Optimization of therapy in children with mild bronchial asthma to improve the disease control during seasonal acute respiratory infections

2020 ◽  
Vol 15 (5) ◽  
pp. 102-109
Author(s):  
A.V. Kamaev ◽  
◽  
O.V. Trusova ◽  
I.A. Kamaeva ◽  
N.L. Lyashenko ◽  
...  
Keyword(s):  
Placebo Group ◽  
Disease Control ◽  
Asthma Control ◽  
Bronchial Asthma ◽  
Respiratory Function ◽  
Respiratory Infections ◽  
Acute Respiratory Infections ◽  
Active Therapy ◽  
Mild Bronchial Asthma ◽  
Feno Level

Background. Children with mild bronchial asthma (BA) are prone to poor control of symptoms during seasonal acute respiratory infections (ARIs). Objective. To optimize therapy in children with mild BA to improve disease control during seasonal ARIs. Patients and methods. This single-blind placebo-controlled prospective single-center trial evaluating the efficacy of ammonium glycyrrhizinate (Reglisam, ‘VIFITECH,’ Russia) and lasting 4 months included 63 children with mild BA (21 in the placebo group) aged 5 to 10 years with a disease duration of at least 3 months. We assessed respiratory function, FeNO level, results of the asthma control test, characteristics of BA exacerbations, and the need for betamimetics and budesonide via a nebulizer. We used the Student's t-test and Wilcoxon test to evaluate the differences in mean and median values; the differences were considered significant at р < 0.05. Results. The frequency and mean duration of ARIs were lower in the group of active therapy (1.06 ± 0.35 episodes and 6.52 ± 2.19 days) than in the placebo group (1.77 ± 0.26 episodes and 10.83 ± 3.07 days). The differences were statistically significant (р = 0.036 and р = 0.019, respectively). Patients receiving placebo required longer budesonide administration per one BA exacerbation: 11.72 ± 1.98 days vs 8.65 ± 2.17 days in patients receiving active therapy (р = 0.026). Significant differences in the respiratory function and FeNO level were observed only in the subgroup of patients who had incomplete asthma control upon enrollment. We observed no new adverse events that had not been reported earlier. Conclusion. Our findings suggest high efficacy of ammonium glycyrrhizinate used to enhance basic therapy for mild BA in children, in whom respiratory infections are the most common triggers of BA exacerbations. Key words: ammonium glycyrrhizinate, basic therapy, children, mild bronchial asthma, acute respiratory infections (ARIs)

scholarly journals THE ANALYSIS OF THE ASSOCIATION OF ADRB2 GENE POLYMORPHISM AND EXTERNAL RESPIRATORY FUNCTION IN CHILDREN WITH BRONCHIAL ASTHMA

2021 ◽  
Vol 20 (2) ◽  
pp. 71-76
Author(s):  
E.S. Minina ◽  
◽  
V.I. Novikova ◽  
P.D. Novikov ◽  
A.S. Babenka ◽  
...  
Keyword(s):  
Gene Polymorphism ◽  
Asthma Control ◽  
Bronchial Asthma ◽  
Respiratory Function ◽  
Gene Locus ◽  
Subjective Assessment ◽  
Control Test ◽  
Asthma Control Test ◽  
Individual Program ◽  
Adrb2 Gene

Objectives. To study the role of the ADRB2 gene polymorphism (rs1042713) in the impaired external respiratory function in children with bronchial asthma (BA). Material and methods. The study group included 60 children aged 3-17 years with allergic (n=37) and mixed form of BA (n=23). The genotyping of the investigated gene locus was performed by PCR-RFLP (polymerase chain reaction - restriction fragment length polymorphism), BA control was exercised using the Asthma Control Test (ACT). Results. The analysis of allele frequencies showed an association of allele A with normal spirogram parameters in patients with BA (p=0.042). In children under 12 years, there were statistically significant differences in spirogram indices when comparing patients with genotypes AA and GG (p=0.045). An association of allele A with the absence of pathological changes was revealed when evaluating the results of spirometry (p=0.021). There was a moderate positive correlation (r=0.615, p=0.011) between the assessment of nocturnal symptoms (Asthma Control Test) and the genotype of the ADRB2 gene polymorphism in children aged 12 years and older. Conclusions. An association of the ADRΒ2 gene polymorphism (rs1042713) with the external respiratory function was revealed in an objective study by spirometry and a subjective assessment of this indicator by the patient himself/herself or by his/her parents. This gene locus can be included in the BA target panel in order to determine the likelihood of uncontrolled course development of the disease with impaired external respiratory function and in the future to develop an individual program for dispensary observation of the patient.

scholarly journals The role of human β-defensin 2 (HbD-2) and cathelicidin (LL-37) in the local protection of the upper respiratory tract in children with allergic rhinitis and bronchial asthma

2021 ◽  
Vol 26 (1) ◽  
pp. 150-155
Author(s):  
Yu.K. Bolbot ◽  
T.A. Bordiі ◽  
Ya.V. Vilenskyi
Keyword(s):  
Allergic Rhinitis ◽  
Respiratory Tract ◽  
Antimicrobial Peptides ◽  
Bronchial Asthma ◽  
Respiratory Infections ◽  
Allergic Diseases ◽  
Control Group ◽  
Acute Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Upper Respiratory

Allergic diseases of the respiratory system seriously affect the psychological, physical and social aspects of the live of sick children, morally and financially exhausting members of their families as well. It is known that exacerbations of allergic diseases of the respiratory tract occur due to interaction with numerous triggers, one of which is a respiratory viral infection. At the same time, it is widely known that patients with allergic respiratory diseases are more prone to to acute respiratory infections. One of the reasons for this tendency often is an insufficient activity of non-specific factors of local immunity of the respiratory system – endogenous amphiphilic antimicrobial peptides, in particular the most studied their representatives - the family of defensins and human cathelicidin. Current research proves that these antimicrobial peptides are characterized by broad antiviral, antimicrobial and immunomodulatory activity. The aim of this study was to study the concentrations of local immune factors - human HbD-2 and LL-37 - in the secretion of the mucous membranes of the upper respiratory tract in children with asthma and allergic rhinitis and to clarify their role in protection against respiratory viral infections in this contingent of patients. We performed laboratory and clinical examinations of 76 children aged 7 to 18 years, of whom 24 were diagnosed with allergic rhinitis, 28 children - bronchial asthma, and 24 - bronchial asthma and allergic rhinitis. The control group consisted of 20 healthy children of the appropriate sex and age. In addition to general clinical methods, patterns of respiratory morbidity were analyzed and concentrations of antimicrobial peptides were determined: by ELISA human cathelicidin (LL-37), β-defensin 2 (HbD-2) in the secretion of the upper respiratory tract, statistical analysis was performed. It was found that children with allergic diseases of the respiratory tract are characterized by a higher frequency of acute respiratory infections with more frequent involvement of the lower respiratory tract, which led to an increase in the duration of the disease compared to their healthy peers. In children with allergic rhinitis and bronchial asthma, there was revealed a significant decrease in the concentrations of antimicrobial peptides in the secretion of the upper respiratory tract compared with the control group.

Preventive anti-inflammatory therapy during the acute respiratory infections in children with mild and moderate bronchial asthma

2020 ◽  
Vol 15 (6) ◽  
pp. 35-41
Author(s):  
V.A. Revyakina ◽  
◽  
I.A. Larkova ◽  
E.D. Kuvshinova ◽  
◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Respiratory Infections ◽  
Average Duration ◽  
Clinical Manifestations ◽  
Main Group ◽  
Control Group ◽  
External Respiration ◽  
Acute Respiratory Infections ◽  
Acute Period ◽  
Anti Inflammatory

Objective. To evaluate the efficacy and safety of using anti-inflammatory drugs based on ammonium glycyrrhizinate (AG) (Reglisam, CJSC “VIFITECH”, Russia) in children with BA in the acute period of ARI. Patients and methods. Under observation there were 42 children (from 6 to 10 years old) with a diagnosis of BA in the acute period of ARI (1–2 days from the beginning of clinical manifestations). Patients were randomized into the main group – 20 patients who were prescribed the drug ammonium glycyrrhizinate (Reglisam) in addition to symptomatic ARI therapy, and the control group – 22 children who were prescribed only symptomatic ARI therapy. The observation period was 14 days with 2 checkpoints (1st and 14th days), when the following parameters were evaluated: general clinical examination; asthma symptoms; PCR diagnostics of acute respiratory viral infection and influenza pathogens; external respiration and BA control test (C-ACT), administration of additional medications and development of adverse events. Results. There was a decrease in the average scores of daily and night symptoms of BA in the study group, both in dynamics and in comparison with the control group at visit 2 (p < 0.05). The average duration of ARI in the main group was 6.34 ± ± 1.15 days and was less than that in the control group of patients (10.95 ± 1.45 days) (p < 0.05). The average duration of the use of short-acting β2-agonists in the main group was 3.37 ± 1.05 days and was less in comparison with the control group (6.75 ± 1.6) (p < 0.05). On the 14th day of observation in the main group, the median of C-ACT parameters increased and corresponded to good control of BA, and the level of blood eosinophils decreased to normal values; in the control group, no such dynamics was found. In 78% of patients in the main group, on the 14th day of observation, the persistence of previously detected respiratory viruses and influenza was not determined, the proportion of such patients in the control group was more than 2 times less. Conclusion. The data obtained indicate the feasibility and effectiveness of the inclusion of the drug AG as a preventive therapy for children with asthma in the acute period of ARI to improve control over the course of the disease. Key words: bronchial asthma, children, therapy, ammonium glycyrrhizinate, acute respiratory infections

scholarly journals Vitamin D and Acute Respiratory Infections—The PODA Trial

2019 ◽  
Vol 6 (9) ◽  
Author(s):  
John F Aloia ◽  
Shahidul Islam ◽  
Mageda Mikhail
Keyword(s):  
Vitamin D ◽  
African American ◽  
Placebo Group ◽  
African American Women ◽  
Physical Performance ◽  
Respiratory Infections ◽  
Vitamin D Supplementation ◽  
Acute Respiratory Infections ◽  
American Women ◽  
Older African American Women

Abstract Background There is considerable heterogeneity in clinical trials examining the role of vitamin D in the prevention of acute respiratory infections (ARIs). Methods The primary aim of the Physical Performance, Osteoporosis, and Vitamin D in Older African-American Women (PODA) trial was the prevention of bone loss and decline in physical performance. A questionnaire about ARIs was administered every 3 months for 3 years to 260 black American women in a double-blind randomized clinical trial that had a placebo group and a vitamin D supplementation group. The serum 25(OH)D level was maintained &gt;30 ng/mL in the vitamin D group. Results Serum 25(OH)D was maintained &gt;30 ng/mL in 90% of the active group, whereas levels approximated those associated with the recommended dietary allowance (20 ng/mL) in the placebo group. There was no difference in occurrence of ARIs in the treatment group vs the placebo group. ARIs were not related to total or free 25(OH)D, which were measured at baseline and annually for 36 months. Conclusions Vitamin D supplementation sufficient to maintain serum 25(OH)D &gt;30 ng/mL does not prevent ARIs in older African American women. ClinicalTrials.gov Registration Number NCT01153568.

scholarly journals Inhalation therapy for bronchial obstruction in children: traditional approaches and new opportunities

2021 ◽  
pp. 123-128
Author(s):  
Andrei V. Kamaev ◽  
Olga V. Trusova ◽  
Irina V. Makarova ◽  
Dmitrii S. Korostovtsev
Keyword(s):  
Bronchial Asthma ◽  
Respiratory Infections ◽  
Pediatric Population ◽  
Smooth Muscles ◽  
Practical Experience ◽  
Inhalation Therapy ◽  
Bronchial Obstruction ◽  
Acute Respiratory Infections ◽  
Chronic Infections ◽  
Asthma Attack

Acute respiratory infections are widespread in the pediatric population and represent a significant burden to the health care system and families of patients. Anatomic ans physiological features of preschool children and individual predisposition, especially atopic phenotype, determine high risk of complicated course of acute respiratory infections with bronchial obstruction syndrome. The etiological factors of recurrent AR are quite diverse from chronic infections to foreign bodies of the bronchi or genetically determined diseases, but the most common cause of recurrent AR in children remains bronchial asthma. Therapy of acute obstructive episode in real clinical practice is most often similar to therapy of bronchial asthma attack and includes effects on the main components of pathogenesis: contraction of smooth muscles, mucus hypersecretion and inflammatory edema of the bronchial wall. There has been accumulated a great practical experience of using combined preparation of fenoterol and ipratropium bromide, which currently exists also in the form of domestic medicinal product Astmasol-SOLOpharm. In addition to standard bronchodilator and mucoconstrictor therapy, hypertonic solutions, in particular Ingasalin 3%, are an important component of therapy of prolonged obstruction and relapse prevention. The possibilities of this remedy in shortening of terms of obstructive disorders and decrease of risk of antibiotic therapy are demonstrated by clinical example.

scholarly journals Personification of nordic walking course in children with bronchial asthma depending on physical health level and disease control

2021 ◽  
Vol 37 (6) ◽  
pp. 48-53
Author(s):  
E. N. Kuzina ◽  
E. M. Spivak ◽  
N. N. Nezhkina
Keyword(s):  
Physical Health ◽  
Disease Control ◽  
Asthma Control ◽  
Bronchial Asthma ◽  
Comparison Group ◽  
External Respiration ◽  
Percentage Increase ◽  
Strengthening Effect ◽  
Nordic Walking ◽  
Cardiovascular Systems

Objective. To evaluate the effectiveness of a personalized Nordic walking course in children with bronchial asthma. Material and methods. In conditions of a local sanatorium, 60 children aged 814 years with atopic bronchial asthma in remission were examined, 30 patients received the usual set of health-improving measures (comparison group), 30 patients additionally underwent a course of sports walking, personalized depending on the degree of asthma control and the level of physical health (main group). To evaluate it, the method of L.G. Apanasenko was used. Indicators of external respiration, abdominal and back muscle strength, physical performance, and Robinson and Rufier indices were determined. The children were examined twice: before and after the rehabilitation course. The dynamics of functional indicators was expressed as a percentage increase in relation to the initial values. Results. It was found that 36.7 % of patients had a low, 53.3 % average and only 10 % high level of physical health. Only 10 % had a complete asthma control, and 90 % of children had a partial control. The use of a personalized sports walking course helped to improve the functional parameters of external respiration, muscular and cardiovascular systems. In the comparison group, the positive dynamics of most of functional indicators was significantly less obvious. Conclusions. The course of Nordic walking in children with bronchial asthma at the stage of rehabilitation should be personalized taking into account the level of physical health and the degree of disease control. This technology in this category of patients has a significant positive health-strengthening effect, which is manifested by improving the functional state of the muscular, respiratory and cardiovascular systems.

PERAN IBU DALAM PENINGKATAN SISTEM IMUN ANAK DENGAN INFEKSI SALURAN PERNAFASAN AKUT

2019 ◽  
Vol 11 (2) ◽  
pp. 79-86
Author(s):  
Cindy Ayustin Noya ◽  
Angkit Kinasih ◽  
Venti Agustina ◽  
R.Rr Maria Dyah Kurniasari
Keyword(s):  
Immune System ◽  
Acute Respiratory Infection ◽  
Lower Respiratory Tract ◽  
Research Method ◽  
Respiratory Infections ◽  
Acute Respiratory Infections ◽  
Clean Environment ◽  
History Of ◽  
Qualitative Descriptive

Infeksi saluran pernafasan akut atau yang sering disebut ISPA merupakan infeksi pada saluran pernafasan baik saluran pernafasan atas atau bawah.ISPA juga kebanyakan terjadi pada anak balita karena daya tahan tubuh mereka tidak kuat dalam menghadapi penyakit ISPA. ISPA mengakibatkan kematiansekitar15%-20% per tahun pada usia balita di Negara berkembang. Tujuan penelitian ini adalah untuk mengetahui dan menganalisa peran ibu dalam meningkatkan sistem imun anak dengan ISPA.Metode penelitian yang digunakan dalam penelitian ini adalah kualitatif deskriptif dengan sampel purposive sampling.Populasi dan sampel penelitian ini adalah ibu yang mempunyai anak dengan riwayat dan saat ini menderita penyakit ISPA di Batu Gajah Kota Ambon.Partisipan dalam penelitian ini berjumlah 5 orang. Hasil dari penelitian mendapati 4 kategori yaitu pemberian nutrisi pada anak untuk memenuhi kebutuhan agar sistem imunnya terjaga, kebersihan lingkungan, peran ibu dalam melakukan pencegahan pada anaknya yang mengalami ISPA, dan  peran ibu dalam menjaga dan mempertahankan kesehatan anaknya.   Kata kunci: peran ibu, sistem imun, ispa THE ROLE OF MOTHERS IN INCREASING IMMUNE SYSTEM OF CHILDREN WITH ACUTE RESPIRATORY INFECTION    ABSTRACT Acute respiratory infections or often called ARI is an infection of the upper or lower respiratory tract. ARI occurs mostly in children under the age of five because their endurance is not strong in dealing with ARI. ARI results in deaths of around 15%-20% per year at the age of under-five in developing countries. The purpose of this study was to determine and analyze the role of mothers in improving the immune system of children against ARI. The research method used in this study was qualitative descriptive with a purposive sampling sample. Respondents and samples of this study were five mothers who had children with a history of ARI and currently suffering from the disease in Batu Gajah, Ambon City. The results of the study found 4 categories, namely providing nutrition to children to meet their needs so that their immune systems are maintained, clean environment, mother's role in preventing children with ARI, and mother's role to preserve and maintain the health of their children. The findings indicated that in terms of coping or improving the immune system of a child to avoid ARI, it is necessary to have role the of mothers in providing nutrition so that the immune system is boosted, besides that the mother can prevent and protect her child from various diseases, especially ARI. Keywords: role of mothers, immune system, acute respiratory infections

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