August 31, 2014

Preterm birth, infant weight gain, and childhood asthma risk: A meta-analysis of 147,000 European children

J Allergy Clin Immunol. May 2014; 133(5): 1317–1329.
PMCID: PMC4024198

Preterm birth, infant weight gain, and childhood asthma risk: A meta-analysis of 147,000 European children

Agnes M.M. Sonnenschein-van der Voort, PhD,a,b,c Lidia R. Arends, PhD,d,e,f Johan C. de Jongste, MD, PhD,c Isabella Annesi-Maesano, MD, PhD,g,h S. Hasan Arshad, DM,i Henrique Barros, MD, PhD,j Mikel Basterrechea, MD,k,l Hans Bisgaard, MD, DMSci,m,n Leda Chatzi, MD, PhD,o Eva Corpeleijn, PhD,p Sofia Correia, PharmD, MSc,j Leone C. Craig, MD, PhD,q Graham Devereux, MD, PhD,q Cristian Dogaru, MD, PhD,r Miroslav Dostal, MD, DSc,s Karel Duchen, MD,tMerete Eggesbø, MD, PhD,u C. Kors van der Ent, MD, PhD,v Maria P. Fantini, MD,w Francesco Forastiere, MD, PhD,xUrs Frey, MD, PhD,y Ulrike Gehring, PhD,z Davide Gori, MD,w Anne C. van der Gugten, MD, PhD,v Wojciech Hanke, MD, PhD,aa A. John Henderson, MD, PhD,bb Barbara Heude, PhD,cc,dd Carmen Iñiguez, PhD,l,ee,ff Hazel M. Inskip, MSc, PhD,gg Thomas Keil, MD, MScPH,hh,ii Cecily C. Kelleher, MD, MPH,jj Manolis Kogevinas, MD, PhD,kk Eskil Kreiner-Møller, MD,m,n Claudia E. Kuehni, MD, PhD,r Leanne K. Küpers, MSc,p Kinga Lancz, PhD,ll Pernille S. Larsen, MSc,mm Susanne Lau, MD, PhD,nn Johnny Ludvigsson, MD, PhD,t Monique Mommers, PhD,oo Anne-Marie Nybo Andersen, MD, PhD,mm Lubica Palkovicova, MD, PhD,ll Katharine C. Pike, MD, PhD,pp Costanza Pizzi, MSc,qq Kinga Polanska, PhD,aa Daniela Porta, MSc,x Lorenzo Richiardi, MD, PhD,qq Graham Roberts, DM,i Anne Schmidt, MD,rrRadim J. Sram, MD, DSc,s Jordi Sunyer, MD, PhD,l,ss,tt,uu Carel Thijs, MD, PhD,oo Maties Torrent, MD, PhD,vv Karien Viljoen, MBChB, MSc,jj Alet H. Wijga, PhD,ww Martine Vrijheid, PhD,l,ss,tt Vincent W.V. Jaddoe, MD, PhD,a,b,xx andLiesbeth Duijts, MD, PhDb,c,yy,*

Classification of childhood asthma phenotypes and long-term clinical responses to inhaled anti-inflammatory medications

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J Allergy Clin Immunol. Author manuscript; available in PMC Jun 6, 2014.
Published in final edited form as:
J Allergy Clin Immunol. May 2014; 133(5): 1289–130112.
PMCID: PMC4047642
NIHMSID: NIHMS579247
Judie A. Howrylak, MD,a Anne L. Fuhlbrigge, MD,b,c,d Robert C. Strunk, MD,e Robert S. Zeiger, MD,f Scott T. Weiss, MD,b,c,d and Benjamin A. Raby, MDb,c,d, for the Childhood Asthma Management Program Research Group*

Abstract

Background

Although recent studies have identified the presence of phenotypic clusters in asthmatic patients, the clinical significance and temporal stability of these clusters have not been explored.

Objective

Our aim was to examine the clinical relevance and temporal stability of phenotypic clusters in children with asthma.

Methods

We applied spectral clustering to clinical data from 1041 children with asthma participating in the Childhood Asthma Management Program. Posttreatment randomization follow-up data collected over 48 months were used to determine the effect of these clusters on pulmonary function and treatment response to inhaled anti-inflammatory medication.

Results

We found 5 reproducible patient clusters that could be differentiated on the basis of 3 groups of features: atopic burden, degree of airway obstruction, and history of exacerbation. Cluster grouping predicted long-term asthma control, as measured by the need for oral prednisone (P < .0001) or additional controller medications (P = .001), as well as longitudinal differences in pulmonary function (P < .0001). We also found that the 2 clusters with the highest rates of exacerbation had different responses to inhaled corticosteroids when compared with the other clusters. One cluster demonstrated a positive response to both budesonide (P = .02) and nedocromil (P = .01) compared with placebo, whereas the other cluster demonstrated minimal responses to both budesonide (P = .12) and nedocromil (P = .56) compared with placebo.

Conclusion

Phenotypic clustering can be used to identify longitudinally consistent and clinically relevant patient subgroups, with implications for targeted therapeutic strategies and clinical trials design.
Keywords: Childhood asthma, asthma phenotypes, inhaled corticosteroids, cluster analysis, asthma classification, longitudinal study

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Toll-Like Receptors Required for Dermatophagoides farinae to Activate NF-κB

J-STAGE Home  >  Publications - Top  > Bibliographic Information

Biological and Pharmaceutical Bulletin
Vol. 37 (2014) No. 1 p. 74-80

http://dx.doi.org/10.1248/bpb.b13-00595
 
DN/JST.JSTAGE/bpb/b13-00595
Regular Articles
Copyright © 2014 The Pharmaceutical Society of Japan

August 29, 2014

Prostaglandin E2 receptors in asthma and in chronic rhinosinusitis/nasal polyps with and without aspirin hypersensitivity

Review

Open AccessLiliana Machado-Carvalho123*, Jordi Roca-Ferrer123 and César Picado123

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Abstract (provisional)

Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma frequently coexist and are always present in patients with aspirin exacerbated respiratory disease (AERD). Although the pathogenic mechanisms of this condition are still unknown, AERD may be due, at least in part, to an imbalance in eicosanoid metabolism (increased production of cysteinyl leukotrienes (CysLTs) and reduced biosynthesis of prostaglandin (PG) E2), possibly increasing and perpetuating the process of inflammation. PGE2 results from the metabolism of arachidonic acid (AA) by cyclooxygenase (COX) enzymes, and seems to play a central role in homeostasis maintenance and inflammatory response modulation in airways. Therefore, the abnormal regulation of PGE2 could contribute to the exacerbated processes observed in AERD. PGE2 exerts its actions through four G-protein-coupled receptors designated E-prostanoid (EP) receptors EP1, EP2, EP3, and EP4. Altered PGE2 production as well as differential EP receptor expression has been reported in both upper and lower airways of patients with AERD. Since the heterogeneity of these receptors is the key for the multiple biological effects of PGE2 this review focuses on the studies available to elucidate the importance of these receptors in inflammatory airway diseases.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.


Tattoo-Associated Skin Reaction: The Importance of an Early Diagnosis and Proper Treatment




Biomed Res Int. 2014; 2014: 354608.
Published online Jul 23, 2014. doi:  10.1155/2014/354608
PMCID: PMC4132403

Abstract

Tattoo is going to be a very common practice especially among young people and we are witnessing a gradual increase of numerous potential complications to tattoo placement which are often seen by physicians, but generally unknown to the public. The most common skin reactions to tattoo include a transient acute inflammatory reaction due to trauma of the skin with needles and medical complications such as superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis, granulomatous and lichenoid reactions, and skin diseases localized on tattooed area (eczema, psoriasis, lichen, and morphea). Next to these inflammatory skin reactions we have to consider also the possibility of the development of cutaneous conditions such as pseudolymphomatous reactions and pseudoepitheliomatous hyperplasia. The aim of this study is to underline the importance of an early diagnosis by performing a histological examination especially when we are in front of suspected papulonodular lesions arising from a tattoo, followed by a proper treatment, since cutaneous neoplastic evolution is known to be a rare but possible complication.
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Food allergy training event for restaurant staff; a pilot evaluation

Brief communication


Open AccessSamuel BaileyTiffany Billmeier KindrattHelen Smith and David Reading
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Clinical and Translational Allergy 2014, 4:26  doi:10.1186/2045-7022-4-26
Published: 28 August 2014

Abstract (provisional)

A previous cross-sectional survey highlighted that restaurant staff in Brighton had gaps in their knowledge of food allergy, which could lead to the provision of unsafe meals to food-allergic customers. A food allergy training event was developed by a multi-disciplinary team (health service researcher, clinician, teacher and patient group representative) to equip restaurant staff with the knowledge and skills necessary to safely serve food-allergic customers. This evaluation summarises the training event's impact on participants' knowledge of food allergy and their satisfaction with the event.No attendee had previously attended any formal training on food allergy. The percentage of participants who answered all true-false questions correctly increased from 82% before the training event to 91% afterwards. The percentage of participants who were able to name at least three common allergens increased from 9% to 64%. Both quantitative and qualitative feedback was positive.Restaurant staff require a good understanding of food allergy to ensure that food-allergic customers are kept safe, and their restaurants operate within the law. This food allergy training event improved participants' absolute knowledge of food allergy, and attendees changed practise. Recommendations are made which could improve the impact and uptake of future food allergy training events.

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