Gene-Environment Interactions and Airway Disease in Children

Schwartz, David A.

doi:10.1542/peds.2008-2233e

Cited by 25 publications

(8 citation statements)

References 95 publications

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“…Parameters other than adherence, such as genetic factors [28] and environmental triggers [29] also contribute to asthma control. KLOK et al [30] hypothesised that asthma patients who have reached clinical remission and still receive treatment with ICS may maintain asthma control at a lower level of adherence than patients who have active asthma.…”

Section: Discussionmentioning

confidence: 99%

e-Monitoring of Asthma Therapy to Improve Compliance in children (e-MATIC): a randomised controlled trial

Vasbinder

Goossens²,

Mölken³

et al. 2016

Eur Respir J

101

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Real-time medication monitoring (RTMM) is a promising tool for improving adherence to inhaled corticosteroids (ICS), but has not been sufficiently tested in children with asthma. We aimed to study the effects of RTMM with short message service (SMS) reminders on adherence to ICS, asthma control, asthma-specific quality of life and asthma exacerbation rate; and to study the associated cost-effectiveness.In a multicentre, randomised controlled trial, children (aged 4-11 years) using ICS were recruited from five outpatient clinics and were given an RTMM device for 12 months. The intervention group also received tailored SMS reminders, sent only when a dose was at risk of omission. Outcome measures were adherence to ICS (RTMM data), asthma control (childhood asthma control test questionnaire), quality of life (paediatric asthma quality of life questionnaire) and asthma exacerbations. Costs were calculated from a healthcare and societal perspective.We included 209 children. Mean adherence was higher in the intervention group: 69.3% versus 57.3% (difference 12.0%, 95% CI 6.7%-17.7%). No differences were found for asthma control, quality of life or asthma exacerbations. Costs were higher in the intervention group, but this difference was not statistically significant.RTMM with tailored SMS reminders improved adherence to ICS, but not asthma control, quality of life or exacerbations in children using ICS for asthma.

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Section: Discussionmentioning

confidence: 99%

e-Monitoring of Asthma Therapy to Improve Compliance in children (e-MATIC): a randomised controlled trial

Vasbinder

Goossens²,

Mölken³

et al. 2016

Eur Respir J

101

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“…The pathogenesis of asthma is multifactorial, involving a complex interaction of genetic, environmental, and social forces. As Schwartz 12 notes, "asthma is inherited as a complex trait and results from the interaction of multiple genes." Although certain gene combinations may predispose a child to asthma, their expression may be modified by external factors.…”

Section: Systems Changes In Asthma Management and Access To Carementioning

confidence: 99%

“…Although the current approach to describing the relationship of genetic and environmental factors is informative, it is clear that the development of new genomic technologies and improved personalized exposure studies to identify specific biomarkers are needed for a better understanding of the pathogenesis of asthma. 12 Because we cannot change a child's genetic constitution, a systems approach must address the interactions of these genetic, socioeconomic, and environmental factors.…”

Section: Systems Changes In Asthma Management and Access To Carementioning

confidence: 99%

State of Childhood Asthma and Future Directions Conference: Overview and Commentary

2009

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The Merck Childhood Asthma Network, Inc conference titled "State of Childhood Asthma and Future Directions: Strategies for Implementing Best Practices" was held December 13 to 14, 2006. Here we summarize the presentations and recommendations for systems approaches from that conference and discuss current asthma care. Pediatrics 2009;123:S211-S214 T HE ARTICLES IN this supplement summarize the presentations and recommendations made at the Merck Childhood Asthma Network, Inc conference titled "State of Childhood Asthma and Future Directions: Strategies for Implementing Best Practices," which was held December 13-14, 2006, in Washington DC. In addition, they explore the multidimensional array of issues related to asthma causes, epidemiological features, and care, as well as highlighting a series of new and missed opportunities to improve the quality of life for children with asthma. As we discuss, our current system for treating childhood asthma can be aptly described by the adage, "the system is perfectly designed to get the results that it does." We conclude that improving asthma outcomes for children requires taking a more systematic approach that includes implementation of evidence-based, highquality care. Given the prevalence of childhood asthma and its associated burden, implementing a systems approach to preventing the disease and improving outcomes for children with asthma ought to be a national priority. To start, we need to consider what the system would comprise. SYSTEMS APPROACH TO DISEASE PREVENTIONAny serious attempt at system change begins with measurement, which suggests that we need a reliable surveillance mechanism that can measure asthma incidence and prevalence and identify geographic and population-level patterns ("outbreaks") or increases in morbidity in an actionable time frame. Such data need to be collected and evaluated not only on a national scale but also for individual states and communities, because many of the factors that are related to asthma outcomes can be influenced by local action. Although funding from the Centers for Disease Control and Prevention to develop and to implement multiple local surveillance efforts 1 is a step in the right direction, significant additional funding is necessary to develop a comprehensive public health approach that can achieve positive effects. Since 2001, the United States has made significant investments in surveillance systems for bioterrorism agents and pandemic influenza. Many of these systems use emergency department and inpatient claims data or school absenteeism data; the fact that these data sources are not also used to monitor asthma morbidity is a missed opportunity for asthma surveillance.In 1999, the Centers for Disease Control and Prevention undertook an initiative to monitor and to control childhood asthma. The resulting surveillance data came from a combination of survey and hospital discharge data. If expanded and made more timely, these data could be suitable for monitoring progress in asthma prevention and management. As i...

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“…On the other hand, autism spectrum disorders (ASD) are also on the rise and affect almost 1 in 68 children (2). Perinatal and environmental factors seem to play a significant role in increasing the risk for ASD as in allergic diseases (3,4). Previous studies have found a temporal concordance in the increased prevalence of atopic diseases and ASD.…”

Section: Introductionmentioning

confidence: 98%

Frequencies of Allergic Diseases Among Children with Autism Spectrum Disorders

Çetin¹,

Yilmaz²,

Yılmaz³

2019

Asthma Allergy Immunol

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Objective: Allergic diseases and autism spectrum disorders (ASD) affect millions of children worldwide and the frequencies of these diseases are increasing. Although some genetic and environmental factors have been implicated, the exact reasons of this increase have not been determined yet. In this study, we aimed to investigate the frequencies of allergic diseases among children with ASD. Materials and Methods: A questionnaire containing 23 questions related to asthma, allergic rhinitis, atopic dermatitis and food allergy adapted from the International Study of Asthma and Allergies in Childhood (ISAAC) was used and the questionnaires were filled out by the parents of children with ASD and controls. Results: The study and control groups comprised 59 and 50 children respectively. Allergic rhinitis was diagnosed in 12%, atopic dermatitis in 10.1%, food allergy in 8.4% and asthma in 6.8% of the children with ASD; and 16%, 6%, 8% and 10.0% respectively in the control group. Conclusion: These results suggest that frequency of allergic diseases among children with ASD are not different than controls.

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Gene-Environment Interactions and Airway Disease in Children

Cited by 25 publications

References 95 publications

e-Monitoring of Asthma Therapy to Improve Compliance in children (e-MATIC): a randomised controlled trial

e-Monitoring of Asthma Therapy to Improve Compliance in children (e-MATIC): a randomised controlled trial

State of Childhood Asthma and Future Directions Conference: Overview and Commentary

Frequencies of Allergic Diseases Among Children with Autism Spectrum Disorders

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