Correlation of nitrites in breath condensates and lung function in asthmatic children

Straub, Daniel; Ehmann, Rainer; Hall, Graham L.; Moeller, Alexander; Hamacher, Jürg; Frey, Urs; Sennhauser, Felix H.; Wildhaber, Johannes H.

doi:10.1046/j.0905-6157.2003.00099.x

Cited by 32 publications

(31 citation statements)

References 31 publications

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“…These results are in line with a recently published study in asthmatic children [28]. Especially patients with severe asthma, profit from high-altitude climate therapy without any need to increase systemic GC doses.…”

Section: Discussionsupporting

confidence: 82%

High‐Altitude Climate Therapy Reduces Local Airway Inflammation and Modulates Lymphocyte Activation

Karagiannidis¹,

Hense

Rueckert³

et al. 2006

Scand J Immunol

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High-altitude climate therapy is a well-established therapeutic option, which improves clinical symptoms in asthma. However, little is known about the underlying immunological mechanisms. The study investigates the influence of high-altitude climate therapy on airway inflammation and cellular components of specific and unspecific immune response. Exhaled NO significantly decreased within 3 weeks of therapy in patients with allergic and intrinsic, moderate and severe asthma. Interleukin-10 (IL-10)-secreting peripheral blood mononuclear cells (PBMC) increased within 3 weeks of therapy in six of 11 patients, whereas transforming growth factor-b 1 -secreting PBMC remained stable. Furthermore, monocyte activation, assessed by CD80 expression significantly decreased during therapy. The frequency of CRTH2-expressing T cells decreased, while regulatory T cells (T reg ) remained stable. FOXP3 and GATA-3 mRNA expression in CD4 þ T cells did not change, while interferon-g and IL-13 mRNA expression decreased in eight of 10 patients. The current data demonstrate that high-altitude climate therapy reduces local airway inflammation. Furthermore, monocytes switch towards a tolerogenic phenotype under high-altitude climate therapy. The T reg /Th2 ratio increases; however, because of the absence of antigens/allergens, no de novo differentiation of Th2 nor T reg cells is observed. The high-altitude climate therapy therefore may form the immunological basis for the endogenous control of allergen-driven diseases.

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Section: Discussionsupporting

confidence: 82%

High‐Altitude Climate Therapy Reduces Local Airway Inflammation and Modulates Lymphocyte Activation

Karagiannidis¹,

Hense

Rueckert³

et al. 2006

Scand J Immunol

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“…In the opposite direction, the study of VERKLEIJ et al [14] brought the pooled SMD down to the greatest degree: when excluded, the overall SMD increased to 0.60 (95% CI 0.49-0.70). When excluded, the only study that had reported lung function as a median rather than as a mean value [30] did not substantively change the observed overall SMD (0.55, 95% CI 0.45-0.65). We also wished to calculate SMD for studies performed at altitudes of >2500 MASL, which is an accepted threshold for high altitude.…”

Section: Resultsmentioning

confidence: 99%

“…Weighted mean difference KOLESAR et al [19] BONER et al [20] BRIMKULOV (1) [22] BRIMKULOV (2) [22] PIACENTINI et al [23] SIMON et al [24] ALLEGRA et al [11] BONER et al (1) [25] BONER et al (2) [25] KOKOV [26] VAN VELZEN et al [12] VALLETTA et al [27] GROOTENDORST et al [28] PERONI et al [29] STRAUB et al [30] HUISMANS et al [ …”

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confidence: 99%

High-altitude alpine therapy and lung function in asthma: Systematic review and meta-analysis

Vinnikov

Khafagy

Blanc

et al. 2016

6.2 Occupational and Environmental Health

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We used meta-analysis to measure the effect of high-altitude climate therapy (HACT) on lung function outcomes in asthma, and systematically searched PubMed, Embase and www.elibrary.ru for publications appearing from 1970 to mid-2015. We included studies carried out with children or adults with an exposure of up to 12 weeks at an altitude of ⩾1500 m above sea level. Changes in forced expiratory volume in 1 s (FEV1), FEV1/vital capacity ratio or peak expiratory flow rate as the HACT intervention outcomes were analysed. We included data for 907 participants (age range 4-58 years) from 21 studies, altogether including 28 substrata based on asthma type or severity. Only three of 21 included studies had high quality, whereas 93% of substudies reported lung function improvement with an overall pooled standardised mean difference (SMD) of 0.53 (95% CI 0.43-0.62). The measured effect of HACT was greater in adults (SMD 0.75, 95% CI 0.63-0.88, n=14) than in children (SMD 0.24, 95% CI 0.09-0.38, n=14). Studies at altitude >2000 m above sea level yielded the same effect as those at lower altitude. Based on a cut-point of a 0.50 change in SMD to define a meaningful clinical difference, HACT appears to have efficacy as an intervention. This extent of benefit appears to be limited to adults with asthma. @ERSpublications High-altitude alpine therapy may be an effective intervention to improve lung function in patients with asthma

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“…In children with asthma, the technique has demonstrated increased leukotrienes, interleukin-4, 8-isoprostane, aldehydes and glutathione when compared with controls [7][8][9][10]. The effects of treatment on EBC in asthma include a reduction in nitrites in association with altitude in the Swiss Alps [11], and a reduction in cysteinyl leukotrienes, 8-isoprostane, aldehydes and glutathione during systemic corticosteroid treatment of an acute exacerbation [10,12]. However, there has usually been significant overlap between cases and controls, and no marker has, so far, demonstrated sufficient independence to assist with the diagnosis or treatment in children.…”

mentioning

confidence: 99%

Breath condensate ammonium is lower in children with chronic asthma

MacGregor¹

2005

Eur Respir J

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Exhaled breath condensate pH and ammonium reflect asthmatic status and acute exacerbations in adults. The aim of this study was to assess whether pH and ammonium could reflect asthma and its severity in children.The current study comprised two parts: 1) a cross-section of 74 children with asthma (median age 10.5 yrs) compared with 47 healthy controls (median age 10 yrs); and 2) longitudinal assessment of eight children (mean age 8.5 yrs) admitted with asthma exacerbation. Condensate pH and ammonium were compared with clinical observations.In the cross-sectional part of the study, lower per cent forced expiratory volume in one second was associated with more symptoms and treatment. There was no significant difference between median pH in children with stable asthma (6.05) compared with controls (5.90). Ammonium was significantly lower in children with asthma (median 258 mM) compared with controls (median 428 mM). No association was found between ammonium or pH and lung function or symptom-free days. In the longitudinal study, significant improvements in oxygen saturation and respiratory rate with treatment of an acute exacerbation were not reflected by changes in pH or ammonium.In conclusion, pH does not appear to reflect disease or severity in children with asthma. Ammonium was significantly lower in children with asthma when compared with controls.

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Correlation of nitrites in breath condensates and lung function in asthmatic children

Cited by 32 publications

References 31 publications

High‐Altitude Climate Therapy Reduces Local Airway Inflammation and Modulates Lymphocyte Activation

High‐Altitude Climate Therapy Reduces Local Airway Inflammation and Modulates Lymphocyte Activation

High-altitude alpine therapy and lung function in asthma: Systematic review and meta-analysis

Breath condensate ammonium is lower in children with chronic asthma

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