Search

Chang-Hung Kuo,1,2 Mei-Lan Tsai,3 Chung-Hsiang Li,2,4 Hui-Pin Hsiao,4 Mei-Chyn Chao,4 Ming-Sheng Lee,4 Yi-Ching Lin,5– 8 Chih-Hsing Hung3,4,9 1Ta-Kuo Clinic, Kaohsiung, Taiwan; 2Department of Pediatrics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; 3Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 4Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; 5Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; 6Department of Laboratory Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 7Ph.D. Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; 8Substance and Behavior Addiction Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; 9Department of Pediatrics, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, TaiwanCorrespondence: Chih-Hsing HungDepartment of Pediatrics, Kaohsiung Municipal Hsiao-Kang Hospital, No. 482, Shanming Road, Siaogang District, Kaohsiung, 812, TaiwanTel +886-7-3121101-6506Fax +886-7-3213931Email pedhung@gmail.comPurpose: Asthma causes a substantial morbidity and mortality burden in children and the pathogenesis of childhood asthma is not completely understood. Macrophages are heterogeneous with divergent M1/M2 polarization phenotypes in response to various stimulations during the inflammatory process. We aimed to investigate the pattern of macrophage polarization and its association with severity and exacerbation in asthmatic children.Patients and Methods: Normal and asthmatic children aged 4– 18 years were enrolled for 12 months. Children with asthma were further subgrouped according to their severity and the requirement for hospitalization during exacerbations. Clinical data were obtained from medical records. Peripheral blood samples were collected to analyze macrophage polarization, including M1, M2, and subsets, by flow cytometry.Results: Fifty-one asthmatic cases and 27 normal controls were included in this study. The level of PM-2K+CD14+ but not PM-2K+CD14− was decreased in asthmatic children. The levels of M2a (CCR7−CXCR1+), M2b (CCR7−CD86+), and M2c (CCR7−CCR2+) subsets, but not M1 (CCR7+CD86+), were increased in asthmatic children. The levels of M1 were decreased, but the levels of M2c were increased, in children with moderate asthma compared to those with mild asthma. The levels of PM-2K+CD14+ cells and M1 subsets were decreased, but the M2c subset cells were increased in asthmatic children requiring hospitalization during exacerbations.Conclusion: Macrophage polarization may be involved in the pathogenesis of childhood asthma and is a potential biomarker of childhood asthma disease severity.Keywords: M2 macrophage polarization, asthma severity, asthma exacerbation, childhood asthma hospitalization

Introduction: The role of family support in the care of vulnerable children is rarely discussed, yet has a major impact on family health. How family members’ perceptions of their own health affect their vulnerable children has not been previously explored. Purpose: The objectives of the study were to assess and compare the health status of perception using the Duke Health Profile (DUKE) and perceptions family support using the family APGAR (FAPGAR) across groups-families of children with muscular dystrophy, attention deficit hyperactivity disorders (ADHD), and chromosomal abnormality (Turner syndrome or Klinefelter syndrome, TS/KS). Methods: The participants of the study were 286 from three cross-sectional studies from a southern medical hospital in Taiwan. Results: This manuscript investigated the relationship between families’ perception of health and support in the care of vulnerable children with DMD/SMA, ADHD, or TS/KS. By using multiple comparison, correlation and regression analysis, the authors reported that Duke Health Profile was significantly correlated with family support. Additionally, social health, age, marital status, and vulnerable status as predictors accounted for 35.3% of the variance in family support. Discussion: Data suggest the efficacy to care for families of children as show in the DMD/SMA group, compared to ADHD and chromosome abnormality groups. The authors indicate that family support is critical in the care of vulnerable children. This study did provide some new information in the related field.