similar.


id: cord-320431-0877trhh
title: More Than Just a Barrier: The Immune Functions of the Airway Epithelium in Asthma Pathogenesis
author: Frey, Andreas
date: 2020-04-28
txt: ./txt/cord-320431-0877trhh.txt
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extension: .txt
mime: text/plain
url: https://doi.org/10.3389/fimmu.2020.00761
doi: 10.3389/fimmu.2020.00761
summary:
  In case of asthma, all these functions are impaired by the already existing allergic immune response that per se weakens the barrier integrity and self-cleaning abilities of the airway epithelium making it more vulnerable to penetration of allergens as well as of infection by bacteria and viruses. Besides this innate "rapid response team, " the polarized epithelium of the human airways is also able to transport and apically release immunoglobulins that carry a J-chain (joining chain) by using its poly Ig receptor (pIgR) (145) (146) (147) that is expressed by all non-stratified epithelial cells (Figure 2) . After contact for example with HDM extracts, representing a major source of asthma associated allergens, TLR4 dependent activation of NFκB and protease induced injuries in airway epithelial cells lead to secretion of chemokines and cytokines like thymic stromal lymphopoietin (TSLP), GM-CSF, IL-25, and IL-33 (211) (212) (213) (214) (215) .

abstract:
  Allergic bronchial asthma is a chronic disease of the airways that is characterized by symptoms like respiratory distress, chest tightness, wheezing, productive cough, and acute episodes of broncho-obstruction. This symptom-complex arises on the basis of chronic allergic inflammation of the airway wall. Consequently, the airway epithelium is central to the pathogenesis of this disease, because its multiple abilities directly have an impact on the inflammatory response and thus the formation of the disease. In turn, its structure and functions are markedly impaired by the inflammation. Hence, the airway epithelium represents a sealed, self-cleaning barrier, that prohibits penetration of inhaled allergens, pathogens, and other noxious agents into the body. This barrier is covered with mucus that further contains antimicrobial peptides and antibodies that are either produced or specifically transported by the airway epithelium in order to trap these particles and to remove them from the body by a process called mucociliary clearance. Once this first line of defense of the lung is overcome, airway epithelial cells are the first cells to get in contact with pathogens, to be damaged or infected. Therefore, these cells release a plethora of chemokines and cytokines that not only induce an acute inflammatory reaction but also have an impact on the alignment of the following immune reaction. In case of asthma, all these functions are impaired by the already existing allergic immune response that per se weakens the barrier integrity and self-cleaning abilities of the airway epithelium making it more vulnerable to penetration of allergens as well as of infection by bacteria and viruses. Recent studies indicate that the history of allergy- and pathogen-derived insults can leave some kind of memory in these cells that can be described as imprinting or trained immunity. Thus, the airway epithelium is in the center of processes that lead to formation, progression and acute exacerbation of asthma.


id: cord-321824-zbo75ki3
author: Coverstone, Andrea M.
date: 2019-05-16
txt: ./txt/cord-321824-zbo75ki3.txt
cache: ./cache/cord-321824-zbo75ki3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/31284928/
doi: 10.1016/j.iac.2019.03.007
summary:
  Respiratory viruses other than rhinovirus or respiratory syncytial virus, including human metapneumovirus, influenza virus, and human bocavirus, are important pathogens in acute wheezing illness and asthma exacerbations in young children. Whether infection with these viruses in early life is associated with recurrent wheezing and/or asthma is not fully investigated, although there are data to suggest children with human metapneumovirus lower respiratory tract infection may have a higher likelihood of subsequent and recurrent wheezing several years after initial infection. viruses are associated with acute wheezing illness, including rhinovirus (RV), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), influenza virus, parainfluenza virus, adenovirus, human bocavirus (HBoV), 1 coronavirus, and enterovirus ( Table 1) . 17 In another study of children 1 to 14 years of age with hMPV infection, differences in measures of cell-mediated immunity distinguished hMPV from other respiratory viruses, such as RSV and influenza.

title:
  Beyond Respiratory Syncytial Virus and Rhinovirus in the Pathogenesis and Exacerbation of Asthma: The Role of Metapneumovirus, Bocavirus and Influenza Virus

abstract:
  Respiratory viruses other than rhinovirus or respiratory syncytial virus, including human metapneumovirus, influenza virus, and human bocavirus, are important pathogens in acute wheezing illness and asthma exacerbations in young children. Whether infection with these viruses in early life is associated with recurrent wheezing and/or asthma is not fully investigated, although there are data to suggest children with human metapneumovirus lower respiratory tract infection may have a higher likelihood of subsequent and recurrent wheezing several years after initial infection.


id: cord-323761-9m177ozm
title: Asthma in Pregnancy: Pathophysiology, Diagnosis, Whole-Course Management, and Medication Safety
author: Wang, Huijie
date: 2020-02-22
txt: ./txt/cord-323761-9m177ozm.txt
cache: ./cache/cord-323761-9m177ozm.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32184907/
doi: 10.1155/2020/9046842
summary:
  Studies have shown that maternal asthma increases the risk for adverse complications in fetuses and mothers, including SGA (small for gestational age), LBW (low birth weight), congenital malformations (cleft lip or cleft palate), increased perinatal mortality, PB (premature birth), maternal preeclampsia, gestational hypertension, gestational diabetes, prenatal hemorrhage, caesarean section, urinary tract infection, excessive amniotic fluid, and premature rupture of membranes, especially for those patients with severe or uncontrolled asthma during pregnancy [6, 7] . e long-term goals of asthma management are to achieve good symptom control, maintain normal activity levels, and minimize the risk of acute attacks, irreversible damage to lung function, and drug-related adverse effects. Anti-IgE monoclonal antibody omalizumab is as an add-on therapy for the treatment of nonpregnant patients with moderate-to-severe persistent asthma that is inadequately controlled with ICS and has the effect of preventing exacerbation, reducing the frequency of asthmatic symptoms, reducing the frequency of emergency room visit or hospital admission, and reducing the steroid dose.

abstract:
  Asthma in pregnancy is a health issue of great concern. Physiological changes and drug compliance during pregnancy can affect asthma control in varying degrees, and the control level of asthma and the side effects of asthma medications are closely related to the adverse perinatal outcomes of mother and fetus. This article provides an update on the available literature regarding the alleviating or aggravating mechanism of asthma in pregnancy, diagnosis, disease assessment, and systematic management, to provide a new guidance for physician, obstetric joint doctor, and health care practitioner.


id: cord-327610-cm3vkpcn
title: Virus-Induced Asthma Exacerbations: SIRT1 Targeted Approach
author: Fukuda, Yosuke
date: 2020-08-13
txt: ./txt/cord-327610-cm3vkpcn.txt
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extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9082623
doi: 10.3390/jcm9082623
summary:
  The pathological role of cellular senescence, especially that involving the silent information regulator 2 homolog sirtuin (SIRT) protein family, has recently been demonstrated in stable and exacerbated chronic respiratory disease states. Thus, SIRT1 activators, including resveratrol, may be effective in targeting CXCL8-induced neutrophilic airway inflammation in virus-induced and steroid-resistant asthma exacerbations [58, 59] . These lines of evidence suggest that activation of SIRT1 may lead to suppression of neutrophilic inflammation, possibly through suppression of CXCL8 and may be an effective therapeutic strategy, especially for steroid-resistant virus-induced asthma exacerbations. These results indicated that SIRT1 activation could be a novel therapeutic strategy for virus-induced asthma exacerbations by regulating MMP-9 expression and suppressing airway neutrophilic inflammation and remodeling. These data suggested that SIRT1 activation may ameliorate IgE-mediated airway inflammation in viral-induced asthma exacerbations, whereas the detailed mechanism by which omalizumab blocks IgE is unclear and requires further study.

abstract:
  The prevalence of asthma has increased worldwide. Asthma exacerbations triggered by upper respiratory tract viral infections remain a major clinical problem and account for hospital admissions and time lost from work. Virus-induced asthma exacerbations cause airway inflammation, resulting in worsening asthma and deterioration in the patients’ quality of life, which may require systemic corticosteroid therapy. Despite recent advances in understanding the cellular and molecular mechanisms underlying asthma exacerbations, current therapeutic modalities are inadequate for complete prevention and treatment of these episodes. The pathological role of cellular senescence, especially that involving the silent information regulator 2 homolog sirtuin (SIRT) protein family, has recently been demonstrated in stable and exacerbated chronic respiratory disease states. This review discusses the role of SIRT1 in the pathogenesis of bronchial asthma. It also discusses the role of SIRT1 in inflammatory cells that play an important role in virus-induced asthma exacerbations. Recent studies have hypothesized that SIRT1 is one of major contributors to cellular senescence. SIRT1 levels decrease in Th2 and non-Th2-related airway inflammation, indicating the role of SIRT1 in several endotypes and phenotypes of asthma. Moreover, several models have demonstrated relationships between viral infection and SIRT1. Therefore, targeting SIRT1 is a novel strategy that may be effective for treating virus-induced asthma exacerbations in the future.


id: cord-328918-nc0a77r6
author: Kuczia, Pawel
date: 2020-07-13
txt: ./txt/cord-328918-nc0a77r6.txt
cache: ./cache/cord-328918-nc0a77r6.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s13601-020-00337-8
doi: 10.1186/s13601-020-00337-8
summary:
  title: Citrullinated histone H3, a marker of extracellular trap formation, is increased in blood of stable asthma patients In the present study we have evaluated circulating H3cit in stable asthmatics and investigated its relationship with asthma severity, pulmonary function and selected blood and bronchoalveolar lavage (BAL) biomarkers. We have recently reported evidence of a prothrombotic state in asthma which is characterized by enhanced plasma thrombin formation, impaired clot lysis and platelet activation [13] , all of them related to the low-grade systemic inflammation [3] , endothelial injury [14] , elevated exacerbation rate [15] , and likely increased atherosclerotic risk [16, 17] . In the present study we have demonstrated that serum H3cit, a novel biomarker of ETs formation, is increased in stable asthma subjects. Asthma is characterized by increased circulating H3cit likely related to the enhanced lung ETs formation.

title:
  Citrullinated histone H3, a marker of extracellular trap formation, is increased in blood of stable asthma patients

abstract:
  BACKGROUND: Emerging data indicates that extracellular traps (ETs), structures formed by various immune cell types, may contribute to the pathology of noninfectious inflammatory diseases. Histone hypercitrullination is an important step in ETs formation and citrullinated histone H3 (H3cit) is considered a novel and specific biomarker of that process. In the present study we have evaluated circulating H3cit in stable asthmatics and investigated its relationship with asthma severity, pulmonary function and selected blood and bronchoalveolar lavage (BAL) biomarkers. METHODS: In 60 white adult stable asthmatics and 50 well-matched controls we measured serum levels of H3cit. In asthmatics we also performed bronchoscopy with BAL. We analyzed blood and BAL biomarkers, including interleukin (IL)-4, IL-5, IL-6, IL-10, IL-12p70, IL-17A and interferon γ. For statistical analysis, Mann–Whitney U-test, χ(2) test, one-way ANCOVA, ROC curve analysis and univariate linear regression were applied. Independent determinants of H3cit were established in a multiple linear regression model. RESULTS: Asthma was characterized by elevated circulating H3cit (17.49 [11.25–22.58] vs. 13.66 [8.66–18.87] ng/ml, p = 0.03). In asthmatics positive associations were demonstrated between serum H3cit and lung function variables, including total lung capacity (TLC) (β = 0.37 [95% CI 0.24–0.50]) and residual volume (β = 0.38 [95% CI 0.25–0.51]). H3cit was increased in asthma patients receiving systemic steroids (p = 0.02), as well as in subjects with BAL eosinophilia above 144 cells/ml (p = 0.02). In asthmatics, but not in controls, circulating H3cit correlated well with number of neutrophils (β = 0.31 [95% CI 0.19–0.44]) and monocytes (β = 0.42 [95% CI 0.29–0.55]) in peripheral blood. Furthermore, BAL macrophages, BAL neutrophils, TLC, high-sensitivity C-reactive protein, Il-12p70 and bronchial obstruction degree were independent determinants of H3cit in a multivariate linear regression model. CONCLUSIONS: Asthma is characterized by increased circulating H3cit likely related to the enhanced lung ETs formation. Inhibition of ETs might be a therapeutic option in selected asthma phenotypes, such as neutrophilic asthma.


id: cord-332053-df44guu7
title: The Effect of Viral Infection on Exhaled Nitric Oxide in Children with Acute Asthma Exacerbations
author: Malka, Jonathan
date: 2015-07-26
txt: ./txt/cord-332053-df44guu7.txt
cache: ./cache/cord-332053-df44guu7.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jaip.2015.05.029
doi: 10.1016/j.jaip.2015.05.029
summary:
  The Effect of Viral Infection on Exhaled Nitric Oxide in Children with Acute Asthma Exacerbations Jonathan Malka, MD a,b , Ronina Covar, MD c,d , Anna Faino, MS e , Jennifer Fish, CPNP f , Paige Pickering, BS g , Preveen Ramamoorthy, MD g , Melanie Gleason, PAC b,h , and Joseph D. All patients who presented to the Urgent Care Clinic at National Jewish Health for an acute asthma exacerbation and who had undergone spirometry and FENO measurements within the last 6 months when clinically stable (visit 1) were approached to participate in the study (Figure 1 ). We found FENO levels to be the highest in children with acute asthma exacerbations that were not associated with viral infections [PCR(À)]. B, Change in exhaled nitric oxide levels from baseline, during an exacerbation, and following a course of prednisone in adjusted models.

abstract:
  BACKGROUND: Fraction of exhaled nitric oxide (Feno) level is used as an aid in the diagnosis and management of chronic asthma. Its role in acute asthma remains to be studied. OBJECTIVE: To determine whether Feno levels are elevated in children with asthma exacerbations compared with baseline, and whether there is a difference in Feno levels based on PCR positive (+) (respiratory virus isolated by PCR analysis) versus PCR negative (−) (respiratory virus not isolated by PCR analysis) status. METHODS: Children with a previous Feno level measurement while stable and who presented to an urgent care facility with an asthma exacerbation were enrolled. Feno levels, spirometry, and nasal swabs for viral PCR were obtained at the time of the exacerbation and following a course of prednisone. Data were available on 66 children. Linear mixed models were used to regress the outcomes of interest (FEV(1), FEV(1)/forced vital capacity, forced expiratory flow at 25% to 75% of forced vital capacity, and natural log Feno) on detected virus (yes/no), visit (baseline, exacerbation, follow-up), and the interaction between the detected virus and visit. RESULTS: Compared with baseline, higher Feno values and lower lung function were found at the time of an exacerbation. A respiratory virus was detected in 59% of the exacerbations. The interaction between PCR (+) and PCR (−) groups and visit on log Feno was marginally significant (P = .07). There was no difference in log Feno between the PCR (+) and PCR (−) groups at baseline, while higher log Feno was found in the PCR (−) group at the time of exacerbation and following prednisone (P = .05 and .001, respectively). CONCLUSIONS: Higher Feno concentration in PCR (−) exacerbations suggests an eosinophilic predominance in nonviral compared with viral exacerbations.


id: cord-332298-ig1j5z07
title: Equine Asthma: Current Understanding and Future Directions
author: Couetil, Laurent
date: 2020-07-30
txt: ./txt/cord-332298-ig1j5z07.txt
cache: ./cache/cord-332298-ig1j5z07.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32903600/
doi: 10.3389/fvets.2020.00450
summary:
  In the last few years, the terminology has further evolved with the term equine asthma (EA) now being recommended to describe horses with chronic respiratory signs ranging in severity from mild to severe that were previously referred as inflammatory airway disease and recurrent airway obstruction, respectively (3) . The future development of new portable and sensitive devices for measuring the lung function of horses (forced oscillation or flow interruption techniques), or the discovery of blood biomarkers for EA would help not only to facilitate the diagnosis of mild and moderate forms of EA in clinical practice, but also to possibly identify new phenotypes for these conditions. Qualitative data were gathered through semi-structured focus group discussions designed to capture current practices and opinions relating to the diagnosis and treatment of lower airway inflammation, as well as familiarity with and views on the most recent ACVIM consensus statement (3), in which the term "mild-moderate equine asthma" was recommended.

abstract:
  The 2019 Havemeyer Workshop brought together researchers and clinicians to discuss the latest information on Equine Asthma and provide future research directions. Current clinical and molecular asthma phenotypes and endotypes in humans were discussed and compared to asthma phenotypes in horses. The role of infectious and non-infectious causes of equine asthma, genetic factors and proposed disease pathophysiology were reviewed. Diagnostic limitations were evident by the limited number of tests and biomarkers available to field practitioners. The participants emphasized the need for more accessible, standardized diagnostics that would help identify specific phenotypes and endotypes in order to create more targeted treatments or management strategies. One important outcome of the workshop was the creation of the Equine Asthma Group that will facilitate communication between veterinary practice and research communities through published and easily accessible guidelines and foster research collaboration.


id: cord-332737-iclruwmx
author: Webley, Wilmore C.
date: 2017-05-19
txt: ./txt/cord-332737-iclruwmx.txt
cache: ./cache/cord-332737-iclruwmx.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s12931-017-0584-z
doi: 10.1186/s12931-017-0584-z
summary:
  Another recent study concluded that the nasopharyngeal microbiome within the first year of life was a determinant for infection spread to the lower airways and predicted the severity of accompanying inflammatory symptoms, as well as risk for future asthma development. Factors that predict risk in non-asthmatics for developing the "infectious asthma" syndrome include a previous history of self-limited lower respiratory tract illnesses such as acute bronchitis (often with wheezing) and/or pneumonia [35, 38, 39] . A 2013 metaanalysis of 12 randomized, controlled trials (RCTs) of macrolides for the long term management of asthma in both adults and children found positive effects on peak expiratory flow rate (PEFRa measure of pulmonary function), asthma symptoms, asthma quality of life (AQL), and airway hyper responsiveness (AHR), but not on forced expiratory flow rate in 1 s (FEV1) [77] .

title:
  Infection-mediated asthma: etiology, mechanisms and treatment options, with focus on Chlamydia pneumoniae and macrolides

abstract:
  Asthma is a chronic respiratory disease characterized by reversible airway obstruction and airway hyperresponsiveness to non-specific bronchoconstriction agonists as the primary underlying pathophysiology. The worldwide incidence of asthma has increased dramatically in the last 40 years. According to World Health Organization (WHO) estimates, over 300 million children and adults worldwide currently suffer from this incurable disease and 255,000 die from the disease each year. It is now well accepted that asthma is a heterogeneous syndrome and many clinical subtypes have been described. Viral infections such as respiratory syncytial virus (RSV) and human rhinovirus (hRV) have been implicated in asthma exacerbation in children because of their ability to cause severe airway inflammation and wheezing. Infections with atypical bacteria also appear to play a role in the induction and exacerbation of asthma in both children and adults. Recent studies confirm the existence of an infectious asthma etiology mediated by Chlamydia pneumoniae (CP) and possibly by other viral, bacterial and fungal microbes. It is also likely that early-life infections with microbes such as CP could lead to alterations in the lung microbiome that significantly affect asthma risk and treatment outcomes. These infectious microbes may exacerbate the symptoms of established chronic asthma and may even contribute to the initial development of the clinical onset of the disease. It is now becoming more widely accepted that patterns of airway inflammation differ based on the trigger responsible for asthma initiation and exacerbation. Therefore, a better understanding of asthma subtypes is now being explored more aggressively, not only to decipher pathophysiologic mechanisms but also to select treatment and guide prognoses. This review will explore infection-mediated asthma with special emphasis on the protean manifestations of CP lung infection, clinical characteristics of infection-mediated asthma, mechanisms involved and antibiotic treatment outcomes.


id: cord-333175-klnxnxwm
title: Asthma in COVID-19 patients: An extra chain fitting around the neck?
author: Hussein, Mohammad H.
date: 2020-11-11
txt: ./txt/cord-333175-klnxnxwm.txt
cache: ./cache/cord-333175-klnxnxwm.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0954611120303450?v=s5
doi: 10.1016/j.rmed.2020.106205
summary:
  Currently, the CDC reports that asthma is present in about 17% of hospitalized COVID-19 patients, making it the fourth most prevalent comorbidity behind hypertension, obesity, and diabetes [4] . Obese and diabetic patients have been categorized as high-risk, but there is still limited data regarding the impact of bronchial asthma on COVID-19 outcomes [5] . Univariate analysis of COVID-19 outcomes revealed that asthma was significantly associated with higher rate of endotracheal intubation (40.3% vs 27.8%, p = 0.036), mechanical ventilation (both invasive and non-invasive) (70.7% vs 52.2%, p = 0.039), and longer hospital length of stay (15.14 ± 12.48 days vs 11.51 ± 10.58 days, p = 0.015). Asthma was not associated with a higher rate of Intensive Care Unit (ICU) admission (22.2% vs 14.9%, p = 0.12), acute respiratory distress syndrome (37.5% vs 30.9%, p = 0.27), or death (9.7% vs 13.5%, p = 0.45) among COVID-19 patients.

abstract:
  INTRODUCTION: The novel coronavirus disease 2019 (COVID-19) has rapidly spread across the globe. Pre-existing comorbidities have been found to have a dramatic effect on the disease course. We sought to analyze the effect of asthma on the disease progression and outcomes of COVID-19 patients. METHODS: We conducted a multi-center retrospective study of positively confirmed COVID-19 patients. The primary outcome of interest was in-hospital mortality. Secondary outcomes were the Intensive Care Unit (ICU) admission, intubation, mechanical ventilation, and length of hospital stay. RESULTS: A total of 502 COVID-19 adult patients (72 asthma and 430 non-asthma cohorts) with mean age of 60.7 years were included in the study. The frequency of asthma in hospitalized cohorts was 14.3%. Univariate analysis revealed that asthma patients were more likely to be obese (75% versus 54.2%, p = 0.001), with a higher frequency of intubation (40.3% versus 27.8%, p = 0.036), and required a longer duration of hospitalization (15.1 ± 12.5 versus 11.5 ± 10.6, p = 0.015). After adjustment, multivariable analysis showed that asthmatic patients were not associated with higher risk of ICU admission (OR = 1.81, 95%CI = 0.98–3.09, p = 0.06), endotracheal intubation (OR = 1.77, 95%CI = 0.99–3.04, p = 0.06) or complications (OR = 1.37, 95%CI = 0.82–2.31, p = 0.23). Asthmatic patients were not associated with higher odds of prolonged hospital length of stay (OR = 1.48, 95%CI = 0.82–2.66, p = 0.20) or with ICU stay (OR = 0.76, 95%CI = 0.28–2.02, p = 0.58). Kaplan-Meier curve showed no significant difference in the overall survival of the two groups (p = 0.65). CONCLUSION: Despite the increased prevalence of hospitalization in elder asthmatic COVID-19 patients, after adjustment for other variables, it was neither associated with increased severity nor worse outcomes.


id: cord-336562-5qmzne98
title: Pediatric pulmonology year in review 2016: Part 2
author: Auten, Richard
date: 2017-04-25
txt: ./txt/cord-336562-5qmzne98.txt
cache: ./cache/cord-336562-5qmzne98.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/ppul.23719
doi: 10.1002/ppul.23719
summary:
  The ability to obtain tidal breathing measurements may lead to new insights into changes in chest and abdominal motion in pediatric respiratory disease. 47 Acute viral bronchiolitis, due to RSV and other pathogens, continues to have a major impact worldwide on childhood mortality and hospital admissions, 51 is associated with subsequent asthma and allergy risk, 52 and could be increasing in incidence. 57 Flores et al 58 conducted a randomized clinical trial comparing 3% hypertonic saline to normal saline in previously healthy infants hospitalized with mild-to-moderate acute viral bronchiolitis. Thus, the study does not support the use of nebulized hypertonic saline over normal saline in therapy of hospitalized children with mild-to-moderate acute viral bronchiolitis. Association between trafficrelated air pollution and asthma in preschool children in a national Japanese nested case-control study Changes in lung function measured by spirometry and the forced oscillation technique in cystic fibrosis patients undergoing treatment for respiratory tract exacerbation

abstract:
  Pediatric Pulmonology continues to publish research and clinical topics related to the entire range of children's respiratory disorders. As we have done annually in recent years, we here summarize some of the past year's publications in our major topic areas, as well as selected literature in these areas from other core journals relevant to our discipline. This review (Part 2) covers selected articles on neonatology, asthma, physiology and lung function testing, and infectious diseases.


id: cord-339578-eg19rfvi
title: Role of viral coinfections in asthma development
author: Garcia-Garcia, Maria Luz
date: 2017-12-05
txt: ./txt/cord-339578-eg19rfvi.txt
cache: ./cache/cord-339578-eg19rfvi.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/29206851/
doi: 10.1371/journal.pone.0189083
summary:
  OBJECTIVE: Our aim was to compare the frequency of asthma development at 6–8 years in children with previous admission for bronchiolitis associated with single versus double or multiple viral infection. CONCLUSIONS: Asthma at 6–8 years is more frequent and severe in those children previously hospitalized with viral coinfection-bronchiolitis compared with those with single infection. Of the 351 children previously admitted with bronchiolitis, with positive viral detection and current age between 6 and 8 years, 244 (52 coinfections and 192 single infections) could be located and agreed to participate in the study. In conclusion, asthma at the age of 6-8 is more frequent and severe in those children previously hospitalized with viral coinfection bronchiolitis compared with those with single infection. Moreover, viral coinfection, allergic rhinitis and older age at admission seem also to be strong independent risk factors for asthma development in children previously hospitalised because of bronchiolitis.

abstract:
  BACKGROUND: Viral respiratory infections, especially acute bronchiolitis, play a key role in the development of asthma in childhood. However, most studies have focused on respiratory syncytial virus or rhinovirus infections and none of them have compared the long-term evolution of single versus double or multiple viral infections. OBJECTIVE: Our aim was to compare the frequency of asthma development at 6–8 years in children with previous admission for bronchiolitis associated with single versus double or multiple viral infection. PATIENTS & METHODS: A cross-sectional study was performed in 244 children currently aged 6–8 years, previously admitted due to bronchiolitis between September 2008 and December 2011. A structured clinical interview and the ISAAC questionnaire for asthma symptoms for 6-7-year-old children, were answered by parents by telephone. Specimens of nasopharyngeal aspirate for virological study (polymerase chain reaction) and clinical data were prospectively taken during admission for bronchiolitis. RESULTS: Median current age at follow-up was 7.3 years (IQR: 6.7–8.1). The rate of recurrent wheezing was 82.7% in the coinfection group and 69.7% in the single-infection group, p = 0.06. The number of wheezing-related admissions was twice as high in coinfections than in single infections, p = 0.004. Regarding the ISAAC questionnaire, 30.8% of coinfections versus 15% of single infections, p = 0.01, presented “wheezing in the last 12 months”, data that strongly correlate with current prevalence of asthma. “Dry cough at night” was also reported more frequently in coinfections than in single infections, p = 0.02. The strongest independent risk factors for asthma at 6–8 years of age were: age > 9 months at admission for bronchiolitis (OR: 3.484; CI95%: 1.459–8.317, p:0.005), allergic rhinitis (OR: 5.910; 95%CI: 2.622–13.318, p<0.001), and viral coinfection-bronchiolitis (OR: 3.374; CI95%: 1.542–7.386, p:0.01). CONCLUSIONS: Asthma at 6–8 years is more frequent and severe in those children previously hospitalized with viral coinfection-bronchiolitis compared with those with single infection. Allergic rhinitis and older age at admission seem also to be strong independent risk factors for asthma development in children previously hospitalised because of bronchiolitis.


id: cord-340583-kjrxrk50
title: Asthma and COVID‐19 in children – a systematic review and call for data
author: Castro‐Rodriguez, Jose A.
date: 2020-06-18
txt: ./txt/cord-340583-kjrxrk50.txt
cache: ./cache/cord-340583-kjrxrk50.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/ppul.24909
doi: 10.1002/ppul.24909
summary:
  Importantly, none of the largest epidemiological studies including children with COVID-19 reported clinical findings or underlying characteristics to help assess whether asthma -or other chronic lung diseases-constitutes a risk factor for SARS-CoV-2 infection or COVID-19 severity. Rather than a risk factor, a recent review of data in adults reported that both asthma and COPD appear to be under-represented in the comorbidities reported for patients with COVID-19, compared with global estimates of prevalence for these conditions in the general population (63) . After an extensive review of the current literature, only two reports included information on asthma as a potential risk factor for COVID-19 infection -but not severity or mortality-in children. However, the largest studies to date have been limited to a description of the number of cases by age group, and so it remains unclear whether childhood asthma -or other pediatric respiratory diseases-are associated with COVID-19 risk or severity.

abstract:
  RATIONALE: Whether asthma constitutes a risk factor for COVID‐19 is unclear. Here we aimed to assess whether asthma, the most common chronic disease in children, is associated with higher COVID‐19 risk or severity in pediatric populations. METHODS: We performed a systematic literature search in three stages: First, we reviewed PubMed, EMBASE and CINAHL for systematic reviews of SARS‐CoV‐2 and COVID‐19 in pediatric populations, and reviewed their primary articles; second, we searched PubMed for studies on COVID‐19 or SARS‐CoV‐2 and asthma/wheeze, and evaluated whether the resulting studies included pediatric populations; third, we repeated the second search in BioRxiv.org and MedRxiv.org to find pre‐prints that may have information on pediatric asthma. RESULTS: In the first search, eight systematic reviews were found, of which five were done in pediatric populations; none of the 67 primary studies included data on pediatric asthma as a comorbidity for COVID‐19. In the second search, we found 34 results in PubMed, of which five reported asthma in adults, but none included data on children. In the third search, 25 pre‐prints in MedRxiv included data on asthma, but none on children. We found one report by the U.S. CDC stating that 40/345 (~11.5%) children with data on chronic conditions had “chronic lung diseases including asthma”, and one from a tertiary hospital in New York that reported asthma in 11/46 (~23.9%) children hospitalized for COVID‐19. CONCLUSION: There is scarcely any data on whether childhood asthma (or other pediatric respiratory diseases) constitute risk factors for SARS‐CoV‐2 infection or COVID‐19 severity. Studies are needed that go beyond counting the number of cases in the pediatric age range. This article is protected by copyright. All rights reserved.


id: cord-342464-6vk2oxo5
title: The microbiology of asthma
author: Edwards, Michael R.
date: 2012-06-06
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url: https://doi.org/10.1038/nrmicro2801
doi: 10.1038/nrmicro2801
summary:
  The hygiene hypothesis posits that repeated exposure to diverse common infections (in particular, with bacteria, food-borne and oro faecal parasites 4 , and hookworms 5 ) and exposure to environmental microbiota during childhood 6, 7 are strongly associated with a healthy maturation of the immune system and with protection from the development of asthma and allergies later in life 8, 9 . Case control studies show a clear link between respiratory virus infection together with allergen exposure in sensitized children 108 and adults 109 in increasing the risk of hospital admissions due to asthma exacerbations. 5. Excessive T H 2 type responses are implicated in the pathogenesis of RSV-mediated bronchiolitis 110 , and increased production of IL-5 by T cells at birth is associated with a greater risk of severe respiratory infection 111 .

abstract:
  Asthma remains an important human disease that is responsible for substantial worldwide morbidity and mortality. The causes of asthma are multifactorial and include a complex mix of environmental, immunological and host genetic factors. In addition, epidemiological studies show strong associations between asthma and infection with respiratory pathogens, including common respiratory viruses such as rhinoviruses, human respiratory syncytial virus, adenoviruses, coronaviruses and influenza viruses, as well as bacteria (including atypical bacteria) and fungi. In this Review, we describe the many roles of microorganisms in the risk of developing asthma and in the pathogenesis of and protection against the disease, and we discuss the mechanisms by which infections affect the severity and prevalence of asthma.


id: cord-346253-0mnsm6s4
title: Respiratory viral infections in children with asthma: do they matter and can we prevent them?
author: Ahanchian, Hamid
date: 2012-09-13
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url: https://doi.org/10.1186/1471-2431-12-147
doi: 10.1186/1471-2431-12-147
summary:
  HRV are the most common viral agents [33] ; Other respiratory tract viruses detected in children with an asthma exacerbation include RSV, influenza, coronavirus, hMPV, parainfluenza virus, adenovirus, and bocavirus [34] [35] [36] . Beside importance for bone health, vitamin D plays an important role in adequate function of both the innate and adaptive immune systems including development of dendritic cells and regulatory T lymphocytes [151, 152] production of antimicrobial proteins by airway epithelium [153] , modifying the effect of intestinal flora on inflammatory disorders [107] , and modulation of the inflammatory response to viral infections [154] . In a recent study of 48 children from five to 18 years of age, with newly diagnosed asthma, vitamin D supplementation during the northern hemisphere winter months (September to July) prevented declining serum concentrations of 25(OH) D and reduced the risk of asthma exacerbation triggered by acute respiratory tract infections [161] .

abstract:
  BACKGROUND: Asthma is a major public health problem with a huge social and economic burden affecting 300 million people worldwide. Viral respiratory infections are the major cause of acute asthma exacerbations and may contribute to asthma inception in high risk young children with susceptible genetic background. Acute exacerbations are associated with decreased lung growth or accelerated loss of lung function and, as such, add substantially to both the cost and morbidity associated with asthma. DISCUSSION: While the importance of preventing viral infection is well established, preventive strategies have not been well explored. Good personal hygiene, hand-washing and avoidance of cigarette smoke are likely to reduce respiratory viral infections. Eating a healthy balanced diet, active probiotic supplements and bacterial-derived products, such as OM-85, may reduce recurrent infections in susceptible children. There are no practical anti-viral therapies currently available that are suitable for widespread use. SUMMARY: Hand hygiene is the best measure to prevent the common cold. A healthy balanced diet, active probiotic supplements and immunostimulant OM-85 may reduce recurrent infections in asthmatic children.


id: cord-346751-x3gd19kq
title: Air Pollution and Asthma: Critical Targets for Effective Action
author: Kelly, Frank J.
date: 2020-11-08
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url: https://doi.org/10.1007/s41030-020-00138-1
doi: 10.1007/s41030-020-00138-1
summary:
  There is now consistent evidence that exposure to traffic-related air pollution (TRAP; particularly nitrogen dioxide [NO 2 ]) is associated with an increased risk of developing asthma across the entire life course, and evidence is accumulating for a link between poor indoor air quality and new cases [5, 6] . However, whilst largescale LEZs can deliver improvements in urban air quality, data suggest that, at least in densely populated European cities, more ambitious schemes are required to meet legislative limits and deliver improvements to childhood respiratory health, including asthma symptoms [35] . The introduction and rigorous evaluation of zones with greater reductions in pollutant concentrations are clearly warranted and may benefit from adjuvant clean air zones that introduce no vehicle idling areas, minimise congestion and support active and low-emission travel through the integration of public transport networks, including park-and-ride schemes.

abstract:
  Evidence to advocate for cleaner air for people with asthma is not in short supply. We know that air pollution is associated with the development and worsening of the condition and that mitigating interventions can improve respiratory outcomes. We have clear targets, particularly traffic emissions, especially in urban areas, and plenty of potentially effective actions. Road traffic must be reduced, and what remains should be cleaner and greener. Urban green spaces, safe cycle networks and wider pavements will promote active travel and leisure time exercise. Healthcare professionals must ensure people are aware of their air quality, its impact on asthma and the appropriate behaviour to safeguard health. What remains are realistic policies and effective measures, based on the correct scientific evidence, to be taken forth with political courage and investment so that air pollution no longer contributes to the development or worsening of respiratory ill health.


id: cord-351129-lzzyn570
title: Management of Allergic Patients During the COVID-19 Pandemic in Asia
author: Lee, Jae-Hyun
date: 2020-06-15
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url: https://doi.org/10.4168/aair.2020.12.5.783
doi: 10.4168/aair.2020.12.5.783
summary:
  For allergic patients who have been followed up at an allergy clinic in our region, it is recommended that they (patients with asthma, rhinitis, atopic dermatitis or chronic urticaria) continue to receive maintenance therapy and be in a well-controlled status. It was reported that none of the 140 patients who were hospitalized due to confirmed COVID-19 in Wuhan, China had asthma or other allergic diseases such as AR, atopic dermatitis (AD) and food allergy. The Allergic Rhinitis and its Impact on Asthma (ARIA)-European Academy of Allergology and Clinical Immunology (EAACI) mentioned that patients with common allergic conditions do not develop additional distinct symptoms or seem to be at increased risk of severe disease when infected with COVID-19.

abstract:
  Although a viral infection is a major triggering factor of asthma and allergic diseases, asthma is suggested to be not a predisposing condition for coronavirus disease 2019 (COVID-19) infection. However, patients with severe asthma/allergic disease requiring systemic corticosteroids or immunosuppressive agents may be at higher risk of more severe clinical course of this infectious disease. For allergic patients who have been followed up at an allergy clinic in our region, it is recommended that they (patients with asthma, rhinitis, atopic dermatitis or chronic urticaria) continue to receive maintenance therapy and be in a well-controlled status. Patients who have used biologics (currently available for targeting type 2 inflammation) and allergen immunotherapy should continue the treatment while minimizing hospital and face-to-face visits. It is essential to wear protective equipment for the protection of health care workers as well as patients. We report this consensus to support allergists and clinical immunologists to make optimal decisions under the urgent situation in Asia.


id: cord-351565-ryjxbqno
title: Bronchial hyperresponsiveness and cytokines in virus‐induced asthma exacerbations
author: Johnston, S. L.
date: 2006-04-27
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url: https://www.ncbi.nlm.nih.gov/pubmed/9117884/
doi: 10.1111/j.1365-2222.1997.tb00666.x
abstract: nan
summary:
  In recent years studies employing new sensitive molecular methods of identification for the most common upper respiratory tract viruses (coronavirus and rhinovirus) have demonstrated that viral infections are associated with the majority of asthma exacerbations in children and adults in the community [1, 2] . In this issue of the journal a further detailed study employing experimental rhinovirus infection reports on both these aspects, demonstrating that bronchial hyperreactivity is induced and that IL-8 may play a role in the induction of bronchial hyperreactivity and therefore possibly in exacerbations of asthma [9] . In this study atopic asthmatic subjects were challenged with rhinovirus 16 or placebo and the severity of the cold and asthma symptoms monitored along with bronchial hyperreactivity, pulmonary function, nasal lavage IL-8 levels and peripheral blood lymphocyte and neutrophil counts.


