O17‐1: Asthma status during COVID‐19 pandemic

Abstract Background: We are currently screening human volunteers to determine their sputum polymorphonuclear neutrophil (PMN) response 6 and 24 hours following initiation of exposure to wood smoke particles (WSP). Inflammatory responders (>10% increase in %PMN) are identified for their subsequent participation in mitigation studies against WSP-induced airways inflammation. In this report we compared responder status (N=52) at both 6 and 24hr time points to refine/expand its classification, assessed the impact of the GSTM1 genotype, asthma status and sex on responder status, and explored whether sputum soluble phase markers of inflammation correlate with PMN responsiveness to WSP. Results: In the entire cohort, we found a significant, but very small, decrease in FVC and systolic blood pressure immediately following WSP exposure and sputum %PMNs were significantly increased at 24 hours post exposure, the latter finding was also significantly correlated with sputum IL-1b, IL-6, IL-8, and PMN/mg; a similar response was not found at the 6 hour %PMN response. Blood endpoints in the entire cohort showed a significant increase in %PMN and PMN/mg at 6 but not 24 hours. Six-hour responders tended to be 24-hour responders and vice versa, but 24-hour responders also had significantly increased IL-1b, IL-6, IL-8 at 24 hours post WSP exposure. The GSTM1 null genotype significantly (p<0.05) enhanced the %PMN response at 6 hours in the entire cohort, by 24% in the 24-hour responders and not at all in the 6 hours responders. Asthma status enhanced the 24 hour %PMN response in the entire cohort and in the 6- and 24-hour responders. Sex had no effect on %PMN response. Conclusions: The 24 hour time point was more informative than the 6 hour time point in optimally defining airway inflammatory responsiveness to WSP exposure. GSTM1 and asthma status are significant effect modifiers of this response. These study design and subject parameters should be considered before enrolling volunteers for proof-of-concept WSP mitigation studies.

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The impact of cigarette smoke exposure, COPD, or asthma status on ABC transporter gene expression in human airway epithelial cells

Scientific Reports ◽

10.1038/s41598-018-36248-9 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 9

Author(s):

Jennifer A. Aguiar ◽

Andrea Tamminga ◽

Briallen Lobb ◽

Ryan D. Huff ◽

Jenny P. Nguyen ◽

...

Keyword(s):

Gene Expression ◽

Epithelial Cells ◽

Cigarette Smoke ◽

Abc Transporter ◽

Airway Epithelial Cells ◽

Cigarette Smoke Exposure ◽

Airway Epithelial ◽

Transporter Gene ◽

Asthma Status ◽

The Impact

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Maternal Asthma Status Is Associated With The Child's HLA-G Transcript And MicroRNA-148b Abundance In Human Airway Epithelial Cells

10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a5612 ◽

2012 ◽

Author(s):

Jessie Nicodemus-Johnson ◽

R K. Stern ◽

D A. Loisel ◽

K M. Patterson ◽

J Sudi ◽

...

Keyword(s):

Epithelial Cells ◽

Airway Epithelial Cells ◽

Airway Epithelial ◽

Human Airway ◽

Asthma Status ◽

Human Airway Epithelial Cells

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Risk effects of near-roadway pollutants and asthma status on bronchitic symptoms in children

Environmental Epidemiology ◽

10.1097/ee9.0000000000000012 ◽

2018 ◽

Vol 2 (2) ◽

pp. e012 ◽

Cited By ~ 4

Author(s):

Robert Urman ◽

Sandrah Eckel ◽

Huiyu Deng ◽

Kiros Berhane ◽

Ed Avol ◽

...

Keyword(s):

Risk Effects ◽

Asthma Status

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Air Pollution Exposure Monitoring among Pregnant Women with and without Asthma

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17134888 ◽

2020 ◽

Vol 17 (13) ◽

pp. 4888

Author(s):

Sandie Ha ◽

Carrie Nobles ◽

Jenna Kanner ◽

Seth Sherman ◽

Seung-Hyun Cho ◽

...

Keyword(s):

Air Pollution ◽

Pregnant Women ◽

Well Being ◽

Assessment Methods ◽

Gps Tracking ◽

Fine Particulates ◽

Asthma Status ◽

Personal Monitor ◽

Temperature Exposure ◽

Pollution Exposure

Background: We monitored exposure to fine particulates (PM2.5), ozone, nitrogen dioxide (NO2), and ambient temperature for pregnant women with and without asthma. Methods: Women (n = 40) from the Breathe—Well-Being, Environment, Lifestyle, and Lung Function Study (2015–2018) were enrolled during pregnancy and monitored for 2–4 days. Daily pollutants were measured using personal air monitors, indoor air monitors, and nearest Environmental Protection Agency’s stationary monitors based on GPS tracking and home address. Results: Personal-monitor measurements of PM2.5, ozone, and NO2 did not vary by asthma status but exposure profiles significantly differed by assessment methods. EPA stationary monitor-based methods appeared to underestimate PM2.5 and temperature exposure and overestimate ozone and NO2 exposure. Higher indoor-monitored PM2.5 exposures were associated with smoking and the use of gas appliances. The proportion of waking-time during which personal monitors were worn was ~56%. Lower compliance was associated with exercise, smoking, being around a smoker, and the use of a prescription drug. Conclusions: Exposure did not vary by asthma status but was influenced by daily activities and assessment methods. Personal monitors may better capture exposures but non-compliance merits attention. Meanwhile, larger monitoring studies are warranted to further understand exposure profiles and the health effects of air pollution during pregnancy.

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Use of antibiotics and asthma medication for acute lower respiratory tract infections in people with and without asthma: retrospective cohort study

Respiratory Research ◽

10.1186/s12931-019-1233-5 ◽

2020 ◽

Vol 21 (1) ◽

Cited By ~ 2

Author(s):

Rachel Denholm ◽

Esther T. van der Werf ◽

Alastair D. Hay

Keyword(s):

Primary Care ◽

Retrospective Cohort ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Practice Variation ◽

Asthma Medication ◽

Antibiotic Prescribing ◽

Lower Respiratory Tract Infections ◽

Asthma Status ◽

Tract Infections

Abstract Background Antibiotics are overused in patients with acute lower respiratory tract infections (ALRTIs), but less is known about their use in patients with asthma, or the use of asthma medication for ALRTI in patients without asthma. Our aim was to describe the frequency, variation and drivers in antibiotic and asthma medication prescribing for ALRTI in adults with and without asthma in primary care. Methods A retrospective cohort analysis of patients aged ≥12 years, diagnosed with an ALRTI in primary care in 2014–15 was conducted using data from the Clinical Practice Research Datalink. Current asthma status, asthma medication and oral antibiotic use within 3 days of ALRTI infection was determined. Treatment frequency was calculated by asthma status. Mixed-effect regression models were used to explore between-practice variation and treatment determinants. Results There were 127,976 ALRTIs reported among 110,418 patients during the study period, of whom 17,952 (16%) had asthma. Respectively, 81 and 79% of patients with and without asthma received antibiotics, and 41 and 15% asthma medication. There were significant differences in between-practice prescribing for all treatments, with greatest differences seen for oral steroids (odds ratio (OR) 18; 95% CI 7–82 and OR = 94; 33–363, with and without asthma) and asthma medication only (OR 7; 4–18 and OR = 17; 10–33, with and without asthma). Independent predictors of antibiotic prescribing among patients with asthma included fewer previous ALRTI presentations (≥2 vs. 0 previous ALRTI: OR = 0.25; 0.16–0.39), higher practice (OR = 1.47; 1.35–1.60 per SD) and prior antibiotic prescribing (3+ vs. 1 prescriptions OR = 1.28; 1.04–1.57) and concurrent asthma medication (OR = 1.44; 1.32–1.57). Independent predictors of asthma medication in patients without asthma included higher prior asthma medication prescribing (≥7 vs. 0 prescriptions OR = 2.31; 1.83–2.91) and concurrent antibiotic prescribing (OR = 3.59; 3.22–4.01). Conclusion Findings from the study indicate that antibiotics are over-used for ALRTI, irrespective of asthma status, and asthma medication is over-used in patients without asthma, with between-practice variation suggesting considerable clinical uncertainty. Further research is urgently needed to clarify the role of these medications for ALRTI.

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STUDENT ASTHMA STATUS AND SCHOOL ABSENCE

CHEST Journal ◽

10.1016/j.chest.2020.08.1522 ◽

2020 ◽

Vol 158 (4) ◽

pp. A1715

Author(s):

De De Gardner ◽

Jose Betancourt

Keyword(s):

School Absence ◽

Asthma Status

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Caregiver Asthma in Urban Families

The Journal of School Nursing ◽

10.1177/1059840516689326 ◽

2017 ◽

Vol 34 (2) ◽

pp. 108-113

Author(s):

Robin S. Everhart ◽

Sarah Miller ◽

Gillian G. Leibach ◽

Alexandra L. Dahl ◽

Daphne Koinis-Mitchell

Keyword(s):

High Frequency ◽

Urban Families ◽

School Nurses ◽

School Absenteeism ◽

Asthma Morbidity ◽

Child Asthma ◽

Asthma Status ◽

Children With Asthma ◽

Preliminary Study ◽

The Impact

Asthma is a significant contributor to missed school days, especially for children living in urban settings. This preliminary study examined the impact of caregiver asthma on school absenteeism in a sample of 102 urban children with asthma from African American, Latino, and non-Latino White backgrounds. Caregivers and children participated in a single research session; 32 caregivers had asthma. Children of caregivers with asthma missed more days of school than children whose caregivers did not have asthma (3.97 vs. 2.43 days, p < .05, Cohen’s d = .40). Other indicators of child asthma morbidity (e.g., hospitalizations) did not differ across caregiver asthma status. Findings highlight that caregiver asthma may be an added risk factor for school absenteeism among children with asthma. For children with a high frequency of asthma-related school absenteeism, school nurses may find it useful to provide educational resources and referrals for caregivers with asthma.

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