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Background: Asthmatic children present variable degrees of airway inflammation, remodeling, and resistance, which correlate with disease control and severity. The chronic inflammatory process of the airway triggers airway remodeling, which reflects the degree of airway resistance. Pro-inflammatory and pro-fibrotic mediators are centrally involved in this process. Objective: To investigate whether the levels of pulmonary and systemic pro-inflammatory and pro-fibrotic mediators present a correlation with the resistance of the respiratory system and of the proximal and distal airways. Methods: 39 Asthmatic children (persistent mild and moderate) and 39 non-asthmatic children (both between 6 and 13 years old) were evaluated for anthropometric characteristics, lung function and mechanics, and pulmonary and systemic immune responses. Results: Asthmatic children showed an increased number of blood eosinophils (p < 0.04), basophils (p < 0.04), monocytes (p < 0.002) and lymphocytes (p < 0.03). In addition, asthmatic children showed impaired lung function, as demonstrated by FEV1 (p < 0.0005) and FEV1/FVC (p < 0.004), decreased total resistance of the respiratory system (R5Hz; p < 0.009), increased resistance of the proximal airways (R20Hz; p < 0.02), increased elastance (Z5Hz; p < 0.02) and increased reactance (X5Hz; p < 0.002) compared to non-asthmatic children. Moreover, the following inflammatory factors were significantly higher in asthmatic than non-asthmatic children: GM-CSF in the breath condensate (BC) (p < 0.0001) and in the serum (p < 0.0001); TGF-beta in the BC (p < 0.0001) and in the serum (p < 0.004); IL-5 in the BC (p < 0.02) and in the serum (p < 0.01); IL-4 in the serum (p < 0.0002). Conclusions: Impulse oscillometry is a sensitive method to detect airway resistance in persistent mild and moderate asthmatic children, an event followed by increased levels of pro-inflammatory and pro-fibrotic mediators. [ABSTRACT FROM AUTHOR]

Background: Trace elements are essential micronutrients found in the body in extremely small amounts. The generation of free radicals may be linked to trace element deficiencies and is known to cause damage to cells and tissues. They are assumed to have a role in the etiology of numerous diseases, including bronchial asthma. Zinc (Zn), copper (Cu), and magnesium (Mg) are necessary for antioxidant enzymes and therefore for the optimal functioning of the immune system. Changes in trace elements level decrease the efficacy of these antioxidant enzymes and lead to hyperactivity and inflammation of the respiratory tract. Aim: To find the relationship between serum level of zinc, copper and magnesium and severity of bronchial asthma in children (who are subdivided into intermittent, mild persistent, moderate persistent and severe persistent). Methods: This case-control study was conducted on 124 children at the Pediatric Pulmonology Outpatient Clinic of the Faculty of Medicine, Zagazig University. The children were divided into two groups. Group A comprised 62 children diagnosed with bronchial asthma. We subsequently subdivided this group into four subgroups according to asthma severity: intermittent, mild persistent, moderate persistent and severe persistent. Group B comprised 62 clinically healthy controls. The serum levels of Zn, Cu, and Mg were measured by Atomic Absorption Spectrophotometer and pulmonary function tests were done to studied groups. Results: Compared to the control group, the asthmatic group had significantly lower serum levels of Zn and Mg and higher levels of Cu. There was significant relation between asthma severity and serum level of Zn and Mg. The severe persistent subgroup had significantly lower levels of Zn and Mg than the intermittent and mild persistent subgroups. Serum copper showed no significant correlation with asthma severity. Conclusion: Children with bronchial asthma have lower serum levels of zinc and magnesium and higher levels of copper compared to healthy children. A disruption of these trace elements serum levels could be a factor in the development of bronchial asthma. [ABSTRACT FROM AUTHOR]

Abstract Background Asthma is one of the most common chronic airway diseases in children. Preventing asthma exacerbation is one of the objectives of all asthma action plans. In patients with poor perception, it is difficult to identify acute asthma exacerbations by clinical asthma score, asthma control test or asthma control questionnaire. The aim of this study is to analyze whether children with asthma have changes in peak expiratory flow(PEF)before an acute asthma exacerbation and to evaluate the relationship between PEF and asthma exacerbation. Methods Basic information (including sex, age, atopy, etc.) and clinical information of asthmatic children who registered in the Electronic China Children’s Asthma Action Plan (e-CCAAP) from 1 September 2017 to 31 August 2021 were collected. Subjects with 14 consecutive days of PEF measurements were eligible. Subjects in this study were divided into an exacerbation group and a control group. We analyzed the relationship between changes in PEF% pred and the presence of asthma symptoms. Result A total of 194 children with asthma who met the inclusion criteria were included, including 144 males (74.2%) and 50 females (25.8%), with a male-to-female ratio of 2.88:1. The mean age of the subjects was 9.51 ± 2.5 years. There were no significant differences in sex, age, allergy history or baseline PEF between the two groups. In children with and without a history of allergy, there was no significant difference between the variation in PEF at 14 days. Patients who only had a reduced in PEF but no symptoms of asthma exacerbation had the greatest reduction in PEF compared to the other groups. The most common cause of acute exacerbations of asthma is upper respiratory tract infection. Among the causes of acute exacerbations of asthma, the variation in PEF caused by air pollution was significantly higher than that of other causes (P

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Objectives: The primary objectives are to evaluate the impact of OATP2B1c.935G>A (rs12422149) genetic polymorphisms on montelukast treatment responses in children with asthma in Iraq. Methods: This observational cross_sectional study was conducted from the beginning of October 2022 up to the ending of September 2023 at the respiratory clinic centre of the Karbalaa Hospital for Children. One hundred participants, both male and female, aged between six and fifteen, who had been taking montelukast as a control medication on a daily basis for at least a month, were included in the study. Following DNA extraction, allele_specific PCR was performed to identify the genotypes of the various patients. Measurements of total serum IgE, the Asthma Control Test (ACT), and the Pulmonary Function Tests (PEF and FEV1) were made. Results: Genetic amplification results indicate that the distribution of the polymorphism of the c.935G>A gene was 48% in GG wild homozygous, 45% in GA mutant heterozygous, and 7% in mutant homozygous AA. Patients with mutant genes (GA and AA) exhibit high total IgE, low PEF and FEV1, and <19 ACT scores. This polymorphism is expected to have a significant association (P value < 0.05) with montelukast responsiveness. Conclusions: A significant association, was seen between the montelukast response and the OATP2B1 c.935 G>A genetic polymorphism. [ABSTRACT FROM AUTHOR]

Background: Asthma and allergy are both complex diseases caused by environmental and genetic factors. Food allergy (FA) and asthma have been shown to frequently co-exist with one another; however, the exact link and the extent to which they impact each other are still not fully understood. Objective: To assess association of bronchial asthma and food allergy, relationship between asthma exacerbation and food allergy. Patients and methods: A case control study included 100 asthmatic children ranging in age from 2 to 18 years. Clinical criteria, serum total and specific IgE (sIgE) for common food allergens were done. Results: Serum food-specific IgE test results came back with a positive and negative percentage of 44 percent and 56 percent, respectively. We found that FA was linked to moderate to severe persistent asthma in children, and that food allergy increased the proportion of uncontrolled asthma in children. Conclusion: Children who had food allergy had greater number of exacerbations and hospitalizations. Patients with asthma should be evaluated for food allergies, since they are a risk factor for asthma aggravation. [ABSTRACT FROM AUTHOR]

Abstract Objective Vaccination will be instrumental in controlling the COVID-19 pandemic, and vaccination of children will be necessary to achieve herd immunity. Given that children with chronic health conditions may be at increased risk of COVID-19, it is crucial to understand factors influencing parental decisions about whether to have their child vaccinated. The study objectives were to measure parental intent to have their child with asthma vaccinated against COVID-19 and identify the determinants of their vaccination decision. Study design This study is based on a cross-sectional exploratory observational online survey assessing parents' risk perception in the context of COVID-19. Methods In this study conducted in August 2020, the primary outcome was parent’s answer to the question on their intention to get their child vaccinated if a vaccine against COVID-19 was available. Participants were also asked about their intention to get vaccinated themselves. Independent variables studied included sociodemographic, clinical data (e.g. presence of other chronic diseases), psychological, cognitive and risk perception related to COVID-19. Simultaneous equations models (3SLS) and seemingly unrelated regressions model (SUR) were carried out to identify factors associated with intention to have the child vaccinated and participants’ intention to get vaccinated themselves against COVID-19. Results A total of 305 participants completed the survey. Overall, 19.1% of participants reported being unlikely or very unlikely to vaccinate their child against COVID-19 if a vaccine was available. Similarly, 21.0% were unlikely or very unlikely to get vaccinated themselves. The following factors were significantly associated with parents’ decision to have their child vaccinated: parental level of education (p = 0.003), employment status (p

Background: Arrhythmias and disturbed cardiac conduction can exacerbate uncontrolled asthma. Asthma medications have been linked, either directly or indirectly, to irregular heartbeats. There are few data about risk of arrhythmia in asthmatic children. Objective: The aim of the present study was to assess occurrence of arrhythmia and conduction disturbances in hospitalized asthmatic children and to investigate the predictors and impact of arrhythmia. Patients and Methods: A cross-sectional study was conducted in the Pediatric Chest and Pediatric Intensive Care unit of Zagazig University Children hospital. This study was conducted on 56 asthmatic children. In absence of documented spirometric measurements, diagnosis of bronchial asthma was relied on medical basis. Clinical diagnosis relied on the updated 2022 GINA Guidelines. Assessment of severity of acute exacerbation was based on British National Guidelines and updated 2022 GINA Guidelines. Results: There was significant increase heart rate in children with sinus tachycardia compared to other asthmatic children. Otherwise, there was no difference on other vital signs. There was no difference in serum electrolytes and occurrence of sinus tachycardia. There was no relation between treatment of bronchial asthma and occurrence of sinus tachycardia. Conclusion: Asthmatic children were at increased risk of developing sinus tachycardia. There were significant association between sinus tachycardia with increased heart rate, and reduced hemoglobin level. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea (OSA) is the most common form of respiratory disorders during sleep in children, especially those with severe asthma. However, optimal treatment of asthma might significantly improve OSA severity. Methods: It was a cohort study including children aged >5 years old and diagnosed with asthma according to GINA (Global Initiative for Asthma). The data related to age, gender, height, weight, body mass index (BMI), clinical symptoms and medical history of asthma, spirometry (FEV1: forced expiratory in 1 s), and exhaled nitric oxide (FENO) were recorded for analysis. Respiratory polygraphy (RPG) was done for each study subject to diagnose OSA and its severity. Results: Among 139 asthmatic children, 99 patients with OSA (71.2%) were included in the present study (9.3 ± 0.2 years): 58.6% with uncontrolled asthma and 32.3% with partial controlled asthma. The mean ACT (asthma control testing) score was 19.0 ± 3.4. The most frequent night-time symptoms were restless sleep (76.8%), snoring (61.6%), sweating (52.5%), and trouble breathing during sleep (48.5%). The common daytime symptoms were irritable status (46.5%) and abnormal behavior (30.3%). Themean AHI (apnea-hypopnea index) was 3.5 ± 4.0 events/h. There was a significant correlation between BMI and snoring index (R = 0.189 and P = 0.027), bronchial and nasal FENO with AHI (R = 0.046 and P < 0.001; R = 0.037 and P < 0.001; respectively). There was no significant correlation between asthma level, FEV1 and AHI. The severity of asthma and respiratory function were improved significantly after 3 months and 6 months of asthma treatment in combination with leukotriene receptor antagonist (LRA) treatment. The symptoms related to OSA were significantly improved after treatment with LRA. The severity of OSA was decreased significantly after 3 months and 6 months of treatment. Conclusion: The treatment of asthmatic children with comorbid OSA by LRA in combination with standard therapy for asthma could improve the control of asthma and the symptoms and severity of OSA. [ABSTRACT FROM AUTHOR]

BackgroundAsthma and obstructive sleep apnea (OSA) are common chronic respiratory disorders in children. The relationship between asthma and OSA is bidirectional; these conditions share multiple epidemiological risk factors. Untreated OSA may cause attention deficit hyperactivity disorder (ADHD) symptoms. This study aimed to assess the prevalence of ADHD in asthmatic children with OSA and the link between asthma control and lung function of children with asthma and OSA.MethodsA total of 96 children aged 6–15 years diagnosed with asthma, according to the Global Initiative for Asthma (GINA) 2020, were enrolled in this study. All demographic data, including age, gender, body mass index, asthma control status, therapy, the Vanderbilt ADHD Diagnostic Parent Rating Scale, lung function, and exhaled nitric oxide, were collected. In addition, home respiratory polygraphy was used to identify OSA in study subjects.ResultsA total of 96 patients (8.4 ± 2.4 years) were included in the present study. OSA was identified in 60.4% of asthmatic children with a mean apnea-hypopnea index (AHI) of 3.5 ± 3.0 event/h. The inattentive ADHD subtype was significantly lower in the non-OSA asthmatic group than in the OSA asthmatic group (7.9 vs. 34.5%, p < 0.05). ADHD had a higher probability of presence (OR: 3.355; 95% CI: 1.271–8.859; p < 0.05) in the OSA group (AHI >1 event/h). Children with poorly controlled asthma had a significantly high risk of OSA (83.0 vs. 17.0%, p < 0.001) than children with well-controlled asthma. Allergic rhinitis increased the odds of having OSA in patients with asthma [OR: 8.217 (95% CI: 3.216–20.996); p < 0.05].ConclusionThe prevalence of OSA is increased among poorly controlled asthma. ADHD may have a higher prevalence in children with OSA. Therefore, prompt diagnosis of OSA will lead to an accurate asthma control strategy in patients with asthma.

Introduction Bronchial asthma strongly affects the health-related quality of life (HRQOL) of children in many aspects including physical, emotional, social, and school functioning. Child self-reports of QOL are valid for measuring HRQOL, but the parent proxy reports also provide additional important information. Aim To assess the agreement between the child self-reports of HRQOL and the parent proxy reports among the children and adolescents with well-controlled bronchial asthma. Patients and methods This cross-sectional study was conducted on 75 asthmatic patients aged between 8 and 18 years and their parents who were being followed up in the allergy outpatient clinic in the Department of Pediatrics, Cairo University. HRQOL was assessed by the PedsQL 3.0 asthma module. Results The mean±SD age of the patients was 10.08±1.70 years. Distribution of agreement between patients and parents showed that 40 (53.3%) cases showed agreement in different domains. Agreement between child and parent-by-proxy was 54.3% in the asthma domain, 45.3% in the treatment domain, 34.7% in the worry domain, and 17.3% in the communication domain. A statistically significant correlation was found between QOL in child and parent in all domains; the correlation was strong in the asthma and worry domains and weak in the treatment and the communication domains, where in the asthma domain, confidence interval (CI) was 0.803 (0.690-0.875), with a P value of 0.000; in the treatment domain, CI was 0.305 (0.080-0.499), with a P value of 0.009; in the worry domain, CI was 0.539 (0.357-0.682), with a P value 0.000; and finally, in the communication domain, the CI was 0.374 (0.163-0.552), with a P value of 0.000. Conclusion There was a lack of convergence between the child self-report and the parent's report of the PedsQL 3.0 asthma module. Asthmatic children's self-reports were more accurate than parent proxy reports for the assessment of HRQOL. Parent proxy reports should be spared to very young children or children who lack the logical or analytical ability needed for answering the questionnaire. [ABSTRACT FROM AUTHOR]

Aim of study: This research study aims to compare between two different counseling approaches; traditional verbal counseling vs. advanced counseling (in which we used the acoustic Flo-tone training device and its smartphone application combined with traditional verbal counseling) to determine the most beneficial counseling approach for asthmatic children who use metered-dose inhaler (MDI) with spacers concerning inhalation duration and inhalation technique mistakes. Methods: A total of 100 asthmatic children (8-18) years old were randomized into two groups (a control group, and an advanced group). Each group included 50 subjects. Every subject received 3 counseling meetings, one each month. Asthmatic children in the control group were trained on inhalation technique from MDI + spacer verbally (traditional counseling), while asthmatic children in advanced group were trained on inhalation technique from MDI + spacer verbally and by advanced counseling (whistling Flo-tone + smartphone application). At each visit mistakes in inhalation technique steps were; detected, corrected, and recorded and the inhalation duration was measured for every child in each group. Results: In both study groups, the total mean number of inhalation technique mistakes decreased significantly (p < 0.05) from visit 2, also the total mean inhalation durations in seconds showed a significant increase (p < 0.05) from visit 2. A significant (p < 0.05) reduction in the total mean number of mistakes and a significant (p < 0.05) increase in total mean inhalation durations were observed from visit 2 in advanced group compared to control group. Conclusion: Combination between traditional verbal and advanced counseling methods resulted in significant (P < 0.05) improvements in the number of inhalation technique mistakes and inhalation durations from MDI with spacer in children compared to using traditional verbal counseling alone. [ABSTRACT FROM AUTHOR]

Introduction: A minority of asthmatic children develop persistent airflow limitation (PAL), associated with an increased risk of chronic airflow obstruction and poor prognosis. This study aimed to identify risk factors for PAL and develop a prediction model to identify high-risk asthmatic children., Methods: This retrospective study included 2072 children (5-16 years) with asthma. After a 2-year follow-up, patients were categorized into non-PAL, reversible PAL (RPAL), and irreversible PAL (IPAL) groups. Logistic regression (LR) was used to identify independent risk factors for RPAL and IPAL. A prediction model based on multivariate LR was developed and validated to identify asthmatic children at high risk of developing PAL. A nomogram was created for visualization., Results: Among the 2072 asthmatic patients, 14.72% (n = 305) developed PAL. Asthma exacerbation history (OR 1.80, 95% CI 1.03-3.01) and poor adherence (OR 1.83, 95% CI 1.26-2.65) were independent risk factors of RPAL. Independent risk factors for IPAL were BMI over 19.0 kg/m 2 (OR: 1.81, 95% CI: 1.03-3.21) and a history of pneumonia (OR: 2.40, 95% CI: 1.30-4.26). The prediction model incorporated nine variables and showed good discriminatory ability, with AUC values of 0.79 (95% CI: 0.76-0.81) for the training set, 0.76 (95% CI: 0.76-0.77) for internal validation, and 0.73 (95% CI: 0.64-0.81) for temporal validation., Conclusion: Asthma exacerbation history and poor adherence were independent risk factors for developing RPAL. BMI over 19.0 kg/m 2 and a history of pneumonia were risk factors for IPAL. Our prediction model effectively identified asthmatic children at high risk of developing PAL., (© 2024 Wiley Periodicals LLC.)

Objective: Vaccination will be instrumental in controlling the COVID-19 pandemic, and vaccination of children will be necessary to achieve herd immunity. Given that children with chronic health conditions may be at increased risk of COVID-19, it is crucial to understand factors influencing parental decisions about whether to have their child vaccinated. The study objectives were to measure parental intent to have their child with asthma vaccinated against COVID-19 and identify the determinants of their vaccination decision.Study Design: This study is based on a cross-sectional exploratory observational online survey assessing parents' risk perception in the context of COVID-19.Methods: In this study conducted in August 2020, the primary outcome was parent's answer to the question on their intention to get their child vaccinated if a vaccine against COVID-19 was available. Participants were also asked about their intention to get vaccinated themselves. Independent variables studied included sociodemographic, clinical data (e.g. presence of other chronic diseases), psychological, cognitive and risk perception related to COVID-19. Simultaneous equations models (3SLS) and seemingly unrelated regressions model (SUR) were carried out to identify factors associated with intention to have the child vaccinated and participants' intention to get vaccinated themselves against COVID-19.Results: A total of 305 participants completed the survey. Overall, 19.1% of participants reported being unlikely or very unlikely to vaccinate their child against COVID-19 if a vaccine was available. Similarly, 21.0% were unlikely or very unlikely to get vaccinated themselves. The following factors were significantly associated with parents' decision to have their child vaccinated: parental level of education (p = 0.003), employment status (p < 0.001), sex of the child (p = 0.019), presence of other chronic diseases (p = 0.028), whether or not the child had been vaccinated against influenza in the past (p < 0.001), parental anxiety (p = 0.046), and consultation with a health professional since the beginning of the pandemic (p = 0.009). There was a strong relationship between likelihood of not intending to have one's child vaccinated and personal intent not to get vaccinated.Conclusion: These findings are essential in planning for the communication and dissemination of COVID-19 vaccination information to parents, especially for children with asthma or other chronic medical conditions. [ABSTRACT FROM AUTHOR]

Background: Asthma is a highly prevalent chronic respiratory disease which has been increasing worldwide. Education to support self-management is an integral part of asthma care that improves disease control, reduces exacerbations and admissions, and improves quality of life of asthmatic children and their caregivers. Objective: The aim of the current work was to assess factors affecting knowledge and self-care management practice of asthmatics and their care givers and to evaluate the effect of implementing an asthma educational intervention. Patients and Method: An interventional study (pre and post comparison study design) was conducted that compared the change in knowledge and self-care practices among participants before and after implementing a health educational program. Results: Asthma educational intervention significantly increased asthma symptoms control and pediatric asthma quality of life among studied asthmatic children, asthma knowledge and pediatric asthma caregivers quality of life among caregivers of the studied asthmatic children after the application of the educational program (P<0.001). Conclusions: It is postulated that children with asthma who receive an interactive, comprehensive educational program would improve their quality of life, asthma management and asthma control compared with children receiving usual care. [ABSTRACT FROM AUTHOR]

Background: One of the heterogenous chronic diseases affecting the lungs is asthma. Etiology of asthma could be attributed to altered functions of forkhead box p3 Gene (FOXP3) through epigenetic mechanism and genetic polymorphism. Objective: To assess the frequency of two FOXP3 polymorphism rs3761548 and rs2232365 among asthmatic children in comparison with healthy children. Patients and methods: A total of 202 Egyptian children were recruited and divided into 2 separate groups, 1st one of asthmatic contained 101 children with asthma and a control group of 101 non-asthmatic apparently healthy children. Results: We found a statistically significant difference in FVC, FEV1 concerning degree of asthma. The lowest values were reported among sever asthmatic cases. The genotype analysis of patients and controls revealed non-statistical significant difference was found in patients when compared to control concerning foxp3 polymorphism for 2 different single nucleotide polymorphisms (SNPs) rs 3761548 and rs 2232365. The AC genotype of rs3761548 and the GG genotype of rs2232365 polymorphisms were the most frequent genotypes among the studied children. The rs3761548 C allele carriers could be more susceptible to have asthma since it could be considered a bronchial asthma allele risk factor. Conclusion: We investigated the association between FOXP3 polymorphism in (rs 3761548 and rs2232365) and occurrence of asthma in Egyptian children. The AC genotype of rs3761548 and the GG genotype of rs2232365 polymorphisms were the most frequent genotypes among the studied children. The rs3761548 C allele carriers could be more susceptible to have asthma since it could be considered a bronchial asthma allele risk factor. [ABSTRACT FROM AUTHOR]

Haiying Yu, Ningning Qi, Qingxia Zhou Department of Pediatrics, Weifang People’s Hospital, Weifang, Shandong 261041, People’s Republic of ChinaCorrespondence: Qingxia ZhouDepartment of Pediatrics, Weifang People’s Hospital, Guangwen Street, Kuiwen District, Wenfang, Shandong 261041, People’s Republic of ChinaTel +86-05368248176Email qingxiazhou@yeah.netBackground: LncRNA H19 expression is down-regulated in patients with asthma. The hyperplasia of airway smooth muscle cells (ASMCs) promotes the development of airway remodeling in asthma. Therefore, we attempted to evaluate the regulatory function of H19 in the proliferation and migration of ASMCs.Methods: The expressions of H19 and miR-21 were detected using qRT-PCR. PDGF-BB-induced abnormal proliferation and migration of ASMCs was used as the airway remodeling model in vitro. The expressions of H19 and miR-21 were modified by transfection with pcDNA3.1-H19 and miR-21 mimic, respectively. CCK-8 assay, flow cytometry-based cell cycle analysis was conducted to examine the proliferation ability of ASMCs. The migration ability was measured by transwell assay. Dual-luciferase reporter system was carried out to find the potential relationship between miR-21 and H19 or PTEN. Western blot was conducted to detect the expressions of PCNA, MMP-9, α-SMA, PTEN, and the phosphorylation level of Akt.Results: LncRNA-H19 expression was decreased and microRNA-21 expression was increased in serum samples of children with asthma and PDGF-BB-stimulated ASMCs. Overexpression of H19 reduced the proliferation and migration ability of ASMCs with PDGF-BB treatment and these changes were reversed by miR-21 mimic. H19 promoted the protein level of PTEN via sponging miR-21. Overexpression of H19 suppressed miR-21-induced phosphorylation of Akt, and the suppression effect of H19 on phosphorylation of Akt was significantly reduced after transfecting shPTEN in ASMCs.Conclusion: In this study, overexpression of H19 suppressed the proliferation and migration of ASMCs induced by PDGF-BB via miR-21/PTEN/Akt axis, which could be a potential biomarker and target for treating hyperplasia of airway smooth muscle cells.Keywords: lncRNA H19, asthmatic children, airway smooth muscle cell, miR-21, airway remodeling

Background: This study was done to detect the level of IgE in asthmatic children. Aim: The aim of this study is to evaluate the relation between asthma in children and IgE level in children. Study Design: Case-control study. Patient study: This study was performed in Mosul city from January 2019 to June 2019. The total number of children in this study was 200 (152 patients and 48 control) were recruited from the emergency department, outpatients clinics of Ibn al-Atheer teaching hospital for children, pediatric private clinic and from primary schools of children in Mosul city. The sample size was 152 patients with asthma (109 males and 43 females) whose age between 1-15 years. Methods: 5 ml of blood were collected by vein puncture using disposable syringe from each patients and control enrolled in this study for determination of IgE levels using enzyme linked immune-sorbent assay (ELISA technique). Result: IgE levels was significantly elevated in asthmatic children and even in some control cases. Conclusion: There was a strong association between Asthmatic children and elevated IgE levels in most of patients and some control cases. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the correlation of JNK pathway-associated phosphatase (JKAP) with clinical features, inflammation, exacerbation risk, and severity in asthmatic children. Methods: Asthmatic exacerbation children (N = 90), asthmatic remission children (N = 90), and healthy controls (N = 90) were enrolled in this case-control study, whose venous blood samples were collected after enrollment for routine blood test, JKAP, and inflammatory cytokines detection by enzyme-linked immune sorbent assay. The clinical features included demographic data, family history of asthma, and pulmonary ventilation function. Results: JKAP level was the lowest in asthmatic exacerbation children, followed by asthmatic remission children and healthy controls. ROC curve revealed good ability of JKAP in distinguishing three groups from each other, especially in telling asthmatic exacerbation children from healthy controls (AUC: 0.926; 95%CI: 0.887–0.965). In addition, JKAP was negatively correlated with eosinophil count, immunoglobulin E (IgE), tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and interleukin-17 (IL-17), positively correlated with forced expiratory volume in 1 sec/forced vital capacity (FEV1/FVC) and FEV1 (%predicted) in asthmatic exacerbation children. Whereas in asthmatic remission children, JKAP was negatively correlated with eosinophil count, TNF-α, IL-1β, IL-6, and IL-17 and positively correlated with FEV1 (%predicted), but not with IgE or FEV1/FVC. In healthy controls, the correlation of JKAP with clinical features and inflammatory cytokines was non-obvious. For exacerbation severity, JKAP was the highest in mild exacerbation children, followed by moderate exacerbation children, and severe exacerbation children. Conclusion: JKAP serves as a potential biomarker for asthmatic susceptibility, inflammation, exacerbation risk, and severity in children. [ABSTRACT FROM AUTHOR]

Amaç: Vitamin D ve çinko eksikliğinin astım ile ilişkili olduğu bildirilmektedir. Bu çalışmada astımlıçocukların klinik bulguları ile vitamin D ve çinko düzeyleri arasındaki ilişkiyi araştırmayı istedik.Materyal ve Metot: Bu prospektif çalışmaya yaşları 5‐17 arasında değişen 149 astımlı ve 97 sağlıklı çocukdahil edildi. Tüm katılımcıların serum 25 hidroksivitamin D (25(OH)D) ve çinko düzeyleri ölçüldü, diyetalışkanlıkları, bir yıldaki solunum yolu enfeksiyonu sıklıkları, hastane başvuruları ve güneş ışığınamaruziyet süreleri sorgulandı.Bulgular: Astımlı çocukların serum D vitamini ve çinko düzeyleri sırasıyla (7,7±5,29 ng/ml), (64±16,3mcg/dl) sağlıklı çocuklardan (12,3±12,87 ng/ml), (69±26,2 mcg/dl) belirgin şekilde düşük bulundu (p

Abstract Background Both short and long-term exposure to traffic-related air pollutants have been associated with asthma and reduced lung function. We hypothesized that short-term indoor exposure to fine particulate matter

Conclusion: The frequency and score of SDB were higher in patients with uncontrolled asthma. Frequency and score of SDB were significantly affected by the severity of asthma. SDB must be evaluated in preschool children with uncontrolled asthma., Conclusion: Sleep-disordered breathing (SDB) is more common in asthmatic patients than in non-asthmatic persons, and SDB affects negatively to control asthma. A limited number of studies are discovered on the effect of SDB in preschool asthmatic children. In this study, we aimed to investigate the prevalence of SDB and its effect on control and severity of asthma in preschool children. A pediatric sleep questionnaire was completed by parents of asthmatic children. Patients who received a score of 0.33 or higher were diagnosed with SDB. Control and severity of asthma was assessed by a pediatric allergy specialist based on the Global Initiative for Asthma (GINA) criteria. The study included 249 patients, with a mean±SD age of 4.37±1.04 (range: 2-5.9) years; 69% were boys; 56.6% children had uncontrolled asthma and 28.7% had SDB. The SDB score was significantly different between controlled and uncontrolled asthma (0.19 vs 0.28; P < 0.001). The frequency of uncontrolled asthma in patients with and without SDB was 74.3% and 49.4%, respectively (P < 0.010). Based on the severity of asthma, the frequency of SDB among patients with mild, moderate, and severe asthma was 23.4%, 35.2%, and 47.4%, respectively (P = 0.010).

Exposure to VOCs causes a variety of adverse health effects, with much of the exposure occurring at home during sleep. The use of an air cleaner maybe an effective and convenient way to reduce associated exposures and health risks. Studies about the impacts of air cleaner on VOCs are limited. The main objective of this paper was to assess the inhalation health risks that toxic VOCs present during nighttime sleep and to estimate the removal effectiveness of an indoor air cleaner on these VOCs. Asthmatic children, who are especially vulnerable to the detrimental effects of air pollutants, were recruited and the VOC concentrations in their bedrooms were measured during two periods - once with a true air cleaner and once with a sham air cleaner. Among the toxic VOCs quantified, formaldehyde, acetaldehyde and toluene had the highest concentrations (median: 18.0, 14.0 and 12.1 μg/m³, respectively) in the bedrooms. Health risk assessments were conducted to identify compounds of greatest concern. During nighttime sleep, 7 VOCs presented inhalation cancer risk above the acceptable risk (1 × 10−6), 4 VOCs exceeded the non-cancer risk threshold (1) in most of the homes tested. The results indicate that the use of an air cleaner in residences may lead to significant reductions in VOC concentrations indoors, but even with this reduction, the associated health risks are still of concern. This study highlights the need for reductions in toxic VOCs at home, points to the imminent need for improvements in control of VOC sources. Image 1 • Indoor and outdoor levels and inhalation health risks of toxic VOCs in 20 asthmatic children's homes were analysed. • The contribution of air cleaners on 13 toxic VOCs in asthmatic children's homes were assessed. • Stressed the need to reduce the exposure to toxic VOCs, especially in formaldehyde, acetaldehyde, 1,2-DCP, benzene and 1,4-DCB. [ABSTRACT FROM AUTHOR]

Abstract People generally spend more time indoors than outdoors resulting in a higher proportion of exposure to particulate matter (PM) occurring indoors. Consequently, indoor PM levels, in contrast to outdoor PM levels, may have a stronger relationship with lung function. To test this hypothesis, indoor and outdoor PM 2.5 and fungal spore data were simultaneously collected from the homes of forty-four asthmatic children aged 10–16 years. An optical absorption technique was utilized on the collected PM 2.5 mass to obtain concentrations of black carbon (BC) and ultraviolet light absorbing particulate matter, (UVPM; a marker of light absorbing PM 2.5 emitted from smoldering organics). Enrolled children completed spirometry after environmental measurements were made. Given the high correlation between PM 2.5 , BC, and UVPM, principal component analysis was used to obtain uncorrelated summaries of the measured PM. Separate linear mixed-effect models were developed to estimate the association between principal components of the PM variables and spirometry values, as well as the uncorrelated original PM variables and spirometry values. A one-unit increase in the first principal component variable representing indoor PM (predominantly composed of UVPM and PM 2.5) was associated with 4.1% decrease (99% CI = −6.9, −1.4) in FEV 1 /FVC ratio. 11.3 μg/m3 increase in indoor UVPM was associated with 6.4% and 14.7% decrease (99% CI = −10.4, −2.4 and 99% CI = −26.3, −2.9, respectively) in percent predicted FEV 1 /FVC ratio and FEF 25–75 respectively. Additionally, 17.7 μg/m3 increase in indoor PM 2.5 was associated with 6.1% and 12.9% decrease (99% CI = −10.2, −1.9 and 99% CI = −24.9, −1.0, respectively) in percent predicted FEV 1 /FVC ratio and FEF 25–75 , respectively. Outdoor PM, indoor BC, and indoor fungal spores were not significantly associated with lung function. The results indicate that indoor PM is more strongly associated with lung function in children with asthma as compared with outdoor PM. Graphical abstract Unlabelled Image Highlights • Reduced lung function (FEV 1 /FVC ratio and FEF 25–75) is more strongly associated with indoor particles than outdoor particles. • Lung function is more strongly associated with UVPM than PM 2.5 or black carbon. • Low levels of black carbon indoors (0.6 μg/m3) may not be associated with lung function. [ABSTRACT FROM AUTHOR]

Background and Objective: Regarding the prevalence of premature dental caries in childhood and the role of asthma as a risk factor for increased vulnerability to dental caries, the present study aimed to determine and compare the frequency of dental caries between asthmatic children under treatment with inhaled corticosteroids and healthy children. Methodology: In this case-control study, 70 children with asthma who were taking corticosteroid sprays for at least one year and 70 healthy children aged 3-12 visiting the clinic or office of pediatricians in 2017-2018 were selected as the sample based on convenient sampling method. Clinical examination for the diagnosis of dental caries was conducted using the decayed-missing-filled teeth (DMFT) index. The obtained data were statistically analyzed in SPSS-18. Results: The mean score of DMF index, in each of the subscales of decayed teeth (D/d), missing teeth (M/m), and filled teeth (F/f), was higher in asthmatic children compared to healthy children (p<0.05). Conclusion: The study findings suggest that it is necessary to pay a special attention to prevention programs including increasing the awareness of parents and training in strategies for the reduction of complications of drugs and providing organized dental care and services, especially for asthmatic children who are at greater risk of dental caries. [ABSTRACT FROM AUTHOR]

Background: Acute exacerbation of asthma is divided qualitatively into mild, moderate, and severe attacks and respiratory failure. This system is, however, not suitable for estimating small changes in respiratory condition with time and for determining the efficacy of treatments, because it has a qualitative, but not quantitative nature. Methods: To evaluate the usefulness of quantitative estimation of asthma exacerbation, modified Pulmonary Index Score (mPIS) values were measured in 87 asthmatic children (mean age, 5.0 ± 0.4 years) during hospitalization. mPIS was calculated by adding the sum of scores for 6 items (scores of 0–3 were given for each item). These consisted of heart rate, respiratory rate, accessory muscle use, inspiratory-to-expiratory flow ratio, degree of wheezing, and oxygen saturation in room air. Measurements were made at visits and at hospitalization and were then made twice a day until discharge. Results: mPIS values were highly correlated among raters. mPIS values at visits were 9.1 ± 0.1 and 12.6 ± 0.4 in subjects with moderate and severe attacks, respectively (p

Objectives: It is reported that deficiencies in vitamin D and zinc are associated with asthma. In this study we aimed to investigate the relationship between clinic findings of asthmatic children and vitamin D and zinc levels. Materials and Methods: This prospective study included a total of 149 asthmatics and 97 healthy children with an age range of 5 to 17 years. All of the participants were evaluated for serum levels of 25 - hydroxyvitamin D (25(OH)D) and zinc, dietary habits, the rate of respiratory tract infections, hospital visits and levels of sunlight exposure. Results: Serum vitamin D and zinc levels in asthmatic children (7.7±5.29 ng/ml), (64±16.3 mcg/dl) were significantly lower than that in healthy children (12.3±12.87 ng/ml), (69±26.2 mcg/dl) (p< 0.015), respectively. A relationship was detected between the frequency of infection and vitamin D level's being <10ng/ml (p < 0.001), while no relationship was detected between the frequency of infection and zinc level. No relationship was detected between pulmonary function, nutrition and the levels of vitamin D and zinc. However, a relationship was detected between vitamin D levels and exposure to sunlight. Conclusion: Our results showed that asthmatic children had lower vitamin D and zinc levels than healthy children. Very low levels of vitamin D were found to be associated with an increased rate of infection and required more medication and hospitalization. [ABSTRACT FROM AUTHOR]

Evidence on the comparative effects of fine particulate matter (PM 2.5) and coarse particulate matter (PM 10-2.5) on the lung function of asthmatic children remained limited and inconsistent. This study aims to explore the acute effect of PM 2.5 and PM 10-2.5 on dynamic forced expiratory volume in 1 s (FEV 1) and peak expiratory flow (PEF) among asthmatic children. We conducted a multicenter study and obtained intensively repeated measurements of FEV 1 and PEF of clinically diagnosed asthmatic children in 89 Chinese cities from January 2017 to May 2021. Linear mixed-effects models combined with a polynomial distributed lag model were employed to evaluate the cumulative lag effect of PM 2.5 and PM 10-2.5 on daily FEV 1 and PEF among asthmatic children. We also evaluated the effect modifications by sex, age, testing time, season, and region. A total of 590 clinically diagnosed asthmatic children with over 0.18 million dynamic lung function records were included in this study. The adverse effect of particulate matter on lung function occurred in a short term and could last for around one week. Specifically, both PM 10-2.5 and PM 2.5 were associated with decreases in PEF, but only PM 10-2.5 could impair the measurements of FEV 1. We found that an interquartile range increase in PM 10-2.5 and PM 2.5 were associated with 5.40 [95% confidence interval (CI): 0.88, 9.92] mL/s and 10.48 (95%CI: 5.14, 15.81) mL/s decrease in PEF, 6.46 (95%CI: 4.53, 8.40) mL and 0.25 (95%CI: −2.03, 2.54) mL decreases in FEV 1 , respectively. And the estimated effect of PM 10-2.5 was stronger than PM 2.5 on FEV 1. Besides, these changes were larger in the evening and the south region of China. In conclusion, short-term exposure to both PM 2.5 and PM 10-2.5 could decrease the daily lung function of asthmatic children. The impact of PM 10-2.5 was more hazardous than PM 2.5. • A multicity study on the effect of PM 2.5 and PM 10-2.5 on dynamic lung function in asthmatic children. • Both PM 2.5 and PM 10-2.5 could impair the lung function of asthmatic children. • The adverse effect of particulate matter could last for around one week. • PM 10-2.5 may be more hazardous for lung function in asthmatic children than PM 2.5. [ABSTRACT FROM AUTHOR]